Aneuploidy analysis in day 7 human blastocysts produced by in vitro fertilization

Abstract

Background: Human embryos produced by in vitro fertilization (IVF) are usually cultured to day 6 after insemination, and good quality of embryos should develop to blastocyst stage at days 5 and 6. However, some embryos develop slowly, thus they may form blastocysts on day 7. Most IVF laboratories culture embryos to day 6 and then discard retarded embryos that do not develop to blastocyst stage. It has been reported that transfer of day 7 blastocysts can yield pregnancy although the rates were very low. In the present study, we evaluated the prevalence of aneuploidy in day 7 human blastocysts and also assessed embryo implantation after transfer of normal euploid blastocysts developed on day 7.

Methods: Day 7 blastocysts were biopsied and screened for aneuploidy. Embryo implantation was assessed by transferring of euploid blastocysts.

Results: A total of 1966 blastocysts from 367 IVF cycles were biopsied and screened for aneuploidy. It was found that 81.5 % of the patients had days 5 and 6 blastocysts and 18.5 % (68) patients had blastocysts developed on day 7, including 15.3 % had days 5-7 blastocysts and 3.3 % had only day 7 blastocysts. A total of 151 day 7 blastocysts, which accounted for 7.7 % of total blastocysts, were analyzed. It was found that 36.7 % of the blastocysts were euploid and 63.3 % had abnormal chromosomes, including aneuploidy and euploid with partial chromosome deletion. The aneuploidy rate was also maternal age dependent and was as high as 91.7 % in patients who were ≥40 years old. During the study period, transfer of day 7 euploid blastocysts in 15 patients resulted in 2 healthy live births.

Conclusion(s): Aneuploidy rates in day 7 human blastocysts produced by IVF are very high. However, good euploid blastocysts have potential to implant and transfer of day 7 euploid blastocysts can result in healthy live birth. It is suggested that day 7 blastocyst culture may be necessary in patients who need aneuploidy screening.

Keywords: Aneuploidy; Delayed blastocyst; Implantation; PGS.

Fig. 1

Diagraph of patient population, blastocyst development and embryo transfer (FET). Patients were grouped based on day 5/6 blastocyst, day 5–7 blastocyst and only day 7 blastocyst formation. Aneuploidy was analyzed only in day 7 blastocysts and clinical outcome was also analyzed based on day 7 euploid blastocyst transfer

Fig. 2

Abnormal day 7 blastocysts formation in patients at various maternal ages. Numbers in the top of each bar indicate the numbers of aneuploid blastocysts vs total number of blastocysts biopsied and screened