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Hum. Reprod. Advance Access originally published online on April 12, 2008
Human Reproduction 2008 23(7):1654-1660; doi:10.1093/humrep/den105
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© The Author 2008. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Real and expected delivery rates of patients with myotonic dystrophy undergoing intracytoplasmic sperm injection and preimplantation genetic diagnosis

W. Verpoest1,6, M. De Rademaeker2, K. Sermon3, M. De Rycke3, S. Seneca2, E. Papanikolaou4, C. Spits2, L. Van Landuyt1, J. Van der Elst1, P. Haentjens5, P. Devroey1 and I. Liebaers2

1 Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, UZ Brussel, 101 Laarbeeklaan, B-1090 Brussel, Belgium 2 Centre for Medical Genetics, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Belgium 3 Department of Embryology and Genetics, Vrije Universiteit Brussel, Belgium 4 Centre for Assisted Reproduction ‘Biogenesis’, Genesis Hospital, Thessaloniki, Greece 5 Centre for Outcomes Research and Laboratory for Experimental Surgery, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Belgium

6 Correspondence address. E-mail: willem.verpoest{at}uzbrussel.be

BACKGROUND: This study aimed to analyse the reproductive outcome of a large cohort of myotonic dystrophy type 1 (DM1) patients undergoing ICSI and PGD. The secondary outcome parameter of this study was ovarian response as a way to express gonadal function in female DM1 patients.

METHODS: Prospective cohort study. Real and expected cumulative delivery rates are descriptive. The reproductive outcome per cycle was compared with that of a control group of patients with X-linked recessive disorders. The comparative analysis of ovarian stimulation parameters in the study group versus the control group was carried out using both bivariate (crude) and multivariate (linear regression) analysis.

RESULTS: Between 1995 and 2005, 205 cycles of ICSI and PGD were carried out for DM1 in 78 couples. The real cumulative delivery rate (max 6 cycles) overall was 46%. The expected overall cumulative delivery rate was 72%. Multivariate analysis did not show a significant difference in total dose of gonadotrophins used for ovarian stimulation between Group A (in which the female partner was affected) and a control group.

CONCLUSIONS: This study shows that ICSI and PGD for DM1 offer good reproductive outcome, both in cumulative terms and per treatment cycle. There is no evidence of impaired gonadal function in female DM1 patients.

Key words: ICSI/PGD/myotonic dystrophy/DM1/delivery rate

Submitted on November 12, 2007; resubmitted on January 14, 2008; accepted on January 30, 2008.


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