title: Noninvasive embryo viability assessment by quantitation of human haptoglobin alpha-1 fragment in the in vitro fertilization culture medium: an additional tool to increase success rate.
abstract: OBJECTIVE
  To find new candidate molecules to assess embryo viability in a noninvasive manner.
  
  
  METHODS
  Prospective, blinded study with randomized sample collection.
  
  
  METHODS
  University research center.
  
  
  METHODS
  Ninety embryos implanted in 53 randomly selected patients (mean ± SD age, 32.3 ± 5.1 years) were analyzed.
  
  
  METHODS
  Superovulation treatment was initiated by the administration of the GnRh agonist triptorelin and individual dosages of recombinant FSH. Ovulation was induced by the injection of hCG. Oocytes were fertilized by intracytoplasmic sperm injection.
  
  
  METHODS
  Liquid chromatography coupled mass spectrometric quantification of the α-1 fragment of human haptoglobin in the culture medium.
  
  
  RESULTS
  A novel polypeptide marker was found that might be helpful to differentiate between potentially viable and nonviable embryos. This molecule was identified with tandem mass spectrometry as the α-1 fragment of human haptoglobin. Significant correlation was found in the amount of the peptide fragment and the outcome of pregnancy. In the culture media of embryos that were assigned in the biochemical assay as nonviable (according to the amount of the haptoglobin fragment), there were no pregnancies detected; this assay revealed a 100% successful selection of the nonviable embryos. In the group assigned as viable, the rate of pregnancy was 54.7%.
  
  
  CONCLUSIONS
  Viability of the embryo during the IVF process is assessed by microscopic inspection, resulting in a pregnancy rate of 25%-30%. Detection and quantitation of the α-1 haptoglobin fragment of the culture medium proved to be a useful additional method for identifying nonviable embryos, increasing the success rate to 50%.
authors.affiliation: Department of Laboratory Medicine, Faculty of Medicine, University of Pécs, Pécs, Hungary; Szentágothai Research Center, University of Pécs, Pécs, Hungary.
authors.forename: Gergely
authors.initials: G
authors.lastname: Montskó
authors.affiliation: Department of Laboratory Medicine, Faculty of Medicine, University of Pécs, Pécs, Hungary; Szentágothai Research Center, University of Pécs, Pécs, Hungary.
authors.forename: Zita
authors.initials: Z
authors.lastname: Zrínyi
authors.affiliation: Department of Obstetrics and Gynecology, University of Pécs, Pécs, Hungary.
authors.forename: Tamás
authors.initials: T
authors.lastname: Janáky
authors.affiliation: Department of Obstetrics and Gynecology, University of Pécs, Pécs, Hungary.
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Szabó
authors.affiliation: Department of Medical Chemistry, University of Szeged, Szeged, Hungary.
authors.forename: Ákos
authors.initials: Á
authors.lastname: Várnagy
authors.affiliation: Department of Laboratory Medicine, Faculty of Medicine, University of Pécs, Pécs, Hungary; Szentágothai Research Center, University of Pécs, Pécs, Hungary. Electronic address: kovacs.l.gabor@pte.hu.
authors.forename: Gábor L
authors.initials: GL
authors.lastname: Kovács
authors.affiliation: Department of Laboratory Medicine, Faculty of Medicine, University of Pécs, Pécs, Hungary; Department of Obstetrics and Gynecology, University of Pécs, Pécs, Hungary.
authors.forename: József
authors.initials: J
authors.lastname: Bódis
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis / Q000378:metabolism; D001755:Blastocyst / Q000166:cytology / Q000502:physiology*; D002470:Cell Survival; D002478:Cells, Cultured; D003470:Culture Media / Q000737:chemistry* / Q000378:metabolism; D046149:Embryo Culture Techniques; D005260:Female; D005307:Fertilization in Vitro; D006242:Haptoglobins / Q000032:analysis* / Q000378:metabolism; D006801:Humans; D007246:Infertility / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D011247:Pregnancy; D018873:Pregnancy Rate; D011379:Prognosis; D015203:Reproducibility of Results; D020554:Sperm Injections, Intracytoplasmic; D055815:Young Adult
chemical_list: D015415:Biomarkers; D003470:Culture Media; C485359:HP protein, human; D006242:Haptoglobins
keywords: In vitro fertilization; biomarker; embryo viability; mass spectrometry