Effect of age and morphology on sustained implantation rate after euploid blastocyst transfer

Awadalla, Michael S.; Vestal, Nicole L.; McGinnis, Lynda K.; Ahmady, Ali; Paulson, Richard J.

doi:10.1016/j.rbmo.2021.06.008

Cited by 9 publications

(7 citation statements)

References 27 publications

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“…It seems reasonable to assume that once euploid blastocysts are transferred, pregnancy outcome is independent of blastocyst morphology. A recent retrospective cohort study showed that maternal age, blastocyst morphology and day of biopsy are all associated with sustained implantation rate even after euploid embryos are transferred ( 22 ). Indeed, we found that blastocyst morphology is not associated with embryo survival: the LBRs of poor-quality euploid blastocysts were comparable to those of blastocysts scored as good or average quality.…”

Section: Discussionmentioning

confidence: 99%

Effect of Blastocyst Morphology and Developmental Rate on Euploidy and Live Birth Rates in Preimplantation Genetic Testing for Aneuploidy Cycles With Single-Embryo Transfer

Guan

Ren

et al. 2022

Front. Endocrinol.

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ObjectiveThe aim of this study was to investigate whether blastocyst morphology and developmental rate are associated with euploidy and live birth rates (LBRs) in single euploid frozen–thawed embryo transfer (FET) cycles.DesignRetrospective cohort study.MethodsThis study included 431 preimplantation genetic testing for aneuploidy (PGT-A) cycles followed by 393 FET cycles performed at our center from June 2017 to March 2021. All cycles were analyzed for euploidy based on blastocyst morphology (good, average and poor), developmental stage (day 5 and 6) and maternal age (< 35 and ≥ 35 years old). Multivariate logistic analysis models were used to identify the independent effects of conventional blastocyst morphology, developmental rate and morphological parameters (degree of blastocoele expansion, and grade of inner cell mass and trophectoderm (TE)) on LBRs.ResultsIn the group of women aged < 35 years, compared with poor-quality blastocysts, good-quality blastocysts (62.90% vs. 32.46%; odds ratio (OR) 3.163, 95% confidence interval (CI) 2.247–4.451; P < 0.001) and average-quality blastocysts (46.70% vs. 32.46%; OR 1.665, 95% CI 1.287–2.154; P < 0.001) had significantly higher euploidy rates. Additionally, day 5 blastocysts were associated with higher euploidy rates than day 6 blastocysts (49.28% vs. 35.02%; OR 1.506, 95% CI 1.191–1.903; P= 0.001). In the group of women aged ≥ 35 years, euploidy rates were also associated with blastocyst morphology, with 41.86%, 45.65% and 24.39% of good, average and poor-quality embryos, respectively, exhibiting euploidy. However, no relationship was seen between euploidy and blastocyst developmental rate. Multiple logistic regression analysis show that overall blastocyst morphology of euploid embryos was not associated with LBR, only embryos with A-grade TE had significantly higher LBRs than those with C-grade TE (62.71% vs. 45.40%; OR 2.189, 95% CI 1.166–4.109; P=0.015). Similarly, LBRs were significantly higher when day 5 blastocysts were transferred than when day 6 blastocysts were transferred (57.75% vs. 41.67%; OR 2.132, 95% CI 1.370–3.318; P = 0.001).ConclusionPoor-quality embryos have reduced rates of euploidy. However, blastocyst developmental rate only significantly associates with euploidy rates in women aged younger than 35. Furthermore, only TE grade and blastocyst developmental rate are significantly associated with LBRs following FET cycles.

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Section: Discussionmentioning

confidence: 99%

Effect of Blastocyst Morphology and Developmental Rate on Euploidy and Live Birth Rates in Preimplantation Genetic Testing for Aneuploidy Cycles With Single-Embryo Transfer

Guan

Ren

et al. 2022

Front. Endocrinol.

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“…Following the allocation of the articles that met the eligibility criteria, we extracted several strong points: The body mass index (BMI) and obesity influence the chances of implantation and amplify the risk of miscarriage [ 40 , 46 ], also dependent on the couple’s age [ 27 ], cesarean section (C-section) [ 22 ], and ovarian reserve [ 23 ], rather than correlated with previous unsuccessful pregnancies [ 36 ]; While age exerts a detrimental effect, it is mitigated through SNP-based PGT-A [ 39 ], and the embryos’ morphology possesses a significant threat with greater impact [ 11 , 37 , 47 ], but contradicted on several occasions [ 21 , 29 , 38 ]; Embryo morphokinetic [ 11 , 34 , 37 ] and inner cell mass (ICM) morphology constitute an optimal predictor of sustained implantation [ 48 ]; Mitochondrial DNA (mtDNA) copy numbers are higher in day 5 blastocysts of older women than day 6 blastocysts, further associated with a low chance of ongoing pregnancies [ 14 , 24 ]; The content of mtDNA is unable to predict the miscarriage risk [ 12 ] and additionally refuted when comparing the outcome differences between them [ 19 ] despite the cryo-storage [ 49 ]; Despite the sensitivity of platforms, errors still might occur, and their optimization is mandatory; PGT-NGS significantly improves the clinical outcomes in mosaic embryos [ 28 , 41 , 50 ], FAST-SeqS being a reliable and scalable PGT-A method [ 15 ]; Mosaic embryos have poor reproductive potential but retain the ability to result in live births [ 13 , 33 ], further sustaining that TE biopsy did not add detectable adverse effects [ 42 ] but as a supplement for the management of recurrent implantation failure (RIF) [ 45 ...…”

Section: Resultsmentioning

confidence: 99%

“…While age exerts a detrimental effect, it is mitigated through SNP-based PGT-A [ 39 ], and the embryos’ morphology possesses a significant threat with greater impact [ 11 , 37 , 47 ], but contradicted on several occasions [ 21 , 29 , 38 ]; Embryo morphokinetic [ 11 , 34 , 37 ] and inner cell mass (ICM) morphology constitute an optimal predictor of sustained implantation [ 48 ];…”

Section: Resultsmentioning

confidence: 99%

“…Current PGT-A methods can detect amalgams of euploid and aneuploid cells, which is why several teams of authors had it as an objective to evaluate the benefit of embryo selection. Inner cell mass (ICM) remains the most valuable predictor of sustained implantation [ 48 ], alongside pronuclear for [ 68 ] ploidy at all ages for euploid embryos of good quality at D5 [ 47 ], especially in younger patients. Poor quality does not always imply inadequate competence [ 29 ], considering that the STAR offered novel directions that marked the IVF practice worldwide [ 38 ].…”

Section: Resultsmentioning

confidence: 99%

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A Mini-Review Regarding the Clinical Outcomes of In Vitro Fertilization (IVF) Following Pre-Implantation Genetic Testing (PGT)-Next Generation Sequencing (NGS) Approach

et al. 2022

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Background: PGT-based NGS revolutionized the field of reproductive medicine becoming an integrated component within current assisted reproductive technology (ART) protocols. Methods: We searched the literature published in the last half a decade in four databases (PubMed/Medline, ISI Web of Knowledge, ScienceDirect, and Scopus) between 2018 and2022. Results: A total of 1388 articles were filtered, from which 60 met, initially, the eligibility criteria, but only 42 were included (≥100 patients/couples—62,465 patients and 6628 couples in total) in the present mini-review. In total, forty-two (70.0%) reported reproductive outcomes, while eighteen (30.0%) had distinct objectives. Furthermore, n = 1, 1.66% of the studies focused on PGT, n = 1, 1.66% on pre-implantation genetic testing for monogenic disorders (PGT-M), n = 3, 5.0% on pre-implantation genetic testing for structural rearrangements (PGT-SR) and n = 55, 91.66% on pre-implantation genetic testing for aneuploidies (PGT-A). Conclusions: PGT using NGS proved to be an excellent companion that folds within the current ascending tendency among couples that require specialty care. We strongly encourage future studies to provide a systematic overview expanded at a larger scale on the role of the PGT-NGS.

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“…Our IVF protocols have been described previously [13,15]. Brie y, gonadotropin-releasing hormone (GnRH) antagonist, GnRH agonist suppression, and GnRH are suppression stimulation protocols were used.…”

Section: Ivf Protocolsmentioning

confidence: 99%

Effect of Trophectoderm Biopsy for PGT-A on Live Birth Rate per Embryo in Good Prognosis Patients

Awadalla

Agarwal²,

Ho³

et al. 2022

Preprint

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Purpose: To determine if blastocyst trophectoderm biopsy for PGT-A is associated with an increased rate of live birth per embryo in good prognosis IVF patients at a single center.Methods: We performed a retrospective cohort study of good prognosis embryo transfer cycles at a single center from 1/1/2017 through 12/31/2019. We evaluated the rate of live birh per embryo with and without PGT-A for transfer of embryos in two groups of good prognosis patients: embryos from donor oocytes and embryos from autologous oocytes with maternal age less than 35 years at oocyte retrieval. 2-sided Fisher’s exact tests were used for comparisons between groups.Results: After transfer of embryos created from donor oocytes the live birth rate per euploid embryo was 70.6% (24/34) compared to 34.3% (35/102) for untested embryos for a rate difference of 36.3% (95% CI 18.4-54.1%, p < 0.01). After transfer of embros created from autologous oocytes with maternal age less than 35 years at oocyte retrieval the live birth rate per euploid embryo was 70.0% (49/70) compared to 52.5% (53/101) for untested embryos for a rate difference of 17.5% (95% CI 3.0-32.0%, p = 0.03).Conclusion: In good prognosis patients at our center the live birth rate per euploid blastocyst was higher than for untested blastocysts.

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Effect of age and morphology on sustained implantation rate after euploid blastocyst transfer

Abstract: Highlights Morphology and maternal age both impact pregnancy rates of euploid blastocysts.  Morphology has a greater impact on pregnancy rates than maternal age.  Blastocyst PGT-A increases live birth rate per embryo for all ages at our center.

Cited by 9 publications

References 27 publications

Effect of Blastocyst Morphology and Developmental Rate on Euploidy and Live Birth Rates in Preimplantation Genetic Testing for Aneuploidy Cycles With Single-Embryo Transfer

Effect of Blastocyst Morphology and Developmental Rate on Euploidy and Live Birth Rates in Preimplantation Genetic Testing for Aneuploidy Cycles With Single-Embryo Transfer

A Mini-Review Regarding the Clinical Outcomes of In Vitro Fertilization (IVF) Following Pre-Implantation Genetic Testing (PGT)-Next Generation Sequencing (NGS) Approach

Effect of Trophectoderm Biopsy for PGT-A on Live Birth Rate per Embryo in Good Prognosis Patients

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