title: Day-3 embryo morphology predicts euploidy among older subjects.
abstract: OBJECTIVE
  To evaluate whether day-3 embryo morphology predicts euploidy.
  
  
  METHODS
  Retrospective.
  
  
  METHODS
  Private IVF center.
  
  
  METHODS
  Subjects (n = 144) undergoing in vitro fertilization and preimplantation genetic diagnosis (PGD).
  
  
  METHODS
  Translate day-3 embryo characteristics into a standardized score.
  
  
  METHODS
  Day-3 embryo morphology score and PGD fluorescence in situ hybridization results for chromosomes: 13, 15, 16, 17, 18, 21, 22, X, and Y.
  
  
  RESULTS
  Of 1,043 biopsied blastomeres, 67% (n = 696) were chromosomally abnormal. Women with advanced maternal age (AMA) were 1.3 times more likely to have chromosomal errors (95% CI 1.1-1.4) than younger subjects (<38 years old). Morphology predicted PGD results in the AMA group (n = 553), but not in younger women. Fragmentation predicted euploidy in both the younger and the AMA group, but cell number did not.
  
  
  CONCLUSIONS
  Day-3 embryo morphology selects for euploidy among AMA subjects but not among younger women who may have other factors responsible for embryo dysmorphism. However, cellular fragmentation is a sensitive proxy for selecting chromosomally normal embryos in both age groups. It is unclear that PGD-aneuploidy screening is a better tool for selecting which embryos to transfer than the standard approach of using day-3 embryo features, particularly among older women, a group for whom this technology is targeted.
authors: Department of Obstetrics and Gynecology, Stanford University Medical Center, Stanford, California 94305, USA. smoayeri@stanford.edu
authors: Sharon E
authors: SE
authors: Moayeri
authors: Rene B
authors: RB
authors: Allen
authors: Wendy R
authors: WR
authors: Brewster
authors: Moon H
authors: MH
authors: Kim
authors: Manuel
authors: M
authors: Porto
authors: Lawrence B
authors: LB
authors: Werlin
mesh_terms: D000328:Adult; D000782:Aneuploidy; D001755:Blastocyst / Q000473:pathology*; D046149:Embryo Culture Techniques; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D005820:Genetic Testing; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008423:Maternal Age; D011237:Predictive Value of Tests; D011247:Pregnancy; D019836:Preimplantation Diagnosis / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors