Euploidy in Relation to Blastocyst Sex and Morphology

Overview

Journal J Assist Reprod Genet

Publisher Springer

Specialties Genetics
Reproductive Medicine

Date 2018 Jul 22

PMID 30030712

Citations 14

Authors

Ange Wang

Jonathan Kort

Barry Behr

Lynn M Westphal

Affiliations

Soon will be listed here.

Abstract

Purpose: The objective of our study is to assess the relationship of embryo ploidy status in relation to embryo sex, morphological characteristics, and transfer parameters.

Methods: This is a retrospective cohort study at an academic medical center of patients who underwent in vitro fertilization with preimplantation genetic screening (PGS) from 2010 to 2015. Embryos were screened with 24-chromosome preimplantation genetic screening with day 5/6 trophectoderm biopsy. We investigated embryo euploidy in relation to morphology (expansion, inner cell mass, trophectoderm), embryo sex, biopsy day, and blastocyst cohort size. We used multivariate logistic regression to calculate odds ratios of euploidy in relation to these parameters.

Results: A total of 1559 embryos from 316 cycles and 233 patients (mean maternal age = 37.8 ± 4.2 years) were included in the analysis. Six hundred and twenty-eight blastocysts (40.3%) were found to be euploid. Expansion (p < 0.001), inner cell mass (ICM) (p < 0.01), and trophectoderm grade (p < 0.001) were significantly associated with embryo ploidy in bivariate models controlling for maternal age, while embryo sex, biopsy day, and blastocyst cohort size were not associated with embryo ploidy. In a multivariate model, we found that maternal age (p < 0.001), higher grade of expansion (p < 0.01), and better quality trophectoderm (p < 0.001 for A compared to C grade) remained significantly associated with increased embryo euploidy, but ICM grade was no longer significant. Embryo sex was not associated with ploidy status, though male embryos were found to be associated with higher trophectoderm scores (p < 0.02).

Conclusions: This is the largest study to date to investigate PGS-tested embryo sex and ploidy status. While maternal age and some morphological parameters (expansion, trophectoderm grade) are associated with euploidy in our cohort, other parameters such as embryo sex, biopsy day, and cohort size are not. Though embryo sex was not associated with euploidy, male embryos were found to be associated with higher trophectoderm grades. Additional investigation in larger studies is warranted.

Citing Articles

The correlation between blastocyst morphological parameters and chromosomal euploidy, aneuploidy and other chromosomal abnormalities following pre-implantation genetic testing-a single center retrospective study.

Hochberg A, Amoura L, Zhang X, Zhang L, Dahan M, Ao A Arch Gynecol Obstet. 2025; .

PMID: 39878851 DOI: 10.1007/s00404-025-07968-x.

Non-invasively predicting euploidy in human blastocysts via quantitative 3D morphology measurement: a retrospective cohort study.

Shan G, Abdalla K, Liu H, Dai C, Tan J, Law J Reprod Biol Endocrinol. 2024; 22(1):132.

PMID: 39468586 PMC: 11514912. DOI: 10.1186/s12958-024-01302-x.

Comparison of early and fully expanded blastocysts on pregnancy and birth outcomes in patients with fresh IVF/ICSI cycles: A retrospective cohort study.

Pan X, Zhou Y, Shen L PLoS One. 2024; 19(8):e0308130.

PMID: 39208283 PMC: 11361670. DOI: 10.1371/journal.pone.0308130.

Culture media affect sex after IVF treatment-a detailed analysis of explanatory variables.

Guldager T, Gabrielsen A, Iversen L, Kirkegaard K J Assist Reprod Genet. 2024; 41(5):1181-1191.

PMID: 38472564 PMC: 11143141. DOI: 10.1007/s10815-024-03081-1.

Factors affecting male-to-female ratio at birth in frozen-thawed embryo transfer cycles: a large retrospective cohort study.

Du T, Xie Q, Ye J, Wang X, Qiu J, Yan Z Front Endocrinol (Lausanne). 2023; 14:1188433.

PMID: 37800141 PMC: 10548202. DOI: 10.3389/fendo.2023.1188433.

References

Ahlstrom A, Westin C, Reismer E, Wikland M, Hardarson T . Trophectoderm morphology: an important parameter for predicting live birth after single blastocyst transfer. Hum Reprod. 2011; 26(12):3289-96. DOI: 10.1093/humrep/der325. View

Marquez C, Sandalinas M, Bahce M, Alikani M, Munne S . Chromosome abnormalities in 1255 cleavage-stage human embryos. Reprod Biomed Online. 2003; 1(1):17-26. DOI: 10.1016/s1472-6483(10)61988-8. View

Irani M, Reichman D, Robles A, Melnick A, Davis O, Zaninovic N . Morphologic grading of euploid blastocysts influences implantation and ongoing pregnancy rates. Fertil Steril. 2017; 107(3):664-670. DOI: 10.1016/j.fertnstert.2016.11.012. View

Chen X, Zhang J, Wu X, Cao S, Zhou L, Wang Y . Trophectoderm morphology predicts outcomes of pregnancy in vitrified-warmed single-blastocyst transfer cycle in a Chinese population. J Assist Reprod Genet. 2014; 31(11):1475-81. PMC: 4389933. DOI: 10.1007/s10815-014-0317-x. View

Fragouli E, Alfarawati S, Spath K, Wells D . Morphological and cytogenetic assessment of cleavage and blastocyst stage embryos. Mol Hum Reprod. 2013; 20(2):117-26. DOI: 10.1093/molehr/gat073. View

Chang H, Lee J, Jee B, Suh C, Kim S . Impact of blastocyst transfer on offspring sex ratio and the monozygotic twinning rate: a systematic review and meta-analysis. Fertil Steril. 2008; 91(6):2381-90. DOI: 10.1016/j.fertnstert.2008.03.066. View

Yang Z, Liu J, Collins G, Salem S, Liu X, Lyle S . Selection of single blastocysts for fresh transfer via standard morphology assessment alone and with array CGH for good prognosis IVF patients: results from a randomized pilot study. Mol Cytogenet. 2012; 5(1):24. PMC: 3403960. DOI: 10.1186/1755-8166-5-24. View

Munne S, Chen S, Colls P, Garrisi J, Zheng X, Cekleniak N . Maternal age, morphology, development and chromosome abnormalities in over 6000 cleavage-stage embryos. Reprod Biomed Online. 2007; 14(5):628-34. DOI: 10.1016/s1472-6483(10)61057-7. View

Franasiak J, Forman E, Hong K, Werner M, Upham K, Treff N . The nature of aneuploidy with increasing age of the female partner: a review of 15,169 consecutive trophectoderm biopsies evaluated with comprehensive chromosomal screening. Fertil Steril. 2013; 101(3):656-663.e1. DOI: 10.1016/j.fertnstert.2013.11.004. View

10.

Moayeri S, Allen R, Brewster W, Kim M, Porto M, Werlin L . Day-3 embryo morphology predicts euploidy among older subjects. Fertil Steril. 2007; 89(1):118-23. DOI: 10.1016/j.fertnstert.2007.01.169. View

11.

Ata B, Kaplan B, Danzer H, Glassner M, Opsahl M, Tan S . Array CGH analysis shows that aneuploidy is not related to the number of embryos generated. Reprod Biomed Online. 2012; 24(6):614-20. DOI: 10.1016/j.rbmo.2012.02.009. View

12.

Eaton J, Hacker M, Barrett C, Thornton K, Penzias A . Influence of embryo sex on development to the blastocyst stage and euploidy. Fertil Steril. 2010; 95(3):936-9. DOI: 10.1016/j.fertnstert.2010.06.063. View

13.

Kausche A, Jones G, Trounson A, Figueiredo F, MacLachlan V, Lolatgis N . Sex ratio and birth weights of infants born as a result of blastocyst transfers compared with early cleavage stage embryo transfers. Fertil Steril. 2001; 76(4):688-93. DOI: 10.1016/s0015-0282(01)02010-6. View

14.

Magli M, Gianaroli L, Ferraretti A, Lappi M, Ruberti A, Farfalli V . Embryo morphology and development are dependent on the chromosomal complement. Fertil Steril. 2006; 87(3):534-41. DOI: 10.1016/j.fertnstert.2006.07.1512. View

15.

Majumdar G, Majumdar A, Verma I, Upadhyaya K . Relationship Between Morphology, Euploidy and Implantation Potential of Cleavage and Blastocyst Stage Embryos. J Hum Reprod Sci. 2017; 10(1):49-57. PMC: 5405648. DOI: 10.4103/0974-1208.204013. View

16.

Thompson S, Onwubalili N, Brown K, Jindal S, McGovern P . Blastocyst expansion score and trophectoderm morphology strongly predict successful clinical pregnancy and live birth following elective single embryo blastocyst transfer (eSET): a national study. J Assist Reprod Genet. 2013; 30(12):1577-81. PMC: 3843172. DOI: 10.1007/s10815-013-0100-4. View

17.

Hill M, Richter K, Heitmann R, Graham J, Tucker M, DeCherney A . Trophectoderm grade predicts outcomes of single-blastocyst transfers. Fertil Steril. 2013; 99(5):1283-1289.e1. DOI: 10.1016/j.fertnstert.2012.12.003. View

18.

Munne S . Chromosome abnormalities and their relationship to morphology and development of human embryos. Reprod Biomed Online. 2006; 12(2):234-53. DOI: 10.1016/s1472-6483(10)60866-8. View

19.

Alfarawati S, Fragouli E, Colls P, Stevens J, Gutierrez-Mateo C, Schoolcraft W . The relationship between blastocyst morphology, chromosomal abnormality, and embryo gender. Fertil Steril. 2010; 95(2):520-4. DOI: 10.1016/j.fertnstert.2010.04.003. View

20.

Munne S, Alikani M, Tomkin G, Grifo J, Cohen J . Embryo morphology, developmental rates, and maternal age are correlated with chromosome abnormalities. Fertil Steril. 1995; 64(2):382-91. View