Effect of ovarian stimulation on embryo aneuploidy and mosaicism rate

Figures & data

Table 1. Summary statistics of study population and IVF cycles outcomes

	Global	Euploidy	Aneuploidy	pvalue	No mosaicism	Mosaicisim	pvalue
Maternal age (mean±SD)	35.14 ± 2.16	34.79 ± 2.20	35.46 ± 2.035	<0.001^a	35.02 ± 2.17	35.35 ± 2.05	0.111 ^a
Paternal age (mean±SD)	37.34 ± 4.91	37.00 ± 4.64	37.42 ± 5.16	0.223^a	37.08 ± 4.70	37.66 ± 5.61	0.208 ^a
# Biopsied embryos per patient (mean±SD)	2.88 ± 1.78	3.88 ± 2.14	4.04 ± 2.25	0.317^a	3.98 ± 2.22	3.77 ± 2.02	0.322 ^a
# Aspirated oocytes per patient (mean±SD)	13.67 ± 6.77	15.62 ± 7.61	14.97 ± 6.95	0.214 ^a	15.36 ± 7.19	15.25 ± 8.20	0.878 ^a
# Aspirated oocytes MII per patient (mean±SD)	10.73 ± 6.05	12.24 ± 6.41	11.65 ± 5.37	0.169 ^a	11.97 ± 5.69	12.18 ± 7.49	0.707 ^a
RIF (%)	20.2	22.5	16.9	0.048 ^b	19.9	21.5	0.661 ^b
RPL (%)	21.8	22.5	20.8	0.555 ^b	22.2	20.0	0.580 ^b
Biopsy day
D + 5	63.1	65.9	59.0	0.039 ^b	62.3	66.2	0.606 ^b
D + 6	36.9	34.1	41.0		37.7	33.8
Embryo quality
A	45.2	53.4	33.1	<0.001 ^b	46.6	38.3	0.009 ^b
B	50.1	43.9	59.3		49.8	51.6
C	3.3	1.9	5.5		2.6	7.0
D	1.4	0.8	2.1		1.0	3.1

Test performed for statistical analysis: a:Student t-test; b: Pearson’s Chi-Square test.

RIF: Repeated implantation failure; RPL: Recurrent pregnancy loss

Table 2. Descriptive analysis of the cycles

	IVF cycles n (%)
OCP
Yes	54 (19.3%)
No	226 (80.7%)
Stimulation protocol
Long	65 (23.2%)
Short	5 (1.8%)
Antagonist	201 (71.8%)
Mild	1 (0.4%)
Agonist-Antagonist	3 (1.1%)
Free	5 (1.8%)
Gonadotropin
uFSH	37 (13.2%)
rFSH	30 (10.7%)
uFSH+rFSH	186 (66.4%)
rLH	25 (8.9%)
rFSH+rLH	1 (0.4%)
uFSH+rLH	1 (0.4%)
Trigger
hCG	140 (50.0%)
GnRH antagonist	94 (36.9%)
Dual	45 (16.1%)

OCP: oral contraceptive pills; FSH: follicle-stimulating hormone; LH: luteinizing hormone; rFSH: recombinant FSH; uFSH: urinary FSH; rLH: recombinant LH; hCG: human chorionic gonadotropin; GnRH: gonadotropin-releasing hormone; Dual: hCG+GnRH antagonist

Table 3. Association between aneuploidy rate and IVF cycles parameters

	Aneuploid embryos (n/%)	p value	OR (95% CI)
OCP
No	266 (40.5%)		Reference
Yes	66 (41.2%)	0.222	0.793 (0.546–1.151)
Stimulation protocol			Reference
Long	55 (36.4%)
Short	9 (45.0%)	0.139	2.143 (0.781–5.880)
Antagonist	262 (42.3%)	0.077	1.423 (0.962–2.105)
Mild	0 (0.0%)	0.999	0.000 (0.000–0.000)
Agonist-Antagonist	3 (30.0%)	0.550	0.640 (0.148–2.949)
Free	3 (23.1%)	0.667	0.737 (0.184–2.949)
Gonadotropin
uFSH	51 (46.8%)		Reference
rFSH	41 (38.0%)	0.255	0.719 (0.408–1.269)
uFSH+rFSH	204 (40.1%)	0.438	0.840 (0.540–1.306)
rLH	33 (39.8%)	0.401	0.771 (0.420–1.415)
rFSH+rLH	1 (25.0%)	0.922	0.890 (0.086–9.266)
uFSH+rLH	2 (66.7%)	0.648	1.174 (0.149–21.345)
Trigger
hCG	142 (39.6%)		Reference
GnRH antagonist	128(41.0%)	0.516	1.119 (0.797–1.571)
Dual	58 (42.6%)	0.101	1.423 (0.933–2.172)
# Aspirated oocytes per patient	-	0.857	0.998 (0.978–1.019)
# Aspirated oocytes MII per patient	-	0.589	0.993 (0.969–1.018)
Duration of stimulation	-	0.015*	0.897 (0.822–0.979)
Total dosage of gonadotropins	-	0.151	1.000 (1.000–1.000)
Daily dosage of gonadotropins	-	0.822	1.000 (0.998–1.002)

P values are calculated with a binary logistic regression statistical test using as confounding factors maternal age, embryo quality and biopsy day and genetic analysis technique (NGS or a-CGH) (p < 0.05 is considered significantly different).

OCP: oral contraceptive pills; FSH: follicle-stimulating hormone; LH: luteinizing hormone; rFSH: recombinant FSH; uFSH: urinary FSH; rLH: recombinant LH; hCG: human chorionic gonadotropin; GnRH: gonadotropin-releasing hormone; Dual: hCG+GnRH antagonist

Table 4. Association between mosaicism rate and IVF cycles parameters

	Mosaic embryos (n/%)	p value	OR (95% CI)
OCP
No	111 (16.9%)		Reference
Yes	19 (12.0%)	0.172	1.455 (0.850–2.490)
Stimulation protocol			Reference
Long	25 (16.4%)
Short	3 (15.0%)	0.687	0.759 (0.199–2.902)
Antagonist	96 (15.5%)	0.445	0.820 (0.494–1.363)
Mild	1 (50.0%)	0.152	7.974 (0.465–136.843)
Agonist-Antagonist	2 (20.0%)	0.782	1.260 (0.246–6.466)
Free	3 (23.1%)	0.597	1.467 (0.354–6.078)
Gonadotropin
uFSH	19 (17.3%)		Reference
rFSH	19 (17.8%)	0.737	1.134 (0.545–2.359)
uFSH+rFSH	78 (15.4%)	0.789	1.083 (0.603–1.948)
rLH	13 (15.7%)	0.889	0.944 (0.421–2.116)
rFSH+rLH	0 (0.0%)	0.999	0.000 (0.000-)
uFSH+rLH	1 (33.3%)	0.608	1.911 (0.161–22.662)
Trigger
hCG	59 (16.5%)		Reference
GnRH antagonist	54(17.3%)	0.626	0.897 (0.579–1.389)
Dual	16 (11.8%)	0.351	0.748 (0.406–1.377)
# Aspirated oocytes per patient	-	0.819	1.041 (0.949–1.141)
# Aspirated oocytes MII per patient	-	0.790	1.004 (0.973–1.037)
Duration of stimulation	-	0.754	1.018 (0.912–1.136)
Total dosage of gonadotropins	-	0.348	1.000 (1.000–1.000)
Daily dosage of gonadotropins	-	0.431	1.001 (0.998–1.004)

P values are calculated with a binary logistic regression statistical test using as confounding factors maternal age, embryo quality and biopsy day and genetic analysis technique (NGS or a-CGH) (p < 0.05 is considered significantly different).

OCP: oral contraceptive pills; FSH: follicle-stimulating hormone; LH: luteinizing hormone; rFSH: recombinant FSH; uFSH: urinary FSH; rLH: recombinant LH; hCG: human chorionic gonadotropin; GnRH: gonadotropin-releasing hormone; Dual: hCG+GnRH antagonist