濾泡液G CSF濃度與胚胎著床率有關

濾泡液中之G-CSF濃度與胚胎著床率有關
G-CSF濃度越高懷孕率越高

http://humrep.oxfordjournals.org/content/28/2/406.full

Figure 1

The IR is represented as a function of the logarithm of the follicular fluid G-CSF concentration.

Impact of follicular G-CSF quantification on subsequent embryo transfer decisions: a proof of concept study

1. N. Lédée1,2,*,†, 
2. V. Gridelet3,†, 
3. S. Ravet4, 
4. C. Jouan4, 
5. O. Gaspard4,
6. F. Wenders4, 
7. F. Thonon4, 
8. N. Hincourt4, 
9. M. Dubois4, 
10. J. M. Foidart5,
11. C. Munaut5,† and 
12. S. Perrier d'Hauterive3,4,†

+Author Affiliations

1. ¹INSERM, U976, F-75475 Paris, France
2. ²Université Paris Diderot, F-75475 Paris, France
3. ³Medicine of Experimental Reproduction (MeRE unit), University of Liège, GIGA, Liège, Belgium
4. ⁴Department of Gynaecology and Obstetrics, Centre of AMP (CPMA), University of Liège, CHR Citadelle, Liège, Belgique
5. ⁵Tumor & Development Laboratory, University of Liège, GIGA-R, Liege, Belgium

1. ↵*Correspondence address. E-mail: nathalie-ledee@orange.fr

• Received November 7, 2011.
• Revision received July 19, 2012.
• Accepted July 20, 2012.

 

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Abstract

BACKGROUND Previous experiments have shown that granulocyte colony-stimulating factor (G-CSF), quantified in the follicular fluid (FF) of individual oocytes, correlates with the potential for an ongoing pregnancy of the corresponding fertilized oocytes among selected transferred embryos. Here we present a proof of concept study aimed at evaluating the impact of including FF G-CSF quantification in the embryo transfer decisions.

METHODS FF G-CSF was quantified with the Luminex XMap technology in 523 individual FF samples corresponding to 116 fresh transferred embryos, 275 frozen embryos and 131 destroyed embryos from 78 patients undergoing ICSI.

RESULTS Follicular G-CSF was highly predictive of subsequent implantation. The receiving operator characteristics curve methodology showed its higher discriminatory power to predict ongoing pregnancy in multivariate logistic regression analysis for FF G-CSF compared with embryo morphology [0.77 (0.69–0.83), P < 0.001 versus 0.66 (0.58–0.73),P = 0.01)]. Embryos were classified by their FF G-CSF concentration: Class I over 30 pg/ml (a highest positive predictive value for implantation), Class II from 30 to 18.4 pg/ml and Class III <18.4 pg/ml (a highest negative predictive value). Embryos derived from Class I follicles had a significantly higher implantation rate (IR) than those from Class II and III follicles (36 versus 16.6 and 6%, P < 0.001). Embryos derived from Class I follicles with an optimal morphology reached an IR of 54%. Frozen-thawed embryos transfer derived from Class I follicles had an IR of 37% significantly higher than those from Class II and III follicles, respectively, of 8 and 5% (P < 0.001). Thirty-five per cent of the frozen embryos but also 10% of the destroyed embryos were derived from G-CSF Class I follicles. Non-optimal embryos appear to have been transferred in 28% (22/78) of the women, and their pregnancy rate was significantly lower than that of women who received at least one optimal embryo (18 versus 36%, P = 0.04).

CONCLUSIONS Monitoring FF G-CSF for the selection of embryos with a better potential for pregnancy might improve the effectiveness of IVF by reducing the time and cost required for obtaining a pregnancy.