P–581 The day of blastocyst biopsy and the chromosomal constitution. Evaluation of 5125 embryos by Next Generation Sequency (NGS)

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
P E Villanuev. Zúñiga ◽  
J Huayhua ◽  
L Noriega-Hoces ◽  
G Llerena ◽  
J Noriega-Portella ◽  
...  
Keyword(s):  
Maternal Age ◽  
Blastocyst Stage ◽  
Chromosome Constitution ◽  
Lower Probability ◽  
Next Generation ◽  
Preimplantation Genetic Testing ◽  
Mosaic Embryo ◽  
Blastocyst Biopsy ◽  
Registration Number ◽  
Next Generation Sequencing Ngs

Abstract Study question Is there a relationship between the day of blastocyst biopsy and the results NGS analysis? Summary answer Embryos biopsied on day 6 or 7 are associated with the increased probability of being an aneuploidy embryo and less likely to be mosaic embryo. What is known already There is controversy about whether an embryo that reaches the blastocyst stage on day 5 has a higher chance of being euploid than embryos which are biopsied later. In our study, chromosome constitution was evaluated by next-generation sequencing (NGS)-based preimplantation genetic testing for aneuploidy (PGT-A) and confounding factors were eliminated. Study design, size, duration Data was collected retrospectively from June 2016 to January 2020 Participants/materials, setting, methods In total, 5125 blastocyst (day 5=2914, day 6 N = 2154 and day7 N = 57), generated from 1318 cycles were analysed with PGT-A. The chromosome constitution for each embryo was classified as euploid, aneuploid and mosaic. A multilevel model was made and associations betwwen variables by logistic regression were adjusted according to maternal age, SART blastocyst grade, fertilization method, biopsy operator and blastocyst stage. Main results and the role of chance The mean maternal age was 36.2 ± 4.2. Euploid rate was 62.1% and 37.9% (day 5 and day 6–7 respectively), aneuploidy rate was 47.0% and 53.0% (day 5 and day 6–7, respectively), mosaicism rate was 59.6% and 40.4% (day 5 and day 6–7, respectively) (p < 0.001). Embryos biopsied on day 6–7 have a significantly lower probability to be euploid and mosaicism than embryos biopsied on day 5 ((OR = 0.76 [0.68–0.86]); (OR = 0.84 (0.73 – 0.96) respectively) (p < 0.001). On the contrary, embryos biopsy on day 5 were significantly more likely to be euploid than day 6–7 (OR = 1.63[1.42–1.86]) (p < 0.001). Limitations, reasons for caution The results observed in this study should be confirmed using a larger number of samples. For the NGS analysis, a chromosome with a variation between 20 to 80% was considered mosaic. Wider implications of the findings: The present study revealed that embryos that reach blastocyst classified as full to hatched on day 5 are more like to be euploid compared to slow growing embryos. Trial registration number non-clinical trials

P–551 Blastocyst cohort size is not associated with embryo aneuploidy: comprehensive multi-centre data from current preimplantation genetic testing cycles

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
R Vassena ◽  
A Lorenzon ◽  
A L Lopes ◽  
D Sakkas ◽  
A Korkidakis ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Maternal Age ◽  
Age Groups ◽  
Ovarian Response ◽  
Cohort Size ◽  
Preimplantation Genetic Testing ◽  
Indirect Measure ◽  
Next Generation Sequencing Ngs ◽  
Generation Sequencing ◽  
Euploid Embryo

Abstract Study question Does blastocyst cohort size impact aneuploidy rates, evaluated by next generation sequencing (NGS)? Summary answer Embryo aneuploidy rates were independent of blastocyst cohort size across all patient ages. What is known already The effects of ovarian response on oocyte and embryo quality remain controversial. Several studies have proposed that a high response to ovarian stimulation may negatively impact oocyte competence. Alternatively, irrespective of maternal age, a poor ovarian response may potentially compromise embryo quality. Using blastocyst cohort size as an indirect measure of ovarian response, previous studies applying array comparative genomic hybridisation (aCGH) have demonstrated that the number of embryos available for biopsy does not impact embryo aneuploidy rates. Nevertheless, these findings remain to be confirmed in a comprehensive cohort, using current approaches for preimplantation genetic testing for aneuploidies (PGT-A). Study design, size, duration Retrospective, international, cohort study of 3998 patients from 16 clinics undergoing PGT-A from 2016–2020. We evaluated 11665 blastocysts, tested using trophectoderm (TE) biopsy and next generation sequencing (NGS). To eliminate bias of multiple treatments, we considered only the first PGT-A cycle for all patients. Both autologous and donation cycles were included in the analysis. Cycles were excluded if they utilised preimplantation genetic testing for monogenic disorders (PGT-M) or preimplantation genetic testing for structural rearrangements (PGT-SR). Participants/materials, setting, methods We evaluated aneuploidy and mosaicism rates, as well as the proportion of patients who had at least one euploid embryo suitable for transfer. Findings were stratified according to SART-defined maternal age groups, <35 (n = 698/2622 patients/blastocysts), 35–37 (n = 988/3141 patients/blastoycsts), 38–40 (n = 1447/3939 patients/blastocysts), 41–42 (653/1562 patients/blastocysts) and >42 (212/401 patients/blastocysts) and blastoycst cohort size (1–2, 3–5, 6–9 and 10 or more biopsied blastocysts). Main results and the role of chance The mean maternal age was 37.0±3.7. The overall embryo aneuploidy rate was 50.6% (5904/11665), while mosaicism was established in 4.0% (469/11665) of blastocysts. As expected, the proportion of aneuploid embryos increased steadily with advancing maternal age (31.8%, 41.5%, 58.4%, 71.2%, 87.8%; p < 0.0001), while mosaicism rates did not vary significantly (p = 0.2). Within each age group, we observed no association between the number of blastocysts biopsied and aneuploidy or mosaicism rates. However, as previously suggested, the chance of having at least one euploid embryo increased linearly with the number of embryos biopsied. We observed that young patients (<35) with 1–2 blastocysts had a 70.4% of having at least one embryo suitable for transfer, which increased to 96.4% and 99.2% with 3–5 and 6–9 blastocysts, respectively. Similar trends were observed in the 36–38 and 39–40 age groups. Patients in the 40–41 age group had a significantly lower chance of having a suitable embryo for transfer. Nevertheless, the chance increased from 27.2% with 1–2 embryos to 61.2% with 3–5 blastocysts. Patients with >10 embryos had at least one euploid embryo in 100% of cases, across all ages. Albeit, the numbers of patients within this category was low, and decreased significantly with advancing maternal age. Limitations, reasons for caution While blastocyst cohort size is considered to be an indirect measure of ovarian reserve, the number of oocytes retrieved was not evaluated. Our study only included the first PGT-A cycle for all patients. Subsequent, alterations in stimulation protocols may have resulted in an improved response in some patients. Wider implications of the findings: The comprehensive nature of the study, based on current PGT-A approaches and a large number of cycles across 16 centres increases clinical confidence in the notion that ovarian response is independent of embryo aneuploidy. Importantly, our findings may serve as a valuable clinical resource to guide patient counselling strategies. Trial registration number NA

scholarly journals Is day 5 blastocyst better than day 6 blastocyst? Evidence from NGS-based PGT-A results

2021 ◽  
Author(s):  
Ting Zhang
Keyword(s):  
Maternal Age ◽  
Embryo Implantation ◽  
Trophectoderm Biopsy ◽  
Preimplantation Genetic Testing ◽  
Non Invasive ◽  
Next Generation Sequencing Ngs ◽  
Generation Sequencing ◽  
Ploidy Status ◽  
Better Than ◽  
Euploid Embryo

Abstract Background Aneuploidy is the principal genetic factor leading to the failure of embryo implantation. For most patients who accept the non-preimplantation genetic testing (PGT) cycle, non-invasive methods to select euploid embryos with the best pregnancy potential are desirable Methods This retrospective study recruited women undergoing PGT for aneuploidy (PGT-A) with trophectoderm biopsy from January 2019 to December 2020. The ploidy status of embryos was determined by next generation sequencing (NGS). Results Altogether 2531 blastocysts from 839 PGT-A cycles were evaluated. The euploid rate of day 5 blastocysts seemed to be significantly higher than that of day 6 blastocysts, either from the same ovarian stimulation (OS) cycles (49.9% vs 35.7%, P < 0.001) or from different OS cycles (48.2% vs 27.8%, P < 0.001). Both the younger maternal age (adjusted OR = 0.917, 95% CI: 0.892–0.944, P < 0.001) and day 5 stage (adjusted OR = 1.735, 95% CI: 1.415–2.127, P < 0.001) were independently associated with the greater euploid rate of blastocysts. However, after single euploid embryo transfer, the clinical outcomes of day 5 blastocysts were comparable to those of day 6 blastocysts, no matter whether they were from the same OS cycles or not. Conclusions Our results revealed that day 5 blastocysts possess a higher euploid rate than day 6 blastocysts independent of the OS cycles. Giving priority to a day 5 blastocyst over day 6 blastocyst will increase the likelihood to select single euploid embryo for transfer in non-PGT cycles.

scholarly journals Different Strategies of Preimplantation Genetic Testing for Aneuploidies in Women of Advanced Maternal Age: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (17) ◽  
pp. 3895
Author(s):  
Wei-Hui Shi ◽  
Zi-Ru Jiang ◽  
Zhi-Yang Zhou ◽  
Mu-Jin Ye ◽  
Ning-Xin Qin ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Live Birth ◽  
Maternal Age ◽  
Birth Rate ◽  
Live Birth Rate ◽  
Advanced Maternal Age ◽  
Controlled Trials ◽  
Preimplantation Genetic Testing ◽  
Randomized Controlled ◽  
Blastocyst Biopsy

Background: Preimplantation genetic testing for aneuploidies (PGT-A) is widely used in women of advanced maternal age (AMA). However, the effectiveness remains controversial. Method: We conducted a comprehensive literature review comparing outcomes of IVF with or without PGT-A in women of AMA in PubMed, Embase, and the Cochrane Central Register of Controlled Trials in January 2021. All included trials met the criteria that constituted a randomized controlled trial for PGT-A involving women of AMA (≥35 years). Reviews, conference abstracts, and observational studies were excluded. The primary outcome was the live birth rate in included random control trials (RCTs). Results: Nine randomized controlled trials met our inclusion criteria. For techniques of genetic analysis, three trials (270 events) performed with comprehensive chromosomal screening showed that the live birth rate was significantly higher in the women randomized to IVF/ICSI with PGT-A (RR = 1.30, 95% CI 1.03–1.65), which was not observed in six trials used with FISH as well as all nine trials. For different stages of embryo biopsy, only the subgroup of blastocyst biopsy showed a higher live birth rate in women with PGT-A (RR = 1.36, 95% CI 1.04–1.79). Conclusion: The application of comprehensive chromosome screening showed a beneficial effect of PGT-A in women of AMA compared with FISH. Moreover, blastocyst biopsy seemed to be associated with a better outcome than polar body biopsy and cleavage-stage biopsy.

scholarly journals Preimplantation Genetic Testing of Aneuploidy by Next Generation Sequencing: Association of Maternal Age and Chromosomal Abnormalities of Blastocyst

2019 ◽  
Vol 7 (24) ◽  
pp. 4427-4431 ◽  
Author(s):  
Tien-Truong Dang ◽  
Thi Mui Phung ◽  
Hoang Le ◽  
Thi-Bich-Van Nguyen ◽  
Thi Sim Nguyen ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Next Generation Sequencing ◽  
Maternal Age ◽  
Chromosomal Abnormalities ◽  
Abnormal Chromosome ◽  
High Rate ◽  
Next Generation ◽  
Chromosome 11 ◽  
Preimplantation Genetic Testing ◽  
Generation Sequencing

BACKGROUND: Aneuploidy is a major cause of miscarriages and implantation failure. Preimplantation genetic testing for aneuploidy (PGT-A) by Next Generation Sequencing (NGS) is able to detect of the numeral and structural chromosomal abnormalities of embryos in vitro fertilization (IVF). AIM: This study was aimed to assess the relationship between maternal age and chromosomal abnormalities NGS technology. METHODS: 603 human trophectoderm (TE) biopsied samples were tested by Veriseq kit of Illumina. The relation of marternal age and chromosomal abnormality of blastocyst embryo was evaluated. RESULTS: Among the 603 TE samples, 247 samples (42.73%) presented as chromosomal abnormalities. The abnormalities occurred to almost chromosomes, and the most popular aneuploidy observed is 22. Aneuploidy rate from 0.87% in chromosome 11 to 6.06% in chromosome 22. The rate of abnormal chromosome increased dramatically in group of mother's ages over 37 (54.17%) comparing to group of mother's ages less than 37 (38.05%) (p < 0.000). The Abnormal chromosome and maternal age has a positive correlation with r = 0.4783 (p<0.0001). CONCLUSION: These results showed high rate abnormal chromosome and correlated with advanced maternal age of blastocyst embryos.

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