Research: Aneuploidy by Age, Day, and Grade

 It's been a while since I've done a good research-related post. Shame on me, that's what happens when life gets too busy! I have a few that I'd like to share. They're basically a chronical of my neuroses, so take this for what it's worth.

Today's topic is aneuploidy by day and grade. Where possible, age is also factored in. My one euploid blast is a day 7 4AA, so I looked for data on grade to set expectations.

Looking at day 5 and 6 embryos, by age and by grade, this 2014 study from Human Genetics & Embryology is probably my favorite, because it shows some of the highest euploidy rates for my age group! It's around 45% of day 5 embryos from 40-42 year old eggs. It also shows AA embryos, regardless of day, having an aneuploidy rate of just over 50%. I cling to this one for hope.

Article text:  https://www.omicsonline.org/open-access-pdfs/morphological-and-kinetic-embryological-criteria-and-correlation-withaneuploidy-rates-how-might-they-be-used-to-choose-the-best-iv-2161-0436-1000129.pdf 

This is another awesome resource, from 2019. It splits out euploidy rates by day and grade, and includes day 7 embryos. Mean maternal age was 37, and in keeping with my own results, it finds that AA blasts, regardless of day, have the highest euploidy rate, including 58.5% of day 5, 50% of day 6, and 63% of day 7. The article also mentions pregnancy outcomes for transfers, and notes that the live birth rate for day 5 euploids is 77%, while the live birth rate for day 7 euploids is 43.8%. 

Article text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364279/

This 2016 article is more somber, showing a 90%+ aneuploidy rate for day 7 embryos in the 40+ age range. It also lists out pregnancy outcomes by transfer of embryos. The caveat with this one is that the sample is extremely small.  

Article text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4832487/

Meanwhile, here's 2019 Human Reproduction article looking at aneuploidy by day and age. The researchers included embryos with C quality, which might explain their much lower euploidy rates in the 41-42 year old range (25% day 5, 23% day 6, 18% day 7). This also had a lower live birth rate for euploid embryos, ranging from 56% for day 5 embryos, to 45.8% for day 6 embryos, to only 21.5% for day 7 embryos. The split out live birth rates for day 7 embryos by embryo quality, however they lump everything 4BB and greater into the same "good quality" bucket, which sees a 26% live birth rate. 

Article text: https://www.rmany.com/content/2-our-team/1-physicians/dr-eric-flisser/what-is-the-reproductive-potential-of-day-7-euploid-embryos.pdf

So there you have it. If you're wondering what the probability of aneuploidy is for your embryos, based on day, grade, and age of the eggs, here are some of the top research articles. There are more articles available, although most older ones relied on day 3 blastomere biopsies, and therefore produce a different picture than day 5/6/7 blastocyst biopsy.