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IVF BIG DATA

PCRS 2014 · Poster presentation

Clinical pregnancy rate after single euploid embryo transfer is age-independent

O. O. Barash, K. A. Ivani, M. R. Hinckley, D. S. Wachs, S. P. Willman, C. F. MacKenzie, S. C. Lefko, L. N. Weckstein

Reproductive Science Center of the San Francisco Bay Area, USA

Pacific Coast Reproductive Society (PCRS) 2014

195

IVF PGT cycles with SET

Jan 2013 – Dec 2014

1,072

Embryos analyzed

SNP PGT · day 5 or 6 biopsy

56.8 vs 51.8 %

Ongoing PR

≤ 37 vs ≥ 38 y.o. · p = 0.49

6.59 vs 3.92

Embryos for biopsy / cycle

≤ 37 vs ≥ 38 y.o. · p < 0.05

Background

Why this study

Single embryo transfer (SET) is a proven option to achieve high pregnancy rates in young patients (Martikainen et al., 2001). The introduction of PCR-based PGT can become the basis for expanding SET to the older patient population. Precise evaluation of genetic status of embryos should facilitate accurate embryo selection for transfer (Handyside, 2013).

Objective. Compare pregnancy rates after SET for patients < 38 y.o. and ≥ 38 y.o. in PGT cycles.

Materials & Methods

Cohort and groups

  • Design. Retrospective SNP PGT pregnancy outcome study. 195 cycles; one euploid embryo transferred per cycle.
  • Groups. Young group (≤ 37 y.o., 81 cycles in 69 patients, mean 33.25 ± 3.29). Older group (≥ 38 y.o., 114 cycles in 97 patients, mean 40.68 ± 1.67).
  • Biopsy. Day-3 hatching; day-5 or day-6 biopsy. Only good/fair embryos with ≥ 3–7 herniating cells meeting cryopreservation criteria considered.

Results · Euploidy & PR

Ongoing PR is age-independent once a euploid embryo is available

Euploidy was significantly higher in the young group — 56.32 % vs 37.55 % (p < 0.05, χ² = 27.57). Average blastocysts available for biopsy were 6.59 ± 2.36 (≤ 37) vs 3.92 ± 1.92 (≥ 38), p < 0.05.

Ongoing PR — 56.8 % (46/81) vs 51.8 % (59/114), p = 0.487, χ² = 0.483. Linear regression of PR by age: y = −1.0043x + 56.779.

Results · Elective vs non-elective SET

When only one euploid embryo is available, PR is the same

75/81 SETs in the young group were elective; in the older group only 74/114 SETs were elective. Ongoing PR did not differ between cases where only one euploid embryo was available vs cases with two or more — p = 0.570, χ² = 0.323.

0%25%50%75%100%Share of SETs92.6%eSET — ≤ 37(75/81)7.4%non-eSET — ≤ 37(6/81)64.9%eSET — ≥ 38(74/114)35.1%non-eSET — ≥ 38(40/114)
Fig. 4 — Share of elective vs non-elective SETs in each age group.

Conclusion

Summary of findings

The data prove the effectiveness of PGT for infertile patients of advanced maternal age. Single embryo transfer in PGT cases can significantly decrease multiple-gestation rates without compromising clinical pregnancy rate, regardless of patient age.

References

Cited works

  1. 1.Martikainen H, Tiitinen A, Tomás C, et al. One versus two embryo transfer after IVF and ICSI: a randomized study. Hum Reprod. 2001;16(9):1900–1903. PubMed
  2. 2.Handyside AH. 24-chromosome copy number analysis: a comparison of available technologies. Fertil Steril. 2013;100(3):595–602. PubMed
  3. 3.Gardner DK, Schoolcraft WB. Culture and transfer of human blastocysts. Curr Opin Obstet Gynecol. 1999;11(3):307–311. PubMed

Reprint requests

Oleksii Barash, Ph.D. · ivfbigdata@gmail.com