EC Gynaecology

As with any assisted reproductive technology, blastocyst stage embryo biopsy for comprehensive chromosome screening continues to evolve in FET cycles as a strategy to optimize reproductive outcomes for the patient, decrease the risk of fetal loss due to whole chromosome aneuploidy, and to limit risk of transferring single gene disorders to the offspring. The concern for embryo damage with embryo biopsy has been addressed multiple times in the literature; however, embryo rebiopsy for a non-actionable original result has not been robustly investigated. Further, there is significant variation in embryo morphologic grading and quality and this can variably affect the post biopsy recovery of an embryo. This commentary outlines how biopsy day and embryo scoring, in the setting of embryo re-biopsy, have been accounted in the studies and could potentially impact the current evidence on the topic [1-3].

1. Zhuo R., et al. “Comparison of pregnancy outcomes between single-biopsied and rebiopsied euploid embryos”. Fertility and Sterility4 (2023): e51.
2. Cam van NT. ““No Result” Embryos After PGTA: Should They Be Disposed?” Fertility and Reproduction4 (2023): 419.
3. Bhaumik R., et al. “Fate of thaw-biopsied/re-biopsied embryos: an analysis of clinical pregnancy outcomes for day 5 and 6 embryos”. Fertility and Sterility1 (2023): e69.
4. Theodorou E., et al. “Impact of double trophectoderm biopsy on reproductive outcomes following single euploid blastocyst transfer”. European Journal of Obstetrics and Gynecology and Reproductive Biology 298 (2024): 35-40.
5. Mao D., et al. “Impact of trophectoderm biopsy for preimplantation genetic testing on obstetric and neonatal outcomes: a meta-analysis”. American Journal of Obstetrics and Gynecology 2 (2024): 199-212.e5.
6. De Vos A., et al. “Multiple vitrification-warming and biopsy procedures on human embryos: clinical outcome and neonatal follow-up of children”. Human Reproduction 11 (2020): 2488-2496.
7. Kim JG., et al. “Neonatal outcomes are not impacted by a second trophectoderm biopsy”. Fertility and Sterility3 (2021): e288.
8. Cimadomo D., et al. “Inconclusive chromosomal assessment after blastocyst biopsy: prevalence, causative factors and outcomes after re-biopsy and re-vitrification. A multicenter experience”. Human Reproduction10 (2018): 1839-1846.
9. Chae-Kim J., et al. “How to deal with confounders in an infertility study?” Fertility and Sterility 6 (2023): 897-901.
10. Balaban B., et al. “Istanbul consensus workshop on embryo assessment: Proceedings of an expert meeting”. Reproductive BioMedicine Online 6 (2011): 632-646.
11. Capalbo A., et al. “Correlation between standard blastocyst morphology, euploidy and implantation: an observational study in two centers involving 956 screened blastocysts”. Human Reproduction 6 (2014): 1173-1181.