Pregnancy outcomes in female patients with X chromosome mosaicism after
the first IVF/ICSI treatment: A 6-year retrospective cohort study
Abstract
Objective: The present study focused on the clinical pregnancy and
cumulative live birth rate (CLBR) of female patients with X chromosome
mosaicism (XM) after the first in-vitro-fertilization
(IVF)/intracytoplasmic sperm injection (ICSI) treatment, and the
possible impact of different mosaic subtypes. Design: Retrospective
cohort study Setting: Single Center study Population: Infertility
couples Methods: In total, 76 couples with XM female partners and normal
male partners were included (2014–2019) as the X group, with another 76
couples with normal karyotype included as the control group. Subgroup X1
included 41 45,X/46,XX cases, Subgroup X2 included 22 47,XXX/46,XX
cases, and Subgroup X3 included 12 45,X/47,XXX/46,XX cases. Main Outcome
Measures: The ovarian stimulation, embryo results and pregnancy outcomes
were analyzed. Results: The X group presented similar CLBR but required
a higher total gonadotropin (Gn) dosage than the control group (1800 IU
vs. 1612 IU). Following subgroup analysis, the number of follicles
during oocyte retrieval and average number of fertilized oocytes was
lower in subgroup X1 than in X3. The clinical pregnancy rate and CLBR
were similar in all groups. Conclusion: Females with XM may present a
similar CLBR until one year after oocyte retrieval, but may require a
higher total Gn dosage. Females with 45,X cells may recover fewer
follicles during oocyte retrieval, resulting in fewer embryos. A higher
45,X cell ratio (over 5%) may lead to a lower CBLR. Funding: This study
was supported by the Ministry of Science and Technology of China
(2016YFC1000602). Keywords X chromosome mosaicism, IVF/ICSI outcome,
cumulative live birth rate