Morin SJ, et al. - Researchers investigated if infertile women aged <38 years with quantitative evidence of diminished ovarian reserve and/or poor response to stimulation also exhibit poor oocyte quality as measured by blastulation rates, aneuploidy rates, and live birth rates. Findings revealed equivalent blastulation rates, aneuploidy rates and live birth rates per euploid embryo transfer among these women vs age-matched controls with normal precycle and postcycle parameters.

Methods

• Between 2012 and 2016, researchers performed a retrospective cohort study at a single center.
• They specifically chose this time frame as all embryos were cultured to the blastocyst stage at this center during the study period (no cleavage stage transfers were performed).
• They made following 2 comparisons: precycle assessment of ovarian reserve (based on anti-mullerian hormone (AMH) level) and postcycle oocyte yield results.
• They compared patients in <10th percentile to patients in the interquartile range (IQR) for each comparison, with respect to blastulation rate, aneuploidy rate and live birth rate.
• To control for female age (in the <38 year old range) and correlation among oocytes from a given cohort, they created a mixed effects model.
• They included patients with AMH data available for the precycle blastulation analysis (345 patients with AMH in the <10th percentile vs 1758 patients with AMH in the 25th to 75th percentile (IQR)).
• They then analyzed the subset of these patients who pursued preimplantation genetic testing for aneuploidy (PGT-A) to compare aneuploidy rates (124 patients in the <10th percentile vs 782 patients in the IQR).
• They included all patients who proceeded to retrieval (whether or not they also had AMH data available) in the postcycle blastulation analysis (535 patients with oocyte yield in the <10th percentile vs 2675 patients in the IQR).
• They then analyzed the subset of these patients who pursued PGT-A to compare aneuploidy rates (156 patients in the <10th percentile vs 1100 patients in the IQR).

Results

• Findings revealed no differences in the adjusted odds of a given fertilized oocyte developing to a blastocyst, being aneuploid or leading to a live birth after euploid transfer, if the oocyte was retrieved from a cycle with ovarian reserve parameters or oocyte yield in the <10th percentile compared to an oocyte retrieved in a cycle with those parameters in the 25–75th percentile.
• Due to global arrest of embryos, an AMH level in the <10th percentile led to cycle cancellation prior to retrieval and after retrieval prior to transfer more commonly.