Maternal and neonatal outcomes following blastocyst biopsy for preimplantation genetic testing in single frozen-thawed embryo transfer cycles

Abstract Research Question Does blastocyst biopsy for preimplantation genetic testing (PGT) increase the risk of adverse maternal and neonatal outcomes? Study design A retrospective cohort study was conducted. A total of 5097 single frozen-thawed blastocyst transfer cycles, including 2061 cycles in the biopsied group and 3036 cycles in the unbiopsied group, from January 2016 to December 2018 were enrolled in our analyses. Maternal and neonatal outcomes were compared between the two groups. Results The live birth rate in the biopsied group (41.1%) was significantly higher than that in the unbiopsied group (35.6%, adjusted OR=1.34 [95% CI: 1.10, 1.63], p=0.003) after adjusting for maternal age, maternal body mass index, gravidity, parity, infertility diagnosis, timing of blastocyst transfer, blastocyst quality, regimen of endometrial preparation, endometrial thickness before transfer, and treatment year. The rates of biochemical pregnancy loss (12.6% vs. 14.6%, adjusted OR=0.64 [0.43, 0.95], p=0.026) and early miscarriage (12.1% vs. 17.3%, adjusted OR=0.49 [0.33, 0.75, p=0.001) were significantly lower in the biopsied group than in the unbiopsied group. No significant differences were found in sex ratio or the risks of hypertensive disorders in pregnancy, diabetes in pregnancy, placenta previa, preterm premature rupture of membranes, low birth weight, very low birth weight, macrosomia, small for gestational age, large for gestational age or birth defects between the two groups. When the subgroup analyses were conducted based on different types of PGT, Similar patterns were found for all types. Conclusion Blastocyst biopsy might not increase the risks of adverse maternal and neonatal outcomes in the short term.