PGT-A Chromosomal Outcomes in Trophectoderm Biopsies from Women with Endometriosis: A Retrospective IVF Cohort Study

Background/Objectives: Endometriosis is frequently associated with infertility and may affect several aspects of reproductive competence. However, whether women with endometriosis exhibit different preimplantation genetic testing for aneuploidy (PGT-A) outcomes compared with women without endometriosis remains uncertain. This study aimed to compare the distribution of PGT-A chromosomal outcomes—including euploid, mosaic, aneuploid, and complex aneuploid results—between women with and without endometriosis undergoing IVF. Methods: This retrospective observational study included 160 women who underwent IVF treatment between January 2023 and January 2026, including 55 women with endometriosis and 105 controls without evidence of endometriosis. A total of 129 blastocysts underwent trophectoderm biopsy and PGT-A, of which 120 yielded conclusive chromosomal results. PGT-A outcomes were classified as euploid, mosaic, aneuploid, or complex aneuploid. The overall distribution of the four PGT-A outcome categories was compared between groups using an unadjusted chi-square test. Results: Among blastocysts with conclusive PGT-A results, the proportions of euploid, mosaic, aneuploid, and complex aneuploid embryos were 31.6%, 18.4%, 26.3%, and 23.7%, respectively, in the endometriosis group and 42.7%, 14.6%, 25.6%, and 17.1%, respectively, in the control group. The overall distribution of PGT-A chromosomal outcome categories did not differ significantly between groups (χ2 = 1.65, df = 3, p = 0.648). Conclusions: In this retrospective cohort, no statistically significant difference was observed in the overall distribution of PGT-A chromosomal outcomes between women with endometriosis and controls. Although numerical differences were observed across individual outcome categories, the absence of statistical significance should not be interpreted as evidence of equivalence between the groups, particularly given the limited precision of the estimates. Larger patient-level studies accounting for within-patient clustering and relevant clinical and embryological confounders are needed to further clarify the relationship between endometriosis and PGT-A outcomes.