Correlation between standard blastocyst morphology, euploidy and implantation: an observational study in two centers involving 956 screened blastocysts

Capalbo, Antonio; Rienzi, Laura; Cimadomo, Danilo; Maggiulli, Roberta; Elliott, Thomas; Wright, Graham; Nagy, Zsolt; Ubaldi, Filippo Maria

doi:10.1093/humrep/deu033

Cited by 428 publications

(317 citation statements)

References 34 publications

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“…The difference in findings between studies may be attributable to the later day of biopsy in our study (Day 5) compared to theirs (Day 3), or the lower overall aneuploidy rate among day 5 blastocysts in our study. These findings are similar to a recent morphokinetic study that observed a delay in the initial compaction and blastulation among aneuploid embryos relative to euploid counterparts [12] but contrasts with a retrospective multicenter analysis that did not observe any significant difference in euploid or implantation rates between day 5 or day 6 blastocysts [7] and another morphokinetic study that did not find any correlation between aneuploid rates and the timing of initiation or completion of blastulation [13]. Due to the inconsistency of study results, a larger analysis with a diverse patient population and uniformity of chromosomal analysis is obviously needed.…”

Section: Discussionsupporting

confidence: 84%

“…Many centers do not biopsy day 5 morulae or early blastocysts, limiting day 5 biopsy to only expanded or expanding blastocysts, and choosing to rather wait until day 6 to determine if subsequent development warrants day 6 biopsy and immediate cryopreservation of embryos that have not reached the expanded blastocyst stage on day 5 [7]. However, these slower but non-arrested embryos are frequently found to have progressed to blastocyst stage by the time of a day 6 transfer, and the inability to perform a day 5 biopsy on these embryos precludes the availability of genetic information by the time of a fresh day 6 transfer.…”

Section: Introductionmentioning

confidence: 99%

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Aneuploidy rates and blastocyst formation after biopsy of morulae and early blastocysts on day 5

Kort

Lathi

Brookfield

et al. 2015

J Assist Reprod Genet

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Purpose Studies have demonstrated high implantation rates after trophectoderm biopsy of day 5 expanded blastocysts. However, biopsy of cleavage stage embryos may adversely affect embryo development and implantation. No studies have assessed the utility of day 5 morulae and early blastocyst biopsy. This study sought to better understand these slower embryos' aneuploidy rates and implantation potential. Methods This was a retrospective review of all autologous IVF cycles utilizing PGS at a single academic infertility center. Results The biopsy of day 5 morulae and early blastocysts provided 22 % additional euploid blastocysts available for fresh day 6 transfer compared to day 5 biopsy of only expanded blastocysts. Aneuploidy did correlate with embryo stage on day 5, even after controlling for maternal age, with 16 % of morulae and 35 % of blastocysts being euploid. The majority (83 %) of euploid morulae progressed to the blastocyst stage by day 6. Experience transferring slower developing embryos is limited, but preliminary pregnancy and implantation rates appear similar to euploid embryos biopsied as expanded blastocysts.Conclusions The biopsy of all non-arrested embryos on day 5 provides genetic information for all blastocysts on day 6, increasing the pool of euploid blastocysts available for fresh transfer and avoiding the need to cryopreserve developmentally competent embryos without genetic information.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Aneuploidy rates and blastocyst formation after biopsy of morulae and early blastocysts on day 5

Kort

Lathi

Brookfield

et al. 2015

J Assist Reprod Genet

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“…The biopsy procedure was performed as previously described. 19 5-10 TE cells were aspirated into the TE biopsy pipette (Research Instruments) followed by laser-assisted removal of the target cells from the body of the embryo. TE rebiopsies on aneuploid embryos were carried out following the same protocols used for TE biopsies during clinical PGS cycles.…”

Section: Ivf Proceduresmentioning

confidence: 99%

Comparison of array comparative genomic hybridization and quantitative real-time PCR-based aneuploidy screening of blastocyst biopsies

et al. 2014

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Comprehensive chromosome screening (CCS) methods are being extensively used to select chromosomally normal embryos in human assisted reproduction. Some concerns related to the stage of analysis and which aneuploidy screening method to use still remain. In this study, the reliability of blastocyst-stage aneuploidy screening and the diagnostic performance of the two mostly used CCS methods (quantitative real-time PCR (qPCR) and array comparative genome hybridization (aCGH)) has been assessed. aCGH aneuploid blastocysts were rebiopsied, blinded, and evaluated by qPCR. Discordant cases were subsequently rebiopsied, blinded, and evaluated by single-nucleotide polymorphism (SNP) array-based CCS. Although 81.7% of embryos showed the same diagnosis when comparing aCGH and qPCR-based CCS, 18.3% (22/120) of embryos gave a discordant result for at least one chromosome. SNP array reanalysis showed that a discordance was reported in ten blastocysts for aCGH, mostly due to false positives, and in four cases for qPCR. The discordant aneuploidy call rate per chromosome was significantly higher for aCGH (5.7%) compared with qPCR (0.6%; Po0.01). To corroborate these findings, 39 embryos were simultaneously biopsied for aCGH and qPCR during blastocyst-stage aneuploidy screening cycles. 35 matched including all 21 euploid embryos. Blinded SNP analysis on rebiopsies of the four embryos matched qPCR. These findings demonstrate the high reliability of diagnosis performed at the blastocyst stage with the use of different CCS methods. However, the application of aCGH can be expected to result in a higher aneuploidy rate than other contemporary methods of CCS.

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“…The quality of the blastocyst has been associated with the results of comprehensive chromosome screening of trophectoderm biopsies [10].…”

Section: Discussionmentioning

confidence: 99%

Chromosomal Status Assessed by CGH after a Day-3 Biopsy, in Embryos Classified by Standard Scoring Methodology at Pronuclear, Cleavage and Blastocyst Stage

Anagnostopoulou¹

2017

EMIJ

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Background: The standard scoring methodology, combined with blastocyst culture remains a valuable tool for embryo selection. Nevertheless, the embryo assessment based exclusively on morphological traits does not provide information about the chromosomal status of the embryo. Objective:The purpose of the present study has been to investigate the association between embryo morphology and chromosomal ploidy. Materials and methods:A total of 196 embryos resulting of 30 PGS cycles were biopsied on day 3 and tested for aneuploidies by comparative hybridization array. The embryos were classified into groups according to their morphology at zygote, cleavage and blastocyst stage.Results: Significantly statistical differences in embryo ploidy were observed when optimal day 3 morphology embryos were compared to medium morphology embryos (30.63% versus 17.28% respectively). A significantly higher proportion of euploid embryos were found in the group that achieved the blastocyst stage than in the arrested embryos group (42.57% versus 7.36%). Conclusion:The results provide evidence that embryo morphology and aneuploidy are linked both at day 3 and blastocyst stage. However the chromosomal status of the embryo may not be predicted relying exclusively on morphological assessment.

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Correlation between standard blastocyst morphology, euploidy and implantation: an observational study in two centers involving 956 screened blastocysts

Abstract: None.

Cited by 428 publications

References 34 publications

Aneuploidy rates and blastocyst formation after biopsy of morulae and early blastocysts on day 5

Aneuploidy rates and blastocyst formation after biopsy of morulae and early blastocysts on day 5

Comparison of array comparative genomic hybridization and quantitative real-time PCR-based aneuploidy screening of blastocyst biopsies

Chromosomal Status Assessed by CGH after a Day-3 Biopsy, in Embryos Classified by Standard Scoring Methodology at Pronuclear, Cleavage and Blastocyst Stage

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