Higher rates of aneuploidy in blastocysts and higher risk of no embryo transfer in recurrent pregnancy loss patients with diminished ovarian reserve undergoing in vitro fertilization
Recurrent pregnancy loss (RPL) patients with DOR have a higher rate of aneuploid embryos compared with RPL patients with normal ovarian reserve, but they have similar success rates with euploid transfer.
Volume 106, Issue 5, Pages 1124-1128
Authors:
Lora K. Shahine, M.D., Lorna Marshall, M.D., Julie D. Lamb, M.D., Lee R. Hickok, M.D.
Abstract:
Objective
To study the prediction of aneuploidy rate in blastocysts from patients with recurrent pregnancy loss (RPL) on the basis of ovarian reserve testing.
Design
Prospective cohort analysis.
Setting
Private, university-affiliated fertility clinic.
Patient(s)
A total of 239 patients with RPL, defined as two or more clinical miscarriages, were screened for inclusion. One hundred two (102) cycles in patients with unexplained RPL resulted in at least one euploid embryo transferred. Outcomes were compared by ovarian reserve test results, with diminished ovarian reserve (DOR) defined as a cycle day 3 FSH >10 IU/mL and/or antimüllerian hormone <1 ng/mL.
Intervention(s)
In vitro fertilization with blastocyst biopsy and aneuploidy screening of all 23 chromosome pairs.
Main Outcome Measure(s)
Rate of aneuploidy in blastocysts and incidence of IVF cycles with no transfer owing to no euploid blasts.
Result(s)
Patients with DOR had a higher percentage of aneuploid blastocysts (57% vs 49%) and a higher incidence of no euploid embryos to transfer (25% vs 13%). The higher rate of aneuploidy in blastocysts was most significant in patients aged <38 years (67% vs 53%). Implantation rates after transfer of euploid blastocysts were similar (61% compared with 59%), and miscarriage rates were low (14% and 10%).
Conclusion(s)
Unexplained RPL patients with DOR have a higher percentage of aneuploid blastocysts and risk of no euploid embryo to transfer compared with unexplained RPL patients with normal ovarian reserve testing. The difference is most significant in patients aged <38 years. Patients with RPL and DOR with euploid embryo transferred had similar outcomes compared with patients with RPL and normal ovarian reserve testing.
