Euploidy and live birth rates, according to the blastocyst quality in patients with chromosomal translocation undergoing PGT cycles

Abstract

Introduction Blastocyst (BLA) quality has been considered an important predictor of successful pregnancy. Furthermore, Preimplantation Genetic Screening (PGS) has been used for several years with the goal of either improving pregnancy by selecting euploid embryo. As we know, the transmission of unbalanced translocations can cause infertility and miscarriage. So the aim of this study is to assess the correlation with BLA quality and PGS euploidy rate in translocation patients. We also compared the clinical outcomes between female carriers and male carriers. Materials and Methods From May 2014 to December 2017, we performed 61 PGS-IVF cycles in 34 translocation patients. BLA underwent trophectoderm (TE) biopsy on 5 day and 6 day were analyzed using array comparative genomic hybridization (aCGH) (BAC 1440 chip protocol, Macrogen). BLA morphology was evaluated using Gardner classification (inner cell mass and trophectoderm grades of BB or better: good quality (GQ), BC or worse: poor quality (PQ)). In all cases, BLA were vitrified and thawed for embryo transfer and the only single euploid BLA was transferred. Results Mean maternal age (35.6±3.5, female carrier group vs. 35.1±3.3, male carrier group) and paternal age (37.8±4.7, female carrier group vs. 37.4±4.0 male carrier group) showed no significant differences.61 translocation cycles were classified into 41 male carrier group and 20 female carrier group. We identified male carrier group was a high proportion of BLA (61.3%, 171/279) than female carrier group (32.8%, 58/177). In female carrier groups, from 34 BLA, 18.2% (4/22) were euploid in GQ BLA and 8.3% (1/12) were euploid in PQ BLA. In male carrier groups, from 96 BLA, 32.9% (24/73) were euploid in GQ BLA and 8.7% (2/23) were euploid in PQ BLA.After thawing, transferred single euploid BLA were presented high pregnancy (57.1%, 12/21) and live birth rates (42.9%, 9/21).Within the group of female carrier, 1 patient had a 20% (1/5) pregnancy. In male carrier groups, 11 patients had 68.8% (11/16) pregnancy. Until now, 1 baby was delivered in female carrier group (1 female baby, 3.06kg), and 8 babies were delivered in male carrier group (6 female babies and 2 male babies, 3.31±0.38kg). One case is ongoing after 12 weeks of pregnancy in male carrier group. Conclusion Euploidy and live birth rates were significantly higher for the GQ BLA as compared to PQ BLA in chromosomal translocations.Furthermore, this study shows that BLA and GQ euploidy rates were higher in the male carrier group. We also observed that pregnancy rates and live birth rates were higher in the male carrier group. Additionally, only GQ BLA were born.However, there is a limited number of live birth case in a female carrier group. Therefore, we need more studies to optimize this results.