Myotonic dystrophy type 1 and PGD: ovarian stimulation response and correlation analysis between ovarian reserve and genotype

Abstract This study aimed at evaluating parameters and results of ovarian stimulation for myotonic dystrophy type 1 (DM1) female patients undergoing preimplantation genetic diagnosis (PGD) and to assess an eventual association between genotype and ovarian reserve. A retrospective study involved all...

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Published in:Reproductive biomedicine online 2010-05, Vol.20 (5), p.610-618
Main Authors: Dechanet, C, Castelli, C, Reyftmann, L, Coubes, C, Hamamah, S, Hedon, B, Dechaud, H, Anahory, T
Format: Article
Language:English
Subjects:
Adult
Female
Genotype
Humans
Myotonic Dystrophy - genetics
myotonic dystrophy type 1
Obstetrics and Gynecology
ovarian reserve
ovarian stimulation
Ovulation Induction
PGD
Preimplantation Diagnosis
Retrospective Studies
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Summary:Abstract This study aimed at evaluating parameters and results of ovarian stimulation for myotonic dystrophy type 1 (DM1) female patients undergoing preimplantation genetic diagnosis (PGD) and to assess an eventual association between genotype and ovarian reserve. A retrospective study involved all 17 DM1 patients treated in the study centre’s PGD programme. The control group consisted of 22 patients treated for X-linked disorders in the same period. Comparative analysis of ovarian stimulation parameters and results was performed with bivariate and multivariate analysis. Then, among DM1 patients, a correlation between genotype (number of CTG repeats) and ovarian reserve, assessed by antral follicle count, was investigated. Comparative study showed no difference concerning the number of oocytes, embryos and pregnancy rate between the two groups. Multivariate analysis demonstrated that DM1 patients needed a significantly higher dose of gonadotrophins (+544 IU, P < 0.001) than X-linked disorders patients and suggests a decreased ovarian sensitivity. However, with higher dose of gonadotrophins, PGD for DM1 offers good reproductive outcomes with a clinical pregnancy rate of 35.7%. Genotype was not correlated to ovarian reserve and appeared not to be helpful for the choice of the dose of gonadotrophins.
ISSN:1472-6483
1472-6491
DOI:10.1016/j.rbmo.2010.02.003