Number of biopsied trophectoderm cells is likely to affect the implantation potential of blastocysts with poor trophectoderm quality

Capsule:
We found that the implantation potential is negatively affected by the biopsied cell number in blastocysts with poor trophectoderm morphological score.

Authors:
Shuoping Zhang, M.Sc., Keli Luo, M.D., Ph.D., Dehua Cheng, M.Sc., Yueqiu Tan, Ph.D., Changfu Lu, Ph.D., Hui He, M.Sc., Yifan Gu, Ph.D., Guangxiu Lu, M.D., Fei Gong, M.D., Ph.D., Ge Lin, M.D., Ph.D.

Volume 105, Issue 5, Pages 1222-1227

Abstract:

Objective:
To evaluate whether the developmental potential of the blastocyst is affected by the number of trophectoderm (TE) cells biopsied in preimplantation genetic diagnosis (PGD) cycles.

Design:
Retrospective study.

Setting:
University-affiliated center.

Patient(s):
Women underwent PGD cycles of blastocyst biopsy and fluorescence in situ hybridization analysis.

Intervention(s):
Not applicable.

Main Outcome Measure(s):
Biopsied TE cell number of blastocysts, survival, and implantation rates.

Result(s):
The biopsied TE cell number was affected by the TE quality and experience of different embryologists. The diagnostic efficiency increased when from one to five cells were biopsied (86.7%, 91.7%%, 96.0%, 96.8%, to 98.7%) and was maximized when more than six cells were biopsied. To compare the clinical efficiencies, blastocysts were divided into four groups according to biopsied TE cell number: 1–5, 6–10, 11–15, and 16–41. For the blastocysts with grade A TE score, no significant difference was observed in the survival and implantation rates among the four groups. For the blastocysts with grades B and C TE scores, the survival rates showed no significant differences among the four groups, but a significant decreasing trend in implantation rates was observed with increasing biopsied TE cell number.

Conclusion(s):
The implantation potential is negatively affected by the biopsied TE cell number in blastocysts with poor TE morphological score.

  • Daniel J. Kaser, MD

    Dear Dr. Zhang and colleagues,

    Congratulations on your work, in which your group nicely illustrates an inverse association between increasing cell number on TE biopsy and implantation rate in embryos with a B or C quality trophectoderm. As the number of cells biopsied was also related to embryologist experience, what implications does your work have with respect to training and certifying embryologists in blastocyst biopsy? In labs that do not use FISH, how best to quantify in real-time the number of cells removed given the observed relationship?

    Thanks very much for your comments.

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