Research question

Does the use of preimplantation genetic testing for aneuploidies (PGT-A) improve outcomes in couples with severe male factor infertility (SMFI)?

Design

This retrospective cohort study included SMFI cases that underwent blastocyst transfer with/without PGT-A. Inclusion criteria were SMFI (azoospermia and sperm count <1 million/ml), women aged 25–39 years, single vitrified–warmed blastocyst transfer, and no intracavitary pathologies. Patients were divided into PGT-A and non-PGT-A groups. The primary outcome was live birth rate (live birth of an infant after 24 weeks of gestation); secondary outcomes were implantation and clinical pregnancy rates.

Results

The study included 266 SMFI cases (90 and 176 in the PGT-A and non-PGT-A groups, respectively). Men and women in the PGT-A group were significantly older than those in the non-PGT-A group. The groups did not differ in terms of male factor categories, sperm collection methods or additional female factors. Live birth rates in the PGT-A and non-PGT-A groups were 55.6% and 51.1%, respectively (odds ratio [OR] 1.19, 95% confidence interval [CI] 0.71–1.98, P = 0.495). The implantation rates were 65.6% and 64.2%, respectively (OR 1.06, 95% CI 0.62–1.80, P = 0.827). The clinical pregnancy rates were 62.2% and 58.0%, respectively (OR 1.19, 95% CI 0.71–2.01, P = 0.502). The use of PGT-A was not an independent factor for live birth (aOR 1.33, 95% CI 0.66–2.70, P = 0.421). Advanced age in women was the only independent factor associated with live birth (aOR 0.46, 95% CI 0.22–0.96, P = 0.041).

Conclusions

The use of PGT-A does not seem to be an independent factor associated with live birth per transfer in couples with SMFI.

中文翻译：

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严重男性因素不孕症中非整倍体的植入前基因检测。

研究问题

使用胚胎植入前基因检测非整倍体 (PGT-A) 是否可以改善患有严重男性因素不育 (SMFI) 的夫妇的结果？

设计

这项回顾性队列研究包括在有/没有 PGT-A 的情况下接受囊胚移植的 SMFI 病例。纳入标准为 SMFI（无精子症和精子数 <100 万/毫升）、25-39 岁女性、单次玻璃化加热囊胚移植和无腔内病变。患者分为PGT-A组和非PGT-A组。主要结果是活产率（妊娠 24 周后婴儿的活产率）；次要结果是植入率和临床妊娠率。

结果

该研究包括 266 例 SMFI 病例（PGT-A 组和非 PGT-A 组分别为 90 和 176 例）。PGT-A 组的男性和女性显着高于非 PGT-A 组的男性和女性。这些组在男性因素类别、精子收集方法或其他女性因素方面没有差异。PGT-A 和非 PGT-A 组的活产率分别为 55.6% 和 51.1%（优势比 [OR] 1.19，95% 置信区间 [CI] 0.71–1.98，P  = 0.495）。植入率分别为 65.6% 和 64.2%（OR 1.06，95% CI 0.62–1.80，P  = 0.827）。临床妊娠率分别为 62.2% 和 58.0%（OR 1.19，95% CI 0.71–2.01，P  = 0.502）。PGT-A 的使用不是活产的独立因素（aOR 1.33，95% CI 0.66–2.70，P  = 0.421）。女性高龄是与活产相关的唯一独立因素（aOR 0.46，95% CI 0.22–0.96，P  = 0.041）。

结论

PGT-A 的使用似乎不是与 SMFI 夫妇每次转移活产相关的独立因素。