Patterns of ovarian response to gonadotropin stimulation in female carriers of balanced translocation.

Objective: To determine whether maternal balanced translocation is a risk factor for poor ovarian response to controlled ovarian hyperstimulation (COH).

Design: A retrospective analysis.

Setting: Private IVF center.

Patient(s): All couples presenting to a single center for preimplantation genetic diagnosis (PGD) for autosomal balanced translocation in either partner from 1995 through 2001.

Intervention(s): Cycle parameters and embryology outcomes were examined and compared between two groups: 61 cycles in 46 women with balanced translocations compared with 42 cycles in 32 women whose male partner had a balanced translocation.

Main Outcome Measure(s): Response to ovarian stimulation.

Result(s): In couples undergoing IVF/PGD to avoid transmission of an unbalanced karyotype, a significantly higher proportion of women carrying balanced translocations (female carrier) responded very poorly (E2 on the day of hCG <1,000 pg/mL) to ovarian stimulation compared to women whose partner had a balanced translocation (male carrier) (23.0% vs. 7.1%).

Conclusion(s): In couples undergoing IVF/PGD for balanced translocation, the risk for poor response to ovarian stimulation may be increased when the female partner carries the balanced translocation compared to when the male partner carries the translocation. Given significant embryo attrition due to chromosomal imbalance, aggressive stimulation should be considered if the patient does not have risk factors for ovarian hyperstimulation syndrome (OHSS).