O-272 Preimplantation genetic testing of the first polar body is useful for predicting embryo euploidy: data from 1,836 donor oocytes
Authors: Maggiotto G , Aydin B , Strelko H , Hudkova D , Unsal E , Kal N  S , Yetim I , Misyura Y , Kotliarova E , Vitushynska M , Dorofeyeva U 
Published: July 2024

Abstract

Study question
Can preimplantation genetic testing of the first polar body (PGT-1BP) accurately identify donor oocytes that will produce euploid embryos?

Summary answer
Oocyte chromosomal status determined through PGT-1BP had a strong association with embryo euploidy.

What is known already
Aberrant meiosis during oocyte development leads to aneuploidy, diminished embryo quality, and ultimately, poor reproductive outcomes. Preimplantation genetic testing for aneuploidies (PGT-A) is increasingly employed in donor oocyte cycles, detecting blastocyst euploidy rates ranging from 30% to 80%. However, this variability, together with the clinical and patient resources required to generate blastocysts, support the need for alternative approaches. Oocyte chromosomal status can safely be determined with PGT-1PB. This strategy has shown that 20–30% oocytes obtained from donors with proven fertility are aneuploid, allowing clinicians and patients to make informed reproductive decisions.

Study design, size, duration
In this prospective study, PGT-1BP was performed on 1,836 fresh donor oocytes collected between September 2017 and January 2022. Vitrified-thawed euploid oocytes were grouped according to donor age (n = 714, n = 554, and n = 568 from 20–24, 25–29, and 30–34-year-old donors, respectively). Oocyte survival and chromosomal status, fertilization through ICSI, blastocyst use and euploidy status were analyzed.

Participants/materials, setting, methods
Oocytes were derived from donors (n = 115) whose oocytes previously led to at least one live birth. First polar body biopsies were performed 2 hours after in vitro maturation, which corresponds to 38 hours post-hCG trigger. PGT-1BP and PGT-A analyses were performed on the Illumina platform. Oocyte and embryology data as well as the association between oocyte and embryo chromosomal status was evaluated using Mann-Whitney U test.

Main results and the role of chance
The post-thawing viability rates for the biopsied oocytes were 98.2%, 99.5%, and 96.5% for the three age groups, respectively. Donor oocyte euploidy significantly decreased with advancing age (81.9% vs. 76.9% vs. 70.0%, respectively; p ≤ 0.05). The rate of blastocyst use was comparable across age groups (68.1% vs. 71.7% vs. 68.7%, respectively; p &gt; 0.05). Blastocysts derived from euploid oocytes maintained their euploid status in 88.7%, 90.1%, and 85.6% of cases, respectively. Euploid oocyte-euploid blastocyst matching rates were 89.2%, 90.1%, and 88.1%.

Limitations, reasons for caution
Although PGT-1BP may not guarantee euploid embryos, it could allow clinicians and couples to make informed decisions about proceeding with fertilization and embryo culture. The associations between euploidy rate of embryos derived from euploid donor oocytes should be confirmed in further studies with larger cohorts.

Wider implications of the findings
Selecting euploid oocytes with a high probability of becoming euploid embryos may increase the odds of achieving a successful pregnancy at the first attempt. This approach is cost-effective, could prevent unnecessary emotional distress for patients, and is an attractive option for couples with limited sperm available for IVF/ICSI.

Trial registration number
not applicable