Abstract:Objective: To investigate the effect of preimplantation genetic testing (PGT) on the early spontaneous abortion rate of patients of advanced maternal age (AMA) having a clinical pregnancy during cycles of frozen-thawed embryo transfer (FET). Methods: A retrospective analysis was performed on patients at the age of 35 or above who underwent 103 cycles of PGT-FET or 1495 cycles of conventional FET between April 1, 2015 and July 30, 2020 at the Reproductive Medicine Center of the Affiliated Drum Tower Hospital of Medical School, Nanjing University. Two cohorts with similar baseline characteristics were identified through 1:2 propensity score matching (PSM) for intergroup comparison of clinical indicators, such as clinical pregnancy, early spontaneous abortion, and live birth rates. Results: After 1:2 PSM, 103 patients in the PGT-FET group were successfully matched to 206 patients in the conventional FET group. The two groups showed no statistically significant difference in baseline information. The PGT-FET group had an early spontaneous abortion rate significantly lower than that in the conventional FET group (11.11% vs 27.18%, P <0.05). The live birth rate in the PGT-FET group was higher compared with the control group (43.69% vs 32.52%, P =0.05), but the difference between the two groups showed no statistical significance. No statistically significant difference was found in the rates of biochemical pregnancy, clinical pregnancy, late spontaneous abortion, and multiple delivery between the two groups.There was no significant difference in biochemical pregnancy rate, clinical pregnancy rate, early spontaneous abortion rate, late spontaneous abortion rate, live birth rate and multiple delivery rate among the three subgroups of PGT, PGT-A(Preimplantation Genetic Testing for Aneuploidy, PGT-A)、PGT-SR(Preimplantation Genetic Testing for Structural Rearrangements)、PGT-M(Preimplantation Genetic Testing for Monogenic Disease,PGT-M). Conclusion: PGT can reduce the early spontaneous abortion rate in AMA patients undergoing FET for clinical pregnancies probably because PGT can screen additional aneuploid embryos induced by AMA.