#284 : Impact of Dosage and Duration of Exogenous Gonadotropins on Embryonic Genetic Status and Cumulative Live Birth Rate: A Secondary Analysis of a Multicenter, Randomized Controlled Trial

Abstract

Background and Aims: The safety of exogenous gonadotropins regarding its impact on embryos as well as pregnancy outcomes is still inconclusive. This study aimed to evaluate the effects of different doses and duration of gonadotropins on embryonic genetic status, pregnancy outcomes in infertile women with a good prognosis. Method: This is a secondary analysis of a multi-center, randomized controlled trial conducted from July 2017 through June 2018, which investigated the efficacy of preimplantation genetic testing for aneuploidy (PGT-A) in good-prognosis infertile population. Couples with PGT-A treatment were included in this study, and were divided into four groups according to the total dosage of exogenous gonadotropins and the duration of stimulation: Group1,2,3,4 with gonadotropins doses and stimulation duration [Formula: see text]1500 IU, 1500 IU, 1500 IU, [Formula: see text]10 days, respectively. Group 1 served as the control group. The main outcome measures were the rates of embryonic aneuploidy, mosaicism and cumulative live birth after transfers of euploid embryos. Results: A total of 579 couples were included, with 1737 embryos being genetically screened using NGS. After adjusting for confounding factors, embryo mosaicism rate was significantly increased in Group 2, 3, 4 in comparison with Group 1 (Group 2,3,4: 13.4%, 14.8%, 12.4%, respectively, vs. Group1: 8.9%; adjusted OR [95% CI]: 1.65[1.07, 2.54], [Formula: see text]=0.024; 1.76[1.02, 3.30], [Formula: see text]=0.041; 1.50[1.01, 2.22], [Formula: see text]=0.043; respectively). There was no association between gonadotropins dose or duration and embryo aneuploidy rate. The cumulative live-birth rate was significantly lower in Group 2, 3 and 4 than that in Group 1 (Group 2,3,4: 73.2%, 64.8%, 75.2%, respectively, vs. Group 1: 85.0%; adjusted OR [95% CI]: 0.50 0.28, 0.89], [Formula: see text]=0.019; 0.34[0.17, 0.68], [Formula: see text]=0.002; 0.59[0.35, 0.98], [Formula: see text]=0.043; respectively). Conclusions: High dose, prolonged ovarian stimulation may increase mosaic embryo rate and decrease cumulative live-birth rate after transfers of euploid embryos.in infertile women with a good prognosis.