Timing day-3 vitrification for PGT-M embryos: pre- or post-blastomere biopsy?
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ASSISTED REPRODUCTION TECHNOLOGIES
Timing day-3 vitrification for PGT-M embryos: preor post-blastomere biopsy? Adva Aizer 1,2 & Chen Shimon 1 & Olga Dratviman-Storobinsky 1,2 & Hagit Shani 2,3 & Noa Harel Inbar 3 & Ettie Maman 1,2 & Raoul Orvieto 1,2,4 Received: 16 June 2020 / Accepted: 3 August 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To assess the efficacy and clinical outcomes of preimplantation genetic testing for monogenic diseases (PGT-M), following blastomere biopsy prior or following vitrification. Methods A cohort-historical study of all consecutive patients admitted to IVF in a large tertiary center for PGT-M and PCR cycle from September 2016 to March 2020. Patients were divided into 4 groups: Group A1 consisted of patients undergoing day-3 embryos biopsy followed by a fresh transfer of unaffected embryos. Group A2 consisted of Group A1 patients that their surplus unaffected embryos were vitrified, thawed, and transferred in a subsequent FET cycle. Group B1 consisted of patients that their day-3 embryos were vitrified intact (without biopsy) for a subsequent FET cycle. Later embryos were thawed and underwent blastomere biopsies, and the unaffected embryos were transferred, while the surplus unaffected embryos were re-vitrified for a subsequent FET cycle. Group B2 consisted of Group B1 patients that their surplus unaffected embryos were re-vitrified, thawed, and transferred in a subsequent FET cycle. The laboratory data and clinical results were collected and compared between groups. Results A total of 368 patients underwent 529 PGT-M cycles in our center: 347 with day-3 embryos biopsied before undergoing vitrification (Group A1) and 182 following vitrification and thawing (Group B1). There were no between group differences in embryo survival rate post-thawing, nor the ongoing implantation and pregnancy rates. Conclusion In PGT-M cycles, the timing of embryos vitrification, whether prior or following blastomere biopsy, has no detrimental effect on post-thawing embryo survival rate, nor their potential ongoing implantation and pregnancy rates. Keywords Preimplantation genetic testing . Blastomere biopsy . Vitrification . Pregnancy rate . PGT-M . Day-3 biopsy
Introduction Couples at risk for transmitting a serious genetic disease may benefit from preimplantation genetic testing (PGT), enabling the birth of healthy unaffected offspring [1]. PGT is performed either on oocytes (polar bodies) or cleavage-stage * Adva Aizer [email protected] 1
Department of Obstetrics and Gynecology, Infertility and IVF Unit, Sheba Medical Center, Ramat Gan, Israel
2
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
3
Danek Gertner Institute of Human Genetics, Sheba Medical Center, Ramat Gan, Israel
4
The Tarnesby-Tarnowski Chair for Family Planning and Fertility Regulation, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
(blastomeres) or blastocyst-stage (trophectoderm cells) embryos. According to the European Society of
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