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PGDIS 2015 · Poster presentation

Top-quality embryos from patients under 38 years old have euploidy rates similar to euploidy rates in donor oocyte cycles

O. O. Barash, K. A. Ivani, S. P. Willman, C. F. MacKenzie, S. C. Lefko, N. Huen, L. N. Weckstein

Reproductive Science Center of the San Francisco Bay Area, USA

PGDIS 2015 International Conference

507

SNP + aCGH PGT cycles

211 < 38 y.o. · 272 ≥ 38 y.o. · 24 donor

2,589

Embryos analyzed

Good 991 · Fair 928 · Poor 670

71.4 vs 75.8 %

Good · < 38 vs donor

p = 0.238 · χ² = 1.39

72.7 %

Blastulation · donor

Autologous: 61 % ≤ 35 y.o. → 36 % > 44 y.o.

Background

Why this study

The number of chromosomal aneuploidies in preimplantation embryos rises with maternal age. Comprehensive chromosome screening is the most effective method for detecting aneuploidy and improving IVF outcomes; the correlation between embryo morphology and euploidy rates across age groups remains a topic of active study.

Objective. Compare euploidy rates of good-quality embryos from patients < 38 y.o. with euploidy rates in donor oocyte cycles.

Materials & Methods

Cohort and grouping

  • Design. Retrospective comparative study, January 2013 – March 2015. 507 IVF PGT cycles — 211 autologous < 38 y.o., 272 autologous ≥ 38 y.o., 24 donor oocyte.
  • Embryos. 2,589 analyzed — good (top, 991), fair (928), poor (670). Morphology graded by two embryologists using Gardner classification.
  • Oocyte source. Donor (198) vs autologous (2,391).

Results · Good quality

Top-quality embryos from patients < 38 y.o. match donor-oocyte euploidy

No statistically significant difference in euploidy between good-quality embryos in patients < 38 y.o. (33.3 ± 2.6 y.o.) and embryos in IVF cycles using donor oocytes (25.1 ± 3.1 y.o.) — 71.38 % (379/531) vs 75.76 % (150/198), p = 0.2381, χ² = 1.39.

Even in the 35 – 37 y.o. subgroup, good-quality euploidy was not statistically different from donor — 69.92 % (165/236) vs 79.76 % (67/84), p = 0.083, χ² = 3.01. Fair-quality embryos in < 38 y.o. were statistically lower than donor — 58.39 % (268/459) vs 75.64 % (59/78), p < 0.05, χ² = 8.33.

0255075100Euploidy rate, %71.4%Good · < 38 y.o.69.9%Good · 35–3775.8%Donor oocytes58.4%Fair · < 38 y.o.75.6%Fair · donor
Fig. 6 — Euploidy rates of good and fair quality embryos vs donor oocyte cycles.

Results · Cohort yield

Donor cycles set an upper benchmark; autologous yield drops with age

Blastulation in donor-egg PGT was 72.68 %; in autologous PGT it fell from 61.12 % (< 36 y.o.) to 35.81 % (> 44 y.o.).

Average number of blastocysts available for biopsy was 8.21 ± 2.89 in donor cycles and ranged from 6.95 ± 2.21 down to 1.91 ± 0.79 in autologous PGT cycles. Donor cycles also had the highest number of normal embryos per cycle (6.2 ± 1.9); in autologous, this decreased rapidly with advancing age.

The proportion of good, fair, and poor quality embryos was roughly stable across age groups (linear regression of good-quality share: y = −0.841 + 42.479).

Results · Pregnancy

Good-quality euploid embryos implant at a higher rate, regardless of oocyte source

Ongoing PRs after SET were significantly higher when good-quality embryos were available for ET (Fig. 7), regardless of oocyte source.

Conclusion

Summary of findings

Good-quality embryos from patients < 38 y.o. have euploidy rates similar to donor egg cycles. This supports wider use of elective SET and limited use of invasive selection methods in the younger patient population.

References

Cited works

  1. 1.Bisignano A, Wells D, Harton G, Munné S. Reply: PGD and aneuploidy screening for 24 chromosomes by genome-wide SNP analysis: a responsible path towards greater utility. Reprod Biomed Online. 2012;24(1):4–5. PubMed
  2. 2.Fragouli E, Alfarawati S, Spath K, et al. The origin and impact of embryonic aneuploidy. Hum Genet. 2013;132:1001–1013. PubMed
  3. 3.Schoolcraft WB, Katz-Jaffe MG. Comprehensive chromosome screening of trophectoderm with vitrification facilitates elective single-embryo transfer for infertile women with advanced maternal age. Fertil Steril. 2013;100:615–619. PubMed
  4. 4.Harper JC, Harton G. The use of arrays in PGD/PGS. Fertil Steril. 2010;94:1173–1177. PubMed
  5. 5.Handyside AH. 24-chromosome copy number analysis: a comparison of available technologies. Fertil Steril. 2013;100:595–602. PubMed
  6. 6.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