The nature of aneuploidy with increasing age of the female partner a review of 15169 consecutive trophectoderm biopsies evaluated with comprehensive chromosomal screening

Capsule:
The lowest aneuploidy risk is between ages 26–30, with higher prevalences in younger and older women, and 67% involve a single chromosome,with the ratio of trisomies/monosomies approximating 1.

Authors:
Jason Franasiak, M.D., Eric J. Forman, M.D., Kathleen H. Hong, M.D., Marie D. Werner, M.D., Kathleen M. Upham, B.S., Nathan R. Treff, Ph.D., Richard T. Scott, M.D.

Volume 101, Issue 3, Pages 656-663.e1, March 2014

Abstract:

Objective:
To determine the relationship between the age of the female partner and the prevalence and nature of human embryonic aneuploidy.

Design:
Retrospective.

Setting:
Academic.

Patient(s):
Trophectoderm biopsies.

Intervention(s):
Comprehensive chromosomal screening performed on patients with blastocysts available for biopsy.

Main Outcome Measure(s):
Evaluation of the impact of maternal age on the prevalence of aneuploidy, the probability of having no euploid embryos within a cohort, the complexity of aneuploidy as gauged by the number of aneuploid chromosomes, and the trisomy/monosomy ratio.

Result(s):
Aneuploidy increased predictably after 26 years of age. A slightly increased prevalence was noted at younger ages, with >40% aneuploidy in women 23 years and under. The no euploid embryo rate was lowest (2% to 6%) in women aged 26 to 37, was 33% at age 42, and was 53% at age 44. Among the biopsies with aneuploidy, 64% involved a single chromosome, 20% two chromosomes, and 16% three chromosomes, with the proportion of more complex aneuploidy increasing with age. Finally, the trisomy/monosomy ratio approximated 1 and increased minimally with age.

Conclusion(s):
The lowest risk for embryonic aneuploidy was between ages 26 and 30. Both younger and older age groups had higher rates of aneuploidy and an increased risk for more complex aneuploidies. The overall risk did not measurably change after age 43. Trisomies and monosomies are equally prevalent.

  • Daniel Kenigsberg

    Great contribution for data on euploidy/anneuploidy. How many IVF cycles (stimulations, retrievals, fertilizations and embryo cultures) were required to produce 3392 cycles for analysis? Since there is attrition at every step, this is crucial information for patient counselling. Most important would be the number of cycles where no embryos (day 1-6 of culture) achieve sufficient blastocyst grade for trophectoderm biopsy. In addition, do you have the outcomes of those treatments (or were they all no embryo transfer)? Many thanks to the authors for this impressive paper and this information.

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