title: Maternal blood platelet physiology and luteal-phase endocrinology as a means of monitoring pre- and postimplantation embryo viability following in vitro fertilization.
abstract: The discovery that the fertilized mouse ovum triggers an increased demand for platelets and results in thrombocytopenia during the preimplantation phase of pregnancy provides a monitor for embryo survival and viability. This paper reports a study in which the platelet count was significantly reduced throughout the human preimplantation phase of pregnancy and returned to normal following embryo implantation. The human embryo was shown to produce a platelet activating factor in vitro which caused the reduction in platelet count after embryo transfer. This factor in the embryo culture medium could be measured using a bioassay which provided a means of assessing embryo viability prior to transfer. Some women showed no reduction in platelets after transfer. These embryos failed to produce a platelet activating factor in vitro and pregnancy was not established. Other women displayed a reduction in platelets following transfer but failed to become pregnant. All of these women had elevated luteal-phase plasma E2 levels compared to pregnant patients, which may have interfered with the implantation process. Our observations provide a possible rapid and simple means for monitoring the viability of human embryos cultured in vitro and the survival of embryos in utero.
mesh_terms: D001792:Blood Platelets / Q000502:physiology*; D006063:Chorionic Gonadotropin / Q000097:blood; D004624:Embryo Transfer; D004622:Embryo, Mammalian / Q000502:physiology*; D004967:Estrogens / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D008183:Luteal Phase; D008991:Monitoring, Physiologic; D010972:Platelet Activating Factor / Q000502:physiology; D010976:Platelet Count; D011247:Pregnancy; D011374:Progesterone / Q000097:blood
chemical_list: D006063:Chorionic Gonadotropin; D004967:Estrogens; D010972:Platelet Activating Factor; D011374:Progesterone