Soluble human leukocyte antigen G expression in phase I culture media at 46 hours after fertilization predicts pregnancy and implantation from day 3 embryo transfer.
OBJECTIVE
To compare pregnancy and implantation rates after ART when embryos for day 3 embryo transfer were selected based on soluble HLA-G (sHLA-G) expression in the culture media at 46 hours after fertilization by intracytoplasmic sperm injection (ICSI).


METHODS
Prospective cohort study.


METHODS
Private practice.


METHODS
One hundred seven patients undergoing ART aged <39 years with normal ovarian reserve, a normal uterine cavity, and two or more embryos scoring > or =70 by the graduated embryo scoring (GES) method, transferred on day 3.


METHODS
Patients were divided into two groups. In group A (n = 51) all embryos transferred expressed sHLA-G above the geometric mean (sHLA-G+), whereas in group B (n = 56) all embryos transferred were sHLA-G-ve.


METHODS
Viable pregnancy rate (patients with fetal heart activity at 8 weeks of gestation per embryo transfer procedure), and implantation rate (viable gestational sacs per total embryos transferred).


RESULTS
When all embryos transferred were sHLA-G+ve the pregnancy and implantation rates were 75% (38/51) and 44% (51/116), respectively, compared to 23% (13/56) and 14% (20/143) when all embryos transferred were sHLA-G-ve.


CONCLUSIONS
Pregnancy and implantation rates after day 3 embryo transfer are improved when sHLA-G expression in phase I culture media at 46 hours after fertilization by ICSI is used prospectively as a criterion for selecting optimal embryos for transfer.
Sher
Geoffrey
G
Sher Institutes for Reproductive Medicine, New York, New York 10016, USA. gsher@sherinstitute.com
Keskintepe
Levent
L
Fisch
Jeffery D
JD
Acacio
Brian A
BA
Ahlering
Peter
P
Batzofin
Joel
J
Ginsburg
Mike
M
D000328:Adult; D016009:Chi-Square Distribution; D003470:Culture Media / Q000494:pharmacology*; D046149:Embryo Culture Techniques / Q000379:methods / Q000706:statistics & numerical data*; D010064:Embryo Implantation / Q000187:drug effects / Q000502:physiology*; D004624:Embryo Transfer / Q000706:statistics & numerical data*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods* / Q000706:statistics & numerical data*; D018507:Gene Expression Regulation, Developmental / Q000187:drug effects / Q000502:physiology; D006680:HLA Antigens / Q000096:biosynthesis* / Q000235:genetics; D059951:HLA-G Antigens; D015395:Histocompatibility Antigens Class I / Q000096:biosynthesis* / Q000235:genetics; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D013997:Time Factors
D003470:Culture Media; D006680:HLA Antigens; D059951:HLA-G Antigens; D015395:Histocompatibility Antigens Class I