Influence of Trophectoderm Biopsy Prior to Frozen Blastocyst Transfer on Obstetrical Outcomes

Awadalla, Michael S.; Park, Kristen E; Latack, Kyle R.; McGinnis, Lynda K.; Ahmady, Ali; Paulson, Richard J.

doi:10.1007/s43032-021-00552-z

Cited by 13 publications

(9 citation statements)

References 26 publications

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“…A different concern is whether the embryo biopsy (which is required for genotyping) may cause risk to the viability and future health of the embryo. Several recent studies have demonstrated no evidence for potential adverse effects of trophectoderm biopsy on rates of successful implantation, fetal anomalies, and live birth ( Awadalla et al, 2021 ; He et al, 2019 ; Riestenberg et al, 2021 ; Tiegs et al, 2021 ). Moreover, no significant adverse effects have been detected for postnatal child development in a recent meta-analysis ( Natsuaki and Dimler, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Utility of polygenic embryo screening for disease depends on the selection strategy

Lencz

Backenroth

Granot‐Hershkovitz

et al. 2021

eLife

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Polygenic risk scores (PRSs) have been offered since 2019 to screen in vitro fertilization embryos for genetic liability to adult diseases, despite a lack of comprehensive modeling of expected outcomes. Here we predict, based on the liability threshold model, the expected reduction in complex disease risk following polygenic embryo screening for a single disease. A strong determinant of the potential utility of such screening is the selection strategy, a factor that has not been previously studied. When only embryos with a very high PRS are excluded, the achieved risk reduction is minimal. In contrast, selecting the embryo with the lowest PRS can lead to substantial relative risk reductions, given a sufficient number of viable embryos. We systematically examine the impact of several factors on the utility of screening, including: variance explained by the PRS, number of embryos, disease prevalence, parental PRSs, and parental disease status. We consider both relative and absolute risk reductions, as well as population-averaged and per-couple risk reductions, and also examine the risk of pleiotropic effects. Finally, we confirm our theoretical predictions by simulating ‘virtual’ couples and offspring based on real genomes from schizophrenia and Crohn’s disease case-control studies. We discuss the assumptions and limitations of our model, as well as the potential emerging ethical concerns.

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Section: Discussionmentioning

confidence: 99%

Utility of polygenic embryo screening for disease depends on the selection strategy

Lencz

Backenroth

Granot‐Hershkovitz

et al. 2021

eLife

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show abstract

“…A different concern is whether the embryo biopsy (which is required for genotyping) may cause risk to the viability and future health of the embryo. Several recent studies have demonstrated no evidence for potential adverse effects of trophectoderm biopsy on rates of successful implantation, fetal anomalies, and live birth (Awadalla et al, 2021;He et al, 2019;Riestenberg et al, 2021;Tiegs et al, 2021). Moreover, no significant adverse effects have been detected for postnatal child development in a recent metaanalysis (Natsuaki & Dimler, 2018 et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

Utility of polygenic embryo screening for disease depends on the selection strategy

Lencz

Backenroth

Green

et al. 2020

Preprint

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As of 2019, polygenic risk scores have been utilized to screen in vitro fertilization embryos for genetic liability to adult diseases, despite a lack of comprehensive modeling of expected outcomes. In this short report, we demonstrate that a strong determinant of the potential utility of such screening is the selection strategy employed, a factor that has not been previously studied. Minimal risk reduction is expected if only extremely high-scoring embryos are excluded, whereas risk reductions are substantially greater if the lowest-scoring embryo (for a given disease) is selected. We systematically examined the relative contributions of the variance explained by the score, the number of embryos, the disease prevalence, and the parental scores on the utility of screening. We discuss the results in the context of relative vs absolute risk, as well as the potential ethical concerns raised by such procedures.

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“…We have found that loss of implantations from embryo biopsy likely decreases with increasing embryologist experience with embryo biopsy over the rst few years of performing the technique [12]. Although there does not seem to be any clinically signi cant adverse obstetrical outcomes after embryo biopsy [13], one study found embryo biopsy for PGT to be associated with a small increase in preterm birth with an adjusted odds ratio of 1.20 [14].…”

Section: Introductionmentioning

confidence: 88%

“…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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Influence of Trophectoderm Biopsy Prior to Frozen Blastocyst Transfer on Obstetrical Outcomes

Cited by 13 publications

References 26 publications

Utility of polygenic embryo screening for disease depends on the selection strategy

Utility of polygenic embryo screening for disease depends on the selection strategy

Utility of polygenic embryo screening for disease depends on the selection strategy

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

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