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

• Published in: Journal of assisted reproduction and genetics 2019-08, Vol.36 (8), p.1623-1629
• Main Authors: Viñals Gonzalez, X., Odia, R., Naja, R., Serhal, P., Saab, W., Seshadri, S., Ben-Nagi, J.
• Format: Article
• Language: English
• Subjects: Adult; Aneuploidy; Assisted Reproduction Technologies; Biopsy; Birth Rate; Blastocyst - cytology; Blastocyst - physiology; Blastocysts; Clinical outcomes; Embryo Implantation; Embryo Transfer; Embryonic Development; Embryos; Female; Fertilization in Vitro - methods; Genetic screening; Genetic Testing - methods; Gynecology; Health risk assessment; High-Throughput Nucleotide Sequencing; Human Genetics; Humans; Maternal Age; Medicine; Medicine & Public Health; Morphology; Next-generation sequencing; Ploidies; Pregnancy; Pregnancy Rate; Preimplantation Diagnosis - methods; Regression analysis; Reproductive Medicine
• ISSN: 1058-0468; 1573-7330
• DOI: 10.1007/s10815-019-01496-9

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.