Abstract

ObjectiveTo evaluate whether trophectoderm (TE) biopsy differentially influence the level of serum β-human chorionic gonadotropin (β-hCG) with different TE-scored blastocysts transferred in early pregnancy.MethodsThis retrospective cohort study contained 7847 single-blastocyst transfer cycles executed between January 2019 and June 2020, including 2657 preimplantation genetic testing (PGT) cycles and 5190 in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) cycles. All cycles were classified into biopsy and control groups, and further stratified based on the TE morphological scores into three subgroups: grades A, B, and C for TE scores, respectively. Intra-group and inter-group analyses were performed on serum β-hCG levels on the 12th day after blastocyst transfer (HCG12), and obstetric and neonatal outcomes.ResultsFor cycles with a live birth, in grade A TE score subgroups, the HCG12 level did not exhibit statistical significance between the control and biopsy groups after adjustment (769 mIU/mL vs. 753 mIU/mL, P=0.631). In contrast, in grade B and C TE score subgroups, the control group showed a significantly higher level of HCG12 relative to the biopsy group (690 mIU/mL vs. 649 mIU/mL, P=0.001; 586 mIU/mL vs. 509 mIU/mL, P<0.001, respectively). We observed no statistically significant differences in obvious adverse obstetric and neonatal outcomes between the same TE-score subgroups of the biopsy group and control group.ConclusionsWhile blastocysts with higher TE grades produced higher serum β-hCG levels in early pregnancy, TE biopsy might exert a negative impact on serum β-hCG levels by blastocysts with a grade-B TE score and below. TE biopsy did not increase the risk for adverse obstetric and neonatal outcomes.

Highlights

  • Preimplantation genetic testing (PGT) is an assisted reproductive technology (ART) procedure that is used to investigate the genetic differences in embryos produced in vitro fertilization (IVF) or IVF in combination with intracytoplasmic sperm injection (ICSI) [1], and is carried out for selecting genetically normal transferable embryos so as to improve live-birth rates (LBRs) with IVF [2, 3]

  • We investigated whether TE biopsy differentially influenced the levels of serum b-Human chorionic gonadotropin (hCG) produced by embryos with different embryonic TE scores in early pregnancy, and assessed whether biopsy would affect certain obstetrical and neonatal outcomes

  • More studies have focused on the safety of use of embryo biopsy and its impact on obstetric and neonatal outcomes, and regarded serum b-hCG as a good evaluation indicator of influence resulting from biopsy

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Summary

Introduction

Preimplantation genetic testing (PGT) is an assisted reproductive technology (ART) procedure that is used to investigate the genetic differences in embryos produced in vitro fertilization (IVF) or IVF in combination with intracytoplasmic sperm injection (ICSI) [1], and is carried out for selecting genetically normal transferable embryos so as to improve live-birth rates (LBRs) with IVF [2, 3]. TE biopsy involves removing several TE cells at the blastocyst stage; this technique has undergone a long history of development [4]. TE biopsy, an invasive manipulation, is increasingly used in clinical practice, but the assessment of potential long-term safety concerns on humans is currently inadequate, it is imperative and advisable to evaluate the potential impact of this modality [5]. Human chorionic gonadotropin (hCG), a heterodimeric glycoprotein composed of alpha and beta subunits [6], is the most important early embryo-derived signal and plays a pivotal role in implantation [7]. It exerts autocrine regulation of trophoblast invasion [8–10] as well as paracrine control of the endometrial environment to support embryo attachment and implantation [11]. Serum b-hCG can be detected in maternal blood about one week after fertilization and is often regarded as a signal of maternal recognition of pregnancy [7, 12]; it is applied to prospectively distinguish viable pregnancies from ectopic pregnancies and spontaneous abortions [13]

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