Hashimi, Balsam Al, Harvey, Simon ORCID: 0000-0002-7504-2227 , Harvey, Katie, Linara-Demakakou, Elena, Raikundalia, Bhavna, Green, Orla, Griffin, Darren, Ahuja, Kamal and Macklon, Nick (2024) Reassessing the conventional fertilisation check: leveraging PGT-A to increase the number of transferrable embryos. Reproductive Biomedicine Online (RBMO). ISSN 1472-6483 (Print), 1472-6491 (Online) (doi:https://doi.org/10.1016/j.rbmo.2024.104595)

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Abstract

Research question
Are some non-2PN zygotes normally fertilised, euploid and thus available for transfer?

Design
Retrospective cohort study on patient data from 1,214 PGT-A cycles a single private IVF clinic. 152 non-2PN embryos were assessed by PGT-A with parent of origin assessment and were compared to 4,822 2PN embryos assessed by PGT-A. Transfer outcomes of euploid embryos were then compared.

Results
Over 40% of the tested non-2PN embryos were euploid. The 152 non-2PN (88 ICSI; 64 IVF), embryos were 2 × 0PN, 50 × 1PN, 24 × 2.1PN, 65 × 3PN, 9 × 4PN and 2 × 5PN. Of 4,822 2PN embryos, 4,737 (98.2%) were diploid, 1.4% polyploid and 0.4% haploid. Embryos resulting from 1PN zygotes were more likely to be haploid. Embryos resulting from 3PN and 4PN zygotes were more likely to be polyploid (p < 0.001). 44/88 (50%) ICSI embryos were either haploid or polyploid; this was significantly higher than those derived from IVF (16/64, 25%, p = 0.004). Maternal origin of polyploidy was more common in ICSI cases (p = 0.004). 42% of the 90 diploid non-2PN embryos were also euploid, with diploid blastocysts from non-2PN zygotes being as likely to be euploid as those from diploid 2PN zygotes (p = 0.10). 12 euploid 1PN, 2.1PN and 3PN embryos have been transferred. Two ongoing pregnancies and four live births are reported.

Conclusions
This approach extends the use of PGT-A in identifying more embryos available for transfer, has the potential to increase cumulative pregnancy rates and questions the value of the fertilisation check.

Item Type:	Article
Uncontrolled Keywords:	abnormal fertilisation, embryo, euploid, pronuclei, zygote
Subjects:	Q Science > QM Human anatomy Q Science > QP Physiology R Medicine > RG Gynecology and obstetrics
Faculty / School / Research Centre / Research Group:	Faculty of Engineering & Science Faculty of Engineering & Science > School of Science (SCI)
Last Modified:	30 Oct 2024 16:06
URI:	http://gala.gre.ac.uk/id/eprint/48445

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