Multiple cryopreservation-warming cycles, coupled with blastocyst biopsy, negatively affect IVF outcomes

REPRODUCTIVE BIOMEDICINE ONLINE

卷:42

Article

Aluko, Ashley^1,2  Vaughan, Denis A.^1,2,3  Modest, Anna M.^1,2  Penzias, Alan S.^1,2,3  Hacker, Michele R.^1,2,4  Thornton, Kim^1,2,3  Sakkas, Denny³ 

[1] Beth Israel Deaconess Med Ctr, Dept Obstet & Gynecol, Boston, MA 02215 USA

[2] Harvard Med Sch, Dept Obstet Gynecol & Reprod Biol, Boston, MA 02115 USA

[3] Boston IVF, Waltham, MA 02451 USA

[4] Harvard TH Chan Sch Publ Hlth, Dept Epidmiol, Boston, MA USA

关键词: Biopsy;    Cryopreservation;    Embryo;    PGT-A;    Vitrification;   

DOI  :  10.1016/j.rbmo.2020.11.019

来源: Elsevier

【 摘 要 】

Research question: Do multiple cryopreservation-warming cycles, coupled with blastocyst biopsy, negatively affect IVF outcomes? Design: Patients undergoing IVF with homologous single embryo transfer, and who underwent trophectoderm biopsy for preimplantation genetic testing for aneuploidy (PGT-A) between 2013 and 2017, were divided into three groups based on degree of embryonic micromanipulation: once-biopsied, once-cryopreserved (group BC, n = 2603), oncebiopsied, twice-cryopreserved (group CBC, n = 95) and twice-biopsied, twice-cryopreserved (group BCBC, n = 15). The primary outcome was live birth; secondary outcomes included positive serum pregnancy test, clinical pregnancy and miscarriage. Results: Group CBC had a significantly lower chance of live birth (adjusted RR 0.57, 95% CI 0.41 to 0.79) and clinical pregnancy (adjusted RR 0.67, 95% CI 0.53 to 0.85) compared with group BC. Miscarriage rates were similar between groups BC and CBC (adjusted RR 1.3, 95% CI 0.64 to 2.7). Conclusions: Multiple cryopreservation-warming cycles, coupled with blastocyst biopsy, negatively affect IVF outcomes. Although PGT-A is thought to improve reproductive outcomes on a per transfer basis, caution must be exercised in counselling patients on the possibility of diminishing returns owing to further embryonic micromanipulation after an embryo has been cryopreserved.

【 授权许可】

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