Effectiveness of preimplantation genetic testing for aneuploidy compared with standard IVF/ICSI in women with recurrent implantation failure: a systematic review and meta-analysis protocol

OBJECTIVE: This systematic review will aim to evaluate the effectiveness of preimplantation genetic testing for aneuploidy (PGT-A) on implantation rate, clinical pregnancy rate, live birth rate, and clinical miscarriage rate compared to standard in vitro fertilization/intracytoplasmic sperm insemination (IVF/ICSI) in women with recurrent implantation failure. INTRODUCTION: Recurrent implantation failure is a complex condition in assisted reproductive technology, attributed to multifactorial causes, with chromosomal aneuploidy being a leading contributor. PGT-A has been proposed as a strategy for selecting euploid embryos, but its effectiveness on reproductive outcomes remains unclear due to conflicting evidence. ELIGIBILITY CRITERIA: This review will include clinical trials and observational studies comparing PGT-A to standard IVF/ICSI in women with recurrent implantation failure. The review will assess the implantation rate, clinical pregnancy rate, live birth rate, and clinical miscarriage rate as outcomes. METHODS: This review will follow the JBI methodology for systematic reviews of effectiveness. A systematic search will be conducted in PubMed, Scopus, and Embase (Embase.com). Two reviewers will independently screen titles, abstracts, and full texts. Data will be extracted using Excel software, and methodological quality will be assessed. Meta-analysis will be performed using a random effects model, with heterogeneity assessed by I2, and publication bias will be evaluated. Evidence certainty will be rated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. English-language studies will be included from the earliest searchable date of each database until January 19, 2026. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD420251029623.