Abstract

PurposeIn a preimplantation genetic diagnosis for aneuploidy (PGD-A) program, the more embryos available for biopsy, consequently increases the chances of obtaining euploid embryos to transfer. The aim was to increase the number of viable euploid blastocysts in patients undergoing PGD-A using fresh oocytes together with previously accumulated vitrified oocytes.MethodsSixty-nine patients with normal ovarian reserve underwent PGD-A for repeated implantation failure or recurrent pregnancy loss indication. After several cycles of ovarian stimulation, 591 accumulated vitrified oocytes and 463 fresh oocytes were micro-injected with the same partner’s semen sample. PGD-A was completed on 134 blastocysts from vitrified/warmed oocytes and 130 blastocysts from fresh oocytes.ResultsA mean of 9.6% euploid blastocyst per micro-injected vitrified/warmed oocytes and 11.4% euploid blastocyst per micro-injected fresh oocyte were obtained (p > 0.05). The euploidy and aneuploidy rates were comparable in blastocysts obtained from micro-injected vitrified/warmed oocytes and fresh oocytes (42.5 versus 40.8% and 57.5 versus 59.2%, p > 0.05). Implantation rates of euploid blastocysts were comparable between the two sources of oocytes (56.0% from vitrified/warmed oocytes versus 60.9% from fresh oocytes, p > 0.05).ConclusionsOocyte vitrification and warming do not generate aneuploidy in blastocysts. The number of viable euploid embryos for transfer can be increased by using accumulated vitrified oocytes together with fresh oocytes in ICSI.Trial registrationNCT02820415 ClinicalTrials.gov

Highlights

  • In in vitro assisted reproduction, the failures in terms of clinical pregnancy and take home baby rate are mainly due to the transfer of embryos with undiagnosed aneuploidies

  • We considered the hypothesis to accumulate vitrified oocytes with a view to increasing the number of oocytes for microinjection and the number of blastocyst to diagnose for patients with normal ovarian reserve and candidate for Preimplantation genetic diagnosis for aneuploidy (PGD-A)

  • The proportion of biopsied blastocysts calculated on MII oocytes at OPU was inferior in vitrified oocytes (138/591, 22.4%) compared to fresh oocytes (135/463, 29.2%, p 0.01)

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Summary

Introduction

In in vitro assisted reproduction, the failures in terms of clinical pregnancy and take home baby rate are mainly due to the transfer of embryos with undiagnosed aneuploidies. Preimplantation genetic diagnosis for aneuploidy (PGD-A) relies on chromosomal profiling of embryos prior to implantation with the aim of transferring in utero only euploid embryos. PGD-A found a field of application in those patient groups with normal karyotypes and the lowest chance of take home baby rate. These patients are grouped in advanced maternal age (AMA), recurrent implantation failure (RIF), recurrent pregnancy loss (RPL), and severe male factor (SMF) [2]. Advances in embryo culture make embryo biopsy applicable at the blastocyst stage

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