title: The effect of the biochemical marker soluble human leukocyte antigen G on pregnancy outcome in assisted reproductive technology--a multicenter study.
abstract: OBJECTIVE
  To determine whether the presence of soluble human leukocyte antigen G (sHLA-G) affects implantation and pregnancy outcomes in vitro.
  
  
  METHODS
  A multicenter retrospective study.
  
  
  METHODS
  Six certified in vitro fertilization (IVF) units.
  
  
  METHODS
  Embryos obtained from 2,040 patients from six different IVF clinics.
  
  
  METHODS
  Soluble HLA-G determination on day-2 embryos after intracytoplasmic sperm injection, with embryos transferred on day 3 using the sHLA-G data.
  
  
  METHODS
  Ongoing pregnancy rate (10- to 12-week ultrasound finding).
  
  
  RESULTS
  All embryos were individually cultured, and a chemiluminescence enzyme-linked immunosorbent assay was used to detect the presence of sHLA-G in the culture medium surrounding the embryos. Embryos were selected based on a positive sHLA-G result and a graduated embryo scoring (GES) score >70, or on embryo morphology if the test was negative. In all centers, a positive sHLA-G result was associated with an increase in the odds of an ongoing pregnancy. The incidence of an ongoing pregnancy was 2.52 times greater in embryos transferred on day 3 with a positive sHLA-G test result than the incidence of an ongoing pregnancy in embryos with a negative sHLA-G test result.
  
  
  CONCLUSIONS
  Data from this multicenter study confirm that sHLA-G expression is a valuable noninvasive embryo marker to assist in improving pregnancy outcomes, with the theoretical potential to reduce multiple pregnancies.
authors.affiliation: Jones Institute, Norfolk, Virginia.
authors.forename: Dirk
authors.initials: D
authors.lastname: Kotze
authors.forename: Thinus F
authors.initials: TF
authors.lastname: Kruger
authors.forename: Carl
authors.initials: C
authors.lastname: Lombard
authors.forename: Trishanta
authors.initials: T
authors.lastname: Padayachee
authors.forename: Levent
authors.initials: L
authors.lastname: Keskintepe
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Sher
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D001755:Blastocyst / Q000276:immunology*; D017077:Culture Media, Conditioned / Q000378:metabolism; D046149:Embryo Culture Techniques; D010064:Embryo Implantation; D004624:Embryo Transfer; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D059951:HLA-G Antigens / Q000378:metabolism*; D006801:Humans; D016015:Logistic Models; D016017:Odds Ratio; D011247:Pregnancy; D018873:Pregnancy Rate; D027724:Reproductive Techniques, Assisted; D012189:Retrospective Studies; D013019:South Africa; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
chemical_list: D015415:Biomarkers; D017077:Culture Media, Conditioned; D059951:HLA-G Antigens
keywords: ART; ICSI; embryo selection; noninvasive embryo testing; pregnancy outcome; sHLA-G testing