Do female translocation influence the ovarian response pattern to controlled ovarian stimulation in preimplantation genetic diagnosis?

Abstract

Evaluate the impact of chromosomal autosomal balanced translocations on ovarian response to controlled ovarian stimulation (COS) in female carriers undergoing IVF-PGD. Retrospective study. All female translocation carriers who underwent PGD at our centre from 2003 to 2010 were included and compared to female from couples with male translocation carriers. Only Robertsonian and reciprocal autosomal translocations were considered. COS parameters and PGD outcomes were analysed by a bivariate analysis. Influence of sex of the carrier on the ovarian response was evaluated through a multivariate analysis. 79 cycles from 33 female carriers were compared to 120 cycles from 57 women from couples with male carriers. No difference was observed for female age (33.2 and 32.6 years in the female and male carriers, respectively), AMH (3.5 vs. 4.0 ng/mL) and AFC (13.7 vs. 14.2). No difference in COS parameters was observed for the total dose of rFSH (2052 vs. 1896 IU, P=0.24). A significantly higher level of E2 the day of hCG was observed in female carriers (2781 vs. 2248 pg/mL, P<0.001). No difference was observed for the number of retrieved oocytes (12.7 and 12.6 for female and male carriers, respectively, P=0.99), embryos (7.9 vs. 7.1, P=0.29), unaffected embryos (1.3 vs. 1.7, P=0.17) and transferred embryos (1.0 vs. 1.2, P=0.27). In the two groups, pregnancy rate was similar per cycle (12.7% vs. 15.0%, P=0.65) and per transfer (28.6% vs. 30.5%, P=0.85). Multivariate analysis after adjustment showed that female carriers had a significantly higher E2 level the day of hCG (+ 540 pg/mL, P=0.046). This is the largest reported cohort of female carriers of balanced translocations treated with PGD. This study showed that the ovarian response to COS was not impaired by balanced translocation status. Female chromosomal structural abnormalities did not influence the results of COS in PGD. Thus, female carriers of balanced translocations could be considered normal responders.