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

J Assist Reprod Genet. 2019 Aug;36(8):1623-1629. doi: 10.1007/s10815-019-01496-9. Epub 2019 Jun 4.

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.

Keywords: Clinical outcomes; Embryo quality; Euploid; Morphology; PGT-A.

MeSH terms

  • Adult
  • Aneuploidy
  • Birth Rate
  • Blastocyst / cytology
  • Blastocyst / physiology*
  • Embryo Implantation*
  • Embryo Transfer
  • Embryonic Development
  • Female
  • Fertilization in Vitro / methods*
  • Genetic Testing / methods*
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Maternal Age*
  • Ploidies
  • Pregnancy
  • Pregnancy Rate
  • Preimplantation Diagnosis / methods*