Short-Term Safety of Blastocyst Biopsy in Young Women Undergoing FET-ICSI: Findings and Future Directions

Recent study aimed to investigate the association between blastocyst biopsy for preimplantation genetic testing (PGT) and maternal as well as neonatal outcomes during frozen embryo transfer (FET) cycles in women aged ≤ 35 years following intracytoplasmic sperm injection (ICSI). The retrospective study was conducted at a tertiary hospital and included women who had undergone single FET cycles resulting in singleton live births of ≥ 28 weeks gestation between January 2020 and June 2022. Women with specific criteria including single blastocyst transfer, age between 20-35 years, BMI ≤ 30 kg/m2, and absence of chronic diseases were included in the study. The patients were divided into two groups: a PGT group (n=269) whose blastocysts underwent trophectoderm biopsy and a control group (n=739) with blastocysts that did not undergo biopsy.

Detailed Methods and Monitoring

The methods for ovarian stimulation, oocyte retrieval, ICSI, and blastocyst biopsy were described in detail. Following the biopsy, only blastocysts with euploid or mosaic embryos were transferred in subsequent FET cycles. Maternal and newborn outcomes were monitored and documented electronically by experienced nurses. Maternal outcomes such as hypertensive disorders of pregnancy (HDP), gestational diabetes mellitus (GDM), and neonatal outcomes like preterm birth (PTB) and small for gestational age (SGA) were investigated.

The results of the study indicated that there were no significant differences in maternal and neonatal outcomes between the PGT group and the control group. Factors like maternal age, BMI, infertility duration, endometrial thickness, and embryo quality transfer did not show significant disparities between the two groups. Univariate regression analyses did not reveal any significant differences in outcomes except for a higher percentage of female newborns in the PGT group compared to the control group (p < 0.05).

Literature Review and Comparison

The discussion highlighted previous studies on the impact of PGT on maternal and neonatal outcomes, with some studies showing conflicting results. The current study's findings were consistent with studies that reported no adverse effects of PGT on maternal and neonatal outcomes. The study narrowed down the analysis to women ≤ 35 years undergoing single live birth FET cycles following ICSI to more accurately assess the association between blastocyst biopsy and adverse perinatal outcomes.

Limitations and Conclusion

The study acknowledged its limitations including a restricted sample size, potential recall bias in patient reports, and the lack of information on long-term effects of blastocyst biopsy on offspring development. In conclusion, the study suggested that blastocyst biopsy may not increase the risks of adverse maternal and neonatal outcomes in the short term for women aged ≤ 35 years undergoing FET cycles following ICSI. Larger cohort studies are recommended to validate these findings and determine the applicability of the results to older age groups.

Key Points

- The study investigated the association between blastocyst biopsy for preimplantation genetic testing (PGT) and maternal as well as neonatal outcomes during frozen embryo transfer (FET) cycles in women aged ≤ 35 years following intracytoplasmic sperm injection (ICSI).

- It was a retrospective study conducted at a tertiary hospital involving women who had undergone single FET cycles resulting in singleton live births of ≥ 28 weeks gestation between January 2020 and June 2022.

- The study included women meeting specific criteria such as single blastocyst transfer, age between 20-35 years, BMI ≤ 30 kg/m2, and absence of chronic diseases, with the patients divided into a PGT group (n=269) and a control group (n=739).

- Methods for ovarian stimulation, oocyte retrieval, ICSI, and blastocyst biopsy were detailed, with only blastocysts with euploid or mosaic embryos transferred in subsequent FET cycles. Maternal and newborn outcomes, including hypertensive disorders of pregnancy, gestational diabetes mellitus, preterm birth, and small for gestational age, were monitored.

- The results showed no significant differences in maternal and neonatal outcomes between the PGT group and the control group, with factors like maternal age, BMI, infertility duration, endometrial thickness, and embryo quality transfer showing no significant disparities.

- The study discussed previous literature on the impact of PGT on maternal and neonatal outcomes, with findings consistent with studies reporting no adverse effects of PGT. Limitations included a small sample size and lack of information on long-term effects, suggesting that blastocyst biopsy may not increase risks of adverse outcomes in the short term for women aged ≤ 35 years undergoing FET cycles after ICSI, but larger cohort studies are needed for validation.

Reference –

Tingting He et al. (2025). Impact Of Blastocyst Biopsy For Preimplantation Genetic Testing On Maternal And Neonatal Outcomes Following Single Frozen Embryo Transfer Cycles. *BMC Pregnancy And Childbirth*, 25. https://doi.org/10.1186/s12884-024-07107-5.