Comparison of single euploid blastocyst transfer cycle outcome derived from embryos with normal or abnormal cleavage patterns.

Autor: Ozbek IY; Anatolia IVF and Women Health Center, Embryology, Ankara, Turkey., Mumusoglu S; Hacettepe University, Department of Obstetrics and Gynecology, Ankara, Turkey., Polat M; Anatolia IVF and Women Health Center, Obstetrics and Gynecology, Ankara, Turkey., Bozdag G; Hacettepe University, Department of Obstetrics and Gynecology, Ankara, Turkey., Sokmensuer LK; Hacettepe University, Department of Histology and Embryology, Ankara, Turkey., Yarali H; Hacettepe University, Department of Obstetrics and Gynecology, Ankara, Turkey; Anatolia IVF and Women Health Center, Obstetrics and Gynecology, Ankara, Turkey. Electronic address: hyarali@anatoliatupbebek.com.tr.
Jazyk: angličtina
Zdroj: Reproductive biomedicine online [Reprod Biomed Online] 2021 May; Vol. 42 (5), pp. 892-900. Date of Electronic Publication: 2021 Feb 14.
DOI: 10.1016/j.rbmo.2021.02.005
Abstrakt: Research Question: To assess incidence of abnormal cleavage among biopsied blastocysts; to compare euploidy rates of the blastocysts with abnormal and normal cleavage; and to compare single euploid blastocyst transfer (SEBT) outcome derived from embryos with normal or abnormal cleavage.
Design: Retrospective analysis of prospectively collected data in a private IVF clinic. Consecutive 554 patients (749 cycles) undergoing preimplantation genetic testing for aneuploidy (n = 497; 671 cycles) or monogenic diseases (n = 57; 78 cycles) were included. All assessments for abnormal cleavage were carried out retrospectively; presence of abnormal cleavage was not a factor in deciding which euploid embryo to transfer. A total of 1015 blastocysts were biopsied and 295 SEBT procedures were carried out. Main outcome measure was live birth rate (LBR).
Results: Incidence of reverse cleavage, direct cleavage, and reverse plus direct cleavage, were 7.7%, 6.4% and 2.3%, respectively. Of the 1015 biopsied blastocysts, 35.0% were euploid. Blastocysts with abnormal cleavage, in total, had a significantly higher euploidy rate compared with blastocysts with normal cleavage (44.6% [74/166] versus 33.1% [281/849]; P = 0.017). The LBR after SEBT with normal, reverse and direct cleavage, and direct cleavage plus reverse cleavage, was 133/238 (55.9%), 6/26 (23.1%), 8/24 (33.3%) and 0/3 (0.0%) (P < 0.001). Generalized estimating equation analysis showed that the presence of abnormal cleavage pattern was the only independent predictor of LBR (OR 0.316; 95% CI 0.115 to 0.867; P = 0.013).
Conclusions: Blastocysts with direct or reverse cleavage should be biopsied in preimplantation genetic testing cycles if they are morphologically eligible. Euploid blastocysts with abnormal cleavage, however, have approximately half the LBR of those euploid blastocyst with normal cleavage, hence, blastocysts with abnormal cleavage should have lower priority for transfer.
(Copyright © 2021 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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