Does Pre-Diabetic mother play role in Sex Chromosome Abnormalities in IVF Embryos?

Glycated hemoglobin or HbA1c level measurement is a useful diagnostic screening method for diabetic patients. HbA1c level equal to or more than 6.5% means more than 48 mmol/mol indicates a diagnosis of diabetes mellitus; whereas, the HbA1c level between 5.7–6.4%  means between 39–46 mmol/mol is considered as a prediabetic condition.

Clinical experts found that the risk of miscarriage and congenital malformation correlates with the HbA1c level. Aneuploidy is a chromosomal defect within a cell. In the human body, 46 chromosomes are present, but 45 or 47 chromosomal development during fetal growth is considered as aneuploidy.

Recently clinical researchers from Philadelphia have declared that the probability of sex chromosome aneuploidies in embryos is double in pre-diabetic patients in comparison with embryos formed in patients who have normal levels of glycated hemoglobin.

Researchers included patients who had undergone IVF with pre-implantation genetic testing for aneuploidies to establish the fact. In this research, diabetic patients were not included to reduce the confusion during result analysis.

Embryos at their blastocyte stage were thoroughly analyzed from 393 patients. Among these study participants, 320 patients had a normal level of HbA1c, whereas the remaining 73 patients had their prediabetic stage as their HbA1c lied between the  39–46 mmol/mol.

The research findings reported a significant correlation between sex-chromosome aneuploidy with the pre-diabetic condition. But it is necessary to mention that no association with autosomal aneuploidies. Researchers had also reported that embryos of both non-diabetic patients and pre-diabetic patients have a 50% chance to develop non-sex chromosomal abnormality. But X and Y chromosomal abnormality is more frequent in the embryos developed among pre-diabetic patients than in embryos develops in non-diabetic patients.  It is necessary to mention that the maternal age and Follicle-stimulating hormone (FSH) and Anti-Mullerian Hormone (AMH) hormonal levels do not correlate with aneuploidy. The study data had revealed at the 75th annual Scientific Congress and Expo of the American Society for Reproductive Medicine, researchers from Northwell Fertility (NY).

Fertility experts commented on this study findings that both diabetic and pre-diabetic patients have a delicate effect on their reproductive system. Further detailed studies provide more detailed results. However, it is necessary to mention that both diabetic and pre-diabetic patients need counseling to provide confidence that positive effort possibly helps them to conceive normally and also can mitigate the associated problems. 

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4296702/

https://www.fertstert.org/article/S0015-0282(19)30860-X/abstract

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