Transfer the Best and Biopsy the Rest? Blastocyst Euploidy Rates Differ by Morphology and Day of Biopsy

Overview

Journal Arch Gynecol Obstet

Specialty Gynecology & Obstetrics

Date 2020 Aug 19

PMID 32808112

Citations 5

Authors

Katherine E McDaniel

Michael S Awadalla

Lynda K McGinnis

Ali Ahmady

Affiliations

Soon will be listed here.

Abstract

Purpose: To determine if blastocyst euploidy rates differ by embryo morphology or day of biopsy.

Methods: We performed a retrospective analysis of euploidy rates based on patient age, overall embryo morphology grade (good, fair, or poor), and day of biopsy (days 5, 6, or 7) for blastocysts undergoing preimplantation genetic testing for aneuploidy (PGT-A). Our primary analysis included 904 embryos from oocytes age 33-39 years at retrieval.

Results: In our primary analysis, euploidy rates were higher for good quality embryos than poor (64% vs. 48%, p < 0.01) and for fair quality embryos than poor (61% vs. 48%, p < 0.01). There was no significant difference in the euploidy rate between good and fair quality embryos (64% vs. 61%, p = 0.56). Embryos biopsied on day 5 were more likely to be euploid than embryos biopsied on day 6 (59% vs. 50%, p < 0.01) or day 7 (59% vs. 37%, p < 0.01). There was no significant difference in the euploidy rate between day 6 and day 7 embryos (50% vs. 37%, p = 0.07).

Conclusion: PGT-A may be more useful in cycles where a lower euploidy rate is expected based on age at oocyte retrieval, embryo morphology, and day of biopsy. There may be little benefit to biopsy of embryos with a high euploidy rate. Young patients with one or more good quality day 5 embryos may benefit from a "transfer the best fresh and biopsy the rest" strategy.

Citing Articles

Effect of Blastocyst Morphology and Developmental Rate on Euploidy and Live Birth Rates in PGT-A Cycles: A Retrospective Cohort Study.

Chen X, Fan Y, Ji H, Zhou L, Wu X, Wei Y Reprod Sci. 2025; .

PMID: 39982651 DOI: 10.1007/s43032-025-01818-6.

Preimplantation genetic testing for aneuploidy: predictive embryonic factors.

Florensa M, Cladellas A, Ballesteros A, Esbert M J Assist Reprod Genet. 2024; 41(5):1329-1339.

PMID: 38386119 PMC: 11143088. DOI: 10.1007/s10815-024-03061-5.

Comparison of aneuploidy rate in spontaneous abortion chorionic villus between D6 and D5 thawed-frozen blastocyst transfer.

Zhao W, Chen P, Liu X, Li Y, Liang X, Li J BMC Pregnancy Childbirth. 2023; 23(1):130.

PMID: 36855078 PMC: 9972745. DOI: 10.1186/s12884-023-05452-5.

Effect of trophectoderm biopsy for PGT-A on live birth rate per embryo in good prognosis patients.

Awadalla M, Agarwal R, Ho J, McGinnis L, Ahmady A Arch Gynecol Obstet. 2022; 306(4):1321-1327.

PMID: 35821525 PMC: 9470687. DOI: 10.1007/s00404-022-06679-x.

Comparison of day 5 blastocyst with day 6 blastocyst: Evidence from NGS-based PGT-A results.

Tong J, Niu Y, Wan A, Zhang T J Assist Reprod Genet. 2022; 39(2):369-377.

PMID: 35013836 PMC: 8956767. DOI: 10.1007/s10815-022-02397-0.

References

Minasi M, Colasante A, Riccio T, Ruberti A, Casciani V, Scarselli F . Correlation between aneuploidy, standard morphology evaluation and morphokinetic development in 1730 biopsied blastocysts: a consecutive case series study. Hum Reprod. 2016; 31(10):2245-54. DOI: 10.1093/humrep/dew183. 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

Vernon M, Stern J, Ball G, Wininger D, Mayer J, Racowsky C . Utility of the national embryo morphology data collection by the Society for Assisted Reproductive Technologies (SART): correlation between day-3 morphology grade and live-birth outcome. Fertil Steril. 2011; 95(8):2761-3. DOI: 10.1016/j.fertnstert.2011.02.008. View

Luke B, Brown M, Stern J, Jindal S, Racowsky C, Ball G . Using the Society for Assisted Reproductive Technology Clinic Outcome System morphological measures to predict live birth after assisted reproductive technology. Fertil Steril. 2014; 102(5):1338-44. PMC: 4252875. DOI: 10.1016/j.fertnstert.2014.07.1242. View

Racowsky C, Stern J, Gibbons W, Behr B, Pomeroy K, Biggers J . National collection of embryo morphology data into Society for Assisted Reproductive Technology Clinic Outcomes Reporting System: associations among day 3 cell number, fragmentation and blastomere asymmetry, and live birth rate. Fertil Steril. 2011; 95(6):1985-9. DOI: 10.1016/j.fertnstert.2011.02.009. View

Gardner D, Lane M, Stevens J, Schlenker T, Schoolcraft W . Blastocyst score affects implantation and pregnancy outcome: towards a single blastocyst transfer. Fertil Steril. 2000; 73(6):1155-8. DOI: 10.1016/s0015-0282(00)00518-5. View

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

Ahlstrom A, Westin C, Wikland M, Hardarson T . Prediction of live birth in frozen-thawed single blastocyst transfer cycles by pre-freeze and post-thaw morphology. Hum Reprod. 2013; 28(5):1199-209. DOI: 10.1093/humrep/det054. View

Van den Abbeel E, Balaban B, Ziebe S, Lundin K, Cuesta M, Klein B . Association between blastocyst morphology and outcome of single-blastocyst transfer. Reprod Biomed Online. 2013; 27(4):353-61. DOI: 10.1016/j.rbmo.2013.07.006. View

10.

Haddad G, Deng M, Wang C, Witz C, Williams D, Griffith J . Assessment of aneuploidy formation in human blastocysts resulting from donated eggs and the necessity of the embryos for aneuploidy screening. J Assist Reprod Genet. 2015; 32(6):999-1006. PMC: 4491073. DOI: 10.1007/s10815-015-0492-4. View

11.

Masbou A, Friedenthal J, McCulloh D, McCaffrey C, Fino M, Grifo J . A Comparison of Pregnancy Outcomes in Patients Undergoing Donor Egg Single Embryo Transfers With and Without Preimplantation Genetic Testing. Reprod Sci. 2018; 26(12):1661-1665. DOI: 10.1177/1933719118820474. View

12.

Capalbo A, Rienzi L, Cimadomo D, Maggiulli R, Elliott T, Wright G . Correlation between standard blastocyst morphology, euploidy and implantation: an observational study in two centers involving 956 screened blastocysts. Hum Reprod. 2014; 29(6):1173-81. DOI: 10.1093/humrep/deu033. View

13.

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

14.

Tiegs A, Sun L, Patounakis G, Scott R . Worth the wait? Day 7 blastocysts have lower euploidy rates but similar sustained implantation rates as Day 5 and Day 6 blastocysts. Hum Reprod. 2019; 34(9):1632-1639. DOI: 10.1093/humrep/dez138. View

15.

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

16.

Reig A, Franasiak J, Scott Jr R, Seli E . The impact of age beyond ploidy: outcome data from 8175 euploid single embryo transfers. J Assist Reprod Genet. 2020; 37(3):595-602. PMC: 7125286. DOI: 10.1007/s10815-020-01739-0. View

17.

Racowsky C, Vernon M, Mayer J, Ball G, Behr B, Pomeroy K . Standardization of grading embryo morphology. J Assist Reprod Genet. 2010; 27(8):437-9. PMC: 2941588. DOI: 10.1007/s10815-010-9443-2. View

18.

Goto S, Kadowaki T, Tanaka S, Hashimoto H, Kokeguchi S, Shiotani M . Prediction of pregnancy rate by blastocyst morphological score and age, based on 1,488 single frozen-thawed blastocyst transfer cycles. Fertil Steril. 2010; 95(3):948-52. DOI: 10.1016/j.fertnstert.2010.06.067. View

19.

Bouillon C, Celton N, Kassem S, Frapsauce C, Guerif F . Obstetric and perinatal outcomes of singletons after single blastocyst transfer: is there any difference according to blastocyst morphology?. Reprod Biomed Online. 2017; 35(2):197-207. DOI: 10.1016/j.rbmo.2017.04.009. View

20.

Wang A, Kort J, Behr B, Westphal L . Euploidy in relation to blastocyst sex and morphology. J Assist Reprod Genet. 2018; 35(9):1565-1572. PMC: 6133810. DOI: 10.1007/s10815-018-1262-x. View