The ASRM has released their 2024 committee opinion on the use of PGT-A, covering the use of PGT-A for patients with a good prognosis, advanced age, donor eggs, recurrent pregnancy loss and more.
Advanced maternal age
The egg cell contains a high number of mitochondria, which are tiny cellular organs that produce energy that the egg needs to power fertilization and embryo development. Research has shown that these mitochondria can become dysfunctional with age, leading to reduced energy availability for the egg that could result in poor egg quality. Different treatments that target mitochondria, like antioxidant supplements or mitochondrial donation, may improve egg quality, although good quality research is lacking that shows these treatments are truly effective.
A 2024 study investigated the genetics of over 3,200 miscarriages, finding that two-thirds were associated with a chromosomal abnormality, with trisomy 16 and the 8p23.1 deletion as the most common abnormalities.
Researchers in a 2023 study compared PGT-A outcomes for patients with different diagnoses, including advanced maternal age (AMA), recurrent implantation failure (RIF), recurrent pregnancy loss (RPL) and severe male factor (SMF).
Researchers in a 2023 study found that older women that are triggered earlier produce immature eggs that may be more competent than mature eggs after rescue IVM.
Researchers in a 2023 study combined the results of 74 studies to investigate what factors contribute to euploid live birth and miscarriage rates, identifying embryo quality, maternal age, specific diagnoses, repeat freeze/thaw, and other factors.
Researchers in a 2023 study evaluated factors affecting pregnancy outcomes after euploid transfer, and found that double euploid transfer, BMI, type of FET protocol, and the day of embryo biopsy all had an impact.
What’s the ideal follicle size for IVF? Researchers in a 2022 study compared follicle size at the time of trigger and related it to rates for egg maturity, fertilization, good quality embryos and euploidy. They also examined the association between follicle size and age and BMI.
This post covers the variety of reasons embryos can fail to implant or miscarry, including as a result of advanced maternal age, chromosomal translocations, lifestyle, endometritis, the microbiota, immunological issues, endometrial receptivity, the clinic, and more. Note that this is not a complete list, and will be updated periodically.
Researchers in a 2021 study found that older women showed worsened IVF outcomes using sperm with high DNA fragmentation, possibly due to compromised DNA repair activity in the older egg.