P-176 Is there a relationship between ovarian reserve, oocyte and embryo quality in patients undergoing PGT-A?
Authors: Carnesi E , Albani E , Castellano S , Bulbul O , Smeraldi A , Busnelli A , Levi Setti P E 
Published: June 2023

Abstract

Study question
Is there a relationship between ovarian reserve, oocyte and embryo quality in patients undergoing PGT-A?

Summary answer
Our data revealed no relationship between percentage of aneuploid blastocysts in patients with hormonal signs of reduced ovarian reserve.

What is known already
Poor ovarian reserve, as determined by serum anti-mullerian hormone (AMH) and antral follicle count (AFC) levels, is a known risk factor for poor outcomes in in vitro fertilization (IVF). Ultrasound imaging is considered to be the most reliable method for measuring ovarian reserve, as it provides a direct and accurate assessment of the number of ovarian follicles. However, the relationship between ovarian reserve and oocyte quality is not well understood, and further research is needed to fully understand the implications of these test results for IVF outcomes.

Study design, size, duration
The present retrospective case-control study, performed between 2015 and 2021, aims to investigate the association between ORTs and the rate of euploid embryos conceived through ICSI. 680 patients underwent in vitro fertilization procedures that included blastocyst biopsy and 23-chromosome aneuploidy testing. Regardless of cycle day, a level greater than 1,2 ng/mL was regarded as normal, less than 10 antral follicles in total were associated with diminished ovarian reserve according to current knowledge.

Participants/materials, setting, methods
AMH and AFC were studied to determine their relationship with rates of abnormal embryo development. Patients were divided into two groups based on their baseline hormone levels. The AMH group (n = 680) had 562 individuals with normal ovarian reserve in Group 1 and 118 with lower reserve in Group 2. A similar division was made in the same group based on AFC values, resulting in 210 patients with low AFC and 348 with normal AFC.

Main results and the role of chance
Low AMH Group was made up of slightly older patients, as would be expected (39,9 compared with 40,41 years for group 1; P = 0,193). Patients with low AMH shown FSH levels significantly higher (P = 0,022) compared to those with normal ones. Not surprisingly, aspirated follicles, oocytes retrieved, pre-ovulatory follicles, fertilizable oocyte, fertilized oocytes and evolutionary embryos appeared significantly higher in people with normal levels of AMH (respectively P&lt;0,01; P&lt;0,01; P = 0,004; P = 0,013; P = 0,009; P = 0,015). This means the latter had a better oocyte quality even though they shown a comparable non-evolutionary embryo mean (P = 0,047). Regarding euploid embryos, it didn’t result in a statistically significant difference between the 2 groups (P = 0,14) AMH cohort and (P = 0,12) AFC cohort. We obtained the almost the same results taking into account AFC cohort. As expected, regarding protocols and gonadotropins used to stimulate women, our data shown a statistically significant value (P = 0,016) due to personalized protocols for women predicted as poor or normal/high responders.

Limitations, reasons for caution
There are many points affecting diminished ovarian reserve (DOR), linked to a variety of etiologies. However, the genetic determinants of DOR remain largely unknown. All these features don’t allow making an easy model for better studying this condition.

Wider implications of the findings
This study can help clinics provide more accurate and informative counseling to patients undergoing IVF, by giving them a better understanding of the factors that affect their chances of success and how they can impact their treatment.

Trial registration number
None