黄体中期子宫内膜BCL6/SIRT的前瞻性评估及其与整倍体冷冻胚胎移植结局的相关性：一项前瞻性队列研究。
Prospective evaluation of mid-luteal endometrial BCL6/SIRT and correlation with outcomes of euploid frozen embryo transfer: a prospective cohort study.
作者信息
Strug Michael, Aghajanova Lusine, Khan Maliha, Zhang Jiaqi, Angress Dan, Young Steven L, Lessey Bruce, Lathi Ruth B
机构信息
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Sunnyvale, CA, USA.
Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA.
出版信息
J Assist Reprod Genet. 2025 Jun 27. doi: 10.1007/s10815-025-03558-7.
PURPOSE
To study whether mid-luteal endometrial B-cell lymphoma 6 (BCL6) or sirtuin-1 (SIRT1) immunostaining in an ovarian stimulation (fresh) in vitro fertilization (IVF) cycle was predictive of risk for endometriosis. Additionally, to evaluate for association with future euploid frozen embryo transfer (FET) pregnancy outcomes.
METHODS
Prospective, blinded observational cohort study in an academic fertility center. Patients pursuing IVF with euploid FET within 1 year who met inclusion criteria for one of three groups: (G1) surgically confirmed endometriosis (n = 10), (G2) unexplained infertility or recurrent pregnancy loss (n = 42), or (G3) controls without identifiable female infertility (n = 24). BCL6 and SIRT1 immunostaining was quantified in endometrial samples obtained 5-7 days after oocyte retrieval (HSCORE > 1.4 considered positive). Euploid FET in a subsequent cycle was blinded to BCL6/SIRT1 assessment. Demographic and pregnancy outcomes for each group were correlated with BCL6/SIRT1 levels.
RESULTS
There was high BCL6 positivity with a significant interaction among groups (G1: 80%, G2: 97.6%, G3: 100%; p = 0.044), but pairwise comparisons did not demonstrate a difference between individual groups. Median BCL6 levels by H-SCORE were similarly high in all groups [median (inter-quartile range); G1: 3.7 (3.45, 4.0), G2: 3.8 (3.6, 3.8), G3: 3.8 (3.4, 4.0); p = 0.95]. Median SIRT1 levels also did not differ between groups. Pregnancy outcomes following FET were comparable between groups (live birth rate G1: 57.1%, G2: 62.1%, G3: 54.5%; p = 0.68). BCL6 levels were inversely correlated with serum progesterone level on the day of endometrial biopsy (τ = - 0.223, p = 0.01). Correlation analysis of pregnancy outcomes for all patients included in the study revealed no difference between BCL6 or SIRT1 levels for patients who did or did not experience a live birth.
CONCLUSION
Endometrial BCL6 and SIRT1 levels collected in a fresh ovarian stimulation cycle did not correlate with endometriosis diagnosis nor pregnancy outcomes. BCL6 levels were inversely correlated with serum progesterone levels.
CLINICAL TRIAL ID
NCT0410712.
目的
研究在卵巢刺激（新鲜）体外受精（IVF）周期中，黄体中期子宫内膜B细胞淋巴瘤6（BCL6）或沉默调节蛋白1（SIRT1）免疫染色是否可预测子宫内膜异位症风险。此外，评估其与未来整倍体冷冻胚胎移植（FET）妊娠结局的相关性。
方法
在一家学术性生育中心进行的前瞻性、盲法观察队列研究。在1年内接受进行整法进行整倍体FET的患者，符合以下三组中一组的纳入标准：（G组1）手术确诊的子宫内膜异位症（n = 10），（G组2）不明原因不孕或复发性流产（n = 42），或（G组3）无明确女性不孕的对照组（n = 24）。在取卵后5 - 7天获得的子宫内膜样本中对BCL6和SIRT1免疫染色进行定量（HSCORE > 1.4视为阳性）。后续周期的整倍体FET对BCL6/SIRT1评估结果设盲。将每组的人口统计学和妊娠结局与BCL6/SIRT1水平进行关联分析。
结果
BCL6阳性率较高，组间存在显著交互作用（G组1：80%，G组2：97.6%，G组3：100%；p = 0.044），但两两比较未显示各单独组之间存在差异。所有组中H - SCORE法测定的BCL中位数水平同样较高[中位数（四分位间距）；G组1：3.7（3.45，4.0），G组2：3.8（3.6，3.8），G组3：3.8（3.4，4.0）；p = 0.95]。组间SIRT1中位数水平也无差异。FET后的妊娠结局在各组间具有可比性（活产率G组1：57.1%，G组2：62.1%，G组3：54.5%；p = 0.68）。BCL6水平与子宫内膜活检当天的血清孕酮水平呈负相关（τ = - 0.223，p = 0.01）。对研究中纳入的所有患者的妊娠结局进行相关性分析发现，活产和未活产患者的BCL6或SIRT1水平无差异。
结论
在新鲜卵巢刺激周期中收集的子宫内膜BCL6和SIRT1水平与子宫内膜异位症诊断及妊娠结局均无相关性。BCL6水平与血清孕酮水平呈负相关。
临床试验编号
NCT0410712
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