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Can the FMR1 (Fragile X) Gene Serve As Predictor of Response to Ovarian Stimulation?

Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, Connecticut, Center for Human Reproduction, New York, and the Foundation for Reproductive Medicine, New York, ngleicher{at}thechr.com

Andrea Weghofer, MD, PhD

Department of Obstetrics and Gynecology, Vienna University School of Medicine, Vienna, Austria, Center for Human Reproduction, New York, and the Foundation for Reproductive Medicine, New York

Kutluk Oktay, MD

Department of Obstetrics and Gynecology, New York Medical College, Valhalla, New York, Center for Human Reproduction, New York, and the Foundation for Reproductive Medicine, New York

David H. Barad, MD, MS

and Departments of Epidemiology and Social Medicine as well as Obstetrics, Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, New York, Center for Human Reproduction, New York, and the Foundation for Reproductive Medicine, New York

Because triple CGG repeats on FMR1 correlate with anti-Müllerian hormone, repeats may also correlate with clinical outcomes. In 55 in vitro fertilization patients, repeats, corrected for gonadotropin dosage, were, therefore, correlated to oocytes. Patients were stratified by <35 and 35 repeats, and by age to <38 or 38 years. Less than 35 (but not 35) repeats demonstrated significantly lower anti-Müllerian hormone at ages 38 than at <38 years ( P < .05). In >38 years, anti-Müllerian hormone was not affected by repeats. In <38 years, with <35 repeats (though not with 35), required significantly less gonadotropins than 38 ( P < .05). In <38 years (though not 38), those with <35 repeats produced significantly more oocytes than women with 35 repeats ( P = .006). In <38 years, retrieved oocytes were inversely related to repeats, adjusted for gonadotropin dosage ( P = .03). This supports FMR1 testing as useful in fertility practice and suggests why response rates to increasing stimulation with gonadotropins may vary.

Key Words: Fragile X • FMR1 gene • premarure ovarian senescence • ovarian aging • ovarian resistance • gonadotropins • ovarian stimulation.

This version was published on May 1, 2009

Reproductive Sciences, Vol. 16, No. 5, 462-467 (2009)
DOI: 10.1177/1933719108328617


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