Embryo selection criteria based on morphology VERSUS the expression of a biochemical marker (sHLA-G) and a graduated embryo score: prediction of pregnancy outcome

Kotzé, Dirk; Hansen, Polly; Keskintepe, Levent; Snowden, Ellen U.; Sher, Geoffrey; Kruger, Thinus F.

doi:10.1007/s10815-010-9403-x

Cited by 16 publications

(8 citation statements)

References 36 publications

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“…Another limitation is that our data have no direct evidence to show the oocyte quality being adversely affected in serum P elevated patients. In this study, we used embryo morphology as our embryo scoring criteria, which may not really represent the ‘real quality’ of embryos [22] , [23] .…”

Section: Discussionmentioning

confidence: 99%

Serum Progesterone Elevation Adversely Affects Cumulative Live Birth Rate in Different Ovarian Responders during In Vitro Fertilization and Embryo Transfer: A Large Retrospective Study

Zhao

Wang

et al. 2014

PLoS ONE

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In order to explore the relationship between serum progesterone (P) level on the day of human chorionic gonadotrophin (HCG) administration and cumulative live birth rate in patients with different ovarian response during in vitro fertilization (IVF), we carried out this retrospective cohort study including a total of 4,651 patients undergoing their first IVF cycles from January 2011 to December 2012. All patients with a final live birth outcome (4,332 patients) were divided into three groups according to ovarian response: poor ovarian responder (≤5 oocytes, 785 patients), intermediate ovarian responder (6–19 oocytes, 3065 patients) and high ovarian responder (≥20 oocytes, 482 patients). The thresholds for serum P elevation were 1.60 ng/ml, 2.24 ng/ml, and 2.50 ng/ml for poor, intermediate, and high ovarian responders, respectively. Cumulative live birth rate per oocyte retrieval cycle was calculated in each group. The relationship between serum P level and cumulative live birth rate was evaluated by both univariate and multivariate logistic regression analysis. Cumulative live birth rate per oocyte retrieval cycle was inversely associated with serum P level in patients with different ovarian response. For all responders, patients with elevated P level had significantly higher number of oocytes retrieved, but lower high quality embryo rate, and lower cumulative live birth rate compared with patients with normal serum P level. In addition, serum P level adversely affected cumulative live birth rate by both univariate and multivariate logistic regression analysis, independent of ovarian response. Serum P elevation on the day of HCG administration adversely affects cumulative live birth rate per oocyte retrieval cycle in patients with different ovarian response.

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Section: Discussionmentioning

confidence: 99%

Serum Progesterone Elevation Adversely Affects Cumulative Live Birth Rate in Different Ovarian Responders during In Vitro Fertilization and Embryo Transfer: A Large Retrospective Study

Zhao

Wang

et al. 2014

PLoS ONE

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“…Previous studies have revealed that higher levels of sHLA-G in an embryo culture is related to better embryo development, cleavage stages, and to a higher pregnancy rate (Kotze et al, 2013 ; Diaz et al, 2019 ). sHLA-G detection has been presented as a non-invasive method for embryo selection and a predictor of pregnancy outcome (Kotze et al, 2010 ; Rebmann et al, 2010 ). Based on the sHLA-G levels in the culture supernatant from a 46-h embryo, specific embryos were selected as beneficial to pregnancy and implantation rates, regardless of age (Sher et al, 2004 , 2005 ).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Maternal Serum sHLA-G Levels for Trisomy 18 Fetuses Screening at Second Trimester

Zhu

et al. 2021

Front. Genet.

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Human leukocyte antigen-G (HLA-G) has been widely acknowledged to play critical roles in fetal-maternal maintenance. However, the significance of using maternal serum sHLA-G to detect prenatal chromosomal abnormality has not been investigated. In China, prenatal screening using maternal α-fetoprotein (AFP), unconjugated estriol (uE3), and free β subunit human chorionic gonadotropin (β-hCG) in the second trimester has been widely applied. In this study, we evaluated the use of sHLA-G as a screening marker, compared with traditional second trimester prenatal screening. Serum samples from 1,019 singleton women in their second trimester were assessed. Among them, 139 infants were confirmed with trisomy 21 (T21) by karyotyping, 83 were confirmed with trisomy 18 (T18), and the remaining 797 infants had no abnormalities. The sHLA-G levels in maternal sera were significantly lower in pregnant women with T18 fetuses (median: 47.8 U/ml, range: 9.8–234.2 U/ml) and significantly higher in those with T21 fetuses (median: 125.7 U/ml, range: 28.7–831.7 U/ml), compared with the normal controls (median: 106.3 U/ml, range: 50.5–1136.4 U/ml) (p < 0.001). The risk values of the screening of T21 or T18 fetuses were assessed using mean and standard deviation log10 analyte multiples of median (MoM) which showed that the predictive values of sHLA-G were the same as free β-hCG, and superior to AFP and uE3 for T18 screening. Logistic regression analysis revealed that sHLA-G MoM was the highest risk factor associated with pregnant women carrying T18 fetuses [Exp(B): 171.26, 95% CI: 36.30–807.97, p < 0.001]. Receiver operating characteristic (ROC) analysis revealed that the area under ROC curve for sHLA-G MoM was 0.915 (95% CI, 0.871–0.959, p < 0.001), for AFP MoM was 0.796 (95% CI, 0.730–0.861, p < 0.001), for free β-hCG MoM was 0.881 (95% CI, 0.829–0.934, p < 0.001), and for uE3 MoM was 0.876 (95% CI, 0.828–0.923, p < 0.001) in the T18 group. sHLA-G MoM demonstrated the best sensitivity and negative predictive value. For the first time, our findings reveal that sHLA-G is a better second trimester screening marker for the detection of T18 fetuses and the combined application of sHLA-G with AFP, free β-hCG, and uE3 could improve clinical screening for T18 fetuses.

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“…Non-invasive embryo selection methods are being improved to distinguish good-quality from poor-quality embryos. One of such laboratory methods is to examine the secretion of embryonic factors into the culture media [ 19 ]. In this study, the expression of sHLA-G protein in all post-fertilized culture media samples was measured by ELISA.…”

Section: Discussionmentioning

confidence: 99%

Increase in concentration of soluble HLA-G in high-quality embryos after intracytoplasmic sperm injection

et al. 2011

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Non-invasive methods are normally preferred to conventional invasive methods when selecting suitable embryos to improve pregnancy rates after assisted reproduction techniques. One of the most recognized non-invasive methods is to examine the supernatants of embryo culture media. Soluble human leukocyte antigen, class I, G (sHLA-G) antigen is a non-classical class I molecule that has been widely considered as a marker of pregnancy failure or implantation success. In the current study of some Iranian patients, we examined the concentration of sHLA-G at different time points after intracytoplasmic sperm injection and compared the rates to the morphology and quality of the selected embryos. We showed that the concentration of sHLA-G increases over time in high-quality embryos. We conclude that there is a positive relationship between morphology, quality, and sHLA-G concentration. We suggest that this relationship can be used to increase the chance of a successful pregnancy.

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Embryo selection criteria based on morphology VERSUS the expression of a biochemical marker (sHLA-G) and a graduated embryo score: prediction of pregnancy outcome

Cited by 16 publications

References 36 publications

Serum Progesterone Elevation Adversely Affects Cumulative Live Birth Rate in Different Ovarian Responders during In Vitro Fertilization and Embryo Transfer: A Large Retrospective Study

Serum Progesterone Elevation Adversely Affects Cumulative Live Birth Rate in Different Ovarian Responders during In Vitro Fertilization and Embryo Transfer: A Large Retrospective Study

Evaluation of Maternal Serum sHLA-G Levels for Trisomy 18 Fetuses Screening at Second Trimester

Increase in concentration of soluble HLA-G in high-quality embryos after intracytoplasmic sperm injection

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