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Euploidy in relation to blastocyst sex and morphology

  • Genetics
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

The objective of our study is to assess the relationship of embryo ploidy status in relation to embryo sex, morphological characteristics, and transfer parameters.

Methods

This is a retrospective cohort study at an academic medical center of patients who underwent in vitro fertilization with preimplantation genetic screening (PGS) from 2010 to 2015. Embryos were screened with 24-chromosome preimplantation genetic screening with day 5/6 trophectoderm biopsy. We investigated embryo euploidy in relation to morphology (expansion, inner cell mass, trophectoderm), embryo sex, biopsy day, and blastocyst cohort size. We used multivariate logistic regression to calculate odds ratios of euploidy in relation to these parameters.

Results

A total of 1559 embryos from 316 cycles and 233 patients (mean maternal age = 37.8 ± 4.2 years) were included in the analysis. Six hundred and twenty-eight blastocysts (40.3%) were found to be euploid. Expansion (p < 0.001), inner cell mass (ICM) (p < 0.01), and trophectoderm grade (p < 0.001) were significantly associated with embryo ploidy in bivariate models controlling for maternal age, while embryo sex, biopsy day, and blastocyst cohort size were not associated with embryo ploidy. In a multivariate model, we found that maternal age (p < 0.001), higher grade of expansion (p < 0.01), and better quality trophectoderm (p < 0.001 for A compared to C grade) remained significantly associated with increased embryo euploidy, but ICM grade was no longer significant. Embryo sex was not associated with ploidy status, though male embryos were found to be associated with higher trophectoderm scores (p < 0.02).

Conclusions

This is the largest study to date to investigate PGS-tested embryo sex and ploidy status. While maternal age and some morphological parameters (expansion, trophectoderm grade) are associated with euploidy in our cohort, other parameters such as embryo sex, biopsy day, and cohort size are not. Though embryo sex was not associated with euploidy, male embryos were found to be associated with higher trophectoderm grades. Additional investigation in larger studies is warranted.

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Contributors

AW and LW participated in study conception and design. AW performed the data analysis and wrote the initial draft of the manuscript. All authors contributed to data interpretation and revisions and approval of the manuscript.

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Authors and Affiliations

  1. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics & Gynecology, Stanford University School of Medicine, Stanford, CA, USA

    Ange Wang, Jonathan Kort, Barry Behr & Lynn M. Westphal

  2. Fertility and Reproductive Health Services Sunnyvale, 1195 W. Fremont Ave, Sunnyvale, CA, 94087, USA

    Lynn M. Westphal

Authors
  1. Ange Wang
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  2. Jonathan Kort
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  3. Barry Behr
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  4. Lynn M. Westphal
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Correspondence to Lynn M. Westphal.

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The authors declare that they have no conflict of interest.

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IRB approval was obtained through Stanford University.

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Wang, A., Kort, J., Behr, B. et al. Euploidy in relation to blastocyst sex and morphology. J Assist Reprod Genet 35, 1565–1572 (2018). https://doi.org/10.1007/s10815-018-1262-x

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  • DOI: https://doi.org/10.1007/s10815-018-1262-x

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