Markers of Ovarian Reserve Do Not Differ Amongst Major Ethnicities as Determined by Genotyping

The data on the relationship of ethnicity and markers of success in IVF have been limited and conflicting. Some suggest differences among ethnicities, others differences only in particular age groups, and some demonstrate no differences at all.1,2 Much of the literature is limited by small sample size, narrow ranges of ethnic backgrounds, and self-reporting of ethnicity, which can have a high non-concurrence rate compared with genetic ethnicity. Recently, genetic profiles created using a select group of single nucleotide polymorphisms (SNPs), termed ancestry informed of markers (AIMs), has clarified ethnic classification.3 The relationship between genetically determined ethnicity using a set of AIMs and markers of ovarian reserve in a large population has not yet been established. The purpose of this study was to evaluate the relationship between genotypically determined ethnicity and markers of ovarian reserve using a validated set of AIMs. We analyzed 2,523 patients undergoing IVF. Ovarian reserve markers included basal antral follicle count (BAFC), day 3 follicle stimulating hormone (FSH), and anti-mullerian hormone (AMH). Patients' serum was genotyped using custom 32 SNP TaqMan® OpenArray® Real-Time PCR Plates selected based on previously validated data used to identify continental origin. Admixture proportions were determined using the Bayesian clustering algorithms implemented in the program STRUCTURE-v2.3.4 Patients were assigned to the population (European, African, East Asian, or Central/South Asian) corresponding to their greatest admixture proportion. Differences in BAFC, FSH, and AMH levels were determined using an analysis of covariance (ANCOVA) while controlling for age. Of the 2,523 samples processed, 2,201 (87%) produced results which allowed for dominant ethnic classification utilizing STRUCTURE. There was an 88% concurrence rate between self-reported and genetic ethnicity. Genetic ethnicity was also determined for 474 patients (19%) who self-reported as “Other” or had no ethnicity data recorded. Age differed among ethnic groups (p=0.001). As expected, AMH and BAFC decreased with increasing age (p=0.001, p=0.001) and FSH increased with age (p=0.002). AMH, BAFC, and FSH were equivalent among the different ethnic groups after controlling for age (p=0.336, p=0.351, p=0.065). There does not appear to be differences in markers of ovarian reserve amongst various ethnic groups in patients undergoing IVF. We used a novel approach of determining continental origin using a validated panel of AIMs as opposed to patient self-reported ethnicities. Markers of ovarian reserve should thus be interpreted similarly for varying ethnic groups in patients undergoing IVF.