Can the FMR1 (fragile X) gene serve as predictor of response to ovarian stimulation?
Because triple CGG repeats on FMR1 correlate with anti-Müllerian hormone, repeats may also correlate with clinical outcomes. In 55 in vitro fertilization patients, repeats, corrected for gonadotropin dosage, were, therefore, correlated to oocytes. Patients were stratified by <35 and > or =35 repeats, and by age to <38 or > or =38 years. Less than 35 (but not > or =35) repeats demonstrated significantly lower anti-Müllerian hormone at ages > or =38 than at <38 years ( P < .05). In >38 years, anti-Müllerian hormone was not affected by repeats. In <38 years, with <35 repeats (though not with > or =35), required significantly less gonadotropins than > or =38 ( P < .05). In <38 years (though not > or =38), those with <35 repeats produced significantly more oocytes than women with > or =35 repeats ( P = .006). In <38 years, retrieved oocytes were inversely related to repeats, adjusted for gonadotropin dosage ( P = .03). This supports FMR1 testing as useful in fertility practice and suggests why response rates to increasing stimulation with gonadotropins may vary.
Gleicher
Norbert
N
Center for Human Reproduction, 21 East 69th Street, New York, NY 10021, USA. ngleicher@thechr.com
Weghofer
Andrea
A
Oktay
Kutluk
K
Barad
David H
DH
D000328:Adult; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods; D051860:Fragile X Messenger Ribonucleoprotein 1 / Q000235:genetics*; D006801:Humans; D007247:Infertility, Female / Q000235:genetics / Q000628:therapy; D054315:Oocyte Retrieval / Q000379:methods; D010062:Ovulation Induction / Q000379:methods; D011237:Predictive Value of Tests; D019680:Trinucleotide Repeat Expansion / Q000235:genetics
D051860:Fragile X Messenger Ribonucleoprotein 1