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This cohort study included 124 females with infertility attributed to female factors undergoing intracytoplasmic sperm injection (ICSI). The total CGG repeat lengths and AGG interspersion patterns of the FMR1 gene were determined by conventional polymerase chain reaction (PCR) and triplet-primed PCR. The allelic complexity (allelic score) was calculated using a previously described formula by combining the allelic scores, allowing for the stratification of samples into equivalent and dissimilar groups. No statistically significant differences were observed in ovarian reserve markers or overall IVF outcomes between the two groups. However, within the dissimilar group, the allelic score of allele 1 was significantly correlated with the number of both injected metaphase II and two-pronuclei oocytes. These findings suggest that FMR1 allelic complexity may contribute to predicting IVF success, particularly in females classified in the dissimilar group, who appear more susceptible to IVF failure than those in the equivalent group. Further research into the predictive utility of FMR1 could provide valuable insights for fertility assessment and enhance assisted reproductive technologies.<\/jats:p>","DOI":"10.3390\/ijms26125752","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T10:47:22Z","timestamp":1750070842000},"page":"5752","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["FMR1 Allelic Complexity and IVF Fertilization Success: Limitations and Future Perspectives"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4698-962X","authenticated-orcid":false,"given":"B\u00e1rbara","family":"Rodrigues","sequence":"first","affiliation":[{"name":"Molecular Genetics Laboratory, Laboratory Genetics Service, Genetics and Pathology Clinic, Unidade Local de Sa\u00fade de Santo Ant\u00f3nio (ULSSA), Largo Professor Abel Salazar, 4099-001 Porto, Portugal"},{"name":"UMIB\u2014Unit for Multidisciplinary Research in Biomedicine, ICBAS\u2014School of Medicine and Biomedical Sciences, UPorto\u2014University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal"},{"name":"ITR\u2014Laboratory for Integrative and Translational Research in Population Health, Rua das Taipas 135, 4050-600 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2967-2666","authenticated-orcid":false,"given":"Em\u00eddio","family":"Vale-Fernandes","sequence":"additional","affiliation":[{"name":"UMIB\u2014Unit for Multidisciplinary Research in Biomedicine, ICBAS\u2014School of Medicine and Biomedical Sciences, UPorto\u2014University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal"},{"name":"ITR\u2014Laboratory for Integrative and Translational Research in Population Health, Rua das Taipas 135, 4050-600 Porto, Portugal"},{"name":"Centre for Medically Assisted Procreation\/Public Gamete Bank, Gynaecology Departament, Centro Materno-Infantil do Norte Dr. Albino Aroso (CMIN), Unidade Local de Sa\u00fade de Santo Ant\u00f3nio (ULSSA), Largo da Maternidade J\u00falio Dinis 45, 4050-651 Porto, Portugal"}]},{"given":"Vanessa","family":"Sousa","sequence":"additional","affiliation":[{"name":"Molecular Genetics Laboratory, Laboratory Genetics Service, Genetics and Pathology Clinic, Unidade Local de Sa\u00fade de Santo Ant\u00f3nio (ULSSA), Largo Professor Abel Salazar, 4099-001 Porto, Portugal"},{"name":"UMIB\u2014Unit for Multidisciplinary Research in Biomedicine, ICBAS\u2014School of Medicine and Biomedical Sciences, UPorto\u2014University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal"},{"name":"ITR\u2014Laboratory for Integrative and Translational Research in Population Health, Rua das Taipas 135, 4050-600 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3561-1288","authenticated-orcid":false,"given":"Isabel","family":"Marques","sequence":"additional","affiliation":[{"name":"Molecular Genetics Laboratory, Laboratory Genetics Service, Genetics and Pathology Clinic, Unidade Local de Sa\u00fade de Santo Ant\u00f3nio (ULSSA), Largo Professor Abel Salazar, 4099-001 Porto, Portugal"},{"name":"UMIB\u2014Unit for Multidisciplinary Research in Biomedicine, ICBAS\u2014School of Medicine and Biomedical Sciences, UPorto\u2014University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal"},{"name":"ITR\u2014Laboratory for Integrative and Translational Research in Population Health, Rua das Taipas 135, 4050-600 Porto, Portugal"}]},{"given":"Ros\u00e1rio","family":"Santos","sequence":"additional","affiliation":[{"name":"Molecular Genetics Laboratory, Laboratory Genetics Service, Genetics and Pathology Clinic, Unidade Local de Sa\u00fade de Santo Ant\u00f3nio (ULSSA), Largo Professor Abel Salazar, 4099-001 Porto, Portugal"},{"name":"UMIB\u2014Unit for Multidisciplinary Research in Biomedicine, ICBAS\u2014School of Medicine and Biomedical Sciences, UPorto\u2014University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal"},{"name":"ITR\u2014Laboratory for Integrative and Translational Research in Population Health, Rua das Taipas 135, 4050-600 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7089-2508","authenticated-orcid":false,"given":"Ant\u00f3nio J. A.","family":"Nogueira","sequence":"additional","affiliation":[{"name":"CESAM\u2014Centre for Environmental and Marine Studies, Department of Biology, University of Aveiro, Campus Universitario de Santiago, 3810-193 Aveiro, Portugal"}]},{"given":"Paula","family":"Jorge","sequence":"additional","affiliation":[{"name":"UMIB\u2014Unit for Multidisciplinary Research in Biomedicine, ICBAS\u2014School of Medicine and Biomedical Sciences, UPorto\u2014University of Porto, Rua Jorge de Viterbo Ferreira 228, 4050-313 Porto, Portugal"},{"name":"ITR\u2014Laboratory for Integrative and Translational Research in Population Health, Rua das Taipas 135, 4050-600 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Ma, Y., Wei, X., Pan, H., Wang, S., Wang, X., Liu, X., Zou, L., Wang, X., Wang, X., and Yang, H. (2019). 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