Dados do Trabalho

Title

The Complex Interplay of Poor Ovarian Response on Embryo Development: Implications for Genetic Health and Reproductive Outcomes

Objective

Low ovarian response is characterized by a reduction in the follicular response resulting in a reduced number of eggs. This fact has an impact on the outcome of assisted reproduction treatments. Therefore, understanding the genetic behavior of the embryos of these patients is still a great challenge for both the clinic and the in vitro fertilization laboratory, because, with a better understanding of the embryo's genetic segregation process, it will be possible to apply more assertive behaviors in the human reproduction routine.

Methods

This retrospective cross-sectional study included 73 patients up to 35 years old, splitted into two groups. The poor ovarian responder group (n=32) and the controls (n=41). The study group included patients with poor ovarian response, less than six MII oocytes after ovarian punction. The control group was selected according to the following inclusion criteria: the presence of tubal factor unexplained infertility, or adenomyosis. The data were collected between January 2019 and December 2021. All patients included in the study (n=73) underwent the same assisted reproduction treatment with embryos transferred after biopsy and PGT-A. The T-Students test was applied to compare numerical variables and the q-square test for categorical variables. All the analysis was performed in SPSS software (V26). Patients who had other factors associated with poor ovarian response were excluded.

Results

In the comparison between the groups, the differences in the levels of AMH, progesterone, and the number of oocytes in MII were observed, as expected for the two groups (p<0.05). However, the control group had a higher rate of chromosomally normal embryos when compared to patients with a low ovarian response (60.9%± 30.1 vs 37.6%± 39.7, p= 0.0057) respectively. The other variables such as age, FSH, LH, BMI, estradiol, fertilization rate, rate of blastocyst formation, and quality of blastocysts did not show statistically significant differences.

Conclusion

Patients with a low ovarian response may have lower rates of embryonic chromosomal normality, this fact is important for the indication of genetic testing for these couples. Future prospective studies should be carried out with a larger number of patients to understand the mechanisms that cause genetic alterations in embryos.

Keywords

Poor Responders, Genetic, Embryo