Euploid blastocysts implant irrespective of their morphology after NGS-(PGT-A) testing in advanced maternal age patients

Gonzalez, Xavier Viñals; Odia, Rabi; Naja, Roy; Serhal, Paul; Saab, Wael; Seshadri, Srividya; Ben-Nagi, Jara

doi:10.1007/s10815-019-01496-9

Cited by 36 publications

(20 citation statements)

References 19 publications

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“…The most likely explanation is that for women aged 35 or older, the most important feature associated with the euploid blastocyst implantation rate is the maternal age at oocyte retrieval rather than blastocyst morphology, which highlights the competence of poor-quality euploid embryos in women of advanced maternal age. This conjecture is supported by Gonzalez’s finding [ 23 ].…”

Section: Discussionsupporting

confidence: 72%

Association between morphologic grading and implantation rate of Euploid blastocyst

Lou

Guan

et al. 2021

J Ovarian Res

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Background Standard morphologic evaluation has been the most widely adopted approach to embryo selection, and remains the most common strategy.The objective of the study to determine the association between the morphologic grading and implantation rate of euploid blastocysts in single frozen-thawed embryo transfer (SET) cycles. Methods A total of 271 patients aged 20–40 years undergoing euploid SET from January 2017 to December 2019 were included in retrospective cohort study.The cycles were divided into three groups based on their morphologic grading before cryopreservation: good-quality (n = 58), average-quality (n = 88) and poor-quality blastocysts (n = 125). The pregnancy outcome of the three morphologic groups were analyzed and a logistic regression of implantation rate was conducted. Results Good-quality blastocysts yielded statistically significantly higher implantation rates than poor-quality (79.31% vs. 48%; P<0.001). Planned subgroup analyses by age and the day of TE biopsy were conducted. Logistic regression analyses that adjusted for these variables identified higher implantation rates (adjusted odds ratio(aOR) = 4.083, 95% confidence interval (CI):1.836–9.082, P<0.001) for the good-quality blastocysts than for those that underwent poor-quality cycles in women aged < 35 years, but not in women aged ≥35 years (aOR = 6.074, 95% CI: 0.456–80.919, P = 0.172). The implantation rates were higher among women with good-quality blastocysts on both Day 5 and Day 6 of TE biopsy than among those with poor-quality blastocysts (Day 5, aOR = 3.294, 95% CI:1.260–8.616, P = 0.015; Day 6, aOR = 4.179, 95% CI:1.004 ~ 17.399, P = 0.049). Day 5 euploid blastocysts had no significant difference in implantation potential and early spontaneous abortion rate compared with similarly graded Day 6 euploid blastocysts. Conclusions Blastocyst morphologic grading was associated with implantation rate for euploid embryo transfers after adjustment for potential confounders. These findings suggest that evaluating blastocyst morphology is critical when selecting the best euploid blastocyst.

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Section: Discussionsupporting

confidence: 72%

Association between morphologic grading and implantation rate of Euploid blastocyst

Lou

Guan

et al. 2021

J Ovarian Res

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“…However, in such patients, the rate of aneuploidy at the blastocyst stage ranges from 30 to 85%, depending on the number of chromosomes studied 17 – 19 . While, chromosomal abnormalities can still be only identified by preimplantation genetic testing for aneuploidies (PGT-A), such promising technology is not used routinely by all IVF centres around the world 20 . As it has been shown that the extent of aneuploidy is lower in blastocysts in comparison with early embryos 21 , it could be expected that extended embryo culture could be useful to select embryos in AMA patients.…”

Section: Introductionmentioning

confidence: 99%

Extended embryo culture is effective for patients of an advanced maternal age

Sainte-Rose

Petit

Dijols

et al. 2021

Sci Rep

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The aim of this study was to determine the effectiveness of extended embryo culture in advanced maternal age (AMA) patients (37–43 years). In this retrospective analysis, 21,301 normally fertilized zygotes from 4952 couples were cultured until the blastocyst stage. Blastocyst development, including kinetics and morphology, transfer rate, implantation and live birth rates, were measured. In AMA patients, the blastocyst rate was significantly decreased as compared to that in younger women. On day 5, blastocysts underwent growth retardation in AMA patients, which was highlighted by a decreased rate of full/expanded blastocysts. Organization of the cells (trophectoderm and inner cell mass) was unaffected by age. However, in AMA patients, a ‘good’ morphology blastocyst had a decreased probability to implant compared with an ‘average’ morphology blastocyst in younger women. While the rates of blastocyst transfer and useful blastocysts were similar to younger patients, in AMA patients, both implantation and live birth rates were significantly reduced. Our results support the idea that extended embryo culture is not harmful for AMA patients. However, embryo selection allowed by such culture is not powerful enough to avoid chromosomal abnormalities in the developed blastocysts and therefore cannot compensate for the effect of a woman’s age.

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“…An additional four articles known to the authors but not contained in the search results were manually included. The 27 included articles were: (Abel et al, 2019;Akamine et al, 2018;Aldemir et al, 2020;Balaban et al, 2001;Bouillon et al, 2017;Capalbo et al, 2014;Cimadomo et al, 2019;Desai et al, 2014;Dobson et al, 2018;Gonzalez et al, 2019;Haas et al, 2018;Herbemont et al, 2017;Hill et al, 2020;Irani et al, 2018Irani et al, , 2017Kirillova et al, 2020;Li et al, 2020;Minasi et al, 2016;Oron et al, 2014;Park et al, 2018;Tao et al, 2013;Tsai et al, 2019;Wintner et al, 2017;Wirleitner et al, 2016;Yang et al, 2016;Zhang et al, 2011;Zhao et al, 2018) Broadly, the analysed articles show LGEs at day three have the opportunity to develop to day five, and that LGBs have similar ongoing rates and perinatal outcomes following implantation. Importantly, no adverse impacts on pregnancy or perinatal outcomes have been determined following the use of LGBs.…”

Section: Methods and Resultsmentioning

confidence: 99%

Should we look for a low-grade threshold for blastocyst transfer? A scoping review

Kemper

Liu

Afnan³

et al. 2021

Reproductive BioMedicine Online

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Euploid blastocysts implant irrespective of their morphology after NGS-(PGT-A) testing in advanced maternal age patients

Cited by 36 publications

References 19 publications

Association between morphologic grading and implantation rate of Euploid blastocyst

Association between morphologic grading and implantation rate of Euploid blastocyst

Extended embryo culture is effective for patients of an advanced maternal age

Should we look for a low-grade threshold for blastocyst transfer? A scoping review

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