Timing day-3 vitrification for PGT-M embryos: pre- or post-blastomere biopsy?

J Assist Reprod Genet. 2020 Oct;37(10):2413-2418. doi: 10.1007/s10815-020-01914-3. Epub 2020 Aug 8.

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: Blastomere biopsy; Day-3 biopsy; PGT-M; Pregnancy rate; Preimplantation genetic testing; Vitrification.

MeSH terms

  • Adult
  • Biopsy
  • Blastocyst / metabolism*
  • Blastomeres / metabolism*
  • Blastomeres / physiology
  • Cryopreservation
  • Embryo Culture Techniques / methods
  • Embryo Transfer / methods
  • Female
  • Genetic Testing*
  • Humans
  • Pregnancy
  • Preimplantation Diagnosis / methods*
  • Vitrification