INSERM, U976, F-75475 Paris, France.
Hum Reprod. 2013 Feb;28(2):406-13. doi: 10.1093/humrep/des354. Epub 2012 Dec 6.
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.
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.
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).
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.
先前的实验表明，在个别卵母细胞的卵泡液（FF）中定量的粒细胞集落刺激因子（G-CSF）与相应受精卵母细胞在选定的转移胚胎中持续妊娠的潜力相关。在这里，我们提出了一项概念验证研究，旨在评估在胚胎转移决策中纳入 FF G-CSF 定量的影响。
使用 Luminex XMap 技术对 78 名接受 ICSI 的患者的 116 个新鲜转移胚胎、275 个冷冻胚胎和 131 个销毁胚胎的 523 个单独的 FF 样本进行了 FF G-CSF 定量。
卵泡 G-CSF 高度预测后续的着床。多变量逻辑回归分析显示，在接收者操作特征曲线方法中，FF G-CSF 比胚胎形态学更能预测持续妊娠[0.77（0.69-0.83），P <0.001 与 0.66（0.58-0.73），P = 0.01）]。根据 FF G-CSF 浓度对胚胎进行分类：第 I 类超过 30pg/ml（具有最高的着床阳性预测值），第 II 类为 30 至 18.4pg/ml，第 III 类 <18.4pg/ml（具有最高的阴性预测值）。来自第 I 类卵泡的胚胎着床率（IR）明显高于第 II 类和第 III 类卵泡（分别为 36%、16.6%和 6%，P <0.001）。具有最佳形态的来自第 I 类卵泡的胚胎的着床率为 54%。来自第 I 类卵泡的冷冻解冻胚胎移植的着床率分别为 37%，明显高于第 II 类和第 III 类卵泡，分别为 8%和 5%（P <0.001）。35%的冷冻胚胎和 10%的销毁胚胎来自 G-CSF 第 I 类卵泡。非最佳胚胎似乎在 28%（22/78）的妇女中被转移，其妊娠率明显低于接受至少一个最佳胚胎的妇女（18%比 36%，P = 0.04）。
通过监测 FF G-CSF 选择具有更好妊娠潜力的胚胎，可能通过减少获得妊娠所需的时间和成本来提高 IVF 的效果。
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