Does first polar body array CGH analysis correlate with a cleavage stage embryo biopsy in IVF-ICSI cycles and preimplantation genetic screening

Abstract

OBJECTIVE: To correlate first polar body(PB1) biopsy(Bx) aCGH technology with cleavage stage(D3) Bx results analyzed with FISH or SNP-array. DESIGN: Prospective clinical trial. Main Outcome: Concordance between PB1 and D3 results, ongoing pregnancy rates and IVF outcome. MATERIALS AND METHODS: Between 09/11-04/12, 27 patients(Pts) consented and 15 enrolled and underwent PB1 Bx followed by a D3 Bx.11 Pts completed their cycle with a total of 101 PB1 and corresponding D3 Bxs.All mature oocytes(MII) were fertilized by ICSI 4-6h post retrieval with PB1 Bx performed and frozen 2-4h thereafter.D3 Bx was then performed and analyzed using 9 probe FISH(13,15,16,17,18,21,22,X,Y) or 24 chromosomes SNP array(physician/Pts preference).Clinical decisions were based solely on D3 analysis.ET was performed on D5. RESULTS: 83% of MIIs fertilized normally.Concordance analysis of PB1 and corresponding D3 revealed 67.3% partial/complete concordance and 32.7% discordance(6% normal embryos possibly discarded or 26.7% abnormal embryos possibly transferred).When 9-probe FISH was used partial concordance was expected.PB1 had a 82% sensitivity and 55% specificity when compared to D3.Kappa statistic was 0.35[fair agreement], P1⁄40.0001(95% CI1⁄40.14,0.54) Implantation rate was 31%(average of 2.28 fresh embryos per ET). Pregnancy rate/cycle started was 36% with 27% ongoing(57% and 42% per cycle transferred).