Chun-I Lee1, Chien-Hong Chen2, Chun-Chia Huang2, En-Hui Cheng2, Hsiu-Hui Chen2, Su-Ting Ho2, Pin-Yao Lin3, Maw-Sheng Lee1, Tsung-Hsien Lee4. 1. Institute of Medicine, Chung Shan Medical University Taichung, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital Taichung, Taiwan; Division of Infertility, Lee Women's Hospital Taichung, Taiwan. 2. Division of Infertility, Lee Women's Hospital Taichung, Taiwan. 3. Institute of Medicine, Chung Shan Medical University Taichung, Taiwan; Division of Infertility, Lee Women's Hospital Taichung, Taiwan. 4. Institute of Medicine, Chung Shan Medical University Taichung, Taiwan; Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital Taichung, Taiwan; Division of Infertility, Lee Women's Hospital Taichung, Taiwan; Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University Taipei, Taiwan. Electronic address: jackth.lee@gmail.com.
Abstract
RESEARCH QUESTION: Are the morphokinetics of euploid blastocysts evaluated by a generally applicable algorithm associated with the clinical outcomes of single-embryo transfer (SET)? DESIGN: Time-lapse microscopy was used to compare morphokinetic variables between expanded blastocysts derived from preimplantation genetic testing for aneuploidy cycles using high-resolution next-generation sequencing (hr-NGS). The clinical efficacy of the morphokinetic algorithm KIDScore D5 was evaluated after euploid SET. RESULTS: Compared with euploid blastocysts, low-level mosaic blastocysts presented comparable morphokinetic and morphological features. However, high-level mosaic blastocysts exhibited significant delays in t5 (median 51.9 h post insemination (hpi), P = 0.034) (where t is the time for the embryo to reach the specific stage in hours after ICSI or conventional IVF) and t8 (median 58.6 hpi, P = 0.032) accompanied by a prolonged time period for the third cell cycle (median 14.7 h, P = 0.012). A significantly higher incidence (P = 0.011) of multinucleation indicated a susceptibility of high-level mosaic blastocysts to mitotic errors. Only a delay in the time for the embryo to reach the full blastocyst stage (median 106.0 hpi, P = 0.039) was revealed in aneuploid blastocysts, reflecting the reduced formation of good-quality blastocysts (42.6% versus 65.7%, P < 0.001). Euploid blastocysts with specific morphokinetic characteristics were graded using the KIDScore D5 algorithm. Grade C embryos achieved significantly lower rates of clinical pregnancy, implantation and ongoing pregnancy (25%, 25% and 10%, respectively) compared with the grade A (76.2%, 79.4% and 68.3%, respectively) or grade B (62.5%, 66.7% and 62.5%, respectively) embryos (P = 0.0171 to <0.0001). CONCLUSIONS: Although morphokinetic features appear dissimilar in embryos with different diploid-aneuploid mosaic levels, predicting chromosomal abnormalities using morphokinetics alone is still insufficient. When combined with hr-NGS, use of the generally applicable KIDScore D5 algorithm has the potential to discriminate euploid blastocysts with different developmental competence.
RESEARCH QUESTION: Are the morphokinetics of euploid blastocysts evaluated by a generally applicable algorithm associated with the clinical outcomes of single-embryo transfer (SET)? DESIGN: Time-lapse microscopy was used to compare morphokinetic variables between expanded blastocysts derived from preimplantation genetic testing for aneuploidy cycles using high-resolution next-generation sequencing (hr-NGS). The clinical efficacy of the morphokinetic algorithm KIDScore D5 was evaluated after euploid SET. RESULTS: Compared with euploid blastocysts, low-level mosaic blastocysts presented comparable morphokinetic and morphological features. However, high-level mosaic blastocysts exhibited significant delays in t5 (median 51.9 h post insemination (hpi), P = 0.034) (where t is the time for the embryo to reach the specific stage in hours after ICSI or conventional IVF) and t8 (median 58.6 hpi, P = 0.032) accompanied by a prolonged time period for the third cell cycle (median 14.7 h, P = 0.012). A significantly higher incidence (P = 0.011) of multinucleation indicated a susceptibility of high-level mosaic blastocysts to mitotic errors. Only a delay in the time for the embryo to reach the full blastocyst stage (median 106.0 hpi, P = 0.039) was revealed in aneuploid blastocysts, reflecting the reduced formation of good-quality blastocysts (42.6% versus 65.7%, P < 0.001). Euploid blastocysts with specific morphokinetic characteristics were graded using the KIDScore D5 algorithm. Grade C embryos achieved significantly lower rates of clinical pregnancy, implantation and ongoing pregnancy (25%, 25% and 10%, respectively) compared with the grade A (76.2%, 79.4% and 68.3%, respectively) or grade B (62.5%, 66.7% and 62.5%, respectively) embryos (P = 0.0171 to <0.0001). CONCLUSIONS: Although morphokinetic features appear dissimilar in embryos with different diploid-aneuploid mosaic levels, predicting chromosomal abnormalities using morphokinetics alone is still insufficient. When combined with hr-NGS, use of the generally applicable KIDScore D5 algorithm has the potential to discriminate euploid blastocysts with different developmental competence.
Authors: Liubin Yang; Mary Peavey; Khalied Kaskar; Neil Chappell; Lynn Zhu; Darius Devlin; Cecilia Valdes; Amy Schutt; Terri Woodard; Paul Zarutskie; Richard Cochran; William E Gibbons Journal: F S Rep Date: 2022-04-15
Authors: Andrea Abdala; Ibrahim Elkhatib; Aşina Bayram; Ana Arnanz; Ahmed El-Damen; Laura Melado; Barbara Lawrenz; Human M Fatemi; Neelke De Munck Journal: J Assist Reprod Genet Date: 2022-01-22 Impact factor: 3.412