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- W3199068868 abstract "Variability in embryo biopsy techniques have been suggested as a contributor to the significant differences in implantation rates observed across IVF laboratories following euploid frozen embryo transfers (FET). One aspect could be the impact of removing excessive trophectoderm (TE) cells from the developing blastocyst. The aim of this study was to evaluate the association between the number of TE cells removed during embryo biopsy and the developmental competence of the resulting euploid blastocyst. The embryo culture system, embryo biopsy procedure, vitrification and embryo transfer techniques were standardized in the IVF laboratory for all PGT-A cycles. Blastocysts (≥Grade 3BB) were classified according to the number of TE cells biopsied from comparable maternally aged patients: Group A included blastocysts that were warmed, total biopsy of 4-7 cells and re-vitrified before FET (n=430; mean maternal age 37.5 ±5.0 years), while Group B included blastocysts that were warmed, total biopsy of 8-14 cells and re-vitrified before FET (n=106; mean maternal age 37.8 ±3.9 years). Primary outcomes were bhCG values 9 days post embryo transfer, implantation rate with fetal cardiac activity at 6.5 week ultrasound, clinical pregnancy loss and live birth rate (≥38-week gestation). Statistical analysis included Unpaired T-test and Fisher’s Exact test where appropriate, significance at P<0.05. There were no significant associations between the two groups in regards to blastocyst morphology including day of biopsy, blastocyst developmental stage, TE cell numbers, inner cell mass numbers or cryopreservation survival and re-expansion. Endometrial lining (8-12mm) and progesterone (<1.4ng/ml) measurements were recorded a week prior to FET with no significant differences observed between the groups. The number of euploid blastocysts transferred was significantly higher in Group B (A=1.2 ±0.4 vs B=1.3 ±0.5; p=0.033). FET reproductive outcomes revealed a significant decrease in bhCG values (A=81.4% vs B=71.7%; p=0.032) and a trend towards a decrease in implantation with fetal cardiac activity for blastocysts in Group B (A=61.6% vs B=54.6%; ns). Both MAB and live birth rates were significantly altered when a euploid blastocyst underwent total biopsy of 8-14 TE cells compared to only half this number (MAB: A=5.7% vs B=18.3%, p=0.0028; live birth: A=61.4% vs B=46.2%, p=0.0058). This study highlights the significant negative effect on embryonic implantation potential that occurs with the biopsy of excessive TE cells for PGT-A. It appears that this adverse outcome extends throughout gestation with a significant increase observed in pregnancy losses for these blastocysts that have fewer cells at the time of implantation. These results could explain the differing reproductive outcomes reported following euploid embryo transfers in multicenter studies evaluating PGT-A." @default.
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- W3199068868 date "2021-09-01" @default.
- W3199068868 modified "2023-09-30" @default.
- W3199068868 title "REMOVAL OF EXCESSIVE TROPHECTODERM CELLS FOR PGT-A ADVERSELY IMPACTS FET OUTCOMES" @default.
- W3199068868 doi "https://doi.org/10.1016/j.fertnstert.2021.07.501" @default.
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