Significant improvement in pregnancy rates following frozen embryo transfers when combined with microarray-comparative genomic hybridization (aCGH)

Abstract

ObjectiveThere is a growing body of evidence that embryo transfer (ET) of vitrified blastocysts in an unstimulated cycle improves implantation rates due to a more receptive uterine environment. Evidence is also growing that 24-chromosome screening to select euploid embryos improves implantation rates. This study looks at the effect of combining these two procedures on pregnancy rates by comparing outcomes of fresh versus warmed transfers of blastocysts that were screened by aCGH and those that were not.DesignRetrospective data analysis at a private fertility clinic.Materials and Methods827 sequential, non-randomized, ET's performed over 11-months during 2012 – 2013 were evaluated. Fresh ET was performed at the blastocyst stage on patients with a mean age of 34.8 years. Warmed ET was performed in unstimulated cycles after blastocysts were vitrified then individually warmed using the Cryotop® method (Kitazato). Trophectoderm biopsy followed by aCGH testing (Reprogenetics) was performed on Day 5 or 6 on patients with a mean age of 38.6 years.ResultsSignificant improvement in clinical pregnancy (CP) was demonstrated in all warmed ETs following aCGH testing (∗p<0.0216). A trend in CP increase was found for both: warmed ET vs. fresh ET without testing (^p<0.0858) and for warmed ET vs. fresh ET following aCGH testing (#p<0.0520).ConclusionSignificant improvement in clinical pregnancy rates may be obtained by taking advantage of the ability of A) blastocysts to survive trophectoderm biopsy for aCGH testing, B) vitrification/warming methodology being successfully applied to biopsied blastocysts, and C) for warmed, euploid embryos to be transferred into an unstimulated uterine environment that is more receptive to embryo implantation. ObjectiveThere is a growing body of evidence that embryo transfer (ET) of vitrified blastocysts in an unstimulated cycle improves implantation rates due to a more receptive uterine environment. Evidence is also growing that 24-chromosome screening to select euploid embryos improves implantation rates. This study looks at the effect of combining these two procedures on pregnancy rates by comparing outcomes of fresh versus warmed transfers of blastocysts that were screened by aCGH and those that were not. There is a growing body of evidence that embryo transfer (ET) of vitrified blastocysts in an unstimulated cycle improves implantation rates due to a more receptive uterine environment. Evidence is also growing that 24-chromosome screening to select euploid embryos improves implantation rates. This study looks at the effect of combining these two procedures on pregnancy rates by comparing outcomes of fresh versus warmed transfers of blastocysts that were screened by aCGH and those that were not. DesignRetrospective data analysis at a private fertility clinic. Retrospective data analysis at a private fertility clinic. Materials and Methods827 sequential, non-randomized, ET's performed over 11-months during 2012 – 2013 were evaluated. Fresh ET was performed at the blastocyst stage on patients with a mean age of 34.8 years. Warmed ET was performed in unstimulated cycles after blastocysts were vitrified then individually warmed using the Cryotop® method (Kitazato). Trophectoderm biopsy followed by aCGH testing (Reprogenetics) was performed on Day 5 or 6 on patients with a mean age of 38.6 years. 827 sequential, non-randomized, ET's performed over 11-months during 2012 – 2013 were evaluated. Fresh ET was performed at the blastocyst stage on patients with a mean age of 34.8 years. Warmed ET was performed in unstimulated cycles after blastocysts were vitrified then individually warmed using the Cryotop® method (Kitazato). Trophectoderm biopsy followed by aCGH testing (Reprogenetics) was performed on Day 5 or 6 on patients with a mean age of 38.6 years. ResultsSignificant improvement in clinical pregnancy (CP) was demonstrated in all warmed ETs following aCGH testing (∗p<0.0216). A trend in CP increase was found for both: warmed ET vs. fresh ET without testing (^p<0.0858) and for warmed ET vs. fresh ET following aCGH testing (#p<0.0520). Significant improvement in clinical pregnancy (CP) was demonstrated in all warmed ETs following aCGH testing (∗p<0.0216). A trend in CP increase was found for both: warmed ET vs. fresh ET without testing (^p<0.0858) and for warmed ET vs. fresh ET following aCGH testing (#p<0.0520). ConclusionSignificant improvement in clinical pregnancy rates may be obtained by taking advantage of the ability of A) blastocysts to survive trophectoderm biopsy for aCGH testing, B) vitrification/warming methodology being successfully applied to biopsied blastocysts, and C) for warmed, euploid embryos to be transferred into an unstimulated uterine environment that is more receptive to embryo implantation. Significant improvement in clinical pregnancy rates may be obtained by taking advantage of the ability of A) blastocysts to survive trophectoderm biopsy for aCGH testing, B) vitrification/warming methodology being successfully applied to biopsied blastocysts, and C) for warmed, euploid embryos to be transferred into an unstimulated uterine environment that is more receptive to embryo implantation.