Embryo selection criteria based on morphology VERSUS the expression of a biochemical marker (sHLA-G) and a graduated embryo score: prediction of pregnancy outcome.
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.
Kotze
Dirk J
DJ
Sher Institute for Reproductive Medicine, Sacramento, CA, USA. dkotze@sherinstitute.com
Hansen
Polly
P
Keskintepe
Levent
L
Snowden
Ellen
E
Sher
Geoffrey
G
Kruger
Thinus
T
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
D015415:Biomarkers; D006680:HLA Antigens; D059951:HLA-G Antigens; D015395:Histocompatibility Antigens Class I