COGI 2023

THE IMPACT OF EMBRYO BIOPSY TIMING ON PREGNANCY RATES IN PATIENTS UNDERGOING PREIMPLANTATION GENETIC TESTING FOR ANEUPLOIDY WITH FRESH EMBRYO TRANSFER

Walid Ghutmi 1 Leyla Depret-Bixio 1 Sahar Abdelaziz 2 Aya Eve Ghutmi 3 Mohamad El Shmoury 1 Michael Fakih 1
1Ivf Department, Fakih IVF Fertility Center, Dubai
2Genomix Laboratory, First Genomix, Dubai
3Department of Biological Sciences, University of California Santa Barbara, Santa Barbara

Problem statement: To assess whether late day 4 embryo biopsy is a comparable option to day 5 biopsy in terms of pregnancy and implantation rates in patients undergoing fresh embryo transfer and Preimplantation Genetic Testing for Aneuploidy (PGT-A).

Methods : retrospective cross sectional chart review in an academic fertility unit. Couples undergoing In Vitro fertilization with PGT-A using fresh embryo transfer, between January 2013 and September 2022 with female partner age < 42 years. PGT-A was performed using Next-Generation Sequencing (NGS) either on late day 4 or day 5.Patients were stratified by age (≤35 and >35 years).Pregnancy was defined as the presence of intrauterine gestation; implantation rate was calculated by dividing the number of sacs seen over the number of embryos transferred.

Results : In patients ≤ 35 years of age , pregnancy rate was 57.7% in late day 4 biopsy group as compared to 42,2% in day 5 biopsy group ( p value= 0.005). Similarly,in patient >35 years of age, late day 4 biopsy pregnancy rate was 68.7% as compared to 31.3% in day 5 biopsy group (p value <0.0001). Regarding implantation rate, there was no statistically significant difference observed between the two groups in patients ≤35 years old, with rates of 37% on Day 4 and 41.7% on Day 5 (p-value = 0.2329). However, for the age category >35, there was a statistically significant difference in the implantation rate between the two groups, with rates of 35.9% and 23.6%, respectively (p-value = 0.00454).

Conclusion : Our study demonstrates that optimal timing of embryo biopsy for PGT-A has a significant impact on pregnancy and implantation rates with consideration of age categories. Tailoring the timing of embryo biopsy based on individual characteristics, particularly age, may contribute to reproductive success. Thus, late day 4 embryo biopsy stands as an alternative and viable option for patients and doctors planning fresh embryo transfer.