Gema Diagnostics, Ann Arbor, Michigan, USA.
Fertil Steril. 2013 Mar 1;99(3):745-752.e6. doi: 10.1016/j.fertnstert.2012.10.041. Epub 2012 Nov 29.
To identify a gene expression signature in human cumulus cells (CCs) predictive of pregnancy outcome across multiple clinics, taking into account the clinic and patient variations inherent in IVF practice.
Retrospective analysis of single human cumulus-oocyte complexes with the use of a combined microarray and quantitative reverse-transcription polymerase chain reaction (qRT-PCR) approach.
Multiple private IVF clinics.
PATIENT(S): Fifty-eight patients. Samples from 55 patients underwent qRT-PCR analysis, and samples from 27 patients resulted in live birth.
INTERVENTION(S): Gene expression analysis for correlation with pregnancy outcome on individual human CCs collected immediately after oocyte retrieval. Pregnancy prediction analysis used leave-one-out cross-validation with weighted voting.
MAIN OUTCOME MEASURE(S): Combinatorial expression of 12 genes in 101 samples from 58 patients.
RESULT(S): We found a set of 12 genes predictive of pregnancy outcome based on their expression levels in CCs. This pregnancy prediction model had an accuracy of 78%, a sensitivity of 72%, a specificity of 84%, a positive predictive value of 81%, and a negative predictive value of 76%. Receiver operating characteristic analysis found an area under the curve of 0.763 ± 0.079, significantly greater than 0.5 (random chance prediction).
CONCLUSION(S): Gene expression analysis in human CCs should be considered in identifying oocytes with a high potential to lead to pregnancy in IVF-ET.
鉴定人卵丘细胞（CCs）中的基因表达特征，以预测多个诊所的妊娠结局，同时考虑到体外受精实践中固有的诊所和患者差异。
使用组合微阵列和定量逆转录聚合酶链反应（qRT-PCR）方法对单个人类卵丘-卵母细胞复合物进行回顾性分析。
多个私人体外受精诊所。
58 名患者。55 名患者的样本进行了 qRT-PCR 分析，27 名患者的样本导致活产。
对采集自卵母细胞回收后即刻的人 CCs 进行基因表达分析，以与妊娠结局相关。采用带权投票的留一法交叉验证进行妊娠预测分析。
58 名患者的 101 个样本中的 12 个基因的组合表达。
我们发现了一组 12 个基因，基于它们在 CCs 中的表达水平可预测妊娠结局。该妊娠预测模型的准确率为 78%，灵敏度为 72%，特异性为 84%，阳性预测值为 81%，阴性预测值为 76%。接收者操作特征分析发现曲线下面积为 0.763 ± 0.079，显著大于 0.5（随机机会预测）。
在体外受精-胚胎移植中，应考虑对人 CCs 进行基因表达分析，以识别具有高妊娠潜力的卵母细胞。
