title: Polar body based aneuploidy screening is poorly predictive of embryo ploidy and reproductive potential.
abstract: OBJECTIVE
  Polar body (polar body) biopsy represents one possible solution to performing comprehensive chromosome screening (CCS). This study adds to what is known about the predictive value of polar body based testing for the genetic status of the resulting embryo, but more importantly, provides the first evaluation of the predictive value for actual clinical outcomes after embryo transfer.
  
  
  METHODS
  SNP array was performed on first polar body, second polar body, and either a blastomere or trophectoderm biopsy, or the entire arrested embryo. Concordance of the polar body-based prediction with the observed diagnoses in the embryos was assessed. In addition, the predictive value of the polar body -based diagnosis for the specific clinical outcome of transferred embryos was evaluated through the use of DNA fingerprinting to track individual embryos.
  
  
  RESULTS
  There were 459 embryos analyzed from 96 patients with a mean maternal age of 35.3. The polar body-based predictive value for the embryo based diagnosis was 70.3%. The blastocyst implantation predictive value of a euploid trophectoderm was higher than from euploid polar bodies (51% versus 40%). The cleavage stage embryo implantation predictive value of a euploid blastomere was also higher than from euploid polar bodies (31% versus 22%).
  
  
  CONCLUSIONS
  Polar body based aneuploidy screening results were less predictive of actual clinical outcomes than direct embryo assessment and may not be adequate to improve sustained implantation rates. In nearly one-third of cases the polar body based analysis failed to predict the ploidy of the embryo. This imprecision may hinder efforts for polar body based CCS to improve IVF clinical outcomes.
authors.affiliation: Division of Reproductive Endocrinology, Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, 08901, USA.
authors.forename: C N
authors.initials: CN
authors.lastname: Salvaggio
authors.forename: E J
authors.initials: EJ
authors.lastname: Forman
authors.forename: H M
authors.initials: HM
authors.lastname: Garnsey
authors.forename: N R
authors.initials: NR
authors.lastname: Treff
authors.forename: R T
authors.initials: RT
authors.lastname: Scott
mesh_terms: D000328:Adult; D000782:Aneuploidy; D010064:Embryo Implantation; D004622:Embryo, Mammalian / Q000166:cytology*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D059705:Polar Bodies; D011237:Predictive Value of Tests; D019836:Preimplantation Diagnosis / Q000379:methods*
references.citation: Mol Cytogenet. 2012 May 02;5(1):24
references.pmid: 22551456
references.citation: Hum Reprod. 2013 May;28(5):1426-34
references.pmid: 23477909
references.citation: Hum Reprod Update. 2004 Sep-Oct;10(5):401-7
references.pmid: 15319376
references.citation: Fertil Steril. 2010 Nov;94(6):2017-21
references.pmid: 20188357
references.citation: Fertil Steril. 2010 Feb;93(3):1006.e7-1006.e10
references.pmid: 19939361
references.citation: Fertil Steril. 2013 Jul;100(1):100-7.e1
references.pmid: 23548942
references.citation: Biochem Mol Med. 1996 Jun;58(1):13-7
references.pmid: 8809340
references.citation: J Med Genet. 2011 Jul;48(7):433-7
references.pmid: 21617258
references.citation: Hum Reprod. 2011 Nov;26(11):3173-80
references.pmid: 21908463
references.citation: Hum Reprod. 2012 Apr;27(4):951-3
references.pmid: 22328558
references.citation: Fertil Steril. 2010 Jul;94(2):477-84
references.pmid: 19394599
references.citation: Hum Reprod. 2012 Apr;27(4):1217-22
references.pmid: 22343551
references.citation: Hum Reprod. 2013 Feb;28(2):509-18
references.pmid: 23148203
references.citation: Hum Reprod. 2011 Nov;26(11):3181-5
references.pmid: 21908464
references.citation: Hum Reprod. 2010 Mar;25(3):575-7
references.pmid: 20031957
references.citation: Fertil Steril. 2011 Sep;96(3):638-40
references.pmid: 21782169
references.citation: Fertil Steril. 2012 Apr;97(4):870-5
references.pmid: 22305103
references.citation: Fertil Steril. 2012 Feb;97(2):395-401
references.pmid: 22195772
references.citation: Hum Reprod. 2013 Feb;28(2):502-8
references.pmid: 23169867
references.citation: Mol Hum Reprod. 2011 Jul;17(7):434-8
references.pmid: 21357209
references.citation: Hum Mol Genet. 2007 Oct 15;16 Spec No. 2:R203-8
references.pmid: 17911163
references.citation: Eur J Hum Genet. 2012 Jul;20(7):742-7
references.pmid: 22317970
references.citation: Hum Genet. 2013 Sep;132(9):1001-13
references.pmid: 23620267
references.citation: J Assist Reprod Genet. 2012 Jun;29(6):533-7
references.pmid: 22460080