- 作者：Jeffrey D. Fisch ; Levent Keskintepe ; Michael Ginsburg ; Mark Adamowicz ; Geoffrey Sher
- 关键词：Soluble HLA-G ; sHLA-G ; IVF ; pregnancy ; implantation ; multiple gestation
- 刊名：Fertility and Sterility
- 出版年：2007
- 出版时间：April 2007
- 年：2007
- 卷：87
- 期：4
- 页码：757-763
- 全文大小：106 K
Objective
To evaluate assisted reproductive technology (ART) outcomes by using Graduated Embryo Score (GES) and soluble human leukocyte antigen-G (sHLA-G) expression to select embryos for transfer on day 3.Design
Prospective cohort.
Setting
Private practice.
Patient(s)
Women undergoing fresh ART cycles (n = 209).
Intervention(s)
In vitro fertilization using standard protocols. Embryos scoring GES of ≥70 using were selected for transfer on the basis of sHLA-G expression in the culture media on day 2.
Main Outcome Measure(s)
Pregnancy, implantation, and multiple-gestation rates.
Result(s)
Ongoing gestations increased with the number of embryos expressing sHLA-G (37 % , 42 % , 58 % , and 56 % with 0, 1, 2, or 3 sHLA-G+, respectively). With at least two sHLA-G+ embryos, ongoing gestation and implantation rates were higher than those with fewer than two sHLA-G+. Differences were even higher for women aged ≤37 years. With at least two sHLA-G+ embryos, the odds ratio (95 % confidence interval) was 1.59 (1.51–1.68) for ongoing gestation compared with the case of fewer than two sHLA-G+. Age was the most important predictor of outcome; the odds ratio (95 % confidence interval) was 2.07 (1.98–2.16) for ongoing gestation in women aged ≤37 years with at least two sHLA-G+ embryos, compared with the case of women aged 38–40 years.
Conclusion(s)
Day 3 embryo transfer using GES and sHLA-G improves ART outcomes by increasing predictive accuracy. High twin rates suggest that couples with at least two sHLA-G+ embryos consider elective single-embryo transfer.