title: Is it acceptable to destroy or include human embryos before day 5 in research programmes?
abstract: Day-3 poor-quality embryos (PQE) from IVF-embryo transfer cycles are usually destroyed or are included in research programmes. Knowing that these embryos have the ability to evolve to the blastocyst stage and yield embryonic stem cell lines, this study postulated that they could also give rise to live births. This is a prospective study including 186 IVF-embryo transfer candidates who had obtained at least one supernumerary PQE on day 3. PQE were kept for extended culture and high-quality blastocysts were frozen. A total of 620 PQE were eligible for the study, 217 (35.0%) reached the blastocyst stage and 73 (33.6%) were frozen. Blastulation rates were 7-fold higher (OR 7.29, 95% CI 5.01-10.61) in embryos compacted on day 4. Of the frozen blastocysts, 40 were thawed during 33 thawed blastocyst transfer cycles, which led to 10 clinical pregnancies. These pregnancies resulted in five miscarriages and five healthy live births at full term. PQE may achieve their development to the blastocyst stage, be frozen-thawed and harbour reasonable implantation potential. These results, thereby, raise an ethical issue regarding the fate reserved to PQE.
authors.affiliation: APHP, Reproductive Biology Unit, Antoine Béclère Hospital, F-92140, France; University Paris-Sud, UMR-967, F-92265, France.
authors.forename: Marine
authors.initials: M
authors.lastname: Poulain
authors.affiliation: APHP, Reproductive Biology Unit, Antoine Béclère Hospital, F-92140, France.
authors.forename: Laetitia
authors.initials: L
authors.lastname: Hesters
authors.affiliation: University Claude Bernard Lyon I, Villeurbanne, France.
authors.forename: Thibaut
authors.initials: T
authors.lastname: Sanglier
authors.affiliation: APHP, Reproductive Biology Unit, Antoine Béclère Hospital, F-92140, France.
authors.forename: Astrid
authors.initials: A
authors.lastname: de Bantel
authors.affiliation: APHP, Reproductive Medicine Unit, Antoine Béclère Hospital, F-92140, France; University Paris-Sud, Clamart, France.
authors.forename: Renato
authors.initials: R
authors.lastname: Fanchin
authors.affiliation: APHP, Reproductive Biology Unit, Antoine Béclère Hospital, F-92140, France; University Paris-Sud, UMR-967, F-92265, France. Electronic address: nelly.frydman@abc.aphp.fr.
authors.forename: Nelly
authors.initials: N
authors.lastname: Frydman
authors.affiliation: APHP, Reproductive Medicine Unit, Antoine Béclère Hospital, F-92140, France; University Paris-Sud, Clamart, France.
authors.forename: Michael
authors.initials: M
authors.lastname: Grynberg
mesh_terms: D000328:Adult; D010064:Embryo Implantation; D033041:Embryo Research / Q000941:ethics*; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D050498:Live Birth; D011247:Pregnancy; D011446:Prospective Studies; D013997:Time Factors
keywords: PQE; blastulation; embryo wastage; ethical practice; implantation; live-birth rate