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Factors associated with vitrification-warming survival in 6167 euploid blastocysts

  • Assisted Reproduction Technologies
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

To understand the clinical factors associated with embryo survival after vitrification in a cohort of human blastocysts screened by preimplantation genetic testing for aneuploidy (PGT-A).

Methods

Patient demographic, embryo, and cycle characteristics associated with failed euploid blastocyst survival were compared in a cohort of women (n = 6167) who underwent IVF-PGT-A.

Results

Compared to those that survived warming, vitrified euploid embryos that failed to survive after warming came from IVF cycles with significantly higher estradiol levels at time of surge (2754.8 ± 1390.2 vs. 2523.1 ± 1190.6 pg/mL, p = 0.03), number of oocytes retrieved (19.6 ± 10.7 vs. 17.5 ± 9.8, p = 0.005), and basal antral follicle count (BAFC) (15.3 ± 8.5 vs. 13.9 ± 7.2, p = 0.05). Euploid embryos were less likely to survive warming if they came from cycles before 2015 (24.6% vs. 13.2%, p < 0.001), were cryopreserved on day 7 versus day 5 or 6 (9.1% vs. 3.0%, p < 0.001), underwent two trophectoderm biopsies (6.9% vs. 2.3%, p < 0.001), had a grade C inner cell mass (15.4% vs. 7.7%, p < 0.001), or were fully hatched (41.1% vs. 12.2%, p < 0.001). In the multivariate model, which controlled for relevant confounders, the association between decreased survival and increased BAFC, year of IVF cycle, double trophectoderm biopsy, and fully hatched blastocysts remained statistically significant.

Conclusion

Euploid embryos that are fully hatched at time of vitrification, come from patients with high ovarian reserve, or require repeat trophectoderm biopsy are less likely to survive vitrification-warming. Our results provide a framework for reproductive counseling and offer realistic expectations to patients about the number of embryos needed to achieve family building goals.

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Data availability

Data is available upon request.

Code availability

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Authors and Affiliations

  1. Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai School of Medicine, Klingenstein Pavilion, 1176 Fifth Ave., 9th Floor, New York, NY, 10029, USA

    Margeaux Oliva, Alan B. Copperman & Lucky Sekhon

  2. Reproductive Medicine Associates of New York, 635 Madison Ave., 10th Floor, New York, NY, 10022, USA

    Christine Briton-Jones, Dmitry Gounko, Joseph A. Lee, Alan B. Copperman & Lucky Sekhon

Authors
  1. Margeaux Oliva
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  2. Christine Briton-Jones
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  3. Dmitry Gounko
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  4. Joseph A. Lee
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  5. Alan B. Copperman
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  6. Lucky Sekhon
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Contributions

MO, CB, DG, JAL, ABC, and LS contributed to the design and implementation of the research, the analysis of the results, and the writing of the manuscript.

Corresponding author

Correspondence to Margeaux Oliva.

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Ethics approval

This study was approved by the Icahn School of Medicine at Mount Sinai Institutional Review Board with a waiver of consent for retrospective analysis of de-identified data.

Conflict of interest

ABC is the Chief Medical Officer of Sema4 and Medical Director of Progyny. MO, CB, DG, JAL, and LS have no relevant financial or non-financial interests to disclose.

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Oliva, M., Briton-Jones, C., Gounko, D. et al. Factors associated with vitrification-warming survival in 6167 euploid blastocysts. J Assist Reprod Genet 38, 2671–2678 (2021). https://doi.org/10.1007/s10815-021-02284-0

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  • DOI: https://doi.org/10.1007/s10815-021-02284-0

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