Can PGT-A reduce the miscarriage rate and time-to-pregnancy? A systematic review.

Vermeulen Merel, Loos Lynn, 2025
The Quest for Parenthood: Shortening the Journey to Pregnancy Since the introduction of in vitro fertilization (IVF), over 8 million babies have been born through this technique, enough to fill a small country. However, despite this success, assisted reproductive technology (ART) continues to present numerous challenges. Did you know that around 60% of women do not achieve a live birth after their first embryo transfer, and success rates drop significantly for older women? On top of that, about 1 in 4 women undergoing ART treatment eventually give up due to the emotional and physical strain in the long journey to pregnancy. So, what makes ART such a tough nut to crack, and how can we turn the tide in favour of hopeful parents? ART can be challenging for several reasons. For example, during creation of the embryos, some may be genetically abnormal, leading to a higher risk of implantation failure or miscarriage. As women age and the biological clock starts ticking, the quality of their eggs declines, making it harder to achieve a successful pregnancy. In addition, the ART journey itself can be emotionally exhausting and physically demanding, involving multiple hormone treatments, frequent doctor visits, and invasive procedures. Reducing the time-to-pregnancy (TTP) and miscarriages rates (MR) could really help women emotionally. To improve ART results, new techniques like Preimplantation Genetic Testing for Aneuploidy (PGT-A) have been developed. PGT-A involves testing embryos for genetic abnormalities before implantation, aiming to select the embryos that are more likely to lead to a healthy pregnancy. While it has shown some promising results, PGT-A comes with certain concerns. For example, PGT-A discards embryos that appear chromosomally abnormal, but some of those could still develop into healthy babies because of their remarkable ability to self-correct after implantation. Our systematic review investigated the effects of PGT-A on both MR and TTP by analysing more than two thousand articles and selecting the ones who fulfilled our in- and exclusion criteria. We then evaluated the quality of the relevant studies using a bias assessment tool provided by Cochrane. After evaluation, we took the quality of the articles in account to formulate the answer to our research question: ‘Can PGT-A reduce the TTP and MR?’. Ultimately, we found that PGT-A is not a one-size-fits-all solution. For women over 35 and women experiencing recurrent pregnancy loss, PGT-A does help do reduce the TTP and MR. This highlights the importance of a personalized approach when considering PGT-A.

Promotor Dominic Stoop
Opleiding Geneeskunde
Kernwoorden PGT-A time-to-pregnancy miscarriage rate ART