Intermediate and normal sized CGG repeat on the FMR1 gene does not negatively affect donor ovarian response

Sir, We applaud Lledo et al. (2012) in their recent attempt to further elucidate the effects of the FMR1 gene on ovarian function. Unfortunately, we cannot agree with the authors' conclusion that the FMR1 screening should not be considered for predicting responses to ovarian stimulation. Nothing in their data, indeed, supports such a conclusion. To assess whether CGGn on the FMR1 gene was predictive of ovarian response to stimulation, the authors chose young oocyte donors. While in detail referring to our work (Gleicher et al., 2009a,b,c,d), they, unfortunately, overlooked our most relevant publication on the subject, in which we, indeed, had performed 2 years earlier almost exactly the same study they now reported (Gleicher et al., 2010a). Had they been aware of our study, they would have noted that young egg donors do not demonstrate evidence for differences in the functional ovarian reserve (FOR), as assessed by anti-Müllerian hormone (AMH), based on CGGn, now referred to as ovarian FMR1 genotypes and sub-genotypes (Gleicher et al., 2010a, Figure 2A, 2010b). We, thus, fully agree with the findings of Lledo et al., or, even more accurately, their findings fully concur with our previously reported findings. As our earlier study, however, also demonstrated, infertile patients do behave differently, and do demonstrate CGGn-associated FOR (Gleicher et al., 2010a, Figure 2B).