Blastocyst euploidy and implantation rates in a young (<35 years) and old (≥35 years) presumed fertile and infertile patient population

Objective: To examine the relationship between blastocyst euploidy and implantation rates in a presumed fertile patient population. Design: Retrospective analysis. Setting: Private IVF clinic. Patient(s): IVF patients undergoing comprehensive chromosome screening (CCS). Intervention(s): Embryo biopsy at the blastocyst stage with preimplantation genetic screening using CCS. Main Outcome Measure(s): Euploidy, chemical pregnancy, and implantation rates. Result(s): There was no significant difference in the number of euploid blastocysts between presumed fertile (68/118, 57.6%) and infertile (75/132, 56.8%) patients <35 years old. Likewise, there was no significant difference in the number of euploid blastocysts between presumed fertile (42/86, 48.8%) and infertile (97/206, 47.1%) patients >= 35 years old. When those same patients underwent a corresponding frozen embryo transfer cycle, presumed fertile patients demonstrated a significantly higher chemical pregnancy rate when compared with infertile patients, 28/33 (84.8%) and 50/81 (61.7%), respectively. Moreover, presumed fertile patients exhibited significantly higher implantation rates compared with infertile patients, 36/42 (85.7%) and 54/109 (66.7%), respectively. Conclusion(s): When subdivided by maternal age, no significant difference was seen in blastocyst euploidy rates between presumed fertile and infertile patients; however, chemical pregnancy and implantation rates were significantly higher in a presumed fertile patient population even when transferring only euploid blastocysts. This would indicate that infertility, as a disease, may encompass other aspects such as uterine or other unknown embryological factors that can influence outcomes. (C) 2014 by American Society for Reproductive Medicine.