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Aneuploidy rates within age groups do not differ within the typical therapeutic range of gonadotropin exposure

      Objective

      Investigators have expressed concerns regarding the impact of exogenous gonadotropins (GND) and the supra-physiologic milieu attained during superovulation. Particularly concerning is the potential association with increased embryonic aneuploidy rates although these data are limited as they employed fluorescence in situ hybridization based analyses. This study seeks to compare aneuploidy rates (AR) with varying levels of exogenous GND exposure using the more robust qPCR based screening platform.

      Design

      Retrospective cohort.

      Materials and Methods

      Patients undergoing qPCR based aneuploidy screening in their 1st IVF cycle during 2010 to 2012 were evaluated. Patients were stratified by age (<35, 35-37, 38-40, 41-42, and ≥43 years) and divided into quartiles of total GND usage. AR was determined for each quartile of GND usage within each age group and compared with contingency table analyses and corrected for multiple comparisons.

      Results

      1277 1st cycles were included. GND dose varied from 75 to 450 international units daily. Total dose increased with age (P<0.0001). Patients receiving lower doses had higher peak E2 levels (P<0.001). AR increased with maternal age (P<0.0001). There was a significant increase in AR with increasing GND dosage (P<0.0001) as has been reported. However, once controlled for maternal age, there was no relation between AR and GND dosage (p=0.23, 0.95, 0.71, 0.99, and 0.62, for each age group respectively).

      Conclusion

      Variation in exogenous GND dosage within the typical therapeutic range employed for IVF does not impact aneuploidy. A limitation of this study is that all patients received some exogenous GND and thus it cannot be determined if the AR is the same as would be found in natural cycles in age controlled peers. Still it is clear that this “dose response” is attributable to patient selection and not variation within the therapeutic range. Further studies comparing these data to natural cycles will be necessary to determine if they impact AR at all.