title: Multinucleation of a sibling blastomere on day 2 suggests unsuitability for embryo transfer in IVF-preimplantation genetic screening cycles.
abstract: OBJECTIVE
  To evaluate the impact of multinucleation of a sibling blastomere of day 2 embryos on the rate of aneuploidy detected by day 3 preimplantation genetic screening (PGS) biopsy and the effect on subsequent implantation and pregnancy rates.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  University-based IVF center.
  
  
  METHODS
  A total of 141 couples undergoing their first IVF-PGS cycle for idiopathic recurrent pregnancy loss (RPL) or multiple failed IVF implantations.
  
  
  METHODS
  Biopsy of single-nucleated blastomeres for PGS analysis of chromosomes X, Y, 13, 15, 16, 17, 18, 21, and 22 by fluorescence in situ hybridization.
  
  
  METHODS
  Aneuploidy, implantation, and pregnancy rates.
  
  
  RESULTS
  PGS revealed an increased incidence of aneuploidy when comparing multinucleated day 2 embryos with single-nucleated embryos (85% vs. 78%; relative risk 0.92 (95% confidence interval 0.84-1.00). Transfer of single-nucleated euploid embryos resulted in clinical pregnancy and implantation rates of 28% and 24%. Transfer of multinucleated euploid embryos resulted in no implantations.
  
  
  CONCLUSIONS
  The presence of multinucleated blastomeres on day 2 of embryo development, 1 day before biopsy, predicts an increase of aneuploidy and poor pregnancy outcomes in IVF-PGS cycles.
authors.affiliation: Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, George Washington University, Washington, DC 20037, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ambroggio
authors.forename: Paul R
authors.initials: PR
authors.lastname: Gindoff
authors.forename: Molina B
authors.initials: MB
authors.lastname: Dayal
authors.forename: Reem
authors.initials: R
authors.lastname: Khaldi
authors.forename: Doug
authors.initials: D
authors.lastname: Peak
authors.forename: David
authors.initials: D
authors.lastname: Frankfurter
authors.forename: Anil K
authors.initials: AK
authors.lastname: Dubey
mesh_terms: D000328:Adult; D000782:Aneuploidy; D001757:Blastomeres / Q000737:chemistry / Q000502:physiology*; D002467:Cell Nucleus / Q000502:physiology; D015331:Cohort Studies; D004624:Embryo Transfer / Q000592:standards; D005260:Female; D005307:Fertilization in Vitro / Q000592:standards; D005820:Genetic Testing / Q000592:standards; D006801:Humans; D009924:Organ Culture Techniques; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000235:genetics; D019836:Preimplantation Diagnosis / Q000592:standards; D012189:Retrospective Studies; D035781:Siblings