To assess D5 and 6 ploidy and cell numbers in some embryos donated to research that reached post-compaction and were diagnosed as abnormal by Day 3 FISH results. The purpose of this study was not to determine the error rate of PGD, which can only be accomplished by reanalysis of all abnormal embryos, and not only those reaching blastocyst, but to determine if morphology can help detect those errors. Cross-sectional analysis. Some embryos reported as abnormal by Day 3 single blastomere FISH, which reached various post-compaction developmental stages by days 5-6, were frozen. Those which survived freeze-thaw and underwent uneventful nuclear fixation were analysed (N=23). FISH analyses involved chromosomes X,Y,13,15,16,17,18,21,22 and were performed at Reprogenetics, N.J. Day 5 or 6 embryos with <28% abnormal cells were classified as minimal mosaics; mean cell number/embryo was 79.5±44.6 (range:10-230 cells). Of the embryos reported by Day 3 PGD as abnormal, 23 reached day 5 or 6 and survived thawing. Of those, 8 developed into blastocysts with ≥90cells. For embryos classified by PGD as monosomies other than X and 21, the proportion forming blastocysts with ≥90 cells was 2/5. Of those two, one was a minimal mosaic and the other an extensive mosaic with most cells abnormal. Average number of cells for Day 5/6 Extensive Mosaic, Minimal Mosaic, Monosomy X or 21, other monosomies and Trisomy embryos was 78, 87.3, 75, 10, and 64.5, respectively. The frequency of chromosome anomalies and number of Day 5/6 embryos reaching ≥90cells as compared to Day 3 FISH findings is shown in the Table.Tabled 1 This approach does not provide the error rate of PGD since only blastocysts were reanalysed and not arrested embryos. It is well known (Sandalinas et al. 2001) that some abnormalities survive less often to blastocyst than normal embryos, thus the population here has been enriched with normal embryos.These findings indicate that the majority of embryos reaching blastocyst stage previously classified by Day 3 PGD as complex, trisomy or monosomy X or 21 were abnormal. Their average numbers of cells did not differ from normal embryos. In contrast, the few monosomies other than X and 21 reaching blastocyst were not monosomies but extensive mosaics or minimal mosaics. We suggest that for those embryos, a blastocyst biopsy could be considered and if confirmed normal, replaced.
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