Transfer the Best and Biopsy the Rest? Blastocyst Euploidy Rates Vary Based on Morphology and Day of Biopsy

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

“…Our group and others have previously shown that blastocyst euploidy rates differ by age, morphology, and expansion rate (Huang et al, 2019;McDaniel et al, 2020;Minasi et al, 2016). At our center the euploidy rate is 76% at age 26 and decreases to 24% at age 43.…”

“…Our IVF protocols have been described previously (Awadalla et al, 2020a(Awadalla et al, , 2020bMcDaniel et al, 2020). In brief, we use a combination of GnRH antagonist, GnRH agonist suppression, and GnRH flare ovarian stimulation protocols.…”

“…The switch to a flicking technique was made to reduce trauma to the embryo from the laser. After biopsy all of the embryos were vitrified using Cryotop (KitaZato, Tokyo, Japan) or VitriGuard (CooperSurgical, Trumbull, CT, USA) vitrification devices as previously described (McDaniel et al, 2020). PGT-A was performed by next generation sequencing (NGS; Progenesis, La Jolla, CA, USA or Reprogenetics, Livingston, NJ, USA) or single nucleotide polymorphism (SNP) analysis (Natera, San Carlos, CA, USA).…”

“…At age 36 where the overall euploidy rate is 56%, the euploidy rate based on overall morphology grade is 68% for good, 63% for fair, and 50% for poor. The euploidy rate at age 36 is 62% for day 5 blastocysts and 52% for day 6 blastocysts (McDaniel et al, 2020). Expansion rate can be measured by the degree of expansion observed on a specific day of culture or by the day of culture on which a blastocyst reaches a sufficient degree of expansion required for vitrification or biopsy.…”

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

“…Although the main bene t is to increase the live birth rate per embryo transferred, additional bene ts include decreased rate of spontaneous abortion and genetically abnormal pregnancy [1][2][3]. At our center the euploidy rate ranges from 76% at a maternal age of 26 years old (at oocyte retrieval) to 24% at a maternal age of 43 years old [4]. Clearly there is more potential bene t of PGT-A at older ages.…”