Assessing the impact of both Preimplantation Genetic Testing for Aneuploidy with blastocyst morphologic grade on live birth rates in frozen embryo transfers from fresh and frozen donor oocytes

Purpose: To evaluate the live birth rate (LBR) following donor frozen embryo transfer (dFET) of preimplantation genetic testing for aneuploidy (PGT-A) versus untested donor embryos, stratified by blastocyst morphologic grade (MG). Methods: This was a retrospective cohort study of 146 patients undergoing dFET of a single euploid blastocyst from fresh or frozen oocytes using PGT-A compared to age-matched controls (1:1 ratio) who did not use PGT-A. Primary outcome was LBR. LBR was compared amongst cohorts, with further stratification by 1) high/low MG and 2) fresh/frozen oocyte status . Secondary outcomes included perinatal outcomes. Result(s): Median age in both groups was 44.5 years (p=0.98). LBR was similar amongst the two cohorts (PGT-A: 57.5% vs. Untested: 50.0%, p=0.20). There was similar LBR in fresh (PGT-A: 59.2% vs. Untested: 50.0%, p=0.20) and frozen (PGT-A: 47.6% vs. Untested: 50.0%, p=0.85) oocyte subgroups. When stratified by MG , we appreciated similar LBR amongst high quality blastocysts (PGT-A-High: 56.5% vs. Untested-High: 52.3%, p=0.49) amongst the whole cohort , as well as in fresh (Fresh-PGT-A-High: 58.3% vs. Fresh-Untested-High: 52.9%, p=0.46) and frozen (Frozen-PGT-A-High: 44.4% vs. Frozen-Untested-High: 51.7%, p=0.59) subgroups. Similarly, we appreciated no difference in LBR amongst low quality blastocysts (PGT-A-Low: 75.0% vs. Untested-Low: 31.2%, p=0.08) amongst the whole cohort , as well as in the fresh (Fresh-PGT-A-Low: 80.0% vs. Fresh-Untested-Low: 16.1%, p=0.08) or frozen (Frozen-PGT-A-Low: 66.7% vs. Frozen-Untested-Low: 40.0%, p=0.56) subgroups. Gestational age (37.8 weeks, p=1.0) and infant birth weight (PGT-A: 3128.0 grams vs. Untested: 3150.2 grams, p=0.60) were similar. Conclusion(s): PGT-A did not improve LBR regardless of blastocyst quality from fresh and previously frozen donor oocytes.