Moayeri SE, Allen RB, Brewster WR, Kim MH, Porto M, Werlin LB. Day-3 embryo morphology predicts euploidy among older subjects.
Fertil Steril 2007;
89:118-23. [PMID:
17451697 DOI:
10.1016/j.fertnstert.2007.01.169]
[Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2006] [Revised: 01/29/2007] [Accepted: 01/29/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVE
To evaluate whether day-3 embryo morphology predicts euploidy.
DESIGN
Retrospective.
SETTING
Private IVF center.
PATIENT(S)
Subjects (n = 144) undergoing in vitro fertilization and preimplantation genetic diagnosis (PGD).
INTERVENTION(S)
Translate day-3 embryo characteristics into a standardized score.
MAIN OUTCOME MEASURE(S)
Day-3 embryo morphology score and PGD fluorescence in situ hybridization results for chromosomes: 13, 15, 16, 17, 18, 21, 22, X, and Y.
RESULT(S)
Of 1,043 biopsied blastomeres, 67% (n = 696) were chromosomally abnormal. Women with advanced maternal age (AMA) were 1.3 times more likely to have chromosomal errors (95% CI 1.1-1.4) than younger subjects (<38 years old). Morphology predicted PGD results in the AMA group (n = 553), but not in younger women. Fragmentation predicted euploidy in both the younger and the AMA group, but cell number did not.
CONCLUSION(S)
Day-3 embryo morphology selects for euploidy among AMA subjects but not among younger women who may have other factors responsible for embryo dysmorphism. However, cellular fragmentation is a sensitive proxy for selecting chromosomally normal embryos in both age groups. It is unclear that PGD-aneuploidy screening is a better tool for selecting which embryos to transfer than the standard approach of using day-3 embryo features, particularly among older women, a group for whom this technology is targeted.
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