Browse > Article
http://dx.doi.org/10.5653/cerm.2012.39.2.52

Array comparative genomic hybridization screening in IVF significantly reduces number of embryos available for cryopreservation  

Liu, Jiaen (IVF Division, Beijing Jia En De Yun Hospital)
Sills, E. Scott (Division of Reproductive Endocrinology, Pacific Reproductive Center)
Yang, Zhihong (Division of Reproductive Endocrinology, Pacific Reproductive Center)
Salem, Shala A. (Division of Reproductive Endocrinology, Pacific Reproductive Center)
Rahil, Tayyab (Division of Reproductive Endocrinology, Pacific Reproductive Center)
Collins, Gary S. (Centre for Statistics in Medicine, Wolfson College Annexe, University of Oxford)
Liu, Xiaohong (IVF Division, Beijing Jia En De Yun Hospital)
Salem, Rifaat D. (Division of Reproductive Endocrinology, Pacific Reproductive Center)
Publication Information
Clinical and Experimental Reproductive Medicine / v.39, no.2, 2012 , pp. 52-57 More about this Journal
Abstract
Objective: During IVF, non-transferred embryos are usually selected for cryopreservation on the basis of morphological criteria. This investigation evaluated an application for array comparative genomic hybridization (aCGH) in assessment of surplus embryos prior to cryopreservation. Methods: First-time IVF patients undergoing elective single embryo transfer and having at least one extra non-transferred embryo suitable for cryopreservation were offered enrollment in the study. Patients were randomized into two groups: Patients in group A (n=55) had embryos assessed first by morphology and then by aCGH, performed on cells obtained from trophectoderm biopsy on post-fertilization d5. Only euploid embryos were designated for cryopreservation. Patients in group B (n=48) had embryos assessed by morphology alone, with only good morphology embryos considered suitable for cryopreservation. Results: Among biopsied embryos in group A (n=425), euploidy was confirmed in 226 (53.1%). After fresh single embryo transfer, 64 (28.3%) surplus euploid embryos were cryopreserved for 51 patients (92.7%). In group B, 389 good morphology blastocysts were identified and a single top quality blastocyst was selected for fresh transfer. All group B patients (48/48) had at least one blastocyst remaining for cryopreservation. A total of 157 (40.4%) blastocysts were frozen in this group, a significantly larger proportion than was cryopreserved in group A (p=0.017, by chi-squared analysis). Conclusion: While aCGH and subsequent frozen embryo transfer are currently used to screen embryos, this is the first investigation to quantify the impact of aCGH specifically on embryo cryopreservation. Incorporation of aCGH screening significantly reduced the total number of cryopreserved blastocysts compared to when suitability for freezing was determined by morphology only. IVF patients should be counseled that the benefits of aCGH screening will likely come at the cost of sharply limiting the number of surplus embryos available for cryopreservation.
Keywords
Fertilization in vitro; Comparative genomic hybridization; Preimplantation genetic diagnosis; Cryopreservation;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Alfarawati S, Fragouli E, Colls P, Stevens J, Gutiérrez-Mateo C, Schoolcraft WB, et al. The relationship between blastocyst morphology, chromosomal abnormality, and embryo gender. Fertil Steril 2011;95:520-4.
2 Hassold T, Hunt P. Maternal age and chromosomally abnormal pregnancies: what we know and what we wish we knew. Curr Opin Pediatr 2009;21:703-8.
3 Kuliev A, Cieslak J, Verlinsky Y. Frequency and distribution of chromosome abnormalities in human oocytes. Cytogenet Genome Res 2005;111:193-8.
4 Bielanska M, Tan SL, Ao A. Chromosomal mosaicism throughout human preimplantation development in vitro: incidence, type, and relevance to embryo outcome. Hum Reprod 2002;17:413-9.
5 Magli MC, Gianaroli L, Ferraretti AP, Lappi M, Ruberti A, Farfalli V. Embryo morphology and development are dependent on the chromosomal complement. Fertil Steril 2007;87:534-41.
6 Munne S, Alikani M, Tomkin G, Grifo J, Cohen J. Embryo morphology, developmental rates, and maternal age are correlated with chromosome abnormalities. Fertil Steril 1995;64:382-91.
7 Munné S, Sandalinas M, Magli C, Gianaroli L, Cohen J, Warburton D. Increased rate of aneuploid embryos in young women with previous aneuploid conceptions. Prenat Diagn 2004;24:638-43.
8 Munné S, Chen S, Colls P, Garrisi J, Zheng X, Cekleniak N, et al. Maternal age, morphology, development and chromosome abnormalities in over 6000 cleavage-stage embryos. Reprod Biomed Online 2007;14:628-34.
9 Vanneste E, Voet T, Le Caignec C, Ampe M, Konings P, Melotte C, et al. Chromosome instability is common in human cleavagestage embryos. Nat Med 2009;15:577-83.
10 Wilton L. Preimplantation genetic diagnosis and chromosome analysis of blastomeres using comparative genomic hybridization. Hum Reprod Update 2005;11:33-41.
11 Staessen C, Platteau P, Van Assche E, Michiels A, Tournaye H, Camus M, et al. Comparison of blastocyst transfer with or without preimplantation genetic diagnosis for aneuploidy screening in couples with advanced maternal age: a prospective randomized controlled trial. Hum Reprod 2004;19:2849-58.
12 Hardarson T, Hanson C, Lundin K, Hillensjo T, Nilsson L, Stevic J, et al. Preimplantation genetic screening in women of advanced maternal age caused a decrease in clinical pregnancy rate: a randomized controlled trial. Hum Reprod 2008;23:2806-12.
13 Schoolcraft WB, Katz-Jaffe MG, Stevens J, Rawlins M, Munne S. Preimplantation aneuploidy testing for infertile patients of advanced maternal age: a randomized prospective trial. Fertil Steril 2009;92:157-62.
14 Mastenbroek S, Twisk M, van Echten-Arends J, Sikkema-Raddatz B, Korevaar JC, Verhoeve HR, et al. In vitro fertilization with preimplantation genetic screening. N Engl J Med 2007;357:9-17.
15 Mastenbroek S, Twisk M, van der Veen F, Repping S. Preimplantation genetic screening: a systematic review and meta-analysis of RCTs. Hum Reprod Update 2011;17:454-66.
16 Voullaire L, Wilton L, Slater H, Williamson R. Detection of aneuploidy in single cells using comparative genomic hybridization. Prenat Diagn 1999;19:846-51.
17 Wells D, Delhanty JD. Comprehensive chromosomal analysis of human preimplantation embryos using whole genome amplification and single cell comparative genomic hybridization. Mol Hum Reprod 2000;6:1055-62.
18 Hellani A, Abu-Amero K, Azouri J, El-Akoum S. Successful pregnancies after application of array-comparative genomic hybridization in PGS-aneuploidy screening. Reprod Biomed Online 2008;17:841-7.
19 Sher G, Keskintepe L, Keskintepe M, Ginsburg M, Maassarani G, Yakut T, et al. Oocyte karyotyping by comparative genomic hybridization [correction of hybrydization] provides a highly reliable method for selecting "competent" embryos, markedly improving in vitro fertilization outcome: a multiphase study. Fertil Steril 2007;87:1033-40.
20 Fragouli E, Lenzi M, Ross R, Katz-Jaffe M, Schoolcraft WB, Wells D. Comprehensive molecular cytogenetic analysis of the human blastocyst stage. Hum Reprod 2008;23:2596-608.
21 Fishel S, Gordon A, Lynch C, Dowell K, Ndukwe G, Kelada E, et al. Live birth after polar body array comparative genomic hybridization prediction of embryo ploidy-the future of IVF? Fertil Steril 2010;93:1006.e7- e10.
22 Gutierrez-Mateo C, Colls P, Sanchez-Garcia J, Escudero T, Prates R, Ketterson K, et al. Validation of microarray comparative genomic hybridization for comprehensive chromosome analysis of embryos. Fertil Steril 2011;95:953-8.
23 Fiorentino F, Spizzichino L, Bono S, Biricik A, Kokkali G, Rienzi L, et al. PGD for reciprocal and Robertsonian translocations using array comparative genomic hybridization. Hum Reprod 2011;26:1925-35.
24 Handyside AH. PGD and aneuploidy screening for 24 chromosomes by genome-wide SNP analysis: seeing the wood and the trees. Reprod Biomed Online 2011;23:686-91.
25 Harper JC, Sengupta SB. Preimplantation genetic diagnosis: state of the art 2011. Hum Genet 2012;131:175-86.
26 Sakkas D, Gardner DK. Noninvasive methods to assess embryo quality. Curr Opin Obstet Gynecol 2005;17:283-8.
27 Sills ES, Schattman GL, Veeck LL, Liu HC, Prasad M, Rosenwaks Z. Characteristics of consecutive in vitro fertilization cycles among patients treated with follicle-stimulating hormone (FSH) and human menopausal gonadotropin versus FSH alone. Fertil Steril 1998;69:831-5.
28 Yang Z, Salem S, Salem-Lyle S, Bayrak A, Salem RD. Trophectoderm cells derived from blastocyst biopsy are suitable for array CGH analysis of 24 chromosomes. Fertil Steril 2011;95:S23.
29 Alfarawati S, Fragouli E, Colls P, Wells D. First births after preimplantation genetic diagnosis of structural chromosome abnormalities using comparative genomic hybridization and microarray analysis. Hum Reprod 2011;26:1560-74.
30 Ismail WA, Menezes MQ, Martin CW, Thong KJ. A comparison of psychological functioning in couples undergoing frozen-thawed embryo replacement in various stages of treatment using the Mean Affect Adjective Check List (MAACL). J Assist Reprod Genet 2004;21:323-7.
31 Karatas JC, Barlow-Stewart K, Meiser B, McMahon C, Strong KA, Hill W, et al. A prospective study assessing anxiety, depression and maternal-fetal attachment in women using PGD. Hum Reprod 2011;26:148-56.
32 Sills ES, Walsh DJ, Walsh AP. Results from the advanced reproductive technologies: fresh vs. frozen? Ir Med J 2008;101:288.
33 Paxman L. IVF babies born from frozen embryos are healthier than those from fresh ones. London Daily Mail 2012 Jan 6; A3.
34 Chang EM, Han JE, Kim YS, Lyu SW, Lee WS, Yoon TK. Use of the natural cycle and vitrification thawed blastocyst transfer results in better in-vitro fertilization outcomes : cycle regimens of vitrification thawed blastocyst transfer. J Assist Reprod Genet 2011;28:369-74.
35 Gardner DK, Surrey E, Minjarez D, Leitz A, Stevens J, Schoolcraft WB. Single blastocyst transfer: a prospective randomized trial. Fertil Steril 2004;81:551-5.
36 Zhu D, Zhang J, Cao S, Heng BC, Huang M, Ling X, et al. Vitrifiedwarmed blastocyst transfer cycles yield higher pregnancy and implantation rates compared with fresh blastocyst transfer cycles-- time for a new embryo transfer strategy? Fertil Steril 2011;95:1691-5.
37 Coetsier T, Dhont M. Avoiding multiple pregnancies in in-vitro fertilization: who's afraid of single embryo transfer? Hum Reprod 1998;13:2663-4.
38 Ryan GL, Sparks AE, Sipe CS, Syrop CH, Dokras A, Van Voorhis BJ. A mandatory single blastocyst transfer policy with educational campaign in a United States IVF program reduces multiple gestation rates without sacrificing pregnancy rates. Fertil Steril 2007; 88:354-60.
39 Zander-Fox DL, Tremellen K, Lane M. Single blastocyst embryo transfer maintains comparable pregnancy rates to double cleavage-stage embryo transfer but results in healthier pregnancy outcomes. Aust N Z J Obstet Gynaecol 2011;51:406-10.
40 Maheshwari A, Griffiths S, Bhattacharya S. Global variations in the uptake of single embryo transfer. Hum Reprod Update 2011;17:107-20.
41 Racowsky C, Ohno-Machado L, Kim J, Biggers JD. Is there an advantage in scoring early embryos on more than one day? Hum Reprod 2009;24:2104-13.