Day-3 embryo morphology predicts euploidy among older subjects
Objective
To evaluate whether day-3 embryo morphology predicts euploidy.
Design
Retrospective.
Setting
Private IVF center.
Patient(s)
Subjects (n = 144) undergoing in vitro fertilization and preimplantation genetic diagnosis (PGD).
Intervention(s)
Translate day-3 embryo characteristics into a standardized score.
Main Outcome Measure(s)
Day-3 embryo morphology score and PGD fluorescence in situ hybridization results for chromosomes: 13, 15, 16, 17, 18, 21, 22, X, and Y.
Result(s)
Of 1,043 biopsied blastomeres, 67% (n = 696) were chromosomally abnormal. Women with advanced maternal age (AMA) were 1.3 times more likely to have chromosomal errors (95% CI 1.1–1.4) than younger subjects (<38 years old). Morphology predicted PGD results in the AMA group (n = 553), but not in younger women. Fragmentation predicted euploidy in both the younger and the AMA group, but cell number did not.
Conclusion(s)
Day-3 embryo morphology selects for euploidy among AMA subjects but not among younger women who may have other factors responsible for embryo dysmorphism. However, cellular fragmentation is a sensitive proxy for selecting chromosomally normal embryos in both age groups. It is unclear that PGD-aneuploidy screening is a better tool for selecting which embryos to transfer than the standard approach of using day-3 embryo features, particularly among older women, a group for whom this technology is targeted.
Key Words: PGD, embryo morphology, aneuploidy, IVF, embryo selection
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PII: S0015-0282(07)00335-4
doi:10.1016/j.fertnstert.2007.01.169
© 2008 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

