Reproductive genetics laboratory may impact euploid blastocyst and live birth rates: a comparison of 4 national laboratories' PGT-A results from vitrified donor oocytes

Objective: To evaluate potential variation in the euploid blastocyst rate and live birth rate (LBR) per single frozen euploid blastocyst transfer, among 4 unique United States reproductive genetics laboratories. Analyses were limited to blastocysts derived from vitrified donor oocytes, to minimize variation in oocyte quality. Design: Retrospective cohort study from 2016 to 2020.Setting: Donor Egg Bank Database.Patient(s): Patients undergoing in vitro fertilization with donor oocytes. We excluded patients with uterine factor, male factor, or surgically extracted sperm. Only healthy women <34 years old were accepted as oocyte donors. Intervention(s): Next generation sequencing platforms for chromosomal analysisMain Outcome Measure(s): Euploid blastocyst rate and LBR per euploid transfer. Secondary outcomes included the rate of aneuploidy, mosaic calls, biochemical pregnancy loss, and miscarriage rate. Result(s): A total of 2,633 embryos were included. Four laboratories had >200 embryos tested. Euploid blastocyst rate was signifi- cantly higher in laboratory A (73.6%) vs. B (63.3%), C (60.9%), and D (52.3%). Mosaic rate was significantly lower for Laboratories B (2.8%) and C (5.5%) vs. Laboratories A (9.9%) and D (11.5). The LBR was significantly higher in laboratory A (58.73%) vs. laboratory D (47.3%). There were no significant differences in the implantation or miscarriage rate among laboratories.Conclusion(s): In this large study, controlling for oocyte quality, some preimplantation genetic testing for aneuploidy (PGT-A) laboratories report a significantly higher euploid blastocyst rate with concurrent higher LBR. This type of comparison is important as it provides insight into the role of the PGT-A process in outcomes. Further research is needed to evaluate the differences in laboratory techniques and bioinformatic algorithms accounting for variable outcomes across PGT-A laboratories. (Fertil Sterile 2023;119: 29-35. (c) 2022 by American Society for Reproductive Medicine.)

Automated summary

The objective of this study was to evaluate the potential variation in euploid blastocyst and live birth rates among 4 reproductive genetics laboratories in the United States. The results showed that Laboratory A had significantly higher euploid blastocyst and live birth rates compared to Laboratories B, C, and D. This comparison provides important insights into the role of the PGT-A process in outcomes and further research is needed to understand the differences in laboratory techniques and bioinformatic algorithms.