Diagnostic efficiency, embryonic development and clinical outcome after the biopsy of one or two blastomeres for preimplantation genetic diagnosis

Abstract

While removal of two blastomeres decreases the likelihood of blastocyst formation, compared with removal of one blastomere, Day 3 in vitro developmental stage is a stronger predictor for Day 5 developmental potential than the removal of one or two cells. The biopsy of only one cell significantly lowers the efficiency of a PCR-based diagnosis, whereas the efficiency of the FISH PGD procedure remains similar whether one or two cells are removed. Delivery rates with live birth per started cycle were not significantly different.

Preimplantation genetic diagnosis for chromosome rearrangements – one blastomere biopsy versus two blastomere biopsy

“…Furthermore, our data indicates that there is no significant difference in clinical outcomes following the removal of one versus two blastomeres. While these findings support previous data reported by Van de Velde et al [13] and Michiels et al [9], they are in contrast to studies performed by other groups [4,6]. The laboratory of Goossens et al [6] and De Vos et al [4] reported that the removal of more than one blastomere from a day 3 embryo has a detrimental affect on developmental potential and day 5 embryo quality, and subsequently on clinical outcomes.…”

“…Another area of difference between the current study and the studies performed by Goossens et al [6] and De Vos et al [4] was the embryo culture media that was used. We have previously shown that the type of embryo culture media used in the laboratory can have a significant impact on embryo development and clinical outcomes [2].…”

“…In this study, we only considered embryos ≥7 blastomeres in size suitable for two blastomere biopsy. This contrasts to Goossens et al [6] and De Vos et al [4] who biopsied one or two blastomeres from embryos ≥6 blastomeres in size. It is possible that embryos with fewer blastomeres on day 3 respond more poorly to the biopsy of two blastomeres than embryos of greater size, presumably due to a larger percentage of their cellular mass being removed.…”

“…Despite this, there is currently no consensus between clinics as to how many blastomeres should be removed from the embryo for genetic analysis. Some clinics advocate the removal of a single blastomere [4,6], while others recommend that two blastomeres be biopsied in order to obtain a conclusive PGD result [1,9,13]. Given that embryo biopsy is an invasive procedure, it has long been recognised that this procedure could affect the subsequent growth and development of the embryo [3].…”

High-risk consumers’ perceptions of preimplantation genetic diagnosis for hereditary cancers: a systematic review and meta-analysis

“…PGD cannot detect abnormalities in all chromosomes and may also result in false-positive diagnoses. 41 Douma et al 35 found that 84% of 157 FAP patients of childbearing age (<40) reported PGD was not discussed in any clinical setting. Twenty percent indicated they would like more information on this technology.…”