Live birth rate is associated with oocyte yield and number of biopsied and suitable blastocysts to transfer in preimplantation genetic testing (PGT) cycles for monogenic disorders and chromosomal structural rearrangements

Abstract

Live birth rate is associated with oocyte yield and number of biopsied and suitable blastocysts to transfer in preimplantation genetic testing (PGT) cycles for monogenic disorders and chromosomal structural rearrangements Jara Ben-Nagia,*, Benjamin Jonesb, Roy Najac, Ahmed Amera, Sesh Sunkarad, Sioban SenGuptae, Paul Serhala a Centre for Reproductive and Genetic Health, 230–232 Great Portland Street, London, W1W 5QS, UK b Imperial College London, Du Cane Road, London, W12 0NN, UK c IGENOMIX, 40 Occam Road, Guildford, Surrey, GU2 7YG, UK d Queen’s Hospital, Barking Havering and Redbridge University Hospitals NHS Trust, Essex, UK e UCL, Institute for Women’s Health, 86-96 Chenies Mews, London, WC1E 6HX, UK A R T I C L E I N F O Article history: Received 14 March 2019 Received in revised form 19 May 2019 Accepted 23 May 2019 Available online 1 June 2019 Keywords: Live birth Preimplantation genetic testing Monogenic disorders Chromosomal rearrangements Oocyte Blastocysts A B S T R A C T Objectives: To investigate whether live birth (LB) is associated with oocyte yield and number of biopsied and suitable blastocyst to transfer following preimplantation genetic testing (PGT) for monogenic disorders (PGT-M) and chromosomal structural rearrangements (PGT-SR). Study design: All couples underwent controlled ovarian stimulation, blastocyst biopsy, vitrification and transfer of suitable embryo(s) in a frozen embryo transfer (FET) cycle. Results: Of 175 couples who underwent PGT treatment, 249 oocytes retrievals were carried out and 230 FET were subsequently undertaken. 122/230 (53%, 95% CI 47–59) FET resulted in a LB and 16/230 (7%, 95% CI 4–11) have resulted in ongoing pregnancies. 21/230 (9%, 95% CI 6–14) FET resulted in miscarriage and 69/230 (30%, 95% CI 24–36) concluded with failed implantation. Two (1%, 95% CI 0–3) transfers underwent termination for congenital malformation, with no evidence of misdiagnosis by prenatal testing. The relationship between number of oocytes retrieved and number of blastocysts biopsied and suitable embryos to transfer were significant (p = 0.00; Incidence rate ratio (IRR) 1.05; 95% 1.04–1.06; p = 0.00; IRR 1.04; 95%, 1.03–1.06), respectively. The number of oocytes collected (p = 0.007; OR 1.06; 95% CI 1.01–1.10), the number of blastocysts biopsied (p = 0.001; OR 1.14; 95% 95% CI 1.06–1.23) and the number of suitable embryos to transfer (p = 0.00; OR 1.38; 95% CI 1.17–1.64) were all significantly associated with the odds of achieving a LB. There is a 14% and 38% increased chance of a LB per additional blastocyst biopsied and suitable embryo to transfer, respectively. Conclusions: PGT-M and PGT-SR outcomes are significantly associated with egg yield, number of blastocysts to biopsy and suitable embryos to transfer.