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基础促卵泡激素(FSH)值与高龄产妇(AMA)而非 AMA 患者的非整倍体发生率呈正相关。

Basal FSH values are positively associated with aneuploidy incidence in pre-advanced maternal age (AMA) but not in AMA patients.

机构信息

Huntington Medicina Reprodutiva - Eugin Group, Sao Paulo, Brazil.

Biogenesi, Reproductive Medicine Centre, Monza, Italy.

出版信息

J Assist Reprod Genet. 2024 Sep;41(9):2397-2404. doi: 10.1007/s10815-024-03190-x. Epub 2024 Jul 12.

Abstract

PURPOSE

To assess the impact of maternal age on the association between maternal basal FSH and aneuploidy.

METHODS

A retrospective study including data from 1749 blastocysts diagnosed as euploid or aneuploid by PGT-A (preimplantation genetic testing for aneuploidy). Aneuploidy incidence was compared between embryos from mothers with high vs. low basal FSH levels (above and below the group median, respectively) in total, pre-AMA (advanced maternal age; < 35 years, 198 embryos) and AMA (≥ 35 years, 1551 embryos) patient groups, separately. To control for the interference of potentially confounding variables, the association between aneuploidy and high basal FSH levels was assessed by multivariate logistic analysis in overall, pre-AMA and AMA patient groups.

RESULTS

Overall, aneuploidy rate was 9% higher (p = 0.02) in embryos from patients with high basal FSH (63.7%) compared to those with low basal FSH (58.4%). In the pre-AMA subgroup, aneuploidy incidence was 35% higher (p = 0.04) in embryos from patients with high basal FSH (53.5%) compared to those with low basal FSH (39.4%). Differently, aneuploidy occurrence did not vary between embryos from AMA patients with low (61.0%) and high (64.8%) basal FSH (p = 0.12). The multivariate analysis revealed that, in pre-AMA embryos, the association between aneuploidy occurrence and high basal FSH is independent of potential confounding variables (p = 0.04).

CONCLUSION

Maternal basal FSH values are associated with embryo aneuploidy in pre-AMA but not in AMA patients. The present findings suggest that basal FSH is a useful parameter to assess aneuploidy risk in pre-AMA patients and reinforce the hypothesis that excessive FSH signalling can predispose to oocyte meiotic errors.

摘要

目的

评估母体基础 FSH 水平与非整倍体之间的关联受母体年龄的影响。

方法

这是一项回顾性研究,纳入了 1749 个通过 PGT-A(胚胎植入前非整倍体检测)诊断为整倍体或非整倍体的囊胚的数据。在总人群、高龄产妇(<35 岁)组和高龄产妇(≥35 岁)组中,分别比较了母体基础 FSH 水平较高(高于组内中位数)与较低(低于组内中位数)的胚胎中非整倍体的发生率。为了控制潜在混杂变量的干扰,在总人群、高龄产妇前组和高龄产妇组中,通过多变量逻辑分析评估了非整倍体与基础 FSH 水平较高之间的关联。

结果

总体而言,基础 FSH 水平较高的患者(63.7%)胚胎中非整倍体的发生率比基础 FSH 水平较低的患者(58.4%)高 9%(p=0.02)。在高龄产妇前组中,基础 FSH 水平较高的患者(53.5%)胚胎中非整倍体的发生率比基础 FSH 水平较低的患者(39.4%)高 35%(p=0.04)。相反,基础 FSH 水平较低(61.0%)和较高(64.8%)的高龄产妇组胚胎中非整倍体的发生率没有差异(p=0.12)。多变量分析显示,在高龄产妇前组胚胎中,非整倍体发生率与基础 FSH 水平较高之间的关联不受潜在混杂变量的影响(p=0.04)。

结论

母体基础 FSH 值与高龄产妇前组而非高龄产妇组胚胎的非整倍体相关。本研究结果表明,基础 FSH 是评估高龄产妇前组非整倍体风险的有用参数,并进一步证实了过量 FSH 信号可能导致卵母细胞减数分裂错误的假说。

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