Whether PGS application improves cumulative pregnancy rates is age-dependent

The main reason for higher pregnancy rates for those >35 years of age is the higher rate of chromosomal abnormalities in blastocysts.

In young patients <35 years of age, because of the lower rate of chromosomal abnormalities in blastocysts, PGS has little effect on increasing the cumulative pregnancy rate.

Success rates with preimplantation genetic testing for aneuploidy in good prognosis patients are dependent on age

https://www.fertstert.org/article/S0015-0282(24)02261-1/abstract

To evaluate cumulative live birth after preimplantation genetic testing for aneuploidy (PGT-A) with next generation sequencing (NGS) compared with morphology alone among patients aged 21-40 years undergoing single blastocyst transfer.

- A total of 56,469 retrieval cycles were included in the analysis. Retrieval cycles were stratified based on age (<35, 35-37, and 38-40 years) and exposure to PGT-A with NGS. Retrieval cycles were stratified based on age (<35, 35-37, and 38-40 years) and exposure to PGT-A with NGS. 

- The use of PGT-A was associated with a slightly lower cumulative live birth in individuals aged <35 years (risk ratio [RR]: 0.96; 95% CI : 0.93-0.99) compared with no PGT, and 

- but higher cumulative live births in ages 35-37 years (RR: 1.04; 95% CI: 1.00-1.08), and 

- and 38-40 years (RR: 1.14; 95% CI: 1.07-1.20). 

- PGT-A was associated with higher cumulative live birth in individuals aged ≥35 years 

- was similar to no PGT in individuals aged <35 years. 

- Miscarriage was significantly less likely in individuals aged ≥35 years using PGT-A compared with no PGT-A.