Dr. Zhang’s October Pick of the Month

Hello everyone. I’m hoping to start making this blog a little bit more interactive and put some things out here for comments and debate. I’m encouraging everyone who stops by to leave a comment, question, or any other kind of feedback. I would love to hear from you!

One of the first hot topics that I wanted to post about are Array Comparative Genomic Hybridization (aCGH) and Time-Lapse monitoring via Embryoscope. I recently co-authored a pilot study that indicated that implantation and ongoing pregnancy rates improve when time-lapse monitoring is combined with aCGH in IVF patients undergoing preimplantation genetic screening.

Time-lapse monitoring has given us new morphokinetic markers for identifying embryos with higher probabilities of successful implementation. We set to determine whether using these new markers in conjunction with conventional aCGH techniques would result in better outcomes for IVF patients undergoing Preimplantation Genetic Screening, otherwise known as PGS.

In a blind study, 1163 sibling MII oocytes from 138 patients with a mean age of 36.6 plus/minus 2.4 years were randomized into two groups. Group A oocytes were cultured using time-lapse technology. Group B oocytes were cultured in a conventional incubator. Both groups then underwent whole genomic amplification and aCGH after trophectoderm biopsy on day 5. One to two euploid blastocysts were selected from each group for transfer to patients on day 6.

We compared the ongoing pregnancy and implantation rates for both groups and found significant differences in both clinical and ongoing pregnancy rates between the two groups. The clinical pregnancy rate for the group using time lapse techniques was 71.1%. The rate for the group cultured conventionally was 45.9%. The ongoing pregnancy rate for the time-lapse group was 68.9% compared to 40.5% for the group cultured conventionally.

Additionally, the study showed that implantation rates per embryo increased significantly in the group using both time-lapse and aCGH compared to the group using aCGH only. There was no significant difference in miscarriage rates between the groups.

This is the first study of its kind using sibling oocytes to measure the efficiency of methods for selecting competent blastocysts for transfer. For patients undergoing preimplantation genetic screening this is good news. The data clearly shows that using both time lapse and aCGH confers a significant benefit.

You can read more about this by seeing the article here: http://www.biomedcentral.com/1755-8794/7/38

I’d love to hear your thoughts on this!

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