Research Information System
78th ASRM Congress, Louisiana, United States Of America, 14 - 18 October 2023, vol.120, no.4, pp.82, (Summary Text)
OBJECTIVE: Recurrent Pregnancy Loss(RPL) is a complex disease affecting 2-4% of reproductive women and may occur with single or combination of endocrinological, immunological, endometrial, genetic and embryological factors. There are limited numbers of studies investigating the embryo morphokinetics and risk factors in RPL patients. Studies on embryo morphokinetics show variable results in PGT-A embryos. We aimed to investigate the patient and embryo related risk factors in terms of embryo ploidy and embryo grading(EG) in RPL patients when endometrial factor and male infertility excluded.
MATERIALS AND METHODS: A hundred RPL patients(female age %38) with normozoospermic partners, 366 PGT-A embryos which were incubated in Time-Lapse incubators were included into the study. EG was performed according to Gardner’s classification as following; Top Quality(TQ):Hatched AA, 6AA, 5AA, 4AA, Good Quality(GQ):- Hatched AB/BA/BB, 5AB/BA/BB, 4AB/BA/BB, 3AA, Moderate Quality(MQ):3AB/BA, 2AA. Next Generation Sequencing(NGS) method was used for PGT-A analysis. Student’s t-test and Anova were used in the comparison of morphokinetic parameters between groups. The Bonferroni post hoc analysis was used for multiple comparisons. Chi-square and Logistic Regression analysis were performed for aneuploidy risk assessment. RESULTS: tEB was longer in mosaic embryos than euploids(113.47.0 vs 109.67.5, p:0.043). When the morphokinetics were compared according to EG, TQ embryos showed earlier development than GQ and MQ embryos in terms of t8, tM, tSB, tB, tEB, t2-t8 (t8:TQ vs GQ p:0.003, TQ vs MQ p:0.022; tM:TQ vs MQ p:0.003; tSB:TQ vs MQ p:0.004; tB:TQ vs GQ p:0.034, TQ vs MQ p<0.001; tEB:TQ vs MQ p:0.001; duration of t2-t8: TQ vs GQ p:0.004, TQ vs MQ p:0.027). In young RPL patients(age %30), duration of t8-tM, t8-tSC and tSB-tEB were found lower than patients with the age of 36-38 (p:0.002, p:0.002, p<0.001, respectively).The direct cleavage(DC) and separated blastomer(SB) existance in the embryos were found associated with EG(p<0.001), but not with ploidy status. While male age, female BMI were not found to have an effect on PGT results and EG, frequency of TQ and GQ were decreasing with increasing female age without having an effect on PGT results (female age/TQ+GQ%; %30/ 96.1%, 31-35/ 89.1%, 36-38/ 81.5%; p:0.005). EG was found the main risk factor for aneuploidy risk in RPL patients amoung others (female/ male age, female BMI).
CONCLUSIONS: This is a single center, small-sized, retrospective study evaluating the risk factors in terms of embryo morphokinetics, EG and ploidy in RPL patients. Our data suggests that female age, DC and SB could affect EG. Embryo morphokinetics could not have a predictive value in aneuploidy detection in RPL patients. Our results should be confirmed with further studies including the pregnancy results of the euploid embryos.
IMPACT STATEMENT: EG is found as the main factor affecting ploidy of the embryo. Increasing female age, DC and SB existance decrease the EG.According to our results, since the embryo morphokinetics could be similar between euploid and aneuploid embryos, thus, PGT-A could be offered to patients in order to exlude aneuploidy related pregnancy losses.
SUPPORT: None