Supplemental Table 1: Epidemiological characteristics of participatingcouples.

PGD-A / Non PGD-A
No. of cycles performed / 100 / 105
Mean female age (SD) / 39.1 (1.1) / 39.5 (1.0)
Mean BMI (SD) / 23.1 (3.6) / 23.6 (4.1)
Mean sperm concentration x106/mL (SD) / 46.6 (45.5) / 45.6 (32.5)
Mean sperm with progressive motility x106/mL (SD) / 34.5 (17.2) / 39.0 (15.6)
Mean number previous miscarriages (SD) / 0.2 (0.4) / 0.1 (0.3)
Mean number previous IVF failures (SD) / 0.2 (0.4) / 0.2 (0.4)

NS differences between groups by Fisher´s exact test and Student’s t-test for non-categorical variables.

Supplemental Table 2: Description of the chromosome status of embryos analyzed in the PGD-A group.

PGD-A
No. of embryos analyzed / 538
No. of informative embryos (%) / 523 (97.2)
No. of euploid embryos (%) / 112 (21.4)
No. of aneuploid embryos (%) / 411 (78.6)
No. of embryos with 1 aneuploidy / 176 (33.6)
No. of embryos with 2 aneuploidies / 86 (16.4)
No. of embryos with 3-6 aneuploidies / 71 (13.6)
No. of embryos with chaotic pattern (>6 aneuploidies) / 78 (14.9)
No. of embryos with segmental aneuploidies (>15Mb) / 6 (1.1)
No. of embryos with NO FISH aneuploidies* / 96 (18.3)

*Abnormal embryos not including aneuploidies for chromosomes 13, 15, 16, 17, 18, 21, 22, X and Y.

Supplemental Table 3: Cumulative clinical outcome after transfer of cryopreserved embryos.

PGD-A / Non PGD-A / p-value / OR (CI 95%)
No. of cycles performed / 100 / 105 / --- / ---
No. of patients with surplus vitrified blastocysts (%) / 13 (13.0) / 55 (52.4) / <0.0001 / 0.13 (0.07-0.27)
No. of cryo-transfers / 1 / 35 / --- / ---
Total of transfers / 69 / 130 / --- / ---
Total embryos transferred / 90 / 226 / --- / ---
No. of pregnancies from surplus vitrified blastocysts / 1 / 17 / --- / ---
Cumulative PR/ patient / 38/100 (38.0) / 58/105 (55.2) / 0.0172 / 0.50 (2.28-0.87)
No. of miscarriages (%) / 1 (2.6) / 21* (36.2) / <0.0001 / 0.05 (0.01-0.37)
No. of ectopic pregnancies (%) / 0 / 2 (3.5) / NS / NS
Cumulative delivery rate/ patient / 37/100 (37.0) / 35/105 (33.3) / NS / NS
No. of livebirths/patient(%) / 45 (45.0) / 39 (37.1) / NS / NS

* One fetal loss (Down Syndrome).

Supplemental Table 4: Number of transfers and time to pregnancyfor a healthy baby at home.

PGD-A / Non PGD-A / p-value
Number of pregnancies at the first attempt / 36 / 23 / ---
Number pregnancies after transfer of cryopreserved embryos / 1 / 10 / ---
Mean time to ongoing pregnancy (SD, weeks) / 4.5 (4.1) / 5.8 (4.5) / NS
Mean number of transfer attempts (SD) / 1.0 (0.2) / 1.3 (0.4) / <0.0001
Mean theoretical number of transfers to achieve a LB / 1.8 / 3.7 / ---
Mean theoretical time to achieve a LB (weeks) / 7.7 / 14.9 / ---

Student’s t-test with Welch correction.

Supplemental Table 5: Cost-effectiveness estimation per baby at home.

PGD-A / Non PGD-A
No. of cycles / 100 / 105
No. of pregnancies at the first attempt / 36 / 23
No. of cycles with vitrification / 13 / 55
No. of cryo transfers / 1 / 35
No. of miscarriages / 1 / 21+2 ect
IVF lab cost / 5490x100 (549,000) / 5490x105
(576,450)
Drug cost / 1200x100 (120,000) / 1200x105
(126,000)
Vitrification cost / 1100x13
(14,300) / 1100x55
(60,500)
Cost of additional transfers / 1950x1
(1950) / 1950x35
(68,250)
Cost of PGD-A + day-3 embryo biopsy / 3890x100
(389,000) / ---
Cost of D&C+POC / 1023x1
(1023) / 1023x21
(21,483)
Cost of medical treatment of ectopic / --- / 2040x2
(4080)
Mean cost/baby
Day-3 biopsy / 1075,273/45 babies
(23,895) / 856,763/39 babies
(21,968)
Estimated cost (euros)/baby
with blastocyst biopsy in Europe / 19,250 / 21,968
Estimated cost (dollars)/baby
With blastocyst biopsy in USA / 36,098 / 40,211

The detailed cost presented in the table corresponded to the cost of the different steps of the treatment in the patients included in the study (Euros). The last two rows of the table include the estimation of the costs in Europe and USA if blastocyst biopsy and NGS would have been employed in the study instead of day-3 biopsies and aCGH.