Trophectoderm biopsy for preimplantation genetic test and technical tips: A review

Reprod Med Biol. 2020 Jan 26;19(3):222-231. doi: 10.1002/rmb2.12318. eCollection 2020 Jul.

Abstract

Background: Recently, the Japan Society of Obstetrics and Gynecology initiated a clinical study of preimplantation genetic test for aneuploidy. There will be a great need for a standardized embryo biopsy technique in Japan. However, the gold standard trophectoderm (TE) biopsy procedure has not been established, and this review outlines the clinical use of TE biopsy.

Methods: Based on literature, the method and associated techniques for TE biopsy, a dissection method of TE cells from blastocysts, were investigated.

Main findings: Two TE biopsy methods are used, namely assisted hatching (herniating) and non-assisted hatching (direct suction); however, it is not clear which of these methods is superior. It is critical to understand whether the flicking or pulling method is beneficial.

Conclusion: Non-assisted hatching biopsy method may cause blastocyst collapse with a higher probability, and it may extend the biopsy time. The biopsy procedure should be performed within 3 minutes, and thus direct TE suction may have greater disadvantages. It is a fact that pulling method of TE dissection with laser pulse is simple; however, excess laser shots may induce a higher frequency of mosaicism. It is important to understand that each technique of TE biopsy has benefits and disadvantages.

Keywords: assisted hatching; blastocyst; non‐assisted hatching; preimplantation genetic testing for aneuploidy; trophectoderm biopsy.

Publication types

  • Review