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      • The most ideal interval between blastocyst biopsy and vitrification applied in preimplantation genetic screening (PGS)

        ( Hui-ying Low ),( Hsiu-hui Chen ),( Chun-chia Huang ),( Tsung-hsien Lee ),( Chung-i Chen ),( Lii-sheng Huang ),( Maw-sheng Lee ) 대한산부인과학회 2016 대한산부인과학회 학술대회 Vol.102 No.-

        Study Question: To evaluate the most ideal interval between blastocyst biopsy and vitrification in preimplantation genetic screening (PGS). Study Design, Size, Duration: This is a retrospective study and total 224 patients underwent the PGS from 2012 Dec. to 2015 Mar. All of patients underwent blastocyst vitrification after biopsy and 1~2 euploid blastocyst for transfer after warming. The primary outcome measures were the implantation and pregnancy rates per PGS-frozen embryo transfer cycle. Materials, Setting, Methods: The blastocyst grading including grade 4, 5 and 6 (according to Gardner grading system) on day 5 or day 6 were selected for trophectoderm biopsy. All blastocyst underwent vitrification immediately (interval: 0.5 hour) or 1 to 7 hours after biopsy. At the time of vitrification the grade of blastocyst expansion was also recorded. All patients were divided into two groups according to the grade of expanded (Group1: ≤1/2 expansion (n=41), Group2: ≥3/4 expansion (n=183)). Furthermore, combined two factors including the interval and morphology of blastocyst after biopsy, all patients were further divided into interval 1 (<3 hours and ≤1/2 expansion) and interval 2 (≥3 hours and ≥3/4 expansion). The morphologically best euploid blastocyst(s) (1~2 embryos) was/were selected first for transfer on the next cycle. Main Results: Assessment morphology of blastocyst after biopsy in different interval, at 0.5 hour after biopsy, 100% blastocyst was non-expansion; at 1 hour after biopsy, only 17% blastocyst was 3/4 expansion or all-expansion; at 3 hours after biopsy, 86% blastocyst was 3/4 expansion or all-expansion and after 5.5 hours, 100% blastocyst was all-expansion or hatching. All blastocysts were survival (100%, 359/359) after warming. The mean of embryo transfer number between all groups were no significantly difference. The implantation rate in Group2 (63.4%) was significantly higher than that in Group1 (46.9%, p=0.014). The pregnancy rates in Group4 (73.8%) was sig-nificantly higher than that in Group1 (51.2%, p=0.004). The implantation and pregnancy rates in the group of embryo ≥3/4 expansion combined with ≥3 hours after biopsy (63.6%, 178/280; 73.8%, 127/172) were significantly higher than that in the group of ≤1/2 expansion with <3 hour (45.6, 26/57; 50.0%, 18/36; p=0.0113 and p=0.0056, respectively). Conclusion: The most ideal interval between biopsy and vitrification was least 3 hours and ≥3/4 expansion of blastocyst after biopsy could improve the implantation and pregnancy rates for PGS.

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