Higher chromosomal aberration rate in miscarried conceptus from polycystic ovary syndrome women undergoing assisted reproductive treatment

Women with polycystic ovarian syndrome were observed to miscarry chromosomally aberrant embryos/ fetuses at higher rates during treatment with assisted reproductive technology. Polycystic ovarian syndrome was an independent risk factor for the conceptus to be chromosomally abnormal.

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Volume 111, Issue 5, Pages 936–943.e2

Authors:

Ying Li, M.M., Linlin Wang, M.M., Jiawei Xu, Ph.D., Wenbin Niu, M.M., Hao Shi, Ph.D., Linli Hu, M.D., Yile Zhang, M.D., Meixiang Zhang, M.D., Xiao Bao, M.D., Nan Zhang, M.M., Yingpu Sun, M.D., Ph.D.

Abstract:

Objective

To assess the potential association between polycystic ovary syndrome (PCOS) and chromosomally aberrant miscarriage during treatment with assisted reproductive technology (ART).

Design

A retrospective, single-center study.

Setting

University-affiliated reproductive center.

Patient(s)

A total of 328 patients sent their first trimester miscarried chorionic villus for genetic examination after ART in our center from January 2013 to September 2016, of which 119 cases were women with PCOS and 209 were non-PCOS controls. No known definite miscarriage-related concomitants existed in any study subject.

Intervention(s)

Single nucleotide polymorphism array analysis was performed on all collected samples.

Main Outcome Measure(s)

Frequency of aberrant karyotype of miscarried conceptus and the correlation between PCOS and chromosomally aberrant miscarriage.

Result(s)

A total of 173 (52.7% of 328) conceptuses were identified as chromosomally aberrant by single nucleotide polymorphism array. Chromosomal aberrations were more frequent in conceptuses from PCOS patients compared with controls (61.3% vs. 47.8%). Furthermore, both univariate and multivariable analysis identified PCOS as a risk factor for an embryo/fetus to be chromosomally abnormal, with odds ratios of 1.957 (95% confidence interval, 1.067–3.590) and 2.008 (95% confidence interval, 1.038–3.883), respectively.

Conclusion(s)

Women with PCOS were at an increased risk of miscarrying a chromosomally aberrant embryo/fetus compared with non-PCOS controls during ART. Mechanisms require further investigation. Preimplantation genetic screening might be an effective approach to decrease the risk of spontaneous miscarriage for women with PCOS.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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