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Order from chaos: a case report of a healthy live birth from a genetically "chaotic" embryo
Joanna Lin1, Wendy Vitek2, Erin L Scott2,3
1Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York.
Objective:
To report a case of a healthy, live birth resulting from a "chaotic" embryo (at least 6 chromosomal aneuploidies) after preimplantation genetic testing for aneuploidy (PGT-A).
Design:
Case report.
Setting:
University-affiliated fertility clinic.
Patients:
A same-sex couple with infertility due to failed donor intrauterine insemination and past implantation failure with in vitro fertilization (IVF)/intracytoplasmic sperm injection using donor sperm.
Interventions:
Frozen single embryo transfer of a "chaotic" embryo after genetic counseling and informed consent.
Main Outcome Measures:
Live birth of a healthy infant.
Results:
Controlled ovarian hyperstimulation and transvaginal oocyte retrieval in a 35-year-old female yielded 10 mature oocytes that underwent intracytoplasmic sperm injection with anonymous donor sperm and in vitro culture for 6 days. A single embryo underwent trophectoderm (TE) biopsy at the blastocyst stage and was cryopreserved. PGT-A revealed a "chaotic" test result. After genetic counseling and proper informed consent, a frozen single embryo transfer of this "chaotic" embryo resulted in a successful pregnancy and live birth of a healthy male infant.
Conclusions:
The reproductive potential of embryos with a "chaotic" TE biopsy result is unknown, but herein, we report a healthy, live birth from a "chaotic" embryo. We recommend that patients and providers faced with disposition decisions regarding "chaotic" embryos seek genetic counseling, consider rebiopsy, or consider transfer with informed consent.
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