Abstract
Increasing maternal age promotes embryonic aneuploidy and subfecundity whereas elevated serum levels of FSH predict subfecundity, regardless of age. It is unclear, however, whether rising serum FSH levels also predict poor oocyte quality leading to embryonic aneuploidy. Therefore, the objective of this study was to determine if basal serum FSH levels predict the risk of embryonic aneuploidy in women undergoing IVF, independent of age. Historical cohort study. Seventy-six patients undergoing 97 IVF cycles of preimplantation genetic screening (PGS) with comparative genomic hybridization (CGH) were studied. Basal serum FSH levels on cycle day 3 were assessed before initiation of hormone therapy. GnRH agonist and antagonist were used in 74% and 26% of the IVF cycles, respectively. Embryonic aneuploidy was calculated as a ratio of number of aneuploid embryos per total embryos biopsied on day 3. The association between log serum FSH level and embryonic aneuploidy rate was assessed by multiple linear regression, adjusting for maternal age, total gonadotropins used and maximal serum estradiol (E2) level. Mean maternal age, log serum FSH and log maximal serum E2 were 39 ± 3.5 years, 0.8 ± 0.26 mIU/mL and 3.49 ± 0.23 pg/ml, respectively. 3348 ± 1629 IU of total gonadotropins were used. Embryonic aneuploidy increased at a rate of 0.12 per year with maternal age. There was no significant correlation between log serum FSH level and embryonic aneuploidy rate, controlling for all covariables. There was a significant positive correlation between the interactions of peak E2 levels and maternal age with aneuploidy, which was thought to be secondary to the effect of maternal age. Despite the positive correlation between embryonic aneuploidy rate and maternal age, no relationship was evident between elevated basal serum FSH levels and genetic quality of the embryo, as assessed with PGS with CGH.
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