Serum Stem Cell Factor Assay in Elderly Poor Responder Patients Undergoing IVF: A New Biomarker to Customize Follicle Aspiration Cycle by Cycle

Abstract

In humans, stem cell factor (SCF), produced during follicular phase, may reflect a successful stimulation and oocyte maturation and so it may be a predictor of in vitro fertilization (IVF) outcome. An observational cohort study was conducted on 37 poor responders scheduled for fresh nondonor IVF/intracytoplasmic sperm injection treatment with standard controlled ovarian stimulation (COS) using recombinant follicle-stimulating hormone (rFSH; S-COS group). A total of 35 women received a second treatment using both rFSH and recombinant luteinizing hormone (rLH; LH-COS group). From 144 samples collected at pickup day, serum concentration of SCF (s-SCF) and follicular levels of SCF (f-SCF) were measured by enzyme-linked immunosorbent assay (ELISA) kit. No differences were observed between the 2 protocols in terms of both f-SCF and s-SCF levels. The comparison between f-SCF and s-SCF levels showed a strong linear correlation. The comparison between s-SCF levels and clinical outcomes showed a statistically significant correlation between both the number of metaphase II (MII) oocytes retrieved and the embryos obtained after fertilization. Cases with at least 3 MII oocytes showed s-SCF values >800 pg/mL, 2 MII oocytes >600 pg/mL, and 1 MII oocytes >400 pg/mL. In 100% of cases with s-SCF <400 pg/mL, no MII oocytes were recovered. All 5 pregnancies occurred in patients with s-SCF values >1000 pg/mL. The introduction of s-SCF assay in the management of poor-responder patients may contribute to solving the dilemma of whether to cancel or proceed with the stimulation cycle.

Pituitary block with gonadotrophin‐releasing hormone antagonist during intrauterine insemination cycles: a systematic review and meta‐analysis of randomised controlled trials

“…In spite of recent insights about endometrial-factor infertility, [35][36][37] the introduction of novel targeted drugs [38][39][40] and individualised ovarian stimulation protocols, 41,42 the success rate of IUI is still suboptimal. 12,43,44 Recently, several RCTs have investigated the effectiveness of pituitary block with GnRH-ant during controlled ovarian stimulation and IUI, with controversial results.…”

Ultrasound-guided embryo transfer: summary of the evidence and new perspectives. A systematic review and meta-analysis

“…In recent years, despite great improvements in embryo manipulation techniques (Coates et al, 2017), ovarian stimulation protocols (Alviggi et al, 2016;Gizzo et al, 2014Gizzo et al, , 2015aGizzo et al, , 2016, reproductive surgery (Coccia et al, 2015;Gizzo et al, 2015b) and infertility diagnostic work-ups (Foresta et al, 2015;Noventa et al, 2016;Vitagliano et al, 2017), IVF success rates are only slowly increasing, with an overall delivery rate estimated at about 20% (Dyer et al, 2016). On the basis of different studies, such suboptimal results are mainly ascribable to embryo aneuploidy, especially in women of late reproductive age (Coates et al, 2017), to defects in endometrial receptivity (Vitagliano et al, 2017) and possibly to imperfect embryo transfer techniques (Abou-Setta et al, 2007).…”

New frontiers in human assisted reproduction - from research to clinical practice: Several considerations

“…In an era of advanced, or very late, motherhood, strategies including ʻsocialʼ egg-freezing, surrogacy and commercialisation of fertility treatments represent a potential solution to overcoming obstacles to human reproduction, while simultaneously turning infertile couples into potential consumers. Leaving aside the potential ethical and obstetrical problems associated with an advanced maternal age [as consequences of in vitro fertilisation (IVF) and, in particular, of heterologous fertilisation], which certainly warrant further investigation (1)(2)(3)(4), if assisted reproduction technologies may be considered as a ʻpendulum swingingʼ between the health care service and industry in offering solutions against time, what then are the roles to be adopted by scientists and clinicians involved in human reproductive care? What are their responsibilities, and what effects will developments in the future have?…”