Irregular cleavage in early embryogenesis does not reduce the euploidy after reaching the blastocyst (第36回 ヨーロッパ生殖医学会(ESHRE))
Shinichi Watanabe1, Kaori Yoshikai1, Mari Tomida1, Shigenori Suzuki1,
Yukino Matsuda1, Shunsuke Miyai2, Takema Kato2, Hiroki Kurahashi2,
Eiko Nakano1, Tomio Sawada1

1 Sawada Women’s Clinic, Nagoya, Japan
2 Institute for Comprehensive Medical Science, Fujita Health University, Toyoake, Japan

Study question:
Does euploid rate decrease when the irregular first or second cleavage embryos reach the blastocyst?

Summary answer:
The euploidy of the irregular first or second cleavage blastocysts was equivalent to the normal cleavage blastocysts.

What is known already:
There are some reports that aneuploidy is high when the irregular cleavage embryos develop into blastocysts but there are reports that the rate of transfer pregnancy and miscarriage of irregular cleavage blastocysts is equivalent to that of the normal cleavage blastocysts.

Study design, size, duration:
Retrospective analysis was conducted on 96 discarded blastocysts with consent from patients out of embryos collected and cultured in our clinic from 2013 to 2018. All of these embryos were time-lapse monitored by EmbryoScope (Vitrolife).

Participants/materials, setting, methods:
The subject embryos were biopsied with TE and NGS chromosome analysis was performed. These embryos were classified by time-lapse videos, those with 2 cells in the first cleavage and 4 cells in the second cleavage are the good cleavage groups, those with 3 or more cells in the first cleavage, or those with 5 cells or more in the second cleavage are the irregular cleavage groups.

Main results and the role of chance:
As a result of image analysis by time-lapse monitoring, there were 53 good cleavage groups and 43 irregular cleavage groups. The proportions of euploid embryos, aneuploid embryos and mosaic embryos were 43.4% (23), 45.3% (24) and 11.3% (6) in the good cleavage group, 41.9% (18), 46.5% (20), and 11.6% (5) in the irregular cleavage group, there was no significant difference in euploid rate between the two groups (The odds ratio of the euploid rate of the irregular cleavage group to the good cleavage group was 0.94).

Limitations, reasons for caution:
Because PGT-A is not approved in Japan, this study was conducted using only discarded embryos that were not used for transfer with the consent of the patient.

Wider implications of the findings:
This study showed that Irregular cleavage in early embryogenesis did not reduce the euploid rate after reaching the blastocyst. Irregular cleavage embryos that have reached the blastocyst need not be excluded from transfer.

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