Objective

To estimate the aneuploidy rates in young women with diminished ovarian reserve (DOR) before treatment and poor ovarian response (POR) postretrieval.

Design

Retrospective cohort study.

Setting

A single academically-affiliated fertility clinic.

Patient(s)

Autologous frozen embryo transfer cycles from December 2014 to June 2020 were reviewed. Demographic and clinical factors that impact outcomes were used for propensity score matching (PSM) in a ratio of 2:1 and 4:1 for preimplantation genetic testing for aneuploidy pre-cycle DOR and POR after stimulation, respectively.

Intervention(s)

None.

Main Outcome Measure(s)

Aneuploid rates, defined as the number of aneuploid blastocysts divided by the number of biopsied blastocysts per cycle. No euploid embryos to transfer, defined as all cohorts of embryos being aneuploid.

Result(s)

A total of 383 women diagnosed with DOR were compared with matched controls. Aneuploid rates did not differ significantly between the two groups (42.2% vs. 41.7%; RR = 1.06; 95% CI, 0.95–1.06). No differences were identified in live birth rates per transfer between women with and without DOR after euploid single-embryo transfers (56.0% and 60.5%, respectively). An additional PSM analysis to assess aneuploidy rates for patients with POR (<5 oocytes) vs. those without it, resulted in similar rates of aneuploidy between the two comparison groups (41.1% vs. 44%, R = 1.02; 95% CI, 0.91–1.14). The prevalence of cycles with “no euploid embryos” in the POR cohort was higher (26% vs. 13%); however, rates of cases with a single embryo available for biopsy were lower in the DOR group, relative to controls (11% vs. 31%).

Conclusion(s)

Young women diagnosed with DOR or POR exhibited equivalent aneuploidy rates and live birth rates per euploid embryo transfer in a large matched population, based on age, body mass index, and IVF cycle initiation. The lower percentage of cycles with no euploid embryo available for transfer in DOR and POR patients is because of the decreased total number of oocytes/developing embryos and not because of increased aneuploidy rates in these groups.

中文翻译：

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与卵巢储备正常的患者相比，卵巢储备减少的诊断不会影响胚胎非整倍体或活产率

客观的

估计治疗前卵巢储备减少 (DOR) 和恢复后卵巢反应差 (POR) 的年轻女性的非整倍体率。

设计

回顾性队列研究。

环境

一个学术附属的生育诊所。

病人）

回顾了 2014 年 12 月至 2020 年 6 月的自体冷冻胚胎移植周期。影响结果的人口统计学和临床​​因素以 2:1 和 4:1 的比例用于倾向评分匹配 (PSM)，分别用于非整倍体周期前 DOR 和刺激后 POR 的植入前基因检测。

干预措施

没有任何。

主要观察指标）

非整倍体率，定义为非整倍体囊胚的数量除以每个周期活检囊胚的数量。没有要移植的整倍体胚胎，定义为所有胚胎群都是非整倍体。

结果）

共有 383 名被诊断患有 DOR 的女性与匹配的对照组进行了比较。两组之间的非整倍体率没有显着差异（42.2% 对 41.7%；RR = 1.06；95% CI，0.95–1.06）。在整倍体单胚胎移植后，有和没有 DOR 的女性每次移植的活产率没有差异（分别为 56.0% 和 60.5%）。一项额外的 PSM 分析评估了 POR（<5 个卵母细胞）患者与没有 POR 患者的非整倍体率，导致两个比较组之间的非整倍体率相似（41.1% 对 44%，R = 1.02；95% CI， 0.91–1.14）。POR 队列中“无整倍体胚胎”周期的流行率更高（26% 对 13%）；然而，与对照组相比，DOR 组具有可用于活检的单个胚胎的病例率较低（11% 对 31%）。

结论

根据年龄、体重指数和 IVF 周期开始，诊断为 DOR 或 POR 的年轻女性在大量匹配人群中表现出相当的非整倍体率和每次整倍体胚胎移植的活产率。在 DOR 和 POR 患者中没有可用于移植的整倍体胚胎的周期百分比较低是因为卵母细胞/发育中的胚胎总数减少，而不是因为这些组中的非整倍体率增加。