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In several consecutive formats, for over 20 years PGT-A, in association with in vitro fertilization (IVF), representing the testing of human embryos for chromosomal abnormalities (aneuploid cells) prior to transfer into the uterus, has been used to deselect “abnormal” embryos. As of 2022, it is assumed that over half of all IVF cycles in the U.S. involve PGT-A, likely representing more than 70,000 cycles at an added per cycle cost of approximately $5,000, for an annual national cost of at least $350M on top of regular IVF costs. PGT-A, moreover, has become increasingly controversial over recent years, as multiple studies demonstrated that the procedure does not improve IVF outcomes, as initially represented by its proponents. In some patient populations, PGT-A, indeed, may reduce the chance of pregnancy in association with IVF and prematurely induce many women to prematurely give up on their own eggs in favor of third-party egg donation.
The Center for Human Reproduction (CHR), a leading clinical and research center in human infertility, has, therefore, been transferring selective, by PGT-A as chromosomal-abnormal diagnosed embryos since 2014. The center in 2015 reported the first chromosomal-normal births in the world following transfers of such embryos. Since then, thousands of such transfers have been performed worldwide, uniformly resulting in excellent pregnancy and live birth outcomes, thereby raising further doubt about the clinical utility of PGT-A. Indeed, not a single clinically affected, chromosomal-abnormal birth has been reported among those transfers. Yet, most IVF centers continue utilization of PGT-A and continue refusing transfers of all “abnormal” embryos, even if patients after IVF cycles have no chromosomal-normal embryos and, therefore, would have wasted their IVF attempt.
CHR, therefore, has been accepting such “abnormal” embryos from other IVF centers all over the world and just reported the first 50 such embryo transfers in the prestigious medical journal HUMAN REPRODUCTION, the official organ of the European Society for Human Reproduction and Embryology (ESHRE). The study involved only 31.8% of embryos moved by patients (ages 41.4 ± 3.5 years) to the CHR. Pregnancy, miscarriage, and live birth rates were, respectively, 38.0%, 22.0%, and 16%, with 68.2% of embryos remaining available for future transfers and future outcome benefits.
These data further demonstrate how inappropriate current routine utilization of PGT-A is in association with IVF and offer further statistical detail on how significant the loss of pregnancy and live birth chances are for patients who after PGT-A, in addition, are refused selective transfers of supposedly chromosomal “abnormal” embryos, even if they have no “normal” embryos.
David H. Barad, MD, MS and Norbert Gleicher, MD, the two senior authors of this study are available for further comments by contacting SOCIAL@THECHR.COM. DHB is the Director of CHR’s clinical IVF program and a Senior Scientist at the center. NG is the CHR’s Medical Director and Chief Scientist and a Visiting Research Scientist at Rockefeller University in NYC as well as Visiting Professor (Adj.) at the Medical University of Vienna, Austria
