Risk assessment of medically assisted reproduction and advanced maternal ages in the development of Prader-Willi syndrome due to UPD(15)mat

Clin Genet. 2016 May;89(5):614-9. doi: 10.1111/cge.12691. Epub 2015 Dec 10.

Abstract

Recent studies have suggested that disomic oocyte-mediated uniparental disomy 15 (UPD(15)mat) is increased in patients with Prader-Willi syndrome (PWS) born after medically assisted reproduction (MAR). However, it remains unknown whether the increase is primarily due to MAR procedure itself or advanced maternal childbearing ages as a predisposing factor for the disomic oocyte production. To examine this matter, we studied 122 naturally conceived PWS patients (PWS-NC group) and 13 MAR-conceived patients (PWS-MAR group). The relative frequency of disomic oocyte-mediated UPD(15)mat was significantly higher in PWS-MAR group than in PWS-NC group (7/13 vs 20/122, p = 0.0045), and the maternal childbearing ages were significantly higher in PWS-MAR group than in PWS-NC group [median (range), 38 (26-45) vs 30 (19-42), p = 0.0015]. However, the logistic regression analysis revealed no significant association between the occurrence of disomic oocyte-mediated UPD(15)mat and MAR, after adjusting for childbearing age (p = 0.25). Consistent with this, while the frequency of assisted reproductive technology (ART)-conceived livebirths was higher in the PWS patients than in the Japanese general population (6.4% vs 1.1%, p = 0.00018), the distribution of childbearing ages was significantly skewed to the increased ages in the PWS patients (p < 2.2 × 10(-16) ). These results argue against a positive association of MAR procedure itself with the development of UPD(15)mat.

Keywords: Prader-Willi syndrome; UPD(15)mat; advanced maternal age; assisted reproductive technology; controlled ovarian stimulation; medically assisted reproduction; trisomy rescue.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Chromosomes, Human, Pair 15 / genetics*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Maternal Age
  • Middle Aged
  • Oocytes / metabolism
  • Paternal Age
  • Prader-Willi Syndrome / etiology
  • Prader-Willi Syndrome / genetics*
  • Reproductive Techniques, Assisted / adverse effects
  • Reproductive Techniques, Assisted / statistics & numerical data*
  • Risk Assessment / methods
  • Risk Assessment / statistics & numerical data
  • Uniparental Disomy*
  • Young Adult