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Euploid blastocysts implant irrespective of their morphology after NGS-(PGT-A) testing in advanced maternal age patients

  • Assisted Reproduction Technologies
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Abstract

Purpose

Does blastocyst morphology following euploid elective single embryo transfer (eSET) after preimplantation genetic testing for aneuploidies (PGT-A) via next generation sequencing impact clinical outcome?

Methods

Two hundred ninety-six patients underwent PGT-A. Of 1549 blastocysts, 1410 blastocysts had a conclusive result after PGT-A and were included for analysis. An eSET policy was followed in a frozen embryo replacement cycle. A total of 179 euploid blastocysts were thawed and transferred. Clinical outcomes were categorized in four different embryo quality groups: excellent, good, average and poor.

Results

Euploidy rate was 19/36 (52.7%, 95% CI 37–68), 199/470 (42.3%, 95% CI 38–47), 156/676 (23.0%, 95% CI 20–26) and 39/228 (17.1%, 95% CI 13–23) in the excellent, good, average and poor quality blastocyst groups, respectively. Fitted logistic regression analysis taking into account the following covariables: female, age, embryo chromosomal status and day of blastocyst development/biopsy showed that morphology was predictive of the comprehensive chromosome screening result (p < 0.05). A logistic regression analysis was also performed on clinical outcomes taking into account the effect of blastocyst morphology and day of blastocyst development/biopsy. None of the parameters were shown to be significant, suggesting morphology and day of blastocyst development/biopsy do not reduce the competence of euploid embryos (p > 0.05).

Conclusions

After eSET, implantation rate was 80–86%; live birth rate per embryo transfer was 60–73% and clinical miscarriage rate was found to be < 10% and were not significantly affected by the embryo morphology. Results are concordant with those reported when using aCGH and highlights the competence of poor-quality euploid embryos.

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Authors and Affiliations

  1. Embryology Department, The Centre For Reproductive and Genetic Health, 230-232 Great Portland St, London, W1W 5QS, UK

    X. Viñals Gonzalez & R. Odia

  2. IGENOMIX, 40 Occam Road, Guildford, Surrey, GU2 7YG, UK

    R. Naja

  3. Clinical Department, The Centre For Reproductive and Genetic Health, 230-232 Great Portland St, London, W1W 5QS, UK

    P. Serhal, W. Saab, S. Seshadri & J. Ben-Nagi

Authors
  1. X. Viñals Gonzalez
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  2. R. Odia
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  3. R. Naja
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  4. P. Serhal
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  5. W. Saab
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  6. S. Seshadri
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  7. J. Ben-Nagi
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Correspondence to X. Viñals Gonzalez.

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Viñals Gonzalez, X., Odia, R., Naja, R. et al. Euploid blastocysts implant irrespective of their morphology after NGS-(PGT-A) testing in advanced maternal age patients. J Assist Reprod Genet 36, 1623–1629 (2019). https://doi.org/10.1007/s10815-019-01496-9

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  • DOI: https://doi.org/10.1007/s10815-019-01496-9

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