title: Embryo selection criteria based on morphology VERSUS the expression of a biochemical marker (sHLA-G) and a graduated embryo score: prediction of pregnancy outcome.
abstract: OBJECTIVE
  To compare pregnancy and implantation rates when embryos are selected based on a single Day 3 (D 3) morphology score vs. a GES score plus sHLA-G expression.
  
  
  METHODS
  A prospective randomized study (n = 214) undergoing fresh ICSI cycles. Embryos were selected for transfer based on either Day 3 morphology score (Group A) or GES-scoring plus sHLA-G expression (Group B).
  
  
  RESULTS
  Clinical [35/107 (33%) vs. 52/107 (49%)] and ongoing pregnancy [20/107 (19%) vs. 52/107 (49%)] rates were significantly different between Group A and Group B (p < 0.05). Implantation rates were not significantly different between Group A [52/353 (15%)] and Group B [73/417 (18%)] (p < 0.05). The number of pregnancies lost during the first trimester was nearly 12 times higher in Group A [25/52 (48%)].
  
  
  CONCLUSIONS
  The miscarriage rate was significantly lower in Group B than Group A and the pregnancy results were superior when embryos were selected based on GES plus sHLA-G expression.
authors.affiliation: Sher Institute for Reproductive Medicine, Sacramento, CA, USA. dkotze@sherinstitute.com
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Kotze
authors.forename: Polly
authors.initials: P
authors.lastname: Hansen
authors.forename: Levent
authors.initials: L
authors.lastname: Keskintepe
authors.forename: Ellen
authors.initials: E
authors.lastname: Snowden
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Sher
authors.forename: Thinus
authors.initials: T
authors.lastname: Kruger
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D015415:Biomarkers / Q000378:metabolism; D010064:Embryo Implantation; D004624:Embryo Transfer / Q000379:methods*; D004622:Embryo, Mammalian / Q000166:cytology* / Q000378:metabolism; D005260:Female; D006680:HLA Antigens / Q000378:metabolism*; D059951:HLA-G Antigens; D015395:Histocompatibility Antigens Class I / Q000378:metabolism*; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D020554:Sperm Injections, Intracytoplasmic
chemical_list: D015415:Biomarkers; D006680:HLA Antigens; D059951:HLA-G Antigens; D015395:Histocompatibility Antigens Class I