title: Higher rates of aneuploidy in blastocysts and higher risk of no embryo transfer in recurrent pregnancy loss patients with diminished ovarian reserve undergoing in vitro fertilization.
abstract: OBJECTIVE
  To study the prediction of aneuploidy rate in blastocysts from patients with recurrent pregnancy loss (RPL) on the basis of ovarian reserve testing.
  
  
  METHODS
  Prospective cohort analysis.
  
  
  METHODS
  Private, university-affiliated fertility clinic.
  
  
  METHODS
  A total of 239 patients with RPL, defined as two or more clinical miscarriages, were screened for inclusion. One hundred two (102) cycles in patients with unexplained RPL resulted in at least one euploid embryo transferred. Outcomes were compared by ovarian reserve test results, with diminished ovarian reserve (DOR) defined as a cycle day 3 FSH >10 IU/mL and/or antimüllerian hormone <1 ng/mL.
  
  
  METHODS
  In vitro fertilization with blastocyst biopsy and aneuploidy screening of all 23 chromosome pairs.
  
  
  METHODS
  Rate of aneuploidy in blastocysts and incidence of IVF cycles with no transfer owing to no euploid blasts.
  
  
  RESULTS
  Patients with DOR had a higher percentage of aneuploid blastocysts (57% vs 49%) and a higher incidence of no euploid embryos to transfer (25% vs 13%). The higher rate of aneuploidy in blastocysts was most significant in patients aged <38 years (67% vs 53%). Implantation rates after transfer of euploid blastocysts were similar (61% compared with 59%), and miscarriage rates were low (14% and 10%).
  
  
  CONCLUSIONS
  Unexplained RPL patients with DOR have a higher percentage of aneuploid blastocysts and risk of no euploid embryo to transfer compared with unexplained RPL patients with normal ovarian reserve testing. The difference is most significant in patients aged <38 years. Patients with RPL and DOR with euploid embryo transferred had similar outcomes compared with patients with RPL and normal ovarian reserve testing.
authors.affiliation: Pacific NW Fertility, Seattle, Washington. Electronic address: lshahine@pnwfertility.com.
authors.forename: Lora K
authors.initials: LK
authors.lastname: Shahine
authors.affiliation: Pacific NW Fertility, Seattle, Washington.
authors.forename: Lorna
authors.initials: L
authors.lastname: Marshall
authors.affiliation: Pacific NW Fertility, Seattle, Washington.
authors.forename: Julie D
authors.initials: JD
authors.lastname: Lamb
authors.affiliation: Pacific NW Fertility, Seattle, Washington.
authors.forename: Lee R
authors.initials: LR
authors.lastname: Hickok
mesh_terms: D000026:Abortion, Habitual / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology*; D000782:Aneuploidy; D054304:Anti-Mullerian Hormone / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001755:Blastocyst / Q000473:pathology*; D004624:Embryo Transfer / Q000009:adverse effects; D005260:Female; D005307:Fertilization in Vitro / Q000009:adverse effects*; D043373:Follicle Stimulating Hormone, Human / Q000097:blood; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D065851:Ovarian Reserve; D010053:Ovary / Q000378:metabolism / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D043373:Follicle Stimulating Hormone, Human; D054304:Anti-Mullerian Hormone
keywords: Aneuploidy; diminished ovarian reserve; in vitro fertilization; preimplantation genetic screening; recurrent pregnancy loss