Oocyte vitrification does not increase the risk of embryonic aneuploidy or diminish the implantation potential of blastocysts created after intracytoplasmic sperm injection: a novel, paired randomized controlled trial using DNA fingerprinting

Capsule:
Using a novel, paired study design, this RCT demonstrates that blastocysts derived from previously vitrified oocytes are not at an increased risk of aneuploidy and have equivalent reproductive potential.

Authors:
Eric J. Forman, M.D., Xinying Li, Ph.D., Kathleen M. Ferry, B.S., Katherine Scott, M.S., Nathan R. Treff, Ph.D., Richard T. Scott Jr., M.D.

Volume 98, Issue 3, Pages 644-649, September 2012

Abstract:

Objective:
To assess the impact of oocyte vitrification on aneuploidy and reproductive potential by comparing vitrified and control oocytes from a single patient within a single cycle and a single fresh transfer.

Design:
Paired RCT in which each patient’s cohort of mature oocytes was divided into two even groups with half undergoing Cryotop vitrification and rapid warming, and half serving as controls.

Setting:
Academic center for reproductive medicine.

Patient(s):
Forty-four patients with a mean age of 29.9 ± 2.3 years and normal ovarian reserve.

Intervention(s):
Cryotop vitrification of half of mature oocytes. Trophectoderm biopsy with SNP microarray analysis for ploidy and DNA fingerprinting.

Main Outcome Measure(s):
Rate of aneuploidy (primary outcome), fertilization, cleavage, blastulation and implantation in embryos derived from vitrified and control oocytes.

Results:
A total of 588 mature oocytes were randomized with 240/294 (81.6%) surviving vitrification. Amongst surviving vitrified oocytes, there was a lower fertilization rate with ICSI (77.9% vs. 90.5%, RR 0.86, 95% CI 0.80-0.93, P

Conclusions:
Although the IVF process is less efficient following oocyte vitrification, implantation rates are equivalent and there is not an increased risk of aneuploidy. Given the lack of other viable options, this study provides great reassurance to patients and clinicians applying oocyte vitrification for fertility preservation.

Support:
Reproductive Medicine Associates of New Jersey

ClinicalTrials.gov Identifier:
NCT01223118

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