title: Embryo quality predictive models based on cumulus cells gene expression.
abstract: Since the introduction ofin vitrofertilization (IVF) in clinical practice of infertility treatment, the indicators for high quality embryos were investigated. Cumulus cells (CC) have a specific gene expression profile according to the developmental potential of the oocyte they are surrounding, and therefore, specific gene expression could be used as a biomarker. The aim of our study was to combine more than one biomarker to observe improvement in prediction value of embryo development. In this study, 58 CC samples from 17 IVF patients were analyzed. This study was approved by the Republic of Slovenia National Medical Ethics Committee. Gene expression analysis [quantitative real time polymerase chain reaction (qPCR)] for five genes, analyzed according to embryo quality level, was performed. Two prediction models were tested for embryo quality prediction: a binary logistic and a decision tree model. As the main outcome, gene expression levels for five genes were taken and the area under the curve (AUC) for two prediction models were calculated. Among tested genes,AMHR2andLIFshowed significant expression difference between high quality and low quality embryos. These two genes were used for the construction of two prediction models: the binary logistic model yielded an AUC of 0.72 ± 0.08 and the decision tree model yielded an AUC of 0.73 ± 0.03. Two different prediction models yielded similar predictive power to differentiate high and low quality embryos. In terms of eventual clinical decision making, the decision tree model resulted in easy-to-interpret rules that are highly applicable in clinical practice.
authors: Division of Medical Oncology, Institute of Oncology, Ljubljana, Slovenia.
authors: R
authors: R
authors: Devjak
authors: Reproductive Unit, Department of Obstetrics and Gynaecology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
authors: T
authors: T
authors: Burnik Papler
authors: Reproductive Unit, Department of Obstetrics and Gynaecology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
authors: I
authors: I
authors: Verdenik
authors: Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
authors: K
authors: K
authors: Fon Tacer
authors: Reproductive Unit, Department of Obstetrics and Gynaecology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
authors: E
authors: E
authors: Vrtačnik Bokal
keywords: AMHR2 gene; Cumulus cells (CC); Embryo prediction; In vitro fertilization (IVF); LIF gene