Preimplantation genetic testing for aneuploidy versus morphology as selection criteria for single frozen-thawed embryo transfer in good-prognosis patients: a multicenter randomized clinical trial

To evaluate the benefit of next-generation sequencing (NGS)–based preimplantation genetic testing for aneuploidy (PGT-A) for embryo selection in frozen-thawed embryo transfer. Randomized controlled trial. Not applicable. Women aged 25–40 years undergoing IVF with at least two blastocysts that could be biopsied. Randomization for single frozen-thawed embryo transfer with embryo selection based on PGT-A euploid status versus morphology. Ongoing pregnancy rate (OPR) at 20 weeks' gestation per embryo transfer. A total of 661 women (average age 33.7 ± 3.6 years) were randomized to PGT-A (n = 330) or morphology alone (n = 331). The OPR was equivalent between the two arms, with no significant difference per embryo transfer (50% [137/274] vs. 46% [143/313]) or per intention to treat (ITT) at randomization (41.8% [138/330] vs. 43.5% [144/331]). Post hoc analysis of women aged 35–40 years showed a significant increase in OPR per embryo transfer (51% [62/122] vs. 37% [54/145]) but not per ITT. PGT-A did not improve overall pregnancy outcomes in all women, as analyzed per embryo transfer or per ITT. There was a significant increase in OPR per embryo transfer with the use of PGT-A in the subgroup of women aged 35–40 years who had two or more embryos that could be biopsied, but this was not significant when analyzed by ITT. NCT02268786. El diagnóstico genético preimplantacionalpara aneuploidías versus la morfología como criterio de selección para transferencia de un único embrión criopreservado en pacientes de buen pronóstico: un estudio clínico multicéntrico aleatorizado Evaluar el beneficio de las nuevas técnicas de secuenciación (next-generation sequencing (NGS) aplicadas al diagnóstico genético preimplantatorio para aneuploidías (PGT-A) para la selección embrionaria en transferencias de embriones criopreservados. Estudio controlado aleatorizado. No aplica. Mujeres entre 25-40 años que se sometieron a un ciclo de FIV en el que al menos pudieron ser biopsiados dos blastocistos. Aleatorización para la transferencia de un embrión criopreservado con selección embrionaria basada en el estado euploide de PGT-A versus morfología. Tasa de gestación evolutiva (OPR) hasta las 20 semanas por transferencia embrionaria. Un total de 661 mujeres (edad media de 33.7 ± 3.6 años) fueron aleatorizadas para PGT-A (n=330) o solo morfología (n=331). La OPR fue equivalente entre los dos brazos, sin diferencia significativa por transferencia embrionaria (50% [137/274] vs. 46% [143/313]) ni