Trisomic conceptions associated with subsequent diagnoses of infertility, reveals research

In this large study, cases comprised all women with a pregnancy trisomy between 1987 and 2018, while the respective trisomies were T13 (n=351), T18 (n=1065), and T21 (n=4369), each matched with population controls based on age, residence, and timing of pregnancy.These cases were cross-linked to ICD-10 diagnoses from the National Care Registry for Health Care, covering the period 1996–2019. The research was restricted both to inflammatory disorders, ICD-10: N70–N77, and non-inflammatory disorders of the genital tract, ICD-10: N80–N98. Crude odds ratios with 95% confidence intervals were calculated to estimate the associations of such diagnoses with trisomic conception.

The key findings of the study were:

• The study revealed that a diagnosis of female infertility (ICD-10: N97) was associated with trisomic conceptions (OR: 1.19, 95% CI: 1.08–1.32).

• This association was particularly notable for T18 (OR: 1.29, 95% CI: 1.03–1.61) and T21 (OR: 1.17, 95% CI: 1.04–1.32), but not for T13 (OR: 1.15, 95% CI: 0.75–1.72).

• When considering the timing of the infertility diagnosis, an elevated OR was observed only after the index pregnancy (OR: 1.81, 95% CI: 1.56–2.09).

• Increased odds of infertility following trisomic conceptions were noted both in women under 35 years (T18 OR: 1.91, 95% CI: 1.21–3.00; T21 OR: 1.68, 95% CI: 1.31–2.14) and in women 35 years or older (T18 OR: 2.17, 95% CI: 1.40–3.33; T21 OR: 1.87, 95% CI: 1.47–2.39), with no significant association found after T13 conceptions.

These findings provide evidence for a possible link between trisomic conceptions and subsequent diagnoses of infertility. In this study, associations were seen that suggest some common underlying mechanisms predisposing a woman to trisomy and infertility, irrespective of advanced maternal age. This study, however, does not allow for inference of causality.

Observational data suggest that trisomic conceptions are related to subsequent diagnoses of infertility, raising the possibility of partially shared mechanisms that might predispose to both. The association with the presence of trisomic conception draws attention to the need for data on reproductive history in the management of infertility.

Reference:

Wedenoja, S., Pihlajamäki, M., Gissler, M., Wedenoja, J., Öhman, H., Heinonen, S., Kere, J., Kääriäinen, H., & Tanner, L. (2024). Infertility following trisomic pregnancies: A nationwide cohort study. International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics. https://doi.org/10.1002/ijgo.15828