Deconstructing the myth of poor prognosis for fast-cleaving embryos on day 3. Is it time to change the consensus?
| Autor: | S Garcia, Iñaki González-Foruria, Maria Carme Pons, Mònica Parriego, Montserrat Boada, Pedro N. Barri, Buenaventura Coroleu, Anna Veiga, Beatriz Carrasco |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
0301 basic medicine Poor prognosis Consensus animal structures Pregnancy Rate Cell number Embryonic Development Fertilization in Vitro Biology Embryo Culture Techniques Andrology Young Adult 03 medical and health sciences 0302 clinical medicine Pregnancy Genetics medicine Humans Statistical analysis Embryo Implantation Blastocyst Birth Rate Assisted Reproduction Technologies Preimplantation Diagnosis Genetics (clinical) Retrospective Studies 030219 obstetrics & reproductive medicine Obstetrics and Gynecology Embryo General Medicine Middle Aged Embryo Transfer Prognosis 030104 developmental biology medicine.anatomical_structure Reproductive Medicine embryonic structures Female Live birth Developmental Biology |
| Zdroj: | J Assist Reprod Genet |
| ISSN: | 1573-7330 1058-0468 |
| DOI: | 10.1007/s10815-019-01574-y |
| Popis: | PURPOSE: To determine the developmental competence of fast-cleaving D3 embryos. METHODS: Retrospective study including 4028 embryos from 513 PGT-A cycles performed between July 2014 and June 2017. Embryos were cultured in time-lapse incubators and biopsied at blastocyst stage. Embryos were classified in groups according to the number of cells on D3 (from 2-cell to ≥13 -cell and compacted). A generalized linear mixed model adjusted for confounding factors was performed to assess the chance to give rise to an euploid blastocyst in each group compared with the chance of 8-cell embryos. Implantation and live birth rates were also analyzed. RESULTS: The statistical analysis showed that embryos with 9 to 11 cells had a slightly lower euploid blastocyst rate than 8-cell embryos (OR (95% CI) 0.77 (0.61–0.96)) while embryos with more than 11 cells were found to be just as likely to give rise to an euploid blastocyst as the 8-cell embryos (OR (95% CI) 1.20 (0.92–1.56)). Conversely, slow-cleaving embryos had a significantly lower euploid blastocyst rate than 8-cell embryos (OR (95% CI) 0.31 (0.24–0.39)). Moreover, euploid blastocysts derived from fast-cleaving embryos and from 8-cell embryos exhibit similar live birth rates. No significant differences were found in the chance to give rise a live birth between 8-cell and 9- to 11-cell embryos (OR (95% CI) 1.23 (0.70–2.15)) and > 11-cell embryos (OR (95% CI) 1.09 (0.57–2.09)). CONCLUSIONS: Embryos with more than 11 cells exhibit similar developmental competence to 8-cell embryos. Their poor prognosis should be reconsidered. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s10815-019-01574-y) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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