title: Influence of early ICSI-derived embryo sHLA-G expression on pregnancy and implantation rates: a prospective study.
abstract: BACKGROUND
  We have previously reported the retrospective observation that when at least one embryo, transferred on day 3, expressed sHLA-G above the geometric mean (sHLA-G+) 46 h post-ICSI, there was a marked improvement in both pregnancy (PR) and implantation (IR) rates.
  
  
  METHODS
  The media surrounding individual embryos derived from ICSI performed on oocytes from 482 women < or =43 years of age were tested for sHLA-G expression by specific ELISA.
  
  
  RESULTS
  We report here prospective results showing improved IVF results following the transfer of 'good quality' embryos (7-9 cells with <20% fragmentation) by preferentially including at least one sHLA-G+ embryos. PR and IR for women < or =38 years were 63% and 32% when one transferred embryo was sHLA-G+, and 69% and 36% when at least two embryos were sHLA-G+. When none of the embryos transferred was sHLA-G+, PR and IR were 25% and 13%, respectively. Comparable PR and IR for women 39-43 years were 29% and 11% when none of the transferred embryos were sHLA-G+; 38% and 15% when at least one sHLA-G+ embryo was transferred; and 61% and 26% when at least two 2 sHLA-G+ embryos were transferred. The data were stratified by patient age.
  
  
  CONCLUSIONS
  PR and IR increased with the addition of each sHLA-G+ embryo, regardless of age. While there are significant barriers to routine embryo sHLA-G testing, we believe that if implemented, this would provide a mechanism for optimizing IVF PR while minimizing the risk of multiple pregnancies.
authors.affiliation: gsher@sherinstitute.com
authors.forename: G
authors.initials: G
authors.lastname: Sher
authors.forename: L
authors.initials: L
authors.lastname: Keskintepe
authors.forename: J
authors.initials: J
authors.lastname: Batzofin
authors.forename: J
authors.initials: J
authors.lastname: Fisch
authors.forename: B
authors.initials: B
authors.lastname: Acacio
authors.forename: P
authors.initials: P
authors.lastname: Ahlering
authors.forename: M
authors.initials: M
authors.lastname: Ginsburg
mesh_terms: D000328:Adult; D001755:Blastocyst / Q000276:immunology; D010064:Embryo Implantation / Q000502:physiology*; D004624:Embryo Transfer; D005260:Female; D018507:Gene Expression Regulation, Developmental; D006680:HLA Antigens / Q000235:genetics*; D059951:HLA-G Antigens; D015395:Histocompatibility Antigens Class I / Q000235:genetics*; D006801:Humans; D008297:Male; D008423:Maternal Age; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D020554:Sperm Injections, Intracytoplasmic
chemical_list: D006680:HLA Antigens; D059951:HLA-G Antigens; D015395:Histocompatibility Antigens Class I