{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T05:27:07Z","timestamp":1790400427735,"version":"4.1.0"},"reference-count":38,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T00:00:00Z","timestamp":1753056000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ferring Ltd."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Embryo selection in IVF is traditionally based on morphology, yet many high-quality embryos fail to implant. Preimplantation genetic testing for aneuploidy (PGT-A) using next-generation sequencing (NGS) has been proposed to improve selection by identifying euploid embryos. However, its effectiveness in women of advanced maternal age remains unclear due to limited randomized data. This pilot trial assessed the feasibility of a full-scale RCT comparing PGT-A to morphology-based selection in women aged 35\u201342. Methods: This single-centre, two-arm parallel RCT (NCT05009745) enrolled women aged 35\u201342 undergoing IVF\/ICSI with \u22653 good-quality day-3 embryos. Participants were randomized (1:1) to either embryo selection by morphology with fresh transfer or PGT-A with frozen transfer of a single euploid embryo. Allocation concealment was achieved via a secure web-based randomization platform; patients and clinicians were unblinded, but the biostatistician remained blinded. The primary outcome was feasibility of recruitment, randomization, and adherence. Results: Between June 2021 and January 2023, 138 women consented (recruitment rate: 55.8%, 95% CI: 49.7\u201362.0%) and 100 were randomized. Protocol adherence was 94%. Barriers to recruitment included preference for private PGT-A (19%) or fresh transfer (6%). Among biopsied embryos, 51.4% were euploid and 6.6% low-level mosaic. Intention-to-treat analysis showed no significant differences between PGT-A and control groups in clinical pregnancy rate (50% vs. 40%), live birth rate (50% vs. 38%), or miscarriage rate (12% vs. 8%). Cumulative live birth rate after up to three SETs was 72% vs. 52%, respectively (p &gt; 0.05). No multiple pregnancies occurred. Conclusions: RCTs of PGT-A in older women are feasible. A multicentre design with broader inclusion criteria could improve recruitment and allow better assessment of clinical benefit.<\/jats:p>","DOI":"10.3390\/jcm14145166","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T13:59:11Z","timestamp":1753106351000},"page":"5166","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Preimplantation Genetic Testing for Aneuploidy Versus Morphological Selection in Women Aged 35\u201342: Results of a Pilot Randomized Controlled Trial"],"prefix":"10.3390","volume":"14","author":[{"given":"Yusuf","family":"Beebeejaun","sequence":"first","affiliation":[{"name":"King\u2019s Fertility, Fetal Medicine Research Institute, London SE5 8BB, UK"},{"name":"Department of Women\u2019s and Children\u2019s Health, Faculty of Life Sciences and Medicine, King\u2019s College London, London SE1 7EH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1853-0408","authenticated-orcid":false,"given":"Daniela","family":"Bakalova","sequence":"additional","affiliation":[{"name":"School of Biosciences, University of Kent, Canterbury CT2 7NZ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasia","family":"Mania","sequence":"additional","affiliation":[{"name":"King\u2019s Fertility, Fetal Medicine Research Institute, London SE5 8BB, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3813-3576","authenticated-orcid":false,"given":"Timothy","family":"Copeland","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, University of California San Francisco, San Francisco, CA 94143, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ippokratis","family":"Sarris","sequence":"additional","affiliation":[{"name":"King\u2019s Fertility, Fetal Medicine Research Institute, London SE5 8BB, UK"},{"name":"Department of Women\u2019s and Children\u2019s Health, Faculty of Life Sciences and Medicine, King\u2019s College London, London SE1 7EH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kypros","family":"Nicolaides","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health, Faculty of Life Sciences and Medicine, King\u2019s College London, London SE1 7EH, UK"},{"name":"Harris Birthright Research Centre of Fetal Medicine, Fetal Medicine Research Institute, King\u2019s College Hospital, London SE5 8BB, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Capalbo","sequence":"additional","affiliation":[{"name":"Unit of Molecular Genetics, Center for Advanced Studies and Technology (CAST), \u201cG. d\u2019Annunzio\u201d University of Chieti-Pescara, 661003 Chieti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sesh K.","family":"Sunkara","sequence":"additional","affiliation":[{"name":"King\u2019s Fertility, Fetal Medicine Research Institute, London SE5 8BB, UK"},{"name":"Department of Women\u2019s and Children\u2019s Health, Faculty of Life Sciences and Medicine, King\u2019s College London, London SE1 7EH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1007\/BF01133388","article-title":"A formula for scoring human embryo growth rates in in vitro fertilization: Its value in predicting pregnancy and in comparison with visual estimates of embryo quality","volume":"3","author":"Cummins","year":"1986","journal-title":"J. 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