Fertility Center Put on ice twice: a problem? Comparison of trophectoderm biopsy (Tebx) with preimplantation genetic screening (pgs) in cycles usiNg previously.

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Fertility Center Put on ice twice: a problem? Comparison of trophectoderm biopsy (Tebx) with preimplantation genetic screening (pgs) in cycles usiNg previously frozen vs. fresh autologous oocytes Nicole Noyes, Hsiao-Ling Lee, Sarah Druckenmiller, Patty Labella, Esmeralda Ampeloguio, James Grifo

OBJECTIVE Use of oocyte cryopreservation and TEBX with PGS has rapidly increased over the past decade Together, they allow women to have children when ready and limit embryo transfer to a single euploid blastocyst Aim: to assess whether adding TEBX with PGS to oocyte cryopreservation impacted outcomes Retrospective cohort study Reviewed all autologous oocyte cryopreservation and fresh cycles using TEBX with PGS at our large university-based fertility center Fertility Center

OOCYTE CRYOPRESERVATION RESULTS OOCYTE CRYOPRESERVATION (n = 116 cycles) FRESH (n = 1446 cycles) Median age (y) 39 + 2 No. oocytes survived & assessed as MII at thaw 1004 (78%) Cycles with > 1 blastocyst suitable for TEBX 93/116 (80%) (mean 4 / cycle)* 1243/1446 (86%) (mean 5 / cycle)* TEBX cycles with > 1 euploid blastocyst 57/93 (61%) 753/1243 (61%) Embryo implantation rate 30/51 (59%) 671/963 (70%) Ongoing + delivered rate / transfer 27/50 (54%) 566/941 (60%) Fertility Center

CONCLUSIONS Oocyte cryopreservation was associated with fewer blastocysts suitable for TEBX, but not a lower proportion of cycles with at least one biopsiable blastocyst Euploidy rate per biopsied blastocyst as well as implantation and ongoing + delivered rate per transferred euploid blastocyst were similar whether starting with frozen or fresh oocytes Adding TEBX to oocyte cryopreservation appears potentially beneficial in affording single embryo transfer and thus singleton live birth Fertility Center