Comprehensive Chromosome screening using MALBAC-NGS with cleavage-state embryos as an option for treatment of patients with chromosomal disorders

Abstract

Introduction Comprehensive chromosome screening with next generation sequencing (NGS) has been proved effective in detecting chromosomal abnormalities and has been successfully used in treating patients with chromosomal disorders. In most clinical practice, embryos were in-vitro cultured to blastocyst, trophectoderm biopsies were performed before embryos were cryopreserved for embryo transfer. However, patients with poor embryo number and quality often experienced tremendous stress with the limited blastocyst formation rate. Material & Methods In IVF center of Women's Hospital, Zhejiang University School of Medicine, from July 2016 to January 2018, we have performed preimplantation genetic diagnosis- aneuploidy (PGD-A) on 124 ICSI cycles using MALBAC-NGS with cleavage-state embryos for treatment of patients with chromosomal disorders. Results 61 cycles were performed with D3 biopsy and D4 fresh embryo transfer with overnight MALBAC-NGS reporting; and 63 cycles were performed with D3 biopsy using frozen-thawed embryos and we have seen no significant difference in both clinical pregnancy rate (CPR, 49.18% fresh vs 46.03% frozen) and ongoing pregnancy rate (OPR, 44.26% fresh vs 44.44% frozen). PGD-A also shows significantly improved CPR and OPR versus matched single embryo transfer (SET) cycles as well as FISH-PGD. Conclusions D3 biopsy and D4 fresh embryo transfer strategy in our center is a viable option, especially in patients having concerns about blastocyst culture and frozen embryo transfer with low OHSS risk.