TROPHECTODERM BIOPSY PRIOR TO AUTOLOGOUS FROZEN BLASTOCYST TRANSFER IS NOT ASSOCIATED WITH ADVERSE OBSTETRICAL OUTCOMES

Abstract

To determine if trophectoderm biopsy prior to autologous frozen blastocyst transfer is associated with gestational age at delivery, birth weight, or cesarean rate in ongoing singleton gestations. retrospective cohort study We identified all patients at a university-affiliated center that had viable singleton gestations after autologous frozen blastocyst transfers from January 2016 through December 2018. Obstetrical outcomes of 67 viable singleton pregnancies after blastocyst trophectoderm biopsy for preimplantation genetic testing (PGT) with next generation sequencing were compared to 78 viable singleton pregnancies from unbiopsied frozen blastocysts. All transfers occurred in programmed frozen transfer cycles. Cycles that utilized a gestational carrier, donor oocytes, or frozen oocytes were excluded. Primary outcomes included gestational age at delivery, birth weight, and cesarean rate. The study had 80% power at a significance level of 0.05 to detect a 4-day difference in median gestational age at delivery, 300-gram difference in median birth weight, and 20% difference in cesarean rate. Secondary outcomes included preterm delivery, low birth weight, and birth weight over 4000 grams. There were no significant differences between the two groups in terms of maternal age, BMI, or ethnicity. There were no differences in the PGT cohort compared to the reference cohort for median gestational age at delivery, median birth weight, cesarean rate, preterm delivery rate, rate of low birth weight, or rate of birth weight over 4000 grams (Table). There were no differences in the primary outcomes for subgroup analysis based on fetal sex, single embryo transfer, nulligravid, and no history of prior term birth. Trophectoderm biopsy prior to frozen blastocyst transfer is not associated with adverse obstetrical outcomes related to gestational age at delivery, birth weight, or cesarean rate.Tabled 1No PGT (ref) n = 78PGT n = 67RR (95% CI)P valueDemographics and baseline characteristicsMaternal age (SD)35.6 (4.3)35.8 (3.7)0.77Maternal BMI kg/m2 (SD)24.5 (5.4)24.0 (5.2)0.59Number of embryos transferred1.6 (0.6)1.2 (0.4)< 0.01Prior preterm birth4 (5%)2 (3%)0.69OutcomesCesarean delivery34 (44%)34 (51%)1.16 (0.82-1.64)0.41Birth weight in grams3430 [3033, 3714]3420 [3050, 3799]0.97Birth weight >4000g6 (8%)9 (13%)1.75 (0.66-4.65)0.29Low birth weight, <2500g7 (9%)8 (12%)1.33 (0.51-3.48)0.59Gestational age in weeks39.4 [39.0, 40.4]39.4 [39.0, 40.3]0.80Delivery prior to 37 weeks6 (8%)8 (12%)1.55 (0.57-4.25)0.41Delivery prior to 34 weeks1 (1%)1 (1%)1.16 (0.07-18.3)1.00Data are reported as mean (SD), median [IQR] or n (%). Open table in a new tab