Objective: To compare pregnancy and implantation rates after ART when embryos for day 3 embryo transfer were selected based on soluble HLA-G (sHLA-G) expres sion in the culture media at 46 hours after fertilization by...Objective: To compare pregnancy and implantation rates after ART when embryos for day 3 embryo transfer were selected based on soluble HLA-G (sHLA-G) expres sion in the culture media at 46 hours after fertilization by intracytoplasmic sp erm injection (ICSI). Design: Prospective cohort study. Setting: Private practic e. Patient(s): One hundred seven patients undergoing ART aged < 39 years with no rmal ovarian reserve, a normal uterine cavity, and two or more embryos scoring < 70 by the graduated embryo scoring (GES) method, transferred on day 3. Interven tion(s): Patients were divided into two groups. In group A (n = 51) all embryos transferred expressed sHLA-G above the geometric mean (sHLA-G+), whereas in g roup B (n = 56) all embryos transferred were sHLA-G-ve. Main Outcome Measure(s ): Viable pregnancy rate (patients with fetal heart activity at 8 weeks of gesta tion per embryo transfer procedure), and implantation rate (viable gestational s acs per total embryos transferred). Result(s): When all embryos transferred were sHLA-G+ve the pregnancy and implantation rates were 75%(38/51) and 44%(51/1 16), respectively, compared to 23%(13/56) and 14%(20/143) when all embryos tra nsferred were sHLA-G-ve. Conclusion(s): Pregnancy and implantation rates after day 3 embryo transfer are improved when sHLA-G expression in phase I culture m edia at 46 hours after fertilization by ICSI is used prospectively as a criterio n for selecting optimal embryos for transfer.展开更多
文摘Objective: To compare pregnancy and implantation rates after ART when embryos for day 3 embryo transfer were selected based on soluble HLA-G (sHLA-G) expres sion in the culture media at 46 hours after fertilization by intracytoplasmic sp erm injection (ICSI). Design: Prospective cohort study. Setting: Private practic e. Patient(s): One hundred seven patients undergoing ART aged < 39 years with no rmal ovarian reserve, a normal uterine cavity, and two or more embryos scoring < 70 by the graduated embryo scoring (GES) method, transferred on day 3. Interven tion(s): Patients were divided into two groups. In group A (n = 51) all embryos transferred expressed sHLA-G above the geometric mean (sHLA-G+), whereas in g roup B (n = 56) all embryos transferred were sHLA-G-ve. Main Outcome Measure(s ): Viable pregnancy rate (patients with fetal heart activity at 8 weeks of gesta tion per embryo transfer procedure), and implantation rate (viable gestational s acs per total embryos transferred). Result(s): When all embryos transferred were sHLA-G+ve the pregnancy and implantation rates were 75%(38/51) and 44%(51/1 16), respectively, compared to 23%(13/56) and 14%(20/143) when all embryos tra nsferred were sHLA-G-ve. Conclusion(s): Pregnancy and implantation rates after day 3 embryo transfer are improved when sHLA-G expression in phase I culture m edia at 46 hours after fertilization by ICSI is used prospectively as a criterio n for selecting optimal embryos for transfer.