Blastocyst biopsy with comprehensive chromosome screening and fresh embryo transfer significantly increases in vitro fertilization implantation and delivery rates a randomized controlled trial

Capsule:
A randomized controlled trial demonstrates that blastocyst biopsy followed by rapid quantitative real-time polymerase chain reaction–based comprehensive chromosome screening and fresh embryo transfer significantly increases implantation and delivery rates.

Authors:
Richard T. Scott, Jr, M.D., Kathleen M. Ferry, B.S., Eric J. Forman, M.D., Kathleen H. Hong, M.D., Katherine L. Scott, M.S., Deanne Taylor, Ph.D., Xin Tao, M.S., Nathan R. Treff, Ph.D.

Volume 100, Issue 3, Pages 697-703, September 2013

Abstract:

Objective:
To determine whether blastocyst biopsy and rapid quantitative real-time polymerase chain reaction (qPCR)–based comprehensive chromosome screening (CCS) improves in vitro fertilization (IVF) implantation and delivery rates.

Design:
Randomized controlled trial.

Setting:
Academic reproductive medicine center.

Patient(s):
Infertile couples in whom the female partner (or oocyte donor) is between the ages of 21 and 42 years who are attempting conception through IVF.

Intervention(s):
Embryonic aneuploidy screening.

Main Outcome Measure(s):
Sustained implantation and delivery rates.

Result(s):
We transferred 134 blastocysts to 72 patients in the study (CCS) group and 163 blastocysts to 83 patients in the routine care (control) group. Sustained implantation rates (probability that an embryo will implant and progress to delivery) were statistically significantly higher in the CCS group (89 of 134; 66.4%) compared with those from the control group (78 of 163; 47.9%). Delivery rates per cycle were also statistically significantly higher in the CCS group. Sixty one of 72 treatment cycles using CCS led to delivery (84.7%), and 56 of 83 (67.5%) control cycles ultimately delivered. Outcomes were excellent in both groups, but use of CCS clearly improved patient outcomes.

Conclusion(s):
Blastocyst biopsy with rapid qPCR-based comprehensive chromosomal screening results in statistically significantly improved IVF outcomes, as evidenced by meaningful increases in sustained implantation and delivery rates.

Clinical Trial Registration Number:
NCT01219283

  • S. García-Herrero, PhD

    This is a very interesting randomized controlled trial which demonstrates the
    effectiveness of the comprehensive chromosome screening (CCS) in embryo
    selection to improve IVF cycle outcome. Nevertheless authors emphasize that
    fertilization and delivery rates only improve when CCS is performed with
    trophectoderm biopsy, but our group already has improved those rates performing
    day 3 single blastomere biopsy even in women having low ovarian response. In
    fact, a preliminary validation study of array-CGH technology with day-3 single
    blastomeres described high concordance between the day-3 single-cell array-CGH
    diagnosis and the day-5 reanalysis of the remaining embryo cells via FISH (Mir
    P, 2013).

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