Dr. Reem Al Mannai, MSc, MD

Dr. Reem graduated from Royal College of surgeon (RCSI) in Ireland. She completed her training there as Obs. and Gyn. resident, where she developed special interest in infertility. There she got her master's degree in women's health from RCSI. In 2010, she joined Banoon ART & Cytogenetic center in BDF royal medical centre as an embryologist. Dr Reem received MSc in clinical embryology from Monash University, Melbourne, and Her MSc dissertation was about PGD and biopsy's impact on embryo development.

Title of Presentation

Human Embryo Biopsy

The PGD and PGS techniques facilitates the investigation of genetic composition of the human embryo by either biopsy of polar bodies from oocyte at the day of retrieval or day 1 of fertilization, this has it limitation as only the maternal genetic can be tested.

Other prefer to biopsy the throphectoderm cells from blastocyst stage embryo, this biopsy allow numbers of cell to be investigated (Harton et al., 2011, 2006, Phakphum Phophong and Pornpimol Ruangvutilert) .

Cleavage stage biopsy, involve the removal of one or two blastomeres cells from a 6 to 8 cell stage embryo, this practice accounts for about 90% of the reported cases of PGD (Harton et al., 2011, Harper et al., 2010). But, it also has its limitations.

The standard IVF culture medium can be used for the biopsy during PGD. However, its effectiveness depends on the development stage of the embryo (Harton et al., 2011). Embryos at the cleavage stage (6-8 cells) - which showed compaction when incubated in Ca⁺²/Mg⁺² free medium for short time - helped loosen the blastomeres from the membrane (Goossens et al., 2008) The effectiveness of this practice was reported (Dumoulin et al., 1998); and suggested no adverse outcome on the embryo development. This is becoming a common practice for biopsy at cleavage stage (Harton et al., 2011, Goossens et al., 2008, Van De Velde et al., 2000). Others suggested that incubating embryos in such media can compromise their ability to survive (McArthur et al., 2008).

It has been recognized that embryo biopsy is an invasive technique, which not only involves removal of one blastomere cell or few trophectoderm cells, but the method used for breaching the zona pallucida and the media used for the biopsy may have an impact on the embryo viability.

Investigating the genetic component of a human embryo at different stages is a complicated process and the benefit should outweigh the risks involved.