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Hum. Reprod. Advance Access published online on September 21, 2009
Human Reproduction, doi:10.1093/humrep/dep251
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© The Author 2009. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Impact of cleavage-stage embryo biopsy in view of PGD on human blastocyst implantation: a prospective cohort of single embryo transfers

A. De Vos1,4, C. Staessen2, M. De Rycke2, W. Verpoest1, P. Haentjens3, P. Devroey1, I. Liebaers2 and H. Van de Velde1

1 Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium 2 Centre for Medical Genetics, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium 3 Centre for Outcomes Research, and Laboratory for Experimental Surgery, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium

4 Correspondence address. Tel: +32-2-477-66-97; Fax: +32-2-477-66-92; E-mail: Anick.DeVos{at}uzbrussel.be

BACKGROUND: Human embryo biopsy is performed for preimplantation genetic diagnosis (PGD). The impact of 1- or 2-cell removal at cleavage-stage on future embryo development and implantation capacity is highly debated.

METHODS: In order to explore this issue further, a cohort of Day 5 single embryo transfers was analysed prospectively for embryological and clinical outcome. All transferred embryos resulted from 8-cell embryos on Day 3, from which subsequently either one cell (group I, n = 182) or two cells (group II, n = 259) were removed, or on which no invasion by means of embryo biopsy was performed (group III, control group, n = 702).

RESULTS: Blastocyst formation was significantly better in group III compared with group II, and similar to group I. Group I and group II did not differ in Day 3 nor in Day 5 embryo development. The overall live birth rate was significantly higher in group I (37.4%, CI 29.0–47.4%) than in group II (22.4%, CI 17.0–28.9%), and comparable to the reference ICSI population (35.0%, CI 30.8–39.7%).

CONCLUSIONS: The clinical outcome of 1-cell biopsy was significantly better than that of 2-cell biopsy, even when adjusted for availability of genetically transferable embryos.

Key words: cleavage-stage embryo biopsy/single blastocyst transfer/PGD/1-cell removal/2-cell removal

Submitted on March 13, 2009; resubmitted on June 11, 2009; accepted on June 18, 2009.


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