Evaluation of day 5 versus day 6 blastocyst biopsy in preimplantation genetic testing: clinical and neonatal outcomes

BackgroundPreimplantation genetic testing (PGT) has emerged as a pivotal technique in assisted reproductive technology for enhancing success rates by identifying euploid embryos prior to transfer. The optimal timing for blastocyst biopsy during PGT remains controversial, with conflicting evidence re...

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Main Authors: Zhiming Li, Xiaowu Fang, Lizi Cheng, Zhanhui Ou, Junye Huo, Wenjuan Yu, Jieliang Li, Wanna Ke, Jiaqi Wu, Xiufeng Lin, Xiaojun Wen
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1544009/full
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author Zhiming Li
Xiaowu Fang
Lizi Cheng
Zhanhui Ou
Junye Huo
Wenjuan Yu
Jieliang Li
Wanna Ke
Jiaqi Wu
Xiufeng Lin
Xiufeng Lin
Xiaojun Wen
author_facet Zhiming Li
Xiaowu Fang
Lizi Cheng
Zhanhui Ou
Junye Huo
Wenjuan Yu
Jieliang Li
Wanna Ke
Jiaqi Wu
Xiufeng Lin
Xiufeng Lin
Xiaojun Wen
author_sort Zhiming Li
collection DOAJ
description BackgroundPreimplantation genetic testing (PGT) has emerged as a pivotal technique in assisted reproductive technology for enhancing success rates by identifying euploid embryos prior to transfer. The optimal timing for blastocyst biopsy during PGT remains controversial, with conflicting evidence regarding the clinical outcomes of day 5 (D5) versus day 6 (D6) biopsies, as well as neonatal and perinatal outcomes.MethodsThis study involved a retrospective analysis of 3,647 biopsied blastocysts and 673 PGT-frozen embryo transfer (FET) cycles conducted at Zhongshan Boai Hospital between May 2019 and September 2024. Patients were categorized into D5 and D6 biopsy groups. The study comprised three components: (1) a comparison of chromosomal euploidy, mosaicism, and aneuploidy rates between the two groups, along with an assessment of clinical, neonatal, and perinatal outcomes in PGT-FET cycles; (2) stratification based on embryo quality to compare clinical, neonatal, and perinatal outcomes in PGT-FET cycles between the two groups; and (3) stratification according to maternal age to compare clinical, neonatal, and perinatal outcomes in PGT-FET cycles between the two groups.ResultsThe euploidy rate was significantly higher in D5 blastocysts compared to D6 blastocysts (47.53% vs. 32.38%, p < 0.01). In the PGT-FET cycles, the live birth rate in the D5 biopsy group was significantly higher than that in the D6 biopsy group (56.11% vs. 48.38%, p = 0.046); however, there were no significant differences in the clinical pregnancy rate, miscarriage rate, or neonatal outcome. Stratification by embryo quality revealed no significant differences in clinical pregnancy, live birth, or miscarriage rates for blastocysts of the same quality grade between the D5 and D6 biopsy groups. In the D5 biopsy group, variations in embryo quality did not affect clinical outcomes, whereas in the D6 biopsy group, high-quality blastocysts were associated with improved pregnancy and live birth rates. Age-stratified analysis showed similar clinical outcomes for PGT-FET in the D5 and D6 biopsy groups across different age groups.ConclusionCompared to D6, D5 biopsied blastocysts demonstrated higher euploidy and live birth rates. Therefore, it is recommended to prioritize biopsy at D5 and to thaw blastocysts at D5 for transfer to achieve better clinical pregnancy and neonatal outcomes.
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spelling doaj-art-d4d01e2826a445b9825faa39210df1c32025-08-20T03:45:14ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-06-011610.3389/fendo.2025.15440091544009Evaluation of day 5 versus day 6 blastocyst biopsy in preimplantation genetic testing: clinical and neonatal outcomesZhiming Li0Xiaowu Fang1Lizi Cheng2Zhanhui Ou3Junye Huo4Wenjuan Yu5Jieliang Li6Wanna Ke7Jiaqi Wu8Xiufeng Lin9Xiufeng Lin10Xiaojun Wen11Reproductive Medicine Center, Boai Hospital of Zhongshan, Zhongshan, Guangdong, ChinaReproductive Medicine Center, Boai Hospital of Zhongshan, Zhongshan, Guangdong, ChinaReproductive Medicine Center, Boai Hospital of Zhongshan, Zhongshan, Guangdong, ChinaReproductive Medicine Center, Boai Hospital of Zhongshan, Zhongshan, Guangdong, ChinaReproductive Medicine Center, Boai Hospital of Zhongshan, Zhongshan, Guangdong, ChinaReproductive Medicine Center, Boai Hospital of Zhongshan, Zhongshan, Guangdong, ChinaReproductive Medicine Center, Boai Hospital of Zhongshan, Zhongshan, Guangdong, ChinaReproductive Medicine Center, Boai Hospital of Zhongshan, Zhongshan, Guangdong, ChinaReproductive Medicine Center, Boai Hospital of Zhongshan, Zhongshan, Guangdong, ChinaReproductive Medicine Center, Boai Hospital of Zhongshan, Zhongshan, Guangdong, ChinaThe Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, ChinaReproductive Medicine Center, Boai Hospital of Zhongshan, Zhongshan, Guangdong, ChinaBackgroundPreimplantation genetic testing (PGT) has emerged as a pivotal technique in assisted reproductive technology for enhancing success rates by identifying euploid embryos prior to transfer. The optimal timing for blastocyst biopsy during PGT remains controversial, with conflicting evidence regarding the clinical outcomes of day 5 (D5) versus day 6 (D6) biopsies, as well as neonatal and perinatal outcomes.MethodsThis study involved a retrospective analysis of 3,647 biopsied blastocysts and 673 PGT-frozen embryo transfer (FET) cycles conducted at Zhongshan Boai Hospital between May 2019 and September 2024. Patients were categorized into D5 and D6 biopsy groups. The study comprised three components: (1) a comparison of chromosomal euploidy, mosaicism, and aneuploidy rates between the two groups, along with an assessment of clinical, neonatal, and perinatal outcomes in PGT-FET cycles; (2) stratification based on embryo quality to compare clinical, neonatal, and perinatal outcomes in PGT-FET cycles between the two groups; and (3) stratification according to maternal age to compare clinical, neonatal, and perinatal outcomes in PGT-FET cycles between the two groups.ResultsThe euploidy rate was significantly higher in D5 blastocysts compared to D6 blastocysts (47.53% vs. 32.38%, p < 0.01). In the PGT-FET cycles, the live birth rate in the D5 biopsy group was significantly higher than that in the D6 biopsy group (56.11% vs. 48.38%, p = 0.046); however, there were no significant differences in the clinical pregnancy rate, miscarriage rate, or neonatal outcome. Stratification by embryo quality revealed no significant differences in clinical pregnancy, live birth, or miscarriage rates for blastocysts of the same quality grade between the D5 and D6 biopsy groups. In the D5 biopsy group, variations in embryo quality did not affect clinical outcomes, whereas in the D6 biopsy group, high-quality blastocysts were associated with improved pregnancy and live birth rates. Age-stratified analysis showed similar clinical outcomes for PGT-FET in the D5 and D6 biopsy groups across different age groups.ConclusionCompared to D6, D5 biopsied blastocysts demonstrated higher euploidy and live birth rates. Therefore, it is recommended to prioritize biopsy at D5 and to thaw blastocysts at D5 for transfer to achieve better clinical pregnancy and neonatal outcomes.https://www.frontiersin.org/articles/10.3389/fendo.2025.1544009/fullpreimplantation genetic testingblastocyst biopsyembryo qualitymaternal ageclinical pregnancy outcomesneonatal-perinatal outcomes
spellingShingle Zhiming Li
Xiaowu Fang
Lizi Cheng
Zhanhui Ou
Junye Huo
Wenjuan Yu
Jieliang Li
Wanna Ke
Jiaqi Wu
Xiufeng Lin
Xiufeng Lin
Xiaojun Wen
Evaluation of day 5 versus day 6 blastocyst biopsy in preimplantation genetic testing: clinical and neonatal outcomes
Frontiers in Endocrinology
preimplantation genetic testing
blastocyst biopsy
embryo quality
maternal age
clinical pregnancy outcomes
neonatal-perinatal outcomes
title Evaluation of day 5 versus day 6 blastocyst biopsy in preimplantation genetic testing: clinical and neonatal outcomes
title_full Evaluation of day 5 versus day 6 blastocyst biopsy in preimplantation genetic testing: clinical and neonatal outcomes
title_fullStr Evaluation of day 5 versus day 6 blastocyst biopsy in preimplantation genetic testing: clinical and neonatal outcomes
title_full_unstemmed Evaluation of day 5 versus day 6 blastocyst biopsy in preimplantation genetic testing: clinical and neonatal outcomes
title_short Evaluation of day 5 versus day 6 blastocyst biopsy in preimplantation genetic testing: clinical and neonatal outcomes
title_sort evaluation of day 5 versus day 6 blastocyst biopsy in preimplantation genetic testing clinical and neonatal outcomes
topic preimplantation genetic testing
blastocyst biopsy
embryo quality
maternal age
clinical pregnancy outcomes
neonatal-perinatal outcomes
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1544009/full
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