Array CGH analysis shows that aneuploidy is not related to the number of embryos generated

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Purpose This multicentered retrospective study analyzed whether the quantity of euploid blastocysts in a given cohort after comprehensive chromosomal screening can be used to identify candidates for single embryo transfer. Methods Blastocysts from 437 patients underwent trophectoderm biopsy followed by array comparative genomic hybridization. Embryos were then selected for single or double embryo transfer. The number of euploid blastocysts produced and transferred for each patient was recorded, as was clinical pregnancy rate and multiple gestation rate. Results In patients with e3 euploid blastocysts, clinical pregnancy rate was higher in double, compared to single embryo transfers. However, in patients with Q4 euploid blastocysts, clinical pregnancy rate was not reduced with single embryo transfer was performed, whereas the multiple gestation rate was greatly reduced. Conclusions Size of the euploid embryo cohort is a marker for success in single embryo transfer cycles. Patients who produce at least four euploid blastocysts are outstanding candidates for single embryo transer.

Section: Discussionsupporting

confidence: 53%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A greater number of euploid blastocysts in a given cohort predicts excellent outcomes in single embryo transfer cycles

Morin

Melzer-Ross²,

McCulloh

et al. 2014

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“…The Cochrane review of 12 randomized controlled trials demonstrated that live birth rates can be optimized by performing blastocyst transfer compared to cleavage stage embryo transfers [9]. In addition, a recent study found chromosome abnormalities were reduced at the blastocyst stage compared to the cleavage embryo stage [10].…”

Section: Introductionmentioning

confidence: 99%

Optimal embryo transfer strategy in poor response may include freeze-all

Berkkanoğlu

Coetzee

Bulut

et al. 2016

Purpose In this retrospective cohort study, we investigated the best embryo transfer strategy in ICSI cycles with ≤4 oocytes collected at oocyte retrieval. Methods Women who underwent antagonist co-treatment COS for ICSI treatment between January 2010 and December 2015 at a private ART clinic (N = 2263). Eight hundred seventy-nine women (group 1) had ≤4 oocytes collected at oocyte retrieval, of whom 645 (group A) had cleavage stage embryo transfer (ET), and 234 (group B) had blastocyst ET. One thousand three hundred eighty-four women (group 2) had 10-15 oocytes collected at oocyte retrieval, of whom 676 (group C) had cleavage stage ET, and 708 women (group D) had blastocyst ET. Blastocyst vitrification was performed using the Cryotop method and FET using artificial cycles. Results In group 1, the cancellation rate was significantly lower in group A (25.2 vs 38 %). The pregnancy rate (PR), clinical PR, implantation rate (IR), and live birth rate (LBR) per ET and per oocyte retrieval were all lower in group A. The clinical PR, IR, and LBR per ET of vitrified-warmed blastocyst ET were significantly the highest. In group 2, the cycle cancellation rate was significantly lower in group C (3.5 vs 13.4 %). The PR, clinical PR, and IR per ET and per oocyte retrieval were all lower in group C. The LBR per ET was significantly lower, but the LBR per oocyte retrieval was not significantly lower in group C. Again, the PR, clinical PR, and IR per ET of vitrifiedwarmed blastocyst ET were significantly the highest. Conclusions Day 5 ET strategy has been reserved for normal or high responders. The improved pregnancy outcomes from blastocyst culture and cryopreservation may challenge ART to extend this benefit to poor responders.

“…A recent Cochrane review found that blastocyst ET has a statistically significant higher live birth rate than cleavage stage ET, 32-42 vs 31 % respectively [7]. Furthermore, longer cell culture allows for improved selection of higher grade embryos and decreases the rate of aneuploidy [8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

A comparison of pregnancy outcomes between day 3 and day 5/6 embryo transfers: does day of embryo transfer really make a difference?

Maxwell

Melzer-Ross²,

McCulloh

et al. 2015

Purpose To determine if day of embryo transfer (ET) affects gestational age (GA) and/or birth weight (BW) at a single university fertility center that primarily performs day 5/6 ET. Methods Retrospective cohort study of 2392 singleton live births resulting from IVF/ICSI at a single large university fertility center from 2003 to 2012. Patients were stratified by day 3 or day 5/6 ET. Outcome variables included patient age, gravidity, prior miscarriages, prior assisted reproduction technology cycles, number of embryos transferred, number of single ET, infertility diagnosis, neonatal sex, GA at birth, and BW. Subanalyses were performed on subgroups of preterm infants. A comparison was made between the study data and the Society of Assisted Reproductive Technologies (SART) published data. Results There was no difference in GA at birth (39±2.1 weeks for day 3 ET, 39±1.9 weeks for day 5/6 ET) or BW between ET groups (3308±568 g for day 3 ET, 3268±543 g for day 5/6 ET). There was also no difference in the number of preterm deliveries (8.5 % for day 3 ET vs. 10.8 % for day 5/6 ET). The day 5/6 ET study data had significantly fewer pre-term deliveries than the SART day 5/6 ET data. Conclusion In contrast to published SART data, GA and BW were not influenced by day of ET. Data may be more uniform at a single institution. Day 5/6 ET continues to offer improved pregnancy rates without compromising birth outcomes.