Laboratorio de Investigación y Diagnóstico Molecular, Instituto de Infertilidad y Genética, Ingenes México, Av. IPN 2508, 07360, CDMX, México.
Programa de Doctorado en Ciencias Biológicas y de la Salud, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana-Iztapalapa, Av. IPN 2508, 07360, CDMX, México.
J Ovarian Res. 2018 Sep 21;11(1):84. doi: 10.1186/s13048-018-0456-2.
Current methods for determining superior embryo quality (morphological assessment) are unable to compensate for poor pregnancy outcomes. Due to the importance of the cumulus-oocyte complex and the value of cumulus cells (CCs) as markers of embryo health, we determined the association between the CCs gene expression of the Prostaglandin-Endoperoxide Synthase 2 (PTGS2) and Versican (VCAN) with pregnancy.
One hundred forty-nine women, suffering from infertility and undergoing IVF, were included in this study (age: 29-46 years; BMI = 25.5 ± 5.0 kg/m). Patients underwent a standard IVF protocol. CCs were isolated during oocyte retrieval, and their RNA was isolated using Trizol. The mRNA expression of PTGS2, VCAN, and L19 was measured by qPCR. The PVL index, (PTGS2 + VCAN)*L19, was determined for each oocyte. Clinical pregnancy was confirmed by β-hCG and the presence of a fetal heartbeat. Associations were determined by ROC curves or logistic regression.
There was no correlation between the PVL index and morphological scores. Using only single embryo transfers (SETs), we determined that the PVL index was associated with pregnancy (β-hCG: AUC = 0.87, 95%CI: 0.74-1.00) with an optimal cutoff value of 58.2. Using the complete cohort (consisting of SETs, and patients with 2, 3, or 4 embryos transferred), the presence of at least one embryo with a PVL index score ≥ 58.2 was associated with a greater probability of achieving pregnancy (β-hCG: odds ratio = 17.15, 95%CI: 6.82-43.18, p < 0.001).
Transferring at least one embryo with a PVL index score ≥ 58.2, generates a higher chance of achieving pregnancy.
目前用于确定优质胚胎（形态评估）的方法无法弥补妊娠结局不佳的问题。由于卵丘-卵母细胞复合物的重要性以及卵丘细胞（CCs）作为胚胎健康标志物的价值，我们确定了前列腺素内过氧化物合酶 2（PTGS2）和神经粘蛋白（VCAN）的 CCs 基因表达与妊娠的关系。
本研究纳入了 149 名患有不孕症并接受体外受精（IVF）的女性（年龄：29-46 岁；BMI=25.5±5.0 kg/m²）。患者接受标准的 IVF 方案。在取卵过程中分离 CCs，并使用 Trizol 分离其 RNA。通过 qPCR 测量 PTGS2、VCAN 和 L19 的 mRNA 表达。为每个卵母细胞确定 PVL 指数（PTGS2+VCAN）*L19。通过β-hCG 和胎儿心跳来确认临床妊娠。通过 ROC 曲线或逻辑回归确定相关性。
PVL 指数与形态评分之间没有相关性。仅使用单个胚胎移植（SETs），我们发现 PVL 指数与妊娠相关（β-hCG：AUC=0.87，95%CI：0.74-1.00），最佳截断值为 58.2。使用完整队列（包括 SETs 以及接受 2、3 或 4 个胚胎移植的患者），至少有一个胚胎的 PVL 指数评分≥58.2 与更高的妊娠可能性相关（β-hCG：比值比=17.15，95%CI：6.82-43.18，p<0.001）。
移植至少一个 PVL 指数评分≥58.2 的胚胎可提高妊娠成功率。
