Determinación del factor más relevante en la selección de un único blastocisto euploide en los ciclos de transferencia diferida: la calidad embrionaria vs. día de la biopsia del trofoectodermo
Hypothesis: The pregnancy and implantation rate achieved by the transfer of frozen euploid blastocysts varies depending on which day the biopsy is performed and/or the quality of the blastocyst.\nExperimental design: A single-center, retrospective observational study was conducted at ART Fertility C...
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| Formato: | Tesis de maestría acceptedVersion |
| Lenguaje: | Español |
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Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica
2021
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| Acceso en línea: | http://repositoriouba.sisbi.uba.ar/gsdl/cgi-bin/library.cgi?a=d&c=afamaster&cl=CL1&d=HWA_6875 https://repositoriouba.sisbi.uba.ar/gsdl/collect/afamaster/index/assoc/HWA_6875.dir/6875.PDF |
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| Sumario: | Hypothesis: The pregnancy and implantation rate achieved by the transfer of frozen euploid blastocysts varies depending on which day the biopsy is performed and/or the quality of the blastocyst.\nExperimental design: A single-center, retrospective observational study was conducted at ART Fertility Clinics, Abu Dhabi, between March 2018 and June 2019. A total of 331 blastocyst frozen embryo transfers (FET) cycles were included: 227 with blastocysts biopsied on day (D) 5 and 104 biopsies in D6. All embryo biopsies were analyzed by next generation sequencing (NGS) for preimplantation genetic testing for aneuploidies (PGT-A). All women who underwent their first FET cycle with a single euploid blastocyst were included in the study. The blastocysts internal cell mass (ICM) quality and the trophectoderm (TE) were scored prior to the embryo biopsy on D5 or D6 according to the Gardner scoring system (A, B or C: from highest to lowest number and arrangement of the cells observed). The main outcome measure was whether the day of blastocyst biopsy or blastocyst quality were associated with pregnancy rates (PR). As a secondary objective, the implantation rates (IR) were also analyzed.\nResults: The mean age was similar between both groups (D5: 33,6 ± 5,9 and D6: 34,5 ± 5,5 years old; p= 0,221). A significantly higher number of blastocysts was obtained in the D5 FET group compared to D6 (7,4 ± 4,7 vs. 4,7 ± 3,5; p< 0,001) and a greater number of embryos were biopsied in the group of D5 FET cycles (6,0 ± 3,9 vs. 3,7 ± 2,8; p< 0,001). Neither PR nor IR were significantly different between FET cycles with D5 and D6 blastocysts (PR: 7,9% vs. 64,4%; OR= 0,74, 95% CI: 0,44 ? 1,26; p= 0251 and IR: 63,0% vs. 51,9%; OR= 0,62; 95% CI: 0,38 ? 1,02; p= 0,054). According to the multivariate logistic regression model performed, controlled for confounding factors, not only the day of the biopsy was not associated with PR (OR= 0,92; 95% CI: 0,52 ? 1,66; p= 0,793; for D6 compared to D5), but also the quality of the ICM of blastocyst at the time of biopsy did not show any significant effect on PR (OR= 1,00; 95% CI: 0,50 ? 1,98; p= 0,979 for ICM grade B and OR= 0,63; 95% CI: 0,22 ? 1.84; p= 0,405 for ICM grade C, compared to A). The PR was significatively decreased when blastocysts with TE C quality grade were transferred (OR= 0,59; 95% CI: 0,29 ? 1,16; p= 0,139 for TE grade B and OR= 0,36; 95% CI %: 0,14 ? 0,96; p= 0,044 for TE grade C compared to A). None of the variable studied were associated with a significant effect on IR outcomes.\nConclusion: Euploid blastocysts have a clinical potential regardless the day of biopsy and blastocyst ICM quality, although clinical outcomes seem to be improved if the quality of the TE of transferred blastocysts increases. |
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