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. 2021 Mar;42(3):572-578.
doi: 10.1016/j.rbmo.2020.11.019. Epub 2020 Nov 29.

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

Ashley Aluko  1 , Denis A Vaughan  2 , Anna M Modest  1 , Alan S Penzias  3 , Michele R Hacker  4 , Kim Thornton  3 , Denny Sakkas  5
Affiliations

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

Ashley Aluko et al. Reprod Biomed Online. 2021 Mar.

Abstract

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), once-biopsied, 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.

Keywords: Biopsy; Cryopreservation; Embryo; PGT-A; Vitrification.

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Conflict of interest statement

CONFLICT OF INTEREST

No conflicts of interest to declare

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