Zekai Tahir Burak Women Health Care Education and Research Hospital, Ankara, Turkey.
Zekai Tahir Burak Women Health Care Education and Research Hospital, Ankara, Turkey.
Eur J Obstet Gynecol Reprod Biol. 2020 May;248:1-4. doi: 10.1016/j.ejogrb.2020.03.005. Epub 2020 Mar 6.
Recurrent implantation failure is defined as the absence of implantation, after two or three consecutive cycles of in-vitro fertilization (IVF), intracytoplasmic sperm injection or frozen embryo replacement. Human fetuin-A/alpha2-Heremans-Schmid-glycoprotein is a plasma protein secreted by the liver that modulates insulin action in adipocytes. Increased fetuin-A promotes adipocyte dysfunction which results in decreased adiponectin and increased fatty acids and inflammatory cytokines. Fatty acids and inflammatory cytokines were previously reported in implantation failure. Also, fetuin-A inhibits receptor tyrosine kinase activity in trophoblast growth factors which decrease trophoblast viability and invasion. In this study, we aimed to find the association between fetuin-A and implantation failure.
A total of 78 women were included in this case-control study. Serum fetuin-A concentrations were measured in 42 women with recurrent IVF failure and 36 healthy women with regular cycles.
The mean serum fetuin-A levels of implantation failure and control women were 257.77 ± 32.18 and 219.59 ± 48.86 respectively with a p-value <0.001 (independent samples t-test). Our results showed a statistically significant difference between serum fetuin-A levels of implantation failure women and controls.
So far reasons for implantation failure are only partially understood. The current study reveals the association between implantation failure and fetuin-A. Further studies with large population sizes are needed to investigate whether fetuin-A can be used as a marker before controlled ovarian stimulation began or regulation of fetuin-A levels with treatment or lifestyle interventions can improve implantation success.
反复着床失败定义为在连续两次或三次体外受精（IVF）、胞浆内单精子注射或冷冻胚胎移植后，胚胎未能着床。人胎球蛋白 A/α2-赫尔曼斯-施密特糖蛋白是一种由肝脏分泌的血浆蛋白，可调节脂肪细胞中的胰岛素作用。胎球蛋白 A 水平升高会促进脂肪细胞功能障碍，导致脂联素减少，脂肪酸和炎性细胞因子增加。先前的研究报道了着床失败与脂肪酸和炎性细胞因子有关。此外，胎球蛋白 A 还抑制了滋养层生长因子中受体酪氨酸激酶的活性，从而降低了滋养层的活力和侵袭能力。在这项研究中，我们旨在探讨胎球蛋白 A 与着床失败之间的关系。
本病例对照研究共纳入 78 名女性。在 42 名反复 IVF 失败的女性和 36 名月经规律的健康女性中测量了血清胎球蛋白 A 浓度。
着床失败和对照组女性的平均血清胎球蛋白 A 水平分别为 257.77±32.18 和 219.59±48.86，p 值<0.001（独立样本 t 检验）。我们的研究结果显示，着床失败女性和对照组之间的血清胎球蛋白 A 水平存在统计学显著差异。
迄今为止，着床失败的原因仅部分得到了解释。本研究揭示了着床失败与胎球蛋白 A 之间的关系。需要进行更大规模的人群研究，以探讨胎球蛋白 A 是否可以作为控制性卵巢刺激前的标志物，或者通过治疗或生活方式干预调节胎球蛋白 A 水平是否可以提高着床成功率。
