Clinical Scorecard: Comparative Analysis of PGT-A and Expectant Management in Fertile Individuals Experiencing Recurrent Pregnancy Loss and Previous Aneuploidy: A Five-Year Dual-Center Study on Cumulative Pregnancy Outcomes

At a Glance

Key Highlights

• PGT-A resulted in lower conception leading to live birth (CLLB) within 12 months compared to EM (52.1% vs 81.7%)
• Five-year cumulative live birth rates were comparable between PGT-A and EM (94.4% vs 87.3%)
• PGT-A was associated with a longer time to pregnancy leading to live birth (8.6 months vs 3.0 months)
• Early miscarriage rates among clinical pregnancies were not significantly different between groups
• Incremental cost-effectiveness ratios for PGT-A were ¥1,203,800 per additional live birth

Guideline-Based Recommendations

Diagnosis

• Consider PGT-A for patients with recurrent pregnancy loss and previous aneuploidy

Management

• Evaluate both PGT-A and expectant management options for fertility treatment

Monitoring & Follow-up

• Monitor cumulative live birth rates and time to pregnancy outcomes

Risks

• Assess potential risks of longer time to pregnancy with PGT-A

Patient & Prescribing Data

Fertile women aged 25-40 with recurrent pregnancy loss and at least one aneuploid loss

PGT-A may not significantly enhance live birth rates compared to expectant management

Clinical Best Practices

• Conduct genetic counseling prior to intervention
• Utilize controlled ovarian stimulation methods for PGT-A
• Consider patient history of aneuploid losses when recommending PGT-A

Related Resources & Content

• European Society of Human Reproduction and Embryology (ESHRE) Guidelines
• American Society for Reproductive Medicine (ASRM) Guidelines