Does myotonic dystrophy affect ovarian reserve, response to controlled ovarian stimulation and ivf-preimplantation genetic diagnosis outcome in female patients?

Abstract

Introduction Myotonic dystrophy type 1 (DM1) is the most common adult-onset muscular dystrophy with incidence of 1 in 8,000 worldwide. The relationship between DM1 and female infertility remains controversial. This study investigated ovarian reserve, ovarian response to stimulation and IVF-PGD outcome in women with DM1 Materials & Methods This study included female patients with DM1 who performed IVF-PGD cycles in Cheil General Hospital & Women's Healthcare Center from January 2013 to December 2017. During this period, a total of 12 women undergoing PGD for DM1 were compared with 10 age matched women undergoing PGD for X-linked disorders (XLD). Ovarian reserve markers, response to controlled ovarian stimulation, embryo quality, and clinical pregnancy rate were compared. Results Day 3 FSH, E2 and anti-mullerian hormone concentration (median, range: 7.5 (4.6-14.8) verse 7.0 (5.7-10.0) mIU/ml; 22.3 (15.9-53.2) verse 27.5 (9.4-54.3) pg/ml; 1.8 (0.7-7.3) verse 3.6 (1.0-7.5) ng/ml, respectively), the mean number of oocytes retrieved and metaphase II oocytes (15.7±12.7 verse 15.6±6.2; 11.9±10.3 verse 12.4±4.9 respectively), fertilization rate (77.3% verse 83.9%) and prevalence of top quality embryo (39.3% vs 33.4%) showed no significant difference between DM1 and XLD groups. Clinical pregnancy rates (17% vs 21%) were similar in both groups Conclusions The results showed that DM1 does not influence ovarian reserve and reproductive outcomes in female patients. Further studies with sufficient number of cases are required to elucidate the impact of DM1 on female infertility.