Akademik Veri Yönetim Sistemi
11. TSRM Üreme Sağlığı ve İnfertilite Kongresi, Antalya, Türkiye, 16 - 19 Kasım 2023, ss.1-2, (Özet Bildiri)
OBJECTIVE: Unexplained infertility (UEI) is defined when a couple that can not conceive although all infertility tests are normal and occurs with a prevalance of 5-10%. Aneuploidy could be one of the reasons that could affect not to achieve pregnancy in these cases. Thus, we aimed to examine the factors underlying the aneuploidy in UEI patients.
MATERIALS-METHODS: In this retrospective cohort study, 90 UEI patients who are all normoresponder and applied for PGT-A to shorten the time to reach pregnancy were included. Female age >38 and abnormal sperm parameters were excluded. Patients were grouped according to maternal BMI(<25, 25-29.9, ≥30), female age(≤30, 31-35, 36-38) male age(≤39, 40-49, ≥50). Embryos were grouped as Top Quality(TQ): Hatched AA, 6AA, 5AA, 4AA, Good Quality(GQ): Hatched AB/BA/BB, 5AB/BA/BB, 4AB/BA/BB, 3AA, Moderate Quality(MQ): 3AB/BA, 2AA. Embryos were evaluated according to Gardner’s classification. Aneuploidy screening was performed using Next Generation Sequencing (NGS). Frequencies were evaluated using Chi-square test. Logistic regression analysis was performed for risk assessment (for aneuploidy risk, dependent variable was euploid vs aneuploid, for embryo quality dependent variable was TQ vs MQ+GQ).
RESULTS: Aneuploidy was observed 41.6% of the embryos (124/298). Distribution of PGT-A results (euploid, mosaic, aneuploid) and embryo quality (TQ, GQ, MQ) were similar between maternal BMI, female and male age groups in UEI patients (p>0.05). When the risk factors were evaluated for aneuploidy, the risk of aneuploidy is higher in GQ and MQ embriyos comparing to TQ embryos (GQ OR: 2.51 95%CI (1.40-4.51), p=0.020; MQ OR: 3.45 95%CI(1.25-9.48), p=0.016). GQ+MQ frequency is higher than TQ embryos in patients with BMI 25-29.9 comparing to BMI <25 (OR:1.98 95%CI (1.17-3.35), p=0,011). Separate blastomer (SP) existance in blastocysts and direct cleavage (DC) occurance were increasing when embryo quality were decreasing. (SP TQ: 1.2%, GQ: 10.1%, MQ: 29.3%; DC TQ: 3.2%, GQ: 11%, MQ: 27.5%).
CONCLUSIONS: One of the reasons of unsuccesful pregnancy could be aneuploidy in UEI patients. Aneuploidy was found with a frequency of 41.6% in UEI patients in our study. Our data suggests that embryo quality is the main risk factor for aneuploidy. PGT-A could be offered to the UEI patients to shorten the pregnancy time. Clinical outcomes of the embryos were not evaluated in the current study. Further large scale studies incluiding different age and BMI groups with clinical results are needed to confirm our results.