RESUMO
OBJECTIVE: To evaluate the use of implantation data algorithm KIDscoreTM D5 (Vitrolife®, Canada) as an additional tool for morphological assessment and preimplantation genetic testing for aneuploidies (PGT-A) to improve implantation and ongoing pregnancy rates. MATERIALS AND METHODS: This study looked into 912 embryos from 270 patients who underwent IVF at the INMATER Fertility Clinic in Lima, Peru, between October 2016 and June 2018. All embryos were cultured for up to five or six days in an Embryoscope® time-lapse incubator (Vitrolife®, Canada) and evaluated based on the KIDscoreTM D5 algorithm (KS5). Biopsies for PGT-A screening were performed in 778 (85.31%) embryos. A total of 184 single embryo transfers (68% of patients) were performed during the study period and the embryos transferred were divided into four groups: 1) euploid embryos transferred without consideration to their KS5 scores (n=86); 2) euploid embryos transferred considering their KS5 scores (n=48); 3) embryos transferred without consideration to their KS5 scores and that were not evaluated by PGT-A (n=40); and 4) embryos transferred considering their KS5 scores and that were not evaluated by PGT-A (n=10). Implantation and ongoing pregnancy rates were compared between the groups and between euploid embryos with the highest KS5 scores (KS5=6, n=25) and euploid embryos with the lowest KS5 scores (KS5=1, n=51). The correlations between KS5 scores and embryo euploidy rates were also evaluated. RESULTS: Euploid embryo transfers in which KS5 scores were considered in the selection process had significantly higher Implantation and ongoing pregnancy rates compared to euploid embryo transfers in which selection was based on morphology (75.00% vs. 50.00%; p=0.002 and 66.66% vs. 48.83%; p=0.037, respectively). Additionally, implantation rates were significantly higher for blastocysts with the highest KS5 score (KS5=6) compared to blastocysts with the lowest score (KS5=1) (80.00% vs. 49.02%; p=0.045). Ongoing pregnancy rates were not significantly different (72.00% vs. 47.06%; p=0.105). Euploidy rates were significantly higher in the group of embryos with KS5=6 than in the group of embryos with KS5=1 (61.88% vs. 48.33%; p=0.006). CONCLUSION: Embryo selection based on the KS5 algorithm score improved the implantation rates of single euploid blastocyst transfers. Furthermore, embryos with the highest KS5 score had a higher probability of being euploid and implanting.
Assuntos
Algoritmos , Aneuploidia , Testes Genéticos/métodos , Diagnóstico Pré-Implantação/métodos , Transferência de Embrião Único , Adulto , Embrião de Mamíferos/patologia , Feminino , Humanos , Gravidez/estatística & dados numéricosRESUMO
OBJECTIVES: This study aimed to identify human blastocyst contraction patterns and their correlations with ploidy status (PGT-A analysis), the time it took for embryos to reach the blastocyst stage, and pregnancy rates. METHODS: The study included 912 embryos from 270 patients seen in our center. All embryos were cultivated in an Embryoscope incubator. An NGS platform was used to test 778 of the 912 embryos initially included in the study for aneuploidy at a reference laboratory. Blastocyst contractions were evaluated using the embryo drawing tool to compute percent contraction. A total of 182 single-embryo transfers were performed. The mean age of the included patients was 30.44 years (24-39 years). RESULTS: The embryos were divided into two groups, the first with embryos that contracted (CT group) and the second with embryos that did not contract, herein referred to as expanding-only embryos or solo expanding (SE group). In terms of ploidy status, 58.33% of the embryos in the SE group were euploid, while 53.58% of embryos in the CT group were aneuploid. The difference between the groups was statistically significant (p=0.029), showing that embryos that do not contract have a higher chance of being euploid than embryos that contract. Pregnancy rates were also significantly higher among embryos in the SE group than in the CT group (63.10% vs. 46.67%; p=0.012). Finally, we saw that embryos in the CT group took significantly longer to reach the blastocyst stage compared to embryos in the SE group (p=0.004). Patient age was not significantly different between the CT and SE groups, indicating that age might not be a factor in embryo contraction. CONCLUSION: Two of the traits for which the embryos included in this study were compared were statistically different. Embryos in the CT group had lower implantation rates, took longer to reach the blastocyst stage, and had a higher chance of being aneuploid, regardless of maternal age. Therefore, embryo contraction might be a useful parameter in the selection of embryos for transfer.