Logistic regression analysis of risk factors associated with embryo chromosomal abnormalities after embryo transfer in advanced age and young patients

Abstract

Objective To analyze embryo chromosomal abnormalities rate and its risk factors after assisted reproductive technology (ART) in different age groups. Methods This was a retrospective cohort study on 877 patients undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) in Reproductive Medicine Center of the Sixth Affiliated Hospital of Sun Yat-Sen University between January 2016 and June 2018. All patients had embryo chromosomes tested after spontaneous abortion. Clinical data were compared between the patients with normal chromosome karyotype and those with abnormal chromosome karyotype using univariate and multivariate analysis for risk factors of abnormal chromosome karyotype in young (<35 years old) and advanced age (≥35 years old) patients. Results In total, 506 young and 371 advanced age patients were enrolled, whose abnormal chromosome karyotype rate was 42.09% and 62.80%, respectively. Whether young or advanced age patients, there was no statistically significant difference in the rate of freezing embryo transfer and ICSI between abnormal and normal chromosome karyotype groups. No matter young or advanced age patients, patients with abnormal chromosome karyotype were significantly older [(31.1±3.1) years old, (39.6±2.5) years old] than those with normal chromosome karyotype [(30.4±3.0) years old, (37.4±2.1)years old] (P=0.018, P<0.001), whereas anti-Mullerian hormone (AMH) [3.68(3.80) μg/L, 2.13(2.23) μg/L] and AFC (13.72±7.77, 9.76±5.91) were significantly lower in patients with abnormal chromosome karyotype [4.18(4.24) μg/L, 3.12(2.86) μg/L; 15.58±8.04, 11.56±7.29] (P=0.013, P=0.019; P=0.010, P=0.014). The further logistic regression analysis confirmed that only AMH was the risk factor of abnormal chromosome karyotype in young patients (OR=1.021, P=0.010), while age was the risk factor of abnormal chromosome karyotype in advanced age patients after spontaneous abortion (OR=0.789, P=0.001). Conclusion Neither vitrified cryopreservation nor ICSI would increase incidence of abnormal chromosome karyotype. For patients younger than 35 years old, basal serum AMH was independently related to chromosomal abnormalities. For those older than 35 years old, age was the mayor risk factor for chromosomal abnormalities. Key words: Vitrified cryopreservation; Intracytoplasmic sperm injection; Advanced age; Anti-Mullerian hormone; Chromosome karyotype