Evidence that the adverse effect of controlled ovarian hyperstimulation on successful pregnancy outcome following embryo transfer may be related to premature trophoblast invasion.
OBJECTIVE
To determine if premature trophoblast invasion may be a contributing factor to lower fecundity associated with controlled ovarian hyperstimulation (COH) and in vitro fertilization (IVF).


METHODS
Blood samples were obtained three-five days after ET to measure expression by lymphocytes of a 34 kDa protein known as the progesterone-induced blocking factor (PIBF) using an immunocytochemistry technique. Clinical and viable pregnancy rates were determined according to whether PIBF was detected or not.


RESULTS
Progesterone-induced blocking factor was positive in 14 of 67 (21%). Clinical pregnancy rates following fresh ET were 7.1% for those positive for PIBF versus 43.4% for those negative for PIBF.


CONCLUSIONS
Progesterone-induced blocking factor production requires allogeneic induction of progesterone receptors in gamma/delta T-cells. This suggests early detection of PIBF may be related to premature trophoblast invasion possibly into an endometrium not yet prepared for the trophoblast, thus possibly leading to early immune rejection of the fetus.
Check
J H
JH
The University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden, Cooper Hospital, University Medical Center, Department of Obstetrics and Gynecology, USA.
Nazari
P
P
Check
M L
ML
Szekeres-Bartho
J
J
Yuan
W
W
D000328:Adult; D004624:Embryo Transfer; D005260:Female; D006801:Humans; D010062:Ovulation Induction / Q000009:adverse effects*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011257:Pregnancy Proteins / Q000378:metabolism*; D011446:Prospective Studies; D013491:Suppressor Factors, Immunologic / Q000378:metabolism*; D014327:Trophoblasts / Q000502:physiology*
C110058:PIBF1 protein, human; D011257:Pregnancy Proteins; D013491:Suppressor Factors, Immunologic