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Hum. Reprod. Advance Access originally published online on June 10, 2004
Human Reproduction 2004 19(9):1968-1973; doi:10.1093/humrep/deh356
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Human Reproduction vol. 19 no. 9 © European Society of Human Reproduction and Embryology 2004; all rights reserved

Detectable levels of interleukin-18 in uterine luminal secretions at oocyte retrieval predict failure of the embryo transfer

N. Lédée-Bataille1,2,4, F. Olivennes3, J. Kadoch3, S. Dubanchet1, N. Frydman3, G. Chaouat1 and R. Frydman2

1 INSERM U131, Equipe Cytokines et Relation Materno-Foetale Clamart, France, 2 E.A 3538, qualité gamétique et implantation, Clamart, France and 3 Service de Gynécologie-Obstétrique et Médecine de la Reproduction, Hôpital Antoine Béclère, Clamart, France

4 To whom correspondence should be addressed at: Service de Gynécologie-Obstétrique, Centre Hospitalier de poissy, 10, Rue du Champ Gaillard, 78300 Poissy, France. Email: ledeenathalie{at}aol.com

BACKGROUND: Most implantation failures after successful in vitro fertilization-embryo transfer (IVF-ET) result from inadequate uterine receptivity. There is currently no way to predict this receptivity. METHODS: We investigated whether the detection of interleukin-(IL)18 by ELISA in uterine luminal secretions might predict implantation failure. Secretions of 133 patients enrolled in our IVF-ET program were sampled by uterine flushing immediately before oocyte retrieval. We assessed the following outcomes: pregnancy rate, multiple pregnancy rate, and implantation rate per embryo transferred. RESULTS: Interleukin-18 was detected in the flushing fluid of 38 patients (28.6%). Although the two groups were comparable for all other characteristics (age, etiology, ovarian reserve, number of embryos transferred, quality of embryos), all outcome variables differed significantly. The pregnancy rate was 37.9% in the IL-18 –ve group and 15% in the IL-18 + ve group, the multiple pregnancy rate 27.7% and 0%, and the implantation rate per embryo transferred 19.4% and 6.7% (all comparisons, P=0.02). Only embryos meeting good quality criteria were transferred to 65 patients: 50 IL-18 –ve and 15 IL-18 +ve. The pregnancy rate was 51% for the IL-18 –ve group and 20% for the IL-18 +ve group, the multiple pregnancy rate 36% and 0.0%, respectively, and the implantation rate 29% and 8.3% (P=0.02). CONCLUSION: This non-invasive and simple method predicted inadequate uterine receptivity, independent of embryo quality.

Key words: cytokines/implantation/interleukin-18/in vitro fertilization/embryo transfer (IVF-ET)/uterine flushing/uterine receptivity


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