Advantages of day 4 embryo transfer in patients undergoing preimplantationgenetic diagnosis of aneuploidy

Purpose: Following preimplantation genetic diagnosis of aneuploidy, embryo transfer was executed on day 4, with the aim of providing more time for exp anding from six to nine the number of diagnosed chromosomes per single cell (Group 2; 45 cycles). The results obtained were compared to those derived from conventional day 3 transfer (Group 1; 71 cycles). Methods: For multicolor fluorescence in situ hybridization analysis, two pa nels of probes were used: the first, specific for chromosomes XY, 13, 16, 1 8, and 21, was rested in all patients (Groups 1 and 2); the second was impl emented only in Group 2 patients for the detection of chromosomes 14, 15, a nd 22. Results: A total of 406 embryos underwent fluorescence in situ hybridizatio n analysis in Group 1, mid 236 in Group 2. Comparable percentages of both c hromosomal abnormalities (61% and 62%) and Pregnancy and implantation rates (36% and 24.5% in Group 1, 41% and 23.6% in Group 2) resulted, regardless of the higher mean age in Group 2. Conclusions: The diagnosis of the nine chromosomes which are most frequentl y associated with aneuploidy in humans could have an immediate impact on th e rate of spontaneous abortions. Additional advantages are represented by t he more accurate morphological evaluation of euploid embryos; the advanced compaction, which means that embryos are less exposed to damage during the transfer procedure; and the possibility of performing a reanalysis in cases where a fluorescence in situ hybridization diagnosis is not obtained.