The role of genetic and autoimmune factors in poor ovarian response in IVF programs

Abstract

Background: The poor ovarian response (POR) to ovarian stimulation significantly decreases the efficiency of assisted reproduction technologies. The genesis of POR is not well understood, and can result from various genetic and immune factors.Purpose: To determine the role of genetic (number of CGG repeats in the FMR1-gene) and autoimmune factors (anti-ovarian antibodies) in POR in IVF programs.Methods: In a cross-sectional study, 150 infertile women were divided into the POR group (n = 65) and the group with a normal ovarian response (n = 85). All the patients underwent the detection of CGG repeats in the FMR1-gene by polymerase chain reaction, serum anti-zona pellucida antibodies (AZPA) and anti-ovarian antibodies by enzyme-linked immunosorbent assay.Results: The risk of POR was higher in patients with CGG counts > 34, but not in the patients with CGG counts < 26. The higher level of AZPA was found in the patients with the 26–34 CGG repeats compared to the patients with <26/> 34 CGG repeats.Conclusion: A higher number of CGG repeats in the FMR1-gene may be a risk factor of POR in IVF programs. Normal CGG counts in regard to ovarian reserve (26–34) suggest the autoimmune-driven POR.