Association between growth dynamics, morphological parameters, the chromosomal status of the blastocysts, and clinical outcomes in IVF PGS cycles with single embryo transfer

Barash, Oleksii; Ivani, K.; Willman, S.P.; Rosenbluth, Evan M.; Wachs, Deborah S.; Hinckley, Mary D; Reid, Sara Pittenger; Weckstein, Louis N.

doi:10.1007/s10815-017-0944-0

Cited by 43 publications

(34 citation statements)

References 49 publications

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“…The final inclusion was 13 studies that met the selection criteria for our meta‐analysis. Hence, 23 studies were included in the following meta‐analyses . The main characteristics and assessment for risk of bias of the included studies are presented in Table .…”

Section: Resultsmentioning

confidence: 99%

“…Although all studies have reported the pregnancy outcomes following transfer of frozen‐thawed blastocysts that had developed to blastocyst stage on day 5 or day 6, studies included in present meta‐analysis varied in terms of the number of embryo transferred and the chromosomal status of blastocysts. Only three studies transfer euploid blastocysts . Five studies only transfer one embryo per cycle, while remaining studies transfer no more than two blastocysts or more than two blastocysts per cycle .…”

Section: Resultsmentioning

confidence: 99%

“…Hence, 23 studies were included in the following meta-analyses. 4,6,7,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] The main characteristics and assessment for risk of bias of the included studies are presented in Table 1.…”

Section: Results Of the Searchesmentioning

confidence: 99%

“…Recent studies have found that intracellular factors, including spindle assembly checkpoints, abnormal spindles, microtubule kinetics, and mitochondrial function, can cause developmental delay in preimplantation embryo. The impact of intracellular factors on the euploid embryos may be a reason for the higher pregnancy rate of day 5 blastocyst transfer than day 6 blastocyst transfer …”

Section: Discussionmentioning

confidence: 99%

“…Only three studies transfer euploid blastocysts. 13,16,22 Five studies only transfer one embryo per cycle, [12][13][14]16,23 while remaining studies transfer no more than two blastocysts 11,[18][19][20]22,24,27,28 or more than two blastocysts per cycle. 29,30 The decision of when blastocyst was transferred in all included studies was dependent on the day of expansion.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Pregnancy outcomes after day 5 versus day 6 blastocyst‐stage embryo transfer: A systematic review and meta‐analysis

Wang²,

Sun

et al. 2020

J of Obstet and Gynaecol

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Aim To compare the pregnancy outcomes after day 5 blastocyst‐stage embryo transfers (BET) versus day 6 BET following vitrified‐warmed cycle and to evaluate whether the number of embryos transferred and the chromosomal status of embryo influence effect estimates. Methods A literature search (PubMed, Embase and MEDLINE) up to January 2019 was conducted to identify studies where women with day 6 BET were compared to women with day 5 BET. Only studies published in English language, on peer‐reviewed journal were considered eligible. The following subgroup analyses were performed: (i) number of embryos transferred and (ii) chromosomal status of embryo. Results From a total of 1956 articles identified, 23 observational studies were included in the meta‐analysis. We observed that day 6 BET were associated with lower implantation rate (risk ratio, RR: 1.17, 95% confidence interval, CI: 1.10–1.24), clinical pregnancy rate (RR: 1.17, 95% CI: 1.10–1.24), ongoing pregnancy rate (RR: 1.15, 95% CI: 1.07–1.24) and live birth rate (RR: 1.22, 95% CI: 1.11–1.33) than day 5 BET following vitrified‐warmed cycle. The subgroup analysis found that the superiority of day 5 BET compared with day 6 BET is influenced by the number of embryos transferred and chromosomal status of embryos. Conclusion Current evidence shows that day 5 BET is superior to day 6 BET following vitrified‐warmed cycle in clinical practice. Due to the overall low quality of available evidence, more larger and well‐conducted studies are needed to compare the pregnancy outcomes between day 5 and day 6 BET before drawing a clear conclusion.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Results Of the Searchesmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

See 3 more Smart Citations

Pregnancy outcomes after day 5 versus day 6 blastocyst‐stage embryo transfer: A systematic review and meta‐analysis

Wang²,

Sun

et al. 2020

J of Obstet and Gynaecol

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Copy number analysis of meiotic and postzygotic mitotic aneuploidies in trophectoderm cells biopsied at the blastocyst stage and arrested embryos

et al. 2020

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Preimplantation genetic testing for aneuploidy (PGT‐A) by copy number analysis is now widely used to select euploid embryos for transfer. Whole or partial chromosome aneuploidy can arise in meiosis, predominantly female meiosis, or in the postzygotic, mitotic divisions during cleavage and blastocyst formation, resulting in chromosome mosaicism. Meiotic aneuploidies are almost always lethal, however, the clinical significance of mitotic aneuploidies detected by PGT‐A is not fully understood and healthy live births have been reported following transfer of mosaic embryos. Here, we used single nucleotide polymorphism genotyping of both polar bodies and embryo samples to identify meiotic aneuploidies and compared copy number changes for meiotic and presumed mitotic aneuploidies in trophectoderm cells biopsied at the blastocyst stage and arrested embryos. PGT‐A detected corresponding full copy number changes (≥70%) for 36/37 (97%) maternal meiotic aneuploidies. The number of presumed mitotic copy number changes detected exceeded those of meiotic origin. Although mainly in the mosaic range, some of these mitotic aneuploidies had copy number changes ≥70% and would have been identified as full aneuploidies. Interestingly, many arrested embryos had multiple mitotic aneuploidies across a broad range of copy number changes, which may have arisen through tripolar spindle and other mitotic abnormalities.

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IVF embryo choices and pregnancy outcomes

Wang

Liu³

et al. 2021

Prenatal Diagnosis

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Objective: Investigate the chromosome status and transfer outcomes of embryos selected using routine "best morphology" IVF practices. Method:A prospective multi-center, non-selection cohort study involving patients undertaking IVF treatment. Study entry conditions were blastocyst biopsy, >1 embryo with chromosome analysis and frozen transfer of the best morphology embryo. Primary analyses were βhCG positive, implantation, ongoing pregnancy and birth rates and pregnancy-stage progression failures.Results: After transfer, embryo chromosome status was assigned and outcomes divided into two primary groups -euploids (n = 135) and aneuploids (n = 53).Compared to euploid embryo transfers, aneuploid embryos had significantly lower primary outcomes (+βhCG: 67% vs. 30%, p < 0.0001; IR: 56% vs. 19%, p < 0.0001; ongoing week 12: 51% vs. 9%, p < 0.0001; and livebirths: 50% vs. 8%, p < 0.0001, respectively). Transfers were further subdivided into smaller groups according to their main chromosomal feature. Stage analysis showed higher failure rates for aneuploids to initiate a pregnancy (p < 0.0001), higher subclinical miscarriage rate (p = 0.0402) and higher clinical miscarriage rate (p = 0.0038).

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Association between growth dynamics, morphological parameters, the chromosomal status of the blastocysts, and clinical outcomes in IVF PGS cycles with single embryo transfer

Abstract: Good- and fair-quality embryos available for biopsy on day 5 have higher euploidy rates and have a higher chance to result in an ongoing pregnancy. Euploidy rate has significant variations within the same age group depending on the morphology of the blastocysts.

Cited by 43 publications

References 49 publications

Pregnancy outcomes after day 5 versus day 6 blastocyst‐stage embryo transfer: A systematic review and meta‐analysis

Pregnancy outcomes after day 5 versus day 6 blastocyst‐stage embryo transfer: A systematic review and meta‐analysis

Copy number analysis of meiotic and postzygotic mitotic aneuploidies in trophectoderm cells biopsied at the blastocyst stage and arrested embryos

IVF embryo choices and pregnancy outcomes

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