Factors Relating to a Successful Cryopreserved Blastocyst Transfer Program

Objective To study the outcome of blastocysts showing expansion on day 5 and transferred on day 5 or 6, in comparison with those unexpanded and transferred on day 6. Study Design Prospective cohort of 221 women prepared for BET classified into three groups according to timing of blastocyst expansion and day of embryo transfer. Group I; with expanded blastocysts on day 5 having day 5 transfer, group II; with expanded blastocysts on day 5 having day 6 transfer and group III ; with delayed expansion undergoing day 6 BET. Results Implantation rates, pregnancy rates, ongoing pregnancy rates, and live birth rates in the first 2 groups were almost double the rates in the third group. The figures for implantation rates were 40 % in the first two groups vs. 19 % in the third group (P<0.05). Pregnancy rates were 60.9 % and 64 % vs. 31.8 % (P<0.05) and ongoing pregnancy/ live-birth rates were 52.3 % & 56 % vs. 27.3 %. Conclusion The current study reports better implantation and pregnancy rates with earlier expanding blastocysts regardless of the time of transfer.

Section: Resultsmentioning

confidence: 62%

Day 5 expanded blastocysts transferred on same day have comparable outcome to those left for more extended culture and transferred on day 6

Elgindy

Elsedeek

2012

“…There have been inconsistent results regarding the implantation potential of day 5 nonblastocysts compared to day 5 blastocysts. While Shapiro et al did demonstrate a higher implantation rate for embryos that are blastocysts by day 5 [9], these results were not consistent with other studies [10] and may have been confounded by the number of embryos transferred. Whether there are detrimental effects from biopsying morulae and early blastocysts on day 5 is also unknown.…”

Section: Introductioncontrasting

confidence: 55%

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

Kort

Lathi

Brookfield

et al. 2015

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.

“…Advances in our understanding of the pre-implantation embryo have led to significant changes in the philosophy of how best to culture the human embryo, and as a result, there has been a significant evolution in the culture media used in clinical IVF [18][19][20][21]. In this way, we performed a randomized prospective trial to test the ability of 2 different culture media sequences to produce viable human embryos.…”

Section: Discussionmentioning

confidence: 99%

An auto-controlled prospective comparison of two embryos culture media (G III series versus ISM) for IVF and ICSI treatments

Sifer

Handelsman

Grange

et al. 2009

Purpose To compare the effects of 2 different media on embryo morphology and development at days 2/3. Method Six hundred seventy-six attempts from 512 couples were included in this prospective auto-controlled study. Sibling oocytes of all couples undergoing an IVF (n=286) or ICSI (n=390) attempt were randomly assigned to either GIII series (Vitrolife) or ISM (Medicult) media. Primary end points were fertilization and embryo morphology rates. Conclusions Embryo morphology at days 2/3 was significantly enhanced when the embryos were cultured in GIII series.