BACKGROUND AND PURPOSE:

• Feldman et al. (Obstetrics & Gynecology, 2020) examined whether preimplantation genetic testing for monogenic diseases (PGT-M) is associated with a higher risk of pregnancy complications vs IVF without preimplantation genetic testing or spontaneously conceived pregnancies

METHODS:

• Cohort study
• Participants
  • All pregnancies conceived after preimplantation genetic testing for monogenic diseases
  • Compared to patients who (1) conceived spontaneously or (2) conceived with IVF but without preimplantation testing
• Exposure groups
  • PGT-M group: Preimplantation genetic testing for monogenic diseases
  • IVF group: IVF without preimplantation genetic testing
  • Control: spontaneous conception
• Study design
  • Obstetric outcomes were compared between groups
  • Multivariable regression modeling use to assess relationships between PGT-M and adverse outcomes
• Covariates included in the analyses
  • Age | BMI | Smoking history | parity | Mode of conception | Indication for PGT-M

RESULTS:

• Participants
  • PGT-M group 345 singletons | 76 twin deliveries
  • Spontaneous conception: 290 singletons | 92 twin deliveries
  • IVF: 422 singletons | 101 twin deliveries

Singleton Pregnancies

• PGT-M is associated with a higher rate of hypertensive disorders when adjusted for confounders
  • PGT-M: 6.9%
  • Spontaneous conception: 2.3%: aOR 14.8 (95% CI, 7.4 to 29.8)
  • IVF: 4.7%: aOR 5.9 (95% CI 1.9 to 18.2)
• PGT-M was associated with a higher rate of small-for-gestational age (SGA) neonates
  • PGT-M: 12.4%
  • Spontaneous conception: 3.9% | aOR 2.3 (95% CI 1.5 to 3.4)
  • IVF: 4.5% | aOR 2.5 (95% CI, 1.7 to 5.2)

Twin Pregnancies

• PGT-M was also associated with an increased rate of hypertensive disorders
  • PGT-M: 15.7%
  • Spontaneous conception: 4.3% | aOR 10.9 (95% CI 2.3 to 50)
  • IVF: 4% | aOR 3.7 (95% CI 1.1 to 12.8)

CONCLUSION:

• Preimplantation genetic testing for monogenic diseases was associated with an increased risk for hypertensive disorders of pregnancy and SGA vs IVF without preimplantation testing or spontaneous conception
  • There were no differences detected for other complications
• Study limitations include lack of information regarding
  • Mode of fertilization
  • Type of embryo transfer (fresh vs frozen)

Learn More – Primary Sources: 

Obstetric and Perinatal Outcomes in Pregnancies Conceived After Preimplantation Genetic Testing for Monogenetic Diseases 

Related ObG Topics:

Are Offspring of IVF/ICSI Pregnancies at Higher Risk for Congenital Heart Defects?

Infertility Treatment and Childhood Development

ACOG Addresses Preimplantation Genetic Testing