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IVF BIG DATA

PCRS 2015 · Poster presentation

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

O. O. Barash, K. A. Ivani, M. D. 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) 2015

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

56.3 vs 37.6 %

Euploidy · young vs older

p < 0.05 · χ² = 27.57

Background

Why this study

Single embryo transfer (SET) is a proven option to achieve high pregnancy rates in young patients. 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.

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 analysis, January 2013 – December 2014. 195 cycles — one euploid embryo transferred per cycle.
  • Groups. 81 cycles (69 patients) in ≤ 37 y.o. (mean 33.25 ± 3.29); 114 cycles (97 patients) in ≥ 38 y.o. (mean 40.68 ± 1.67).
  • Embryos. 1,072 analyzed for euploidy. All hatched on day 3; biopsied on day 5 or 6; only good/fair quality embryos with ≥ 3–7 herniating cells and meeting cryopreservation criteria were considered.
  • eSET vs non-eSET. 75/81 SETs in the young group were elective; in the older group only 74/114 SETs were elective.

Results · Pregnancy by age

Ongoing PR after single euploid ET is similar in young and older patients

Ongoing PR for ≤ 37 y.o. was 56.8 % (46/81); for ≥ 38 y.o. — 51.8 % (59/114). The difference was not statistically significant — p = 0.487, χ² = 0.483. Linear regression of PR by age: y = −1.0043x + 56.779.

0255075100Ongoing PR, %56.8%≤ 37 y.o.51.8%≥ 38 y.o.
Fig. 6 — Ongoing PR after single euploid ET, ≤ 37 vs ≥ 38 y.o.

Results · Elective vs non-elective SET

PR is the same whether one or several euploid embryos were available

Ongoing PR did not differ between cases with only one euploid embryo available and those with two or more — p = 0.570, χ² = 0.323. The average number of embryos available for biopsy was higher in ≤ 37 y.o. than ≥ 38 y.o. — 6.59 ± 2.36 vs 3.92 ± 1.92, p < 0.05.

Euploidy was statistically higher in the young group — 56.32 % vs 37.55 % in older patients (p < 0.05, χ² = 27.57).

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