#142 : “No Result” Embryos After PGTA: Should They Be Disposed?

Abstract

Background and Aims: Sometimes the preimplantation genetic testing for aneuploidy (PGTA) results return with “no result” (NR) even though the percentage of this type of result is quite small. Our desire was to rebiopsy these embryos and reanalysis, then determining whether it is efficient to perform reanalysis in “no result” embryos with different embryo qualities and evaluating the efficacy of rebiopsied blastocyst transfers. Materials and Methods: Performing trophectoderm rebiopsy for inconclusive blastocysts after PGTA test. The blastocysts would be transferred if the second analysis was eligible. Results: From September 2020 through December 2022, 2838 embryos were biopsied and tested for PGTA, 95 samples were returned as “no result”, accounting for 3.3%. There was no difference between the embryo quality grades in NR embryos (p>0.05), but the NR day 5 embryos was statistically higher than the group of day 6 embryos (85.3% vs 14.7%, p<0.05). The rate of ICM grade A was significantly higher than the rate of ICM grade C (42.1% vs 23.2%, p<0.05). However, TE grade B group was significantly higher than the group of TE grade A and TE group C. We performed re-biopsy and repeated PGTA test for 67 eligible embryos, 66/67 (98.5%) samples had results. The euploid rate after the second analysis was 46.3%. 16 euploid cases were transferred after the second analysis, the warming survival rate was 100% and the ongoing pregnancy rate was 56.3% (9/16) and there were 7 live births. The ongoing pregnancy rate in the group of good blastocyst grade (grade 1, 2) was higher than those in the group of poor blastocyst grade (grade 3) (44.4% vs 11.2%, respectively). Conclusions: Performing re-biopsy and repeat PGTA testing can reduce the risk of embryo wastage, increasing the chance of embryo transfer for patients indicated for PGTA. However, in cases of poor-quality embryo re-biopsy, the pregnancy rate after embryo transfer is very low even though the biopsy result is euploid. Therefore, it is necessary to weigh the benefits and risks of rebiopsy in cases where embryo quality is not eligible to optimize efficiency of time and cost for the patients.