Are ovarian response and pregnancy rates similar in selected FMR1 premutated and mutated patients undergoing preimplantation genetic testing?

Abstract

Purpose

To assess if the ovarian response of FMR1 premutated women undergoing preimplantation genetic testing (PGT) for Fragile X syndrome is lower compared with fully mutated patients, due to their frequent premature ovarian failure.

Methods

In a retrospective cohort study from January 2009 to March 2019, we compared PGT outcomes in 18 FMR1 premutated women and 12 fully mutated women and aimed to identify predictive factors of stimulation outcomes.

Results

Eighty-six IVF/PGT-M cycles for FMR1 PGT were analyzed. Premutation and full mutation patients were comparable in terms of age, body mass index (BMI), basal FSH, antral follicular count, and cycle length. However, premutation carriers had significantly lower AMH (1.9 versus 4.0 ng/mL, p = 0.0167). Premutated patients required higher doses of FSH (2740 versus 1944 IU, p = 0.0069) but had similar numbers of metaphase II oocytes (7.1 versus 6.6, p = 0.871) and embryos (5.6 versus 4.9, p = 0. 554). Pregnancy rates (37.1% versus 13.3%, p = 0.1076) were not statistically different in both groups.

Conclusion

In spite of lower ovarian reserve and thanks to an increased total dose of FSH, FMR1 premutated selected patients seem to have similar ovarian response as fully mutated patients. Neither the number of CGG repeats in FMR1 gene nor FMR1 mutation status was good predictors of the number of retrieved oocytes.

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Acknowledgments

The authors thank Nelly Guigue for her contribution to the data management of the study. We are grateful to the University Hospital of Montpellier for supporting the PGT activity.

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Correspondence to Noemie Ranisavljevic.

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Patients were informed of the investigations and gave their consent before participation in the study, which was approved by the internal ethical board of the Montpellier University Hospital.

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Ranisavljevic, N., Hess, M., Castelli, C. et al. Are ovarian response and pregnancy rates similar in selected FMR1 premutated and mutated patients undergoing preimplantation genetic testing?. J Assist Reprod Genet (2020). https://doi.org/10.1007/s10815-020-01809-3

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Keywords

  • Fragile X syndrome
  • Ovarian reserve
  • Ovarian stimulation
  • IVF
  • Preimplantation genetic testing