Al Hashimi, B, Harvey, KE, Harvey, SC ORCID: https://orcid.org/0000-0002-7504-2227, Linara-Demakakou, E, Griffin, DK, Ahuja, K and Macklon, N (2025) PGT-A can increase the number of embryos available for transfer by ‘rescuing’ morphologically poor-quality blastocysts: an analysis of nine years of data from a single centre. Reproductive Biomedicine Online (RBMO). ISSN 1472-6483 (Print), 1472-6491 (Online) (In Press)

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Abstract

Research Question: Does preimplantation genetic testing for aneuploidy (PGT-A) and the transfer of euploid poor-quality blastocysts (PQBs) reduce the number of transfers needed to achieve live births in comparison to the transfer of their untested counterparts?
Design: This single-centre retrospective cohort study included 7,332 PGT-A blastocysts obtained from 2,258 cycles across 1,344 patients between 2015 and 2024. Transfer outcomes were analysed for a subset of 74 cycles involving tested PQBs from 69 patients and compared with 192 cycles involving untested PQBs from 180 patients during the same period.
Results: High-quality blastocysts (HQBs; AA, AB, BA, and BB) were most likely to be euploid, while poor-quality blastocysts (PQBs; CC, DC, CD, and DD) were more likely to be aneuploid. Embryos that reached the blastocyst stage by day 5 had a higher likelihood of being euploid. Among transferred PQBs, PGT-A did not significantly impact the pregnancy rate (33.3% vs. 23.4%); however, the miscarriage rate was significantly lower in the PGT-A-tested group (13.6% vs 51.2%). The number of live births was higher in the PGT-A group (26.4 % vs 11.1%) and with the transfer of day 5 frozen blastocysts. Notably, live births were also observed from blastocysts with the poorest expansion and morphology scores. Analysis of live births revealed no significant differences in gestational age or birthweight between the PGT-A and untested groups.
Conclusions: A clinically relevant proportion of PQBs are euploid, PQBs can result in live births and euploid transfer is associated with lower miscarriage rates. In combination, this suggests that PQBs should not be routinely discarded, particularly if they are prior-tested using PGT-A.

Item Type:	Article
Additional Information:	Accepted version, so there will be some changes at proof stage. Will be published gold open access as corresponding author is associated with UCL.
Uncontrolled Keywords:	aneuploid, blastocysts, euploid, PGT-A, poor-quality embryos
Subjects:	Q Science > Q Science (General)
Faculty / School / Research Centre / Research Group:	Faculty of Engineering & Science Faculty of Engineering & Science > School of Science (SCI)
Last Modified:	11 Aug 2025 15:49
URI:	https://gala.gre.ac.uk/id/eprint/50919

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