Effect of Experience and Physician on PGS Results and Efficiency

Objective

PGS biopsy results between 2016-2017 showed that 17% of embryos had no reads.
Being concerned, the objectives of this study were to investigate possible clinical and
laboratory causes and/or relationships related to this outcome.

Experimental Design

A retrospective analysis was applied to assess factors affecting the number of embryos
with useable results and the euploidy rate, which served as the two primary endpoints in
this study. Factors considered were year, physician, and day of biopsy. Once a
physician effect was identified, E2 levels at hCG and total units of hMG per stimulation
were calculated for each physician. The differences in E2 and total IU’s were determined
by a two-tailed t-test and the ratio of usable- and euploid embryos by χ2 analyses.

Materials and Methods

87 consecutive cycles were analyzed over this two-year period, representing 327
embryos. All samples were sent to the same PGS lab and biopsied on day five and/or
day six.

Results

2016 2017 P-Value Physician Physician P-Value Day Day P-Value

1 2 5 6

Usable 84 188 0.01 169 26 0.08 150 116 0.35

Results 76% 87% 78% 93% 85% 87%

Euploid 44 110 0.35 90 14 >0.30 90 63 >0.30

52% 59% 53% 54% 60% 54%

No differences were observed between physicians for the stimulation parameters, E2 at

hCG and total IU’s per stimulation.

Discussion

It appears that program experience improved the usable results, but had no effect on
the euploidy rates. Interestingly, we observed a trend for a difference between
physicians for usable results; however, the trend could not be connected to stimulation
parameters. The day of the biopsy had no effect on the usable results or the euploidy
rates.