Oocyte karyotyping by comparative genomic hybridization [correction of hybrydization] provides a highly reliable method for selecting "competent" embryos, markedly improving in vitro fertilization outcome: a multiphase study.
OBJECTIVE
To assess the karyotypic relationship between prefertilized/postfertilized oocytes and embryos using comparative genomic hybridization (CGH) on polar body-1 (PB-1), PB2, and blastomere biopsies and to evaluate IVF outcomes after transfer of blastocysts derived from euploid oocytes.


METHODS
Prospective cohort.


METHODS
Medical center.


METHODS
Phase1: Fourteen oocyte donors (23-29 years). Phase 2: Forty-one healthy embryo recipients aged 29-43 years free of endometrial implantation dysfunction. In 30 cases own eggs were used. Eleven women used donated oocytes.


METHODS
Phase 1: PB-1 biopsies followed intracytoplasmic sperm injection (ICSI), PB-2, and day 3 blastomere biopsies. Phase 2: PB-1 biopsy followed by ICSI using normal sperm and the subsequent embryo transfer of < or =2 blastocysts derived from euploid oocytes. Comparative genomic hybridization on all DNA derived from phase 1 and 2 biopsies.


METHODS
Pregnancy and implantation rate.


RESULTS
Phase 1: 39% of oocytes and 88% of zygotes were euploid; >95% progressed to blastocysts. Mosaicism as evidenced by euploid oocytes developing into aneuploid zygotes or embryos occurred in 13% of concepti. Phase 2: Six of 30 women using own eggs, who failed to produce euploid oocytes, were cancelled. Thirty-five women underwent embryo transfers with < or =2 (mean, 1.3 +/- 0.7) blastocysts derived from euploid oocytes. The ongoing pregnancy/implantation rates per embryo transfer were 74% and 82%, respectively.


CONCLUSIONS
Transferring euploid embryos markedly improved IVF outcome. These findings, if corroborated, could initiate a paradigm shift in assisted reproductive technology (ART).
Sher
Geoffrey
G
Sher Institute for Reproductive Medicine, Las Vegas, Nevada 89109, USA. gsher@sherinstitute.com
Keskintepe
Levent
L
Keskintepe
Meral
M
Ginsburg
Mike
M
Maassarani
Ghanima
G
Yakut
Tahsin
T
Baltaci
Volkan
V
Kotze
Dirk
D
Unsal
Evrim
E
D000328:Adult; D015331:Cohort Studies; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D015894:Genome, Human; D006801:Humans; D007621:Karyotyping / Q000379:methods*; D009693:Nucleic Acid Hybridization / Q000379:methods*; D009865:Oocytes / Q000502:physiology*; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies