Is Preimplantation Genetic Testing Associated with Increased Risk of Abnormal Placentation After Frozen Embryo Transfer?

2020 ◽  
Author(s):  
Kate Swanson ◽  
David Huang ◽  
Amy Kaing ◽  
Cinthia Blat ◽  
Melissa G. Rosenstein ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Embryo Transfer ◽  
Primary Outcome ◽  
Frozen Embryo Transfer ◽  
Secondary Outcome ◽  
Hypertensive Disorders Of Pregnancy ◽  
Abnormal Placentation ◽  
Preimplantation Genetic Testing ◽  
Hypertensive Disorders ◽  
Increased Risk

Objective This study aimed to assess the association of preimplantation genetic testing (PGT) with abnormal placentation among a cohort of pregnancies conceived after frozen embryo transfer (FET). Study Design This is a retrospective cohort study of women who conceived via FET at the University of California, San Francisco from 2012 to 2016 with resultant delivery at the same institution. The primary outcome was abnormal placentation, including placenta accreta, retained placenta, abruption, placenta previa, vasa previa, marginal or velamentous cord insertion, circumvallate placenta, circummarginate placenta, placenta membranacea, bipartite placenta, and placenta succenturiata. Diagnosis was confirmed by reviewing imaging, delivery, and pathology reports. Our secondary outcome was hypertensive disease of pregnancy. Results A total of 311 pregnancies were included in analysis; 158 (50.8%) underwent PGT. Baseline demographic characteristics were similar between groups except for age at conception and infertility diagnosis. Women with PGT were more likely to undergo single embryo transfer (82.3 vs. 64.1%, p < 0.001). There were no statistically significant differences in the rate of the primary outcome (26.6 vs. 27.4%, p = 0.86) or hypertensive disorders of pregnancy (33.5 vs. 33.3%, p = 0.97), which remained true after multivariate analysis was performed. Conclusion Among pregnancies conceived after FET, PGT is not associated with a statistically significant increased risk of abnormal placentation or hypertensive disorders of pregnancy. Key Points

The effects of the day of trophectoderm biopsy and blastocyst grade on the clinical and neonatal outcomes of preimplantation genetic testing–frozen embryo transfer cycles

Zygote ◽  
2021 ◽  
pp. 1-6
Author(s):  
Linjun Chen ◽  
Zhenyu Diao ◽  
Jie Wang ◽  
Zhipeng Xu ◽  
Ningyuan Zhang ◽  
...  
Keyword(s):  
Birth Weight ◽  
Genetic Testing ◽  
Embryo Transfer ◽  
Live Birth ◽  
Frozen Embryo Transfer ◽  
Neonatal Outcomes ◽  
Miscarriage Rate ◽  
Birth Rates ◽  
Preimplantation Genetic Testing ◽  
Live Birth Rates

Summary This study analyzed the effects of the day of trophectoderm (TE) biopsy and blastocyst grade on clinical and neonatal outcomes. The results showed that the implantation and live birth rates of day 5 (D5) TE biopsy were significantly higher compared with those of D6 TE biopsy. The miscarriage rate of the former was lower than that of the latter, but there was no statistically significant difference. Higher quality blastocysts can achieve better implantation and live birth rates. Among good quality blastocysts, the implantation and live birth rates of D5 and D6 TE biopsy were not significantly different. Among fair quality and poor quality blastocysts, the implantation and live birth rates of D5 TE biopsy were significantly higher compared with those of D6 TE biopsy. Neither blastocyst grade nor the day of TE biopsy significantly affected the miscarriage rate. Neonatal outcomes, including newborn sex, gestational age, preterm birth, birth weight and low birth weight in the D5 and D6 TE biopsies were not significantly different. Both blastocyst grade and the day of TE biopsy must be considered at the same time when performing preimplantation genetic testing–frozen embryo transfer.

scholarly journals Assisted Reproductive Technology and Hypertensive Disorders of Pregnancy: Systematic Review and Meta-Analyses

2021 ◽  
Author(s):  
Hui Ju Chih ◽  
Flavia Elias ◽  
Laura Gaudet ◽  
Maria Velez
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Embryo Transfer ◽  
Meta Analysis ◽  
Oocyte Donation ◽  
Reproductive Technology ◽  
Frozen Embryo Transfer ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Singleton Pregnancies

Abstract BackgroundHypertensive disorders of pregnancy (HDP) is one of the most common pregnancy complications and causes of maternal morbidity and mortality. Many cohort studies were conducted to study adverse pregnancy outcomes associated with pregnancies from assisted reproductive technology. We aimed to comprehensively review all available evidence to date to compare the odds of HDP and preeclampsia between pregnancies achieved by in vitro fertilization (IVF) and spontaneous pregnancies.MethodsWe conducted a systematic review and meta-analysis based on cohort studies identified from EMBASE, MEDLINE, and Cochrane Library (up to 2020) and manually using a structured search strategy. Cohort studies that compared pregnancies after IVF with or without intracytoplasmic sperm fertilization (ICSI) and SC with HDP or preeclampsia as the outcome of interest were included. The control group was women who conceived spontaneously without ART or fertility medications. Studies published in English, French, Chinese, and Portuguese were reviewed. Eligibility and quality of studies were evaluated by two reviewers independently. Quality assessment was conducted using the Newcastle Ottawa Scale (NOS) for Cohort Studies. The pooled results were reported in odds ratios (OR) with 95% confidence intervals based on random effects models. I-squared (I2) test was used to evaluate heterogeneity and publication bias was assessed using funnel plots.ResultsSeventy-eight studies were included after a screening of 1,879 abstracts and 275 full text articles. Compared to SC, IVF/ICSI singleton pregnancies (OR 1.63; 95% CI 1.54-1.74; I2 = 79%) and multiple pregnancies (OR 1.31; 95% CI 1.18-1.47; I2 = 73%) were both associated with higher odds of HDP. Singleton pregnancies with oocyte donation had the highest odds of HDP out of all groups analyzed (OR 4.11; 95% CI 2.75-6.16; I2 = 85%). Frozen embryo transfer resulted in higher odds of HDP (OR 1.74; 95% CI 1.58-1.92; I2 = 55%) than fresh embryo transfer (OR 1.43; 95% CI 1.33-1.53; I2 = 72%). Similar findings for preeclampsia were also reported.ConclusionsOur meta-analysis confirmed that IVF/ICSI pregnancies are at high odds of HDP and preeclampsia than SC, irrespective of the plurality. The odds were especially high in frozen embryo transfer and oocyte donation pregnancies.

scholarly journals A prospective double-blinded non-selection trial of reproductive outcomes and chromosomal normalcy of newborns derived from putative low/moderate-degree mosaic IVF embryos

2021 ◽  
Author(s):  
A. Capalbo ◽  
M. Poli ◽  
L. Rienzi ◽  
L. Girardi ◽  
D. Cimadomo ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Embryo Transfer ◽  
Clinical Benefit ◽  
Copy Number ◽  
Primary Outcome ◽  
Moderate Degree ◽  
Clinical Use ◽  
Preimplantation Genetic Testing ◽  
Low Degree ◽  
Double Blinded

ABSTRACTBackgroundNext generation sequencing (NGS) has increased detection sensitivity of intermediate chromosome copy number variations (CNV) consistent with chromosomal mosaicism. Recently, this methodology has found application in preimplantation genetic testing (PGT) of trophectoderm (TE) biopsies collected from IVF-generated human embryos. As a consequence, the detection rate of intermediate CNV states in IVF embryos has drastically increased, posing questions about the accuracy in identifying genuine mosaicism in highly heterogeneous biological specimens. The association between analytical values consistent with mosaicism and the reproductive potential of the embryo, as well as newborn’s chromosomal normalcy, have not yet been thoroughly determined.MethodsWe conducted a multicentre, double-blinded, non-selection trial including 1,190 patients undergoing in a total of 1,337 IVF with preimplantation genetic testing for aneuploidies (PGT-A) treatment cycles. NGS was performed on clinical TE biopsies collected from blastocyst-stage embryos. All embryos were reported as euploid if all autosomes had a chromosomal copy number value below the threshold of 50% abnormal cells per sample. After embryo transfer, three comparative classes were analysed: uniformly euploid profiles (<20% aneuploid cells), putative low-degree mosaicism (20%-30% aneuploid cells) or putative moderate-degree mosaicism (30%-50% aneuploid cells). Primary outcome measure was live birth rate (LBR) per transfer and newborn’s karyotype.ResultsLBR after transfer of uniformly euploid embryos, low-degree, and moderate-degree mosaic embryos were 43.4% (95% C.I. 38.9 - 47.9), 42.9% (95% C.I. 37.1 - 48.9) and 42% (95% C.I. 33.4 - 50.9), respectively. No difference was detected for this primary outcome between euploid and mosaic low/moderate categories (OR= 0.96; 95% CI 0.743 to 1.263; P=0.816). The non-inferiority endpoint was met as the confidence interval for the difference fell below the planned 7.5% margin (95% C.I. −5.7 - 7.3). Likewise, no statistically significant difference was observed comparing moderate versus low degree mosaic embryos (P=0.92). Neonatal karyotypes were also similar and no instances of mosaicism or uniparental disomies (UPDs) were detected in babies born following putative low or moderate-degree mosaic embryo transfer. Should the embryos with low or moderate-degree mosaic TE biopsies had been classified as chromosomally abnormal and thus discarded for clinical use, LBR per cycle would have decreased by 36% without any clinical benefit.ConclusionsThis prospective non-selection trial provides substantial evidence that reporting and/or not transferring embryos with low/moderate-degree mosaicism for whole chromosomes have no clinical utility. Moreover, dismissing these embryos from clinical use has the counterproductive effect of reducing overall embryo availability, thus reducing the chance of successful outcome derived from an IVF treatment without any clinical benefit. (Funded by Igenomix; ClinicalTrials.gov number, NCT03673592)

Effect of next-generation sequencing in preimplantation genetic testing on live birth ratio

2018 ◽  
Vol 30 (12) ◽  
pp. 1720 ◽  
Author(s):  
Joanna Liss ◽  
Ewa Pastuszek ◽  
Sebastian Pukszta ◽  
Eva Hoffmann ◽  
Waldemar Kuczynski ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Next Generation Sequencing ◽  
Embryo Transfer ◽  
Live Birth ◽  
Live Birth Rate ◽  
Frozen Embryo Transfer ◽  
Control Group ◽  
Next Generation ◽  
Preimplantation Genetic Testing ◽  
Generation Sequencing

The present study analysed live birth ratios in frozen embryo transfer (FET) cycles where embryo ploidy status was determined with preimplantation genetic testing (PGT) using next-generation sequencing (NGS). PGT was performed on trophectoderm cells biopsied at the blastocyst stage. The present prospective cohort study included 112 women undergoing frozen embryo transfer, with NGS PGT. The control group consisted of 85 patients who underwent the IVF procedure with FET planned for a subsequent cycle. The live birth rate per cycle was higher by ~18.5 percentage points in the investigated compared with control group (42.0% vs 23.5% respectively; P = 0.012). The differences between the study and control groups were also significant for clinical pregnancy (42.0% vs 23.5% respectively; P = 0.012), implantation (41.2% vs 22.2% respectively; P = 0.001) and pregnancy loss rates (9.6% vs 28.6% respectively; P = 0.027). The results show that PGT NGS is a useful method for embryo selection and it may be implemented in routine clinical practice with propitious results.

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