Hôpital FOCH, Suresnes, France; Instituto Valenciano de Infertilidad Reproductive Medicine Associates, Basking Ridge, New Jersey.
Hôpital FOCH, Suresnes, France.
Fertil Steril. 2022 Sep;118(3):494-503. doi: 10.1016/j.fertnstert.2022.06.011. Epub 2022 Jul 13.
To study the consequences of specific genotype profiles of follicle-stimulating hormone receptor (FSHR) and luteinizing hormone choriogonadotropin receptor (LHCGR) on assisted reproductive technology outcomes when preimplantation genetic testing for aneuploidy is used for controlling the embryo ploidy status. The most common reported single-nucleotide polymorphisms in the amino acid position for the FSHR (N680S; N: asparagine, S: serine; [rs6166]) and the LHCGR (N312S variant; N: asparagine, S: serine [rs2293275]) were chosen for this study.
Retrospective cohort study.
Private Fertility Clinic.
PATIENT(S): All women aged 18-40 years undergoing their first assisted reproductive technology cycle with aneuploidy screening between 2006 and 2017 with body mass index of >18 and <40 kg/m were included.
INTERVENTION(S): All patients received both recombinant follicle-stimulating hormone and human menopausal gonadotropin or low dose human chorionic gonadotropin. Genomic DNA was isolated from patients' blood. Genotyping of the FSHR and LHCGR polymorphisms was performed using TaqMan genotyping assays. Associations between both receptor genotypes and clinical outcomes were assessed using generalized regression and ANOVA.
MAIN OUTCOMES MEASURE(S): Live birth rate was the primary outcome. Secondary outcomes included oocyte yield, mature oocytes, blastulation rate, usable blastocyst rate, and implantation rate.
RESULT(S): A total of 1,183 patients met the inclusion criteria and generated reliable genotype results. The overall genotype frequencies in the study population for the FSHR gene were as follows: 21.7% homozygous for S in codon 680, 29.2% homozygous for N680, and 48.1% heterozygous (N680S). As for the LHCGR, 15.6% were homozygous for N312, 38.5% homozygous for S312 and 45.9% heterozygous (N312S). Our study population consisted of 53.8% non-Hispanic white; 6.1% Hispanic white; 4.1% Afro-American; 15.4% Asian; and 20.6% other or unknown. No significant association was found with any of the studied variables (oocyte yield, usable blastocyst rate, implantation rate, live birth) when genotypes were analyzed per receptor or in combination with one another. There was a statistically significant but clinically irrelevant difference in the rate of mature oocytes across different variant combinations.
CONCLUSION(S): Our findings suggest that the presence of gonadotropin receptor polymorphisms in both FSHR N680S and LHCGR N312S are not associated with assisted reproductive technology outcomes; therefore, these variants should not be considered reproductive predictors.
研究在使用胚胎植入前遗传学筛查来控制胚胎倍性状态的情况下,卵泡刺激素受体(FSHR)和黄体生成素促性腺激素受体(LHCGR)的特定基因型对辅助生殖技术结局的影响。本研究选择了 FSHR(N680S;N:天冬酰胺,S:丝氨酸;[rs6166])和 LHCGR(N312S 变体;N:天冬酰胺,S:丝氨酸[rs2293275])氨基酸位置最常见的单核苷酸多态性。
回顾性队列研究。
私人生育诊所。
所有年龄在 18-40 岁之间、2006 年至 2017 年间接受过胚胎植入前遗传学筛查的、体质量指数(BMI)>18kg/m2 且<40kg/m2 的首次接受辅助生殖技术的女性均纳入本研究。
所有患者均接受重组卵泡刺激素和人绝经期促性腺激素或低剂量人绒毛膜促性腺激素治疗。从患者的血液中提取基因组 DNA。使用 TaqMan 基因分型检测试剂盒对 FSHR 和 LHCGR 多态性进行基因分型。使用广义回归和 ANOVA 评估两种受体基因型与临床结局之间的相关性。
活产率为主要结局。次要结局包括卵母细胞产量、成熟卵母细胞、囊胚形成率、可利用囊胚率和着床率。
共有 1183 名患者符合纳入标准并获得了可靠的基因型结果。研究人群中 FSHR 基因的总体基因型频率如下:21.7%为 680 位密码子的纯合子 S,29.2%为纯合子 N680,48.1%为杂合子(N680S)。对于 LHCGR,15.6%为 N312 纯合子,38.5%为 S312 纯合子,45.9%为杂合子(N312S)。我们的研究人群中,53.8%为非西班牙裔白人;6.1%为西班牙裔白人;4.1%为非裔美国人;15.4%为亚洲人;20.6%为其他或未知。当按受体或相互组合分析基因型时,未发现任何研究变量(卵母细胞产量、可利用囊胚率、着床率、活产率)与任何一个受体存在显著关联。不同变体组合之间的成熟卵母细胞率存在统计学上显著但临床意义不大的差异。
我们的研究结果表明,FSHR N680S 和 LHCGR N312S 中的促性腺激素受体多态性的存在与辅助生殖技术结局无关;因此,这些变体不应被视为生殖预测因素。