Relationship between embryo quality and aneuploidies

Baltacı, Volkan; Şatıroğlu, Hakan; Kabukçu, Cihan; Ünsal, Evrim; Aydınuraz, Batu; Üner, Özge; Aktaş, Yasemin; Çetinkaya, Şerife Esra; Turhan, Feriba; Aktan, A. Özdemir

doi:10.1016/s1472-6483(10)60984-4

Cited by 43 publications

(16 citation statements)

References 28 publications

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“…However, we did find a negative association between embryo morphologic quality and corresponding genetic status of embryos on day 3. It was reported [27] that when embryo quality at the cleavage stage was correlated with chromosomal abnormalities, the morphological assessment might not reflect the chromosomal status of the embryo, because among the aneuploid embryos considerably high proportions were morphologically good quality, confirming our findings. We, therefore, suggest that an embryo’s morphology cannot be correlated with its ploidy prior to transfer.…”

Section: Discussionsupporting

confidence: 81%

A Linear Karyotypic Association between PB-I, PB-II and Blastomere Using Sequentially Performed Comparative Genome Hybridization with No Association Established between Karyotype, Morphologic, Biochemical (sHLA-G Expression) Characteristics, Blastocyst Formation and Subsequent Pregnancy Outcome

Kotzé

Keskintepe

Sher

et al. 2012

Gynecol Obstet Invest

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Background: The importance of oocyte/embryo ploidy to achieve implantation and a subsequent pregnancy. Aim: To correlate first and second polar bodies and day-3 blastomere ploidy, embryo morphology and biochemical (sHLA-G) characteristics with blastocyst development and in vitro pregnancy outcome. Materials and Methods: All oocytes/zygotes and embryos were individually cultured to the blastocyst stage. PB-I, PB-II and blastomeres underwent complete karyotyping and sHLA-G expression was measured on day 2. Results: 57 mature (MII) donor oocytes were obtained, 33/57 (57.9%) were aneuploid, 21/57 (36.8%) were euploid, and 3/57 (5%) were ‘inconclusive’. No correlation was found between comparative genomic hybridization (CGH) status of PB-I, PB-II and the graduated embryo score. Furthermore, no correlation was established between PB-I CGH results and blastocyst morphology grade. There was a significant correlation between PB-I CGH and blastomere CGH results. Euploid and aneuploid PB-I developed into 58 and 67% blastocysts, respectively. ĸ statistics (>0.7) revealed a positive correlation between the ploidy of PB-I, PB-II and the blastomeres. Conclusion: Following ICSI and sequential genetic karyotyping of the oocyte/zygote and subsequent blastomeres, the majority of oocytes fertilized and subsequent zygotes developed into blastocysts, despite their ploidy status. We therefore conclude that blastocyst development is not associated with ploidy.

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Section: Discussionsupporting

confidence: 81%

A Linear Karyotypic Association between PB-I, PB-II and Blastomere Using Sequentially Performed Comparative Genome Hybridization with No Association Established between Karyotype, Morphologic, Biochemical (sHLA-G Expression) Characteristics, Blastocyst Formation and Subsequent Pregnancy Outcome

Kotzé

Keskintepe

Sher

et al. 2012

Gynecol Obstet Invest

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“…Because it is not clear that embryo morphology correlates well with chromosomal content, some authors have suggested that relying on morphology alone is inadequate for embryo selection, particularly among high-risk patients (19,24,30). However, no randomized trial has supported this assertion (21,25,31).…”

Section: Discussionmentioning

confidence: 99%

Day-3 embryo morphology predicts euploidy among older subjects

Moayeri

Allen

Brewster

et al. 2008

Fertility and Sterility

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“…The incorporation of preimplantation genetic diagnosis into assisted reproductive technologies has afforded these women the chance to select and transfer only chromosomally normal embryos, as conventional methods to identify the best euploid embryo for transfer by morphological criteria alone are suboptimal [8][9][10][11][12][13][14]. Though increasingly being applied clinically the reproducibility of PGD for aneuploidy screening in women with repeated implantation failure remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Predictive value of preimplantation genetic diagnosis for aneuploidy screening in repeated IVF-ET cycles among women with recurrent implantation failure

Pagidas

Ying

Keefe

2008

J Assist Reprod Genet

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Objective To determine the predictive value of euploid embryos in women with recurrent implantation failure undergoing repeated IVF-ET cycles with PGD (PGD). Design Cohort of IVF-PGD cycles in a tertiary care ART facility. Materials and method(s) Fifty-five consecutive patients with repeated implantation failure (more than three failed IVF-ET cycles) underwent two or more PGD cycles for aneuploidy testing. Mean maternal age was 37.6±5.3 years. Biopsies were performed on day 3. One blastomere was removed from each pre-embryo, fixed and analyzed by multicolor and multi-probe FISH for chromosomes X and Y, 13, 15, 16, 17, 18, 21, and 22. Result(s) Forty-three of 55 patients (78%) undergoing PGD had at least one euploid embryo for transfer. Of these 31 patients (72%) also had at least one euploid embryo available for transfer with the second cycle. Of the 12 (28%) patients with no euploid embryos available for transfer with the second IVF/PGD cycle, five had a third cycle of PGD and two of these had euploid embryos available for transfer. Seventeen of the 31 patients (55%) who had euploid embryos on the second PGD cycle conceived. The ongoing pregnancy and implantation rates in patients with at least one euploid embryo were 40% and 18%, respectively. Twelve of the 55 patients (22%) had no euploid embryos available for transfer on the first PGD cycle, but on the second PGD cycle, six (50%) of these had euploid embryos for transfer. Only two pregnancies were achieved among this group of women, yielding a pregnancy rate of 17%, but both conceptions resulted in miscarriage. Of the six patients with no euploid embryos available after the second PGD cycle, four patients had a third IVF/PGD cycle, but none had euploid embryos available for transfer. Also, among women with euploid embryos available only in either the first or second PGD cycle, but not both, no ongoing pregnancy was achieved. No woman who had a PGD cycle productive of no euploid embryos had an ongoing pregnancy. Significant differences were found in terms of ongoing pregnancy (40%, P<0.05) and implantation rates (18%, P<0.05) in women with euploid embryos available for transfer with the first and second IVF/PGD cycles, compared to women with no euploid embryos available for transfer with either the first or second cycle. The positive predictive value of the first euploid cycle predicting a second euploid cycle was 72%, 95% CI 0.66-0.78. The negative predictive value of an aneuploid cycle was 50%, 95% CI 0.27-0.72. The sensitivity and specificity of the first PGD cycle predicting the second was 84%, 95% CI 0.77-0.91 and 33%, 95% CI 0.18-0.48, respectively. Conclusion(s) Even with a history of recurrent implantation failure, the availability of euploid embryos, especially on two, consecutive PGD cycles is associated with high ongoing pregnancy and implantation rates. Conversely, the absence of euploid embryos for transfer predicts poor reproductive outcome, even if subsequent cycles do yield euploid embryos.

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Relationship between embryo quality and aneuploidies

Cited by 43 publications

References 28 publications

A Linear Karyotypic Association between PB-I, PB-II and Blastomere Using Sequentially Performed Comparative Genome Hybridization with No Association Established between Karyotype, Morphologic, Biochemical (sHLA-G Expression) Characteristics, Blastocyst Formation and Subsequent Pregnancy Outcome

A Linear Karyotypic Association between PB-I, PB-II and Blastomere Using Sequentially Performed Comparative Genome Hybridization with No Association Established between Karyotype, Morphologic, Biochemical (sHLA-G Expression) Characteristics, Blastocyst Formation and Subsequent Pregnancy Outcome

Day-3 embryo morphology predicts euploidy among older subjects

Predictive value of preimplantation genetic diagnosis for aneuploidy screening in repeated IVF-ET cycles among women with recurrent implantation failure

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