Multiple cryopreservation–warming cycles, coupled with blastocyst biopsy, negatively affect IVF outcomes. Issue 3 (March 2021)

• Record Type: Journal Article
• Authors: Aluko, Ashley; Vaughan, Denis A.; Modest, Anna M.; Penzias, Alan S.; Hacker, Michele R.; Thornton, Kim; Sakkas, Denny
• Is Part Of: Reproductive biomedicine online. Volume 42:Issue 3(2021)
• Page Start: 572
• Page End: 578
• Publication Date: 2021-03
• Subjects: Biopsy -- Cryopreservation -- Embryo -- PGT-A -- Vitrification; Human reproductive technology -- Periodicals; Human embryo -- Periodicals; Reproduction -- Periodicals; 616.692
• DOI: 10.1016/j.rbmo.2020.11.019
• Languages: English
• ISSNs: 1472-6483

Abstract

Abstract: Research question: Do multiple cryopreservation–warming cycles, coupled with blastocyst biopsy, negatively affect IVF outcomes? Design: Patients undergoing IVF with homologous single embryo transfer, and who underwent trophectoderm biopsy for preimplantation genetic testing for aneuploidy (PGT-A) between 2013 and 2017, were divided into three groups based on degree of embryonic micromanipulation: once-biopsied, once-cryopreserved (group BC, n = 2603), once-biopsied, twice-cryopreserved (group CBC, n = 95) and twice-biopsied, twice-cryopreserved (group BCBC, n = 15). The primary outcome was live birth; secondary outcomes included positive serum pregnancy test, clinical pregnancy and miscarriage. Results: Group CBC had a significantly lower chance of live birth (adjusted RR 0.57, 95% CI 0.41 to 0.79) and clinical pregnancy (adjusted RR 0.67, 95% CI 0.53 to 0.85) compared with group BC. Miscarriage rates were similar between groups BC and CBC (adjusted RR 1.3, 95% CI 0.64 to 2.7). Conclusions: Multiple cryopreservation–warming cycles, coupled with blastocyst biopsy, negatively affect IVF outcomes. Although PGT-A is thought to improve reproductive outcomes on a per transfer basis, caution must be exercised in counselling patients on the possibility of diminishing returns owing to further embryonic micromanipulation after an embryo has been cryopreserved.