Can trophectoderm morphology act as a predictor for euploidy?

OBJECTIVE: Euploid embryo transfers yield better implantation rates. In Brazil, morphological evaluation is performed to select the best embryos, since genetic analysis is still an expensive procedure. This study aimed to evaluate whether there is an association between trophectoderm morphology and ploidy status. METHODS: The study included 113 blastocysts formed in D5/D6 from 58 in vitro fertilization cycles held from January/2016 to May/2017. All patients with indication for PGD/PGS were included in the study. The mean age of the female patients was 37.04±5.65years. Biopsied blastocysts were categorized for morphology. Cells were sent for genetic analysis using the CGH array, SNP array or NGS techniques. Statistical analysis was performed using the chi square test, and statistical significance was assigned to differences with p≤0.05. RESULTS: Chromosome analysis revealed that 44 (38.9%) blastocysts were euploid. Blastocysts with trophectoderm grades A, B, and C had euploidy rates of 71.43%, 60% and 19.67%, respectively (p≤0.05). CONCLUSION: Although the best trophectoderm morphology grades had higher euploidy rates, this indicator alone is not enough to warrant embryo genetic viability.

The impact of high progesterone levels on the day of HCG administration in assisted human reproduction treatments.

OBJECTIVE: Progesterone is a steroid hormone that acts on the endometrium. It is known for producing physical and mood-related side effects. Few studies have looked into how progesterone levels affect embryo development and quality. This study aimed to find a cutoff level for serum progesterone on the day of HCG administration from which embryo quality is impaired. METHODS: The study included 145 cycles, from which 885 oocytes and 613 embryos were obtained. All patients had their serum progesterone levels measured on the day of HCG administration. Data sets were collected from patient medical records. The chi-square test was used to assess qualitative variables and the Mann-Whitney test to evaluate quantitative variables. RESULTS: Statistical analysis revealed that serum progesterone levels and reproductive variables were not significantly associated. In regards to oocyte maturity, however, when progesterone levels were greater than 1.3 ng/mL the probability of oocytes being immature increased by 12.7%. The fragmentation rate of embryos categorized as "top quality" in D3 increased proportionately to increases in progesterone levels (12.23%). CONCLUSION: High progesterone levels appeared to be correlated with increased embryo fragmentation rates, but high serum levels of the hormone on the day of HCG administration had no impact on reproductive variables and were not associated with impaired embryo development.