PGT-A in POSEIDON Patients - perspectives and limitations

Area of Science:

• Reproductive Medicine
• Genetics
• Infertility

Background:

• The POSEIDON classification identifies patients with a poor prognosis for in vitro fertilization (IVF).
• Preimplantation genetic testing for aneuploidy (PGT-A) is a tool used to assess embryo chromosomal integrity.
• Understanding PGT-A outcomes in different patient groups is crucial for personalized treatment strategies.

Purpose of the Study:

• To compare the feasibility and outcomes of PGT-A in POSEIDON-classified patients versus age-matched non-POSEIDON controls.
• To evaluate the likelihood of obtaining sufficient blastocysts for PGT-A across different POSEIDON groups.

Main Methods:

• Retrospective analysis of 824 POSEIDON patients undergoing intracytoplasmic sperm injection (ICSI).
• Comparison with 360 non-POSEIDON control patients, stratified by age (<35 and ≥35 years).
• Assessment of blastocyst development, PGT-A testing rates, and euploidy rates.

Main Results:

• The non-POSEIDON <35 years group yielded the most blastocysts for PGT-A (5.1±2/cycle), while POSEIDON IV had the fewest (0.6±0.3/cycle).
• PGT-A testing was significantly less frequent in groups without PGT-A indications (POSEIDON I, III, non-POSEIDON <35Y) compared to those with indications (POSEIDON II, IV, non-POSEIDON ≥35Y).
• Euploidy rates were higher in groups without indications (59%-64%) than in groups with indications (35%-41%), with a significant difference (p<0.001).

Conclusions:

• POSEIDON patients exhibit a willingness to undergo PGT-A testing comparable to non-POSEIDON patients, despite their poorer prognosis.
• The overall PGT-A success rate is substantially lower in POSEIDON patients, primarily due to insufficient oocytes or blastocysts for biopsy and lower euploidy rates, especially in older age groups (≥35 years).