Number of biopsied trophectoderm cells is likely to affect the implantation potential of blastocysts with poor trophectoderm quality

Objective To evaluate whether the developmental potential of the blastocyst is affected by the number of trophectoderm (TE) cells biopsied in preimplantation genetic diagnosis (PGD) cycles. Design Retrospective study. Setting University-affiliated center. Patient(s) Women underwent PGD cycles of blastocyst biopsy and fluorescence in situ hybridization analysis. Intervention(s) Not applicable. Main Outcome Measure(s) Biopsied TE cell number of blastocysts, survival, and implantation rates. Result(s) The biopsied TE cell number was affected by the TE quality and experience of different embryologists. The diagnostic efficiency increased when from one to five cells were biopsied (86.7%, 91.7%%, 96.0%, 96.8%, to 98.7%) and was maximized when more than six cells were biopsied. To compare the clinical efficiencies, blastocysts were divided into four groups according to biopsied TE cell number: 1–5, 6–10, 11–15, and 16–41. For the blastocysts with grade A TE score, no significant difference was observed in the survival and implantation rates among the four groups. For the blastocysts with grades B and C TE scores, the survival rates showed no significant differences among the four groups, but a significant decreasing trend in implantation rates was observed with increasing biopsied TE cell number. Conclusion(s) The implantation potential is negatively affected by the biopsied TE cell number in blastocysts with poor TE morphological score.