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Al Hashimi, Balsam; Harvey, Simon; Harvey, Katie; Linara-Demakakou, Elena; Raikundalia, Bhavna; Green, Orla; Griffin, Darren; Ahuja, Kamal and Macklon, Nick
(2024).
DOI: https://doi.org/10.1016/j.rbmo.2024.104595
Abstract
Research question: Are some non-2PN zygotes normally fertilised, euploid and thus available for transfer?
Design: Retrospective cohort study on patient data from 1,214 PGT-A cycles a single private IVF clinic. 152 non-2PN embryos were assessed by PGT-A with parent of origin assessment and were compared to 4,822 2PN embryos assessed by PGT-A. Transfer outcomes of euploid embryos were then compared.
Results: Over 40% of the tested non-2PN embryos were euploid. The 152 non-2PN (88 ICSI; 64 IVF), embryos were 2 x 0PN, 50 x 1PN, 24 x 2.1PN, 65 x 3PN, 9 x 4PN and 2 x 5PN. Of 4,822 2PN embryos, 4,737 (98.2%) were diploid, 1.4% polyploid and 0.4% haploid. Embryos resulting from 1PN zygotes were more likely to be haploid. Embryos resulting from 3PN and 4PN zygotes were more likely to be polyploid (p < 0.001). 44/88 (50%) ICSI embryos were either haploid or polyploid; this was significantly higher than those derived from IVF (16/64, 25%, p = 0.004). Maternal origin of polyploidy was more common in ICSI cases (p = 0.004). 42% of the 90 diploid non-2PN embryos were also euploid, with diploid blastocysts from non-2PN zygotes being as likely to be euploid as those from diploid 2PN zygotes (p = 0.10). 12 euploid 1PN, 2.1PN and 3PN embryos have been transferred. Two ongoing pregnancies and four live births are reported.
Conclusions: This approach extends the use of PGT-A in identifying more embryos available for transfer, has the potential to increase cumulative pregnancy rates and questions the value of the fertilisation check.
CORE (COnnecting REpositories)
CORE (COnnecting REpositories)
