ArticleFrontiers in cell and developmental biology2026
Embryo ploidy outcomes of PGT-M+PGT-A compared with PGT-A alone: a multicenter real-world cohort study.
Article in Frontiers in cell and developmental biology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Given the increasing adoption of concurrent PGT-M + PGT-A from a single biopsy, understanding the baseline embryo ploidy profiles of patients undergoing combined testing compared to standard PGT-A populations is essential, particularly given concerns about embryo attrition. We aimed to compare embryo ploidy outcomes between PGT-M + PGT-A and PGT-A alone across maternal age strata, using PGT-SR cycles as a high-risk reference group. Methods: This retrospective multicenter real-world cohort included 15,956 PGT cycles performed between January 2021 and August 2024 and analyzed in a single genetics laboratory serving multiple reproductive centers in China (7,635 PGT-A-only; 5,874 PGT-M + PGT-A; 2,447 PGT-SR). Blastocyst trophectoderm biopsies were assessed by next-generation sequencing and classified as euploid, aneuploid, or mosaic. Primary outcomes were cycle-level counts and proportions of each ploidy category. We used Poisson regression for count outcomes and offset-Poisson regression for proportion outcomes (offset = log total embryos tested per cycle), with models prespecified to adjust for female age and to apply cluster-robust standard errors by center. Analyses were repeated across maternal age strata. Results: Patients undergoing PGT-A alone were older than those undergoing PGT-M + PGT-A (median female age 37 vs. 32 years). After adjustment for female age, euploid proportions were similar between PGT-M + PGT-A and PGT-A alone (RR 0.98, 95% CI 0.95-1.01). Mosaic proportions were slightly higher in PGT-M + PGT-A cycles (RR 1.06, 95% CI 1.002-1.13), whereas aneuploid proportions were slightly lower (RR 0.95, 95% CI 0.90-0.999). Across maternal age strata, the probability of obtaining at least one euploid embryo per cycle was slightly lower among women <35 years (RR 0.96), but did not differ significantly from PGT-A alone in the 35-40 years (RR 1.01) and >40 years (RR 0.87) strata. In contrast, PGT-SR cycles consistently showed poorer euploid outcomes and higher aneuploidy rates, and lower mosaic proportions compared with PGT-A alone. Conclusion: After adjusting for maternal age, patients undergoing PGT-M + PGT-A exhibited comparable euploid proportions and probabilities of obtaining at least one euploid embryo per cycle to those undergoing PGT-A alone. Because this study assessed embryo ploidy rather than post-transfer outcomes, evaluating the definitive clinical utility of the combined strategy awaits future prospective studies incorporating live birth and miscarriage data.
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