Blastocyst aneuploidy rates in poor ovarian response patients according to the POSEIDON criteria
Objective To compare the aneuploidy rate of embryos between poor ovarian response(POR)patients and women with normal ovarian reserve stratified by age,and to eliminate the influence of ovarian reserve on embryo quality.Methods This was a retrospective case-control study of patients who underwent preimplantation genetic testing for aneuploidies(PGT-A)at the Department of Reproduction and Genetics in Hospital for Reproductive Medicine,Shandong University from January 2017 to December 2020.According to the POSEIDON criteria,POR patients were divided into group 1[age＜35 years,anti-Müllerian hormone(AMH)≥1.2 μg/L,number of oocytes retrieved≤9,258 cycles],group 2(age≥35 years,AMH≥1.2 μg/L,number of oocytes retrieved≤9,397 cycles),group 3(age＜35 years,AMH＜1.2 μg/L,number of oocytes retrieved≤9,99 cycles)and group 4(age≥35 years,AMH＜1.2 μg/L,number of oocytes retrieved≤9,377 cycles).The aneuploidy rate of the blastocysts in each group was compared with age-matched control women with normal ovarian reserve and normal ovarian response(non-POR 1 group,non-POR 2 group,non-POR 3 group and non-POR 4 group,AMH≥1.2 μg/L,number of oocytes retrieved＞9).Based on the difference in sample size of POR groups and control groups,a 1∶2 propensity score matching(PSM)analysis was performed between the＜35 years old POR groups and age-matched control groups(POR 1 group vs.non-POR 1 group,POR 3 group vs.non-POR 3 group)and a 1∶1 PSM analysis was performed between the ≥35 years old POR groups and age-matched control groups(POR 2 group vs.non-POR 2 group,POR 4 group vs.non-POR 4 group).The main outcomes were the rates of euploid and aneuploid embryo,the secondary outcomes were the numbers of oocytes retrieved,metaphase Ⅱ oocytes,two pronuclei,embryos biopsied,euploid embryos,aneuploid embryos and mosaic embryos per cycle.Results The number of oocytes retrieved and embryos biopsied embryos in POR 1-4 groups was significantly decreased compared with non-POR 1-4 groups[No.of oocytes retrieved:7.0(6.0,9.0)vs.16.0(13.0,20.0),7.0(5.0,8.0)vs.14.0(11.0,17.0),6.0(4.0,9.0)vs.16.0(13.0,20.0),5.0(3.0,7.0)vs.13.0(11.0,17.0),all P＜0.001;No.of embryos biopsied:3.0(2.0,4.0)vs.4.0(3.0,6.0),2.0(1.0,3.0)vs.3.0(2.0,5),3.0(2.0,4.0)vs.4.0(3.0,6.0),2.0(1.0,3.0)vs.3.0(2.0,5.0),all P＜0.001].After adjusting for repeated egg retrieval,PGT-A indications,ovarian stimulation protocol and total dosage of gonadotrophin,the embryo aneuploidy rate in group 4 POR patients was significantly higher than controls(OR=1.252,95％CI:1.053-1.488,P=0.011).However,no differences were identified in embryo aneuploidy rate between POR patients in groups 1,2,3 and corresponding controls,respectively(all P＞0.05).Conclusion The ovarian reserve adversely affects the quantity and quality of oocytes in advanced age POR women(≥35 years old).Decreased ovarian reserve in young women(＜35 years old)mainly affects the number of oocytes retrieved.
Preimplantation genetic testing for aneuploidyAnti-Müllerian hormoneAneuploidyPoor ovarian responsePOSEIDON criteria
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