Faculty Bibliography

OBJECTIVE: Current data conflicts on ART outcomes in pts with 1O. Furthermore, data is limited evaluating embryo quality in these pts. We assessed number of mature oocytes (M2s) and total oocytes retrieved, embryo quality, and embryo transfer outcomes in pts with 1O compared to 2O. MATERIALS AND METHODS: We performed a retrospective cohort study of all pts with 1O who underwent ART at one academic institution from 2012-2020. Pts were 3-to-1 matched to 2O controls by age, ART cycle type (oocyte freezing vs. embryo banking/in vitro fertilization) and number of ART cycles. Our primary outcome was number of M2s. Secondary outcomes included AMH and day 2 FSH prior to first cycle, number of retrieved oocytes, %M2s, 2PN fertilization rate, blastocyst formation rate (BFR), number of euploid embryos, euploidy rate, clinical pregnancy rate per pt (CPR), and live birth rate per pt (LBR). Subgroup analyses were performed comparing left vs. right ovary in situ and reason for loss of 1O. Mann-Whitney, Kruskal-Wallis, Fisher's exact, and Wilcoxon signed-rank tests were used for statistics; with p<0.05 considered significant.
RESULT(S): 104 pts (158 cycles) with 1O were matched to 312 pts (474 cycles) with 2O. Reasons for loss of 1O were torsion (18%), benign cyst (30%), malignant tumor (46%), and congenital absence (6%). Median pt age was 35.5y vs. 35.0y in pts with 1O vs. 2O (p=0.9). AMH was lower (median 1.1 vs 2.2, p<0.01) and day 2 FSH was higher (median 7.4 vs 6.2, p<0.01) in pts with 1O. See Table 1 for outcomes. Pts with 1O had fewer M2s and oocytes retrieved than pts with 2O; however, pts with 1O had more than half the number of M2s and oocytes retrieved than in pts with 2O (Z >5.8, p<0.01). The % M2s, 2PN fertilization rate, and BFR did not differ among groups. The median number of euploid embryos was 1.0 in each group, with a trend towards more euploids in pts with 2O (mean 2.0 vs 1.3, p<0.03). However, euploidy rate, CPR, and LBR did not differ among groups. Among 1O subgroups (left vs. right and reason for 1O), number of M2s, euploidy rate, CPR, and LBR did not differ.
CONCLUSION(S): Pts with 1O had fewer M2s and oocytes retrieved than pts with 2O; however, had more than 50% of the number of M2s and oocytes retrieved in pts with 2O, suggesting a compensatory mechanism in the solitary ovary. In pts with 1O compared to 2O, oocyte and embryo quality, euploidy rate, and embryo transfer outcomes were similar. IMPACT STATEMENT: Pts with 1O can be counseled that, while ART cycles may yield fewer M2s and oocytes, there is no decrease in embryo quality and LBR compared to pts with 2O. (Table Presented)

OBJECTIVE: POC is underutilized by Black women and persons of color1 . We sought to describe the opinions and attitudes toward POC among BOGs and their experiences in counseling patients of color. MATERIALS AND METHODS: An anonymous survey was distributed to BOGs via separate listservs belonging to a BOG organization and a historically Black college/university in April 2021. The survey included 30 demographic and qualitative questions pertaining to personal family building goals, fertility preservation, and patient counseling experiences. Analyses included descriptive statistics and chi square test to compare answers across demographic, professional and subspecialty groups using SPSS (v25) with p<0.05 considered significant.
RESULT(S): Of the 136 potential participants, the response rate was 49% (n=67). The majority of respondents were female (93%) and heterosexual (93%). The mean age was 34.2 years. Attendings (ATT), fellows (FEL) and residents (RES) represented 47%, 17% and 36% of respondents, respectively. Fifty-four percent of ATTs were generalists. Subspecialties represented by ATTs and FELs included Maternal Fetal Medicine (24%), Minimally Invasive Gynecology (2%), Reproductive Endocrinology and Infertility (14%), and Urogynecology (8%). Sixty-six percent of subjects did not currently have children and 20% did not want children. Sixty-eight percent felt the need to postpone family building due to medical training, most commonly citing career plans (88%) and financial concerns (60%). Of the 41% who had tried to conceive in the past, 9% required fertility treatment. Nineteen percent had already undergone POC or planned to in the future. Most (70%) felt that all women planning to undergo residency +/- fellowship training should consider POC. Fifty-six percent reported receiving some form of education on POC and 22% felt ''very comfortable'' counseling patients on POC. Fifty-six percent had recommended POC to patients in the past. When asked to exclude cost, the most common reported personal barriers for POC were time (31%) and fear/stigma (22%) and the most common barriers for their patients of color were knowledge (41%) and fear/stigma (25%). Those <35 years were more likely to not have a child (p <0.01) and more likely to feel the need to postpone family building due to their medical training (p<0.01). RES and FELs were more likely to agree that all women planning medical training should consider POC (p<0.03). Generalist ATTs who had not undergone POC trended toward having more regret compared to subspecialists (p=0.05).
CONCLUSION(S): Medical careers can have an unfavorable impact on family building and our results highlight this effect in Black women and persons of color. Most BOGs think trainees may benefit from POC. Improved education and access to POC could support personalized reproductive planning. IMPACT STATEMENT: Considering the underutilization of POC among Black women1 and the increase in infertility among female physicians2 , a better understanding of the mitigating factors is important in order to develop culturally appropriate counseling and educational interventions for women of color

OBJECTIVE: The rise of the SARS-CoV-2 pandemic and temporary closures of fertility centers made the effect on POC cycles uncertain but garnered national attention1,2. We sought to assess the impact of the pandemic on POC cycles in a pandemic epicenter. MATERIALS AND METHODS: This is a retrospective cohort study of all POC cycles at an academic fertility center in New York City from 1/1/2019- 12/31/2020. Primary outcomes were number of POC patients (pts) and cycles. Secondary outcomes were pt relationship status, payment method, AMH, and cycle parameters; with subgroup analyses by age groups. We also examined the relationship between monthly number of POC cycles and national SaRS-CoV-2 cases. Statistical analyses included z-score analysis, Mann-Whitney, and Chi-squared, with p<0.05 significant.
RESULT(S): Despite a 5.5 week center closure in 2020, POC pts increased 14% and POC cycles increased 16% from 2019 to 2020 (Table), with a 32% increase seen between June-Dec, 2020 . There was a 28% increase in POC pts <37yo in 2020 (252 pts vs. 323 pts, p<0.04) and no change in pts >37yo in 2020 (p=0.9). Relationship status did not differ between years (16% partnered, 76% single, 8% unknown in 2019 vs. 16% partnered, 73% single, 11% unknown in 2020; p=0.6). Fewer patients in 2020 had insurance coverage (16% vs. 24%, p<0.001). AMH was higher in 2020 (2.3 vs. 2.1, p<0.03), but days of stimulation, oocytes retrieved, oocytes frozen, total gonadotropins, and maximum estradiol (E2) were not different (Table). While national SARS-CoV-2 cases peaked in April, July, and November 2020, monthly POC cycles at our center did not decrease with surges in SARS-CoV-2 after our center reopened in May (p=0.24). In 2020 there were 23 cycles cancelled, none due a positive SARS-CoV-2 test.
CONCLUSION(S): POC volume increased at our center in 2020, especially in young patients, despite center closures and SARS-CoV-2 surges. IMPACT STATEMENT: More young people pursued POC despite the SARS-CoV-2 pandemic. Further research is needed to understand POC pt motivations and experiences during a pandemic. (Table Presented)

OBJECTIVE: Segmental aneuploidies (SA) are generated when a piece of chromosome is gained or lost and may contribute to sub-optimal birth outcomes[ 1]. Our objective was to examine the frequency, type and association with maternal age of SA. MATERIALS AND METHODS: This is a retrospective cohort study of all embryos that underwent trophectoderm biopsy for preimplantation genetic testing for aneuploidy (PGT-A) via Next Generation Sequencing between 1/2015 and 12/2020 at a single university-based fertility center that resulted with a non-mosaic SA. SA were characterized by type of abnormality and location (p or q arm). Maternal age was stratified by SART age groups. Primary outcome was the association between age and SA. Secondary outcomes were SA location and type. Statistical analysis included ANOVA and chisquare where appropriate, with p<0.05 considered significant.
RESULT(S): There were 711 embryos with an SA included; of 30,300 embryos biopsied (2.3%). Mean maternal age was 38.8+/-4.7. The frequency of SA increased with maternal age (Table 1). The distribution of SA on p, q and both arms was 58 (8.2%), 539 (75.8%) and 114 (16%) respectively. Partial monosomy was the most common type of SA (298, 41.6%), followed by partial trisomy (154, 21.7%) and the combination of SA and whole chromosome aneuploidy (WCA; 154, 21.7%). There is a significant association between type of SA and increasing maternal age (p<0.00). SA occurred most frequently on chromosomes (CH) 1, 2 and 16 and least frequently on CHs 19, 20 and 21. For single SA only, CH 1, 2 and 4 were most common. For double SA, CH 2 and 8 occurred most. For SA with WCA, SA on CH 1 and WCA on CHs 16 and 22 was most common. Acrocentric CH have less SA than non-acrocentric. Chromosome location was not associated with maternal age across SA types (All: p=0.39, single p=0.86, SA + WCA p= 0.48)
CONCLUSION(S): Among our embryo cohort, the frequency of nonmosaic SA increased with maternal age. Since previous literature suggests that SA is mainly affected by paternal age, this association may be attributed to age similarities within romantic partnerships (2). SA were most common on chromosomes 1 and 2, and the q arm. IMPACT STATEMENT: This is the first study of the association between SA prevalence, type and location with maternal age to provide a basis for future research and understanding about SA detected by PGT-A

OBJECTIVE: The majority of patients surveyed believe that use of social media (SM) to share information benefits the patient experience (1). Our objective was to understand the SM content and activity about mosaic embryos. MATERIALS AND METHODS: This is a retrospective cohort study of the use of search terms ''mosaic embryo'' and ''mosaic embryos'' on Google (GO) and Instagram (IG). Both terms were analyzed from 1/1/2015 to 12/21/2020 on Google Trends, a publicly accessible tool that quantifies GO searches nationally. On IG, all posts that mention either search term were included. Posts were characterized by author type, content, and tone (positive, negative, neutral). Likes per post and total followers on each account were quantified. Percent of likes (PL) from total followers was calculated to assess activity. P-value < 0.05 was considered significant.
RESULT(S): Within the study time period, the term ''mosaic embryo'' was searched most in the months of 4/ 2018 and 2/2020. Both peaks occurred after mosaicism was highlighted by a major news outlet or celebrity (2,3). Use of the term increased over time with a slope of 0.64. On IG, 400 posts utilized the hashtag ''#mosaicembryo'', with 259 listed as top posts, making them most easily accessible. Of top posts, prevalence of author types parent/patient, fertility clinic and patient education (PE) platform was 233 (90%), 10 (3.9%) and 16 (6.2%) respectively. Content included personal stories (212, 81.9%), questions (10, 3.9%) and PE (37, 14.3%). 57.1% of posts were positive, 35.1% neutral and 7.7% negative. Mean number of likes, followers and PL was 104, 1571 and 14.6% respectively. PL was not associated with author type, content or tone (p=0.16, p=0.07, p=0.11). The term ''mosaic embryos'' was most searched on GO in 10/ 2020. Use remained consistent in the time window (m=-0.1). 160 posts on IG utilized the hashtag ''#mosaicembryos'', 78 being top posts. The majority of posts were by patients (58, 74.4%) compared to fertility clinics (11, 14.1%) and PE platforms (9, 11.5%). Frequency of personal story, question and PE was 52 (66.7%), 2 (2.6%), and 24 (30.8%) respectively. Distribution of tone was 55.1% positive, 39.7% neutral, and 5.1% negative. Mean number of likes, followers and PL was 84, 1515 and 8.14% respectively. PL on fertility clinic posts was significantly lower than patient and PE posts ( 2.8, 9.2, 7.3, p<0.05). PL was highest in posts with personal stories compared to questions and PE (9.7, 4.0, 5.1, p<0.05). Tone was not associated with change in PL (p=0.8).
CONCLUSION(S): Internet search of terms related to mosaic embryo has increased in recent years. These terms have a prominent SM presence where patients, clinics and PE platforms can share information. These platforms are mainly used by patients posting about their positive experiences. IMPACT STATEMENT: This is the first study to characterize the use of terms related to embryonic mosaicism on SM. This information is mainly created by non-medical professionals but is easily accessible and often used as a trusted resource. Understanding where patients may be receiving their information is important in providing adequate counseling and management. (Table Presented)

OBJECTIVE: Social media is a popular way to disseminate new information and opinions, perhaps furthered by the COVID-19 pandemic and quarantine. Our objective was to analyze information and sentiments posted regarding the COVID-19 vaccine (VAX) on fertility-related social media. MATERIALS AND METHODS: The search function of Instagram (IG) and Twitter (TW) was used to identify the first fifty accounts with the following terms: fertility doctor, fertility, OBGYN, infertility, TTC, and IVF. Accounts not in English, private, no posts in >1 year, or content unrelated to search terms were excluded. Accounts were evaluated for author type and categorized as physician (PH), individual (ID), or fertility center/fertility-related organization (FCO). Account demographics including number of followers and prior baseline post activity (number of likes/number of followers) were recorded. The VAX was approved on 12/11/2020 and posts dated 12/1/2020 - 2/28/2021 were reviewed. Posts mentioningthe VAX were analyzed for content: sentiment (positive, negative, or neutral), mention of research studies (RS), national guidelines (NG), personal experience (PE), side effects (SE), reproductive related (RR) content and post activity. Statistical analysis included Chi-Squared and Fisher's exact tests, with significance set to <0.05 (*).
RESULT(S): 536 accounts were identified and 276 were included (133 IG and 143 TW). There were 104 PH accounts (45 IG, 59 TW), 91 ID accounts (62 IG, 29 TW), and 81 FCO accounts (26 IG, 55 TW). PH accounts were most associated with mention of COVID (83.7%*) and VAX (68.3%*), followed by FCO (37% COVID*, 30.9% VAX*), and ID (8.8% COVID*, 6.6% VAX*). PH was most associated with >1 VAX posts compared to FCO or ID (51.0% v 11.1% v 1.0%*). Sentiments toward the VAX were largely positive for all groups (PH 90.3%, ID 71.4%, FCO 70%), or neutral (PH 9.7%, ID 28.6%, FCO 30%), with no negative posts identified. Trends in mentions and sentiments were similar on both IG and TW platforms. PH cited NG (24.6%*) and RS (17.5%) more than ID and FCO, with most cited guidelines from ACOG, ASRM, and SMFM. ID posts were mostly PE (87.5%*) and SE (57.1%*). RR posts were most associated with FCO accounts (80%*) which included pregnancy, infertility, and breastfeeding. Sub-group analysis of IG accounts showed an increase in activity on VAX posts compared to baseline by likes (PH 4.86% v 3.76%, ID 7.5% v 6.37%, FCO 2.49% v 0.52%) as well as comments (PH 0.35% v 0.28%, ID 0.90% v 0.69%, FCO 0.10% v 0.02%).
CONCLUSION(S): Overall, the majority of posts expressed positive sentiments toward the VAX with no negative posts identified. PH were most likely to post about COVID-19, the VAX and guidelines. Few ID accounts posted but when present were about personal experiences or side effects and remained positive. IMPACT STATEMENT: There is an active conversation regarding COVID-19 and VAX information on social media, with the majority of posts expressing positive sentiment. Physicians play a large role in circulating information regarding the VAX on social media platforms, and can be influential in discussions of VAX guidelines and dispelling fertility myth

OBJECTIVE: AO cryopreservation (cryo) is widely used, but published thaw data is scarce. We reviewed our elective AO thaws. MATERIALS AND METHODS: Pts who thawed AOs at our FC in 2004- 2020 were reviewed. Pts were excluded if AO cryo was performed for a medical reason, as research, due to no sperm or a natural disaster, with embryo cryo or for use with a gestational carrier. Outcomes included implantation (IR), spontaneous abortion (SABR) and ongoing pregnancy + live birth (LBR) rates / embryo transfer (ET). We calculated a final LBR (FLBR) defined as LBR / pt; FLBR only included pts who a) had live birth (LB) or ongoing pregnancy (OP), or b) consumed all AOs and resultant embryos. Statistics included Mann-Whitney U and Fisher's exact test.
RESULT(S): 543 pts (median age at 1st cryo 38y) underwent 800 cryos (89% our FC, 9% elsewhere, 2% both), 605 thaws and 416 ETs. Cryo used vitrification for 72%, slow freezing for 4% and both for 24% of pts. Median time from 1st cryo to 1st thaw was 4y. In total, we thawed 8511 AOs (7492 M2s). AO survival was 79%, M2 survival was 80% and 2PN fertilization was 66%. When pts returned for thaw, 25% pursued fresh ET, 73% pursued preimplantation genetic testing (PGT), and 2% pursued a combination of both. In pts who pursued fresh ET, 92% had >=1 embryo for ET. In pts who pursued PGT, 57% had >=1 euploid. 13% of pts had no useable embryos (embryos for fresh ET, PGT, cryo). 59% of pts had >=1 ET. 37% of ETs were fresh, with 2% using rush-PGT. 63% of ETs were frozen, with 97% using PGT. In non-biopsied ETs, IR was 29%, SABR was 19% and LBR was 31%. In euploid ETs, IR was 64%, SABR was 10% and LBR was 55%. In our cohort, FLBR was 38%. In total, 178 babies (11 twin, 1 triplet) and 24 OPs resulted. 176 pts have >=1 LB or OP, and 23 pts have >=2 LBs or OPs from AO thaw. 33% of pts have remaining AOs or euploid or untested embryos; 45% of these pts do not have a LB or OP from AO thaw. See table for outcomes by age.
CONCLUSION(S): AO thaw leads to a FLBR of 38%, comparable to our FC's 34% LBR per intended retrieval in pts of similar age1 . IMPACT STATEMENT: Our real thaw data may be more useful than models in pt counseling

OBJECTIVE: OC is widely used for fertility preservation. Many models predict the live birth (LB) rate of OC, but real-world data is lacking. We reviewed our LBs from OC to develop an OC counseling tool based on real outcomes. MATERIALS AND METHODS: We reviewed patients (pts) who thawed autologous oocytes (AOs) at our academic fertility center from 2004-2020. We included pts who: 1) had a LB or ongoing pregnancy (OP) >12 weeks at last contact, or 2) consumed all AOs and resultant embryos. Pts were excluded if they transferred AOs or resultant embryos to another center or if OC was performed for a medical reason, as research, due to no sperm or a natural disaster, combined with embryos or for use with a gestational carrier. We calculated OP + LB rate (LBR) based on number of AOs and metaphase II oocytes (M2s) thawed. Data were stratified by age (<38y vs. >=38y). For pts who underwent OC at <38y and >=38y, a weighted age was calculated (for each OC cycle, #AOs thawed was multiplied by age at OC; the sum of these numbers was then divided by total #AOs thawed). Statistics included Fisher's exact test (p<0.05 significant).
RESULT(S): We included 462 pts (median age at 1st OC 38.5y). Weighted ages were used for 21 pts (5%). Our pts underwent 650 OCs (90% our center, 9% elsewhere, 1% both), 512 thaws and 385 embryo transfers. OC involved vitrification for 72%, slow freezing for 4% and both for 24% of pts. A total of 7050 AOs and 6178 M2s were thawed. 38% of pts (n=176) have >=1 LB or OP from AO thaw. See table for outcomes. Pts who thawed 0-10 AOs had a lower LBR than pts who thawed 11-20, 21-30, or >30 AOs (p<=0.03). Pts who thawed 0-10 M2s had a lower LBR than pts who thawed 11-20 or 21- 30 M2s (p<=0.02). LBR was not significantly different between pts who thawed 11-20, 21-30, or >30 AOs or M2s.
CONCLUSION(S): Pts who thawed 0-10 AOs had a lower LBR (27%) than pts who thawed >10 AOs (LBR >= 43%), and pts who thawed 0-10 M2s had a lower LBR (30%) than pts who thawed > 10 M2s (LBR >= 42%), but LBR was not different with >10 thawed AOs. IMPACT STATEMENT: Our real-world OC outcomes are not consistent with LBRs in published models. These results provide more realistic expectations about OC outcomes and may help pts decide how many AOs to freeze

OBJECTIVE: COVID-19 has influenced family building, delayed fertility care, and affected people's decisions about where to live.We sought to understand differences in movement of cryopreserved reproductive tissue before and during the pandemic. MATERIALS AND METHODS: This was a retrospective cohort study of patients who transported tissue into or out of a single academic fertility center in New York City (NYC). Tissue transport was compared the year before (PRE, 4/1/2019-3/31/2020) and after (DUR, 4/1/2020-3/31/2021) the height of the COVID-19 pandemic in NYC, an epicenter. The primary outcome was the number of patients transporting tissue DUR compared to PRE. Secondary outcomes were the number of geographic changes, type of tissue, geographic origin/destination, and type of movement (in or out). Statistical analyses were performed using Kolmogorov-Smirnov, Wilcoxon Signed Rank Sum, Chi-Square, and Fisher's Exact tests with p<0.05 considered significant.
RESULT(S): A total of 367 tissue transports were included, with similar rates between cohorts (PRE 46.3% (170/367) vs DUR 53.7% (197/367), p=0.16). The median age at transport was the same (PRE 41 (range 29-54) vs DUR 41 (range 28-54) years, p=0.54). A similar amount of tissue was transported in (PRE 30.0% (51/170) vs DUR 35.0% (69/197)) and out (PRE 70.0% (119/170) vs DUR 65.0% (128/197), p=0.32). Patients were more likely to transport embryos pre-pandemic (37.6% (64/170) oocytes vs 61.8% (105/170) embryos, PRE) and oocytes during COVID-19 (51.8% (102/197) oocytes vs 44.2% (87/197) embryos, DUR) (p<0.01). A subgroup analysis excluding tissue moved for a gestational carrier or donor gametes found a similar number of transports were due to patient geographic relocation (PRE 50.0% (61/122) vs DUR 40.5% (60/148), p=0.12). Examination of geographic origin and destination of tissue PRE vs DUR produced no identifiable trends (p=0.38). Timing of tissue transport varied. The monthly transport rates were relatively even PRE (average 8% per month). However, during the pandemic, there were few transports in the beginning (April-May 2020, 0-1% per month) followed by a peak of transports in June-August 2020 (10-11% per month) and February-March 2021 (11-16% per month) (p<0.01). Transport activities were impacted by closure of clinics and courier service availability.
CONCLUSION(S): The rate of cryopreserved tissue movement did not differ in the year before versus during the pandemic at our center, despite being in a COVID-19 epicenter, although transport activities were concentrated into fewer days. There was peak movement of tissue three months after the pandemic onset and roughly one year from the start of the pandemic. The type of tissue transported shifted to favor oocytes during the pandemic, warranting more investigation in how COVID-19 impacted family building activities. IMPACT STATEMENT: Despite the impact of COVID-19 on reproductive and place of living choices, the pandemic did not affect the amount of cryopreserved tissue that was relocated. However, insight into the increased movement of oocytes and potential impacts on warming outcomes or timelines is necessary

OBJECTIVE: Morphologic evaluation of embryos after fertilization is the first step in embryo assessment, with two pronuclei (2PN) indicating normal fertilization. Deviations from 2PN are considered consistent with abnormal fertilization and genetic ploidy, and may be discarded instead of cultured. The aim of this study was to determine the genetic ploidy of three pronuclei (3PN) embryos diagnosed by morphology. MATERIALS AND METHODS: Sixty-two 3PN embryos donated to research that underwent IVF with either insemination or ICSI were collected from January - April, 2021. 3PN embryos were identified at time of fertilization check and vitrified. Batched 3PN embryos were subsequently warmed and cultured. Embryos were assessed for development to the blastocyst stage on days 5, 6 and 7 of culture, and embryos that developed into blastocysts underwent two separate trophectoderm (TE) biopsies. TE biopsies, along with maternal and paternal samples were sent to a pre-implantation genetic testing (PGT) lab to determine the genetic ploidy composition of the morphological based 3PN embryos. Testing included PGT for aneuploidy (PGT-A) using the PGTseq platform that routinely includes triploidy detection via single nucleotide polymorphism (SNP) B allele ratio. Testing was also performed using a second method, SNP allele sharing, with the maternal and paternal DNA samples. This method can detect both triploidy and parental of origin of abnormalities.
RESULT(S): Of the 62 3PN embryos cultured, 17 (27%) developed into blastocysts that underwent TE biopsy. In all cases paired biopsies were concordant. Three of the 17 biopsied embryos were diploid (18%) and 14 were triploid (82%). All 3 diploid embryos were the result of insemination and were aneuploid on PGT-A; no euploid embryos were identified. The overall rate of diploid tested blastocysts was 4.8% (3/62) among all 3PNs collected. Of the 14 triploid embryos, 10 were the result of IVF with traditional insemination and 4 were from ICSI. All triploid embryos from insemination were consistent with paternal origin while all triploid embryos from ICSI were consistent with maternal origin. Both methods for detecting triploidy were concordant.
CONCLUSION(S): Embryos morphologically diagnosed as 3PN are typically discarded as they are likely the result of abnormal fertilization consistent with triploidy. This study demonstrates that a small percentage of 3PN embryos have the potential to develop into blastocysts with a diploid genetic complement. While none of the diploid 3PN embryos in this study were found to be euploid, this could be due to the small sample size and it is possible that a larger number of embryos may result in 3PN euploid embryos which could impact a labs decision on what tissue to discard or culture. It should be noted that due to the inherently subjective component of morphologic assessment, these findings may not translate to other laboratories. IMPACT STATEMENT: While 3PN embryos are typically discarded in IVF after both insemination and ICSI, our study shows that a small proportion have the potential to develop into diploid blastocysts where reproductive potential remains to be seen