Abstract


OBJECTIVE: Current data suggests that LB following transfer of a euploid embryo (EE) is independent of age or type of ART treatment. At our center, OC is routinely performed and trophectoderm biopsy-preimplantation genetic screening (TEBX-PGS) is now being used in conjunction with autologous OC thaw (AOCT) cycles. From our novel data, we estimated the no. of MII oocytes required to achieve LB at different ages.
DESIGN: Retrospective study and theoretical model view more

OBJECTIVE: Current data suggests that LB following transfer of a euploid embryo (EE) is independent of age or type of ART treatment. At our center, OC is routinely performed and trophectoderm biopsy-preimplantation genetic screening (TEBX-PGS) is now being used in conjunction with autologous OC thaw (AOCT) cycles. From our novel data, we estimated the no. of MII oocytes required to achieve LB at different ages.
DESIGN: Retrospective study and theoretical model
MATERIALS AND METHODS: Data from 152 patients (202 retrievals, 167 thaws) who underwent AOCT with intended TEBX-PGS aged 25-40y were reviewed. To calculate the no. of MII oocytes needed to achieve one EE the following data were assessed: total no. of MII oocytes that survived, 2-pronuclear (2PN) fertilization, development to BL, BL achieving quality for TEBX, and BL ploidy status after TEBX-PGS. The no. of MII oocytes needed to achieve one EE was calculated as no. MII thawed/EE. Because combining these technologies is relatively new, many pregnancies are currently ongoing (ONG). Thus "LB" included >1st trimester ONG pregnancies and babies born (BB), with the LB rate calculated as total no. ONG+BB/EE transferred. The theoretical no. of MII oocytes needed for one LB was then calculated as no. thawed MII needed to achieve one EE/LB rate per EE.
RESULTS: See Table. Of the 1,839 MII oocytes that survived, 2PN fertilization rate was 75% and of those, 50% formed BL. 83% of BL were suitable for TEBX. The no. of MII oocytes needed to achieve one EE was 8, 12, and 13 for age groups of 25-34y, 35-37y, and 38-40y; LB rate per EE was 59.8% across all ages. Thus, the no. of MII calculated to achieve one LB was 13, 19, and 22 in the age groups, respectively.
CONCLUSIONS: EE have a relatively uniform efficiency and therefore, achievement of an EE after OC, thaw, and fertilization can help to estimate the theoretical no. of cryopreserved MII oocytes required to achieve a LB. One criticism of OC is that it provides women with a false sense of security; because of varying cycle outcomes, OC cannot guarantee future birth. Our findings serve as a counseling tool by providing women with realistic expectations of OC outcomes at our center.

Oocyte development and ploidy status following AOCT+TEBX-PGS by age
Age (y) 25-34 (mean 30.7; n=23) 35-37 (mean 36.5; n=61) 38-40 (mean 38.9; n=118) Total (mean 37.2; n=202)
Oocytes retrieved 574 1045 1601 3220
MII thawed 385 698 1088 2171
MII survived 329 558 952 1839
2PN fertilized 255 424 693 1372
BL 124 215 353 692
BL biopsied 110 186 279 575
Euploid 48 60 84 192
Aneuploid 59 122 193 374
No. MII to achieve euploid 8.02 (385/48) 11.6 (698/60) 13.0 (1088/84)
No. MII to achieve LB 13.4 (8.02/0.598) 19.4 (11.6/0.598) 21.7 (13.0/0.598)
EE LB rate: 59.8% (52/87)
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