Hum. Reprod. Advance Access originally published online on June 23, 2007
Human Reproduction 2007 22(8):2261-2266; doi:10.1093/humrep/dem157
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Soluble MHC Class I chain-related molecule serum levels are predictive markers of implantation failure and successful term pregnancies following IVF
1 Medical Reproduction Institute, 6 rue François Rocca, 13008 Marseille, France 2 CPMA, Center of Assisted Reproductive Medicine, hôpital de la Conception, Marseille, France 3 Avenir Team INSERM U561, Hôpital St Vincent de Paul, 75014 Paris, France 4 Laboratoire Exploration NK, Laboratoire Hématologie Assistance Publique des Hôpitaux de Marseille (AP-HM), Hôpital de la Conception, 147 Bd Baille, 13005 Marseille, France 5 Delegation a la Recherche Clinique, Faculte de Medecine, Universite de la Mediterranee, Marseille, France 6 UMR-S 608, INSERM, Universite de la Mediterranee Aix Marseille 2, Marseille, France
7 Correspondence address. Tel: +33 491383920; Fax: +33 491383012; E-mail: pascale.paul{at}ap-hm.fr; pascale.paul{at}pharmacie.univ-mrs.fr
BACKGROUND: Despite ongoing progresses of IVF techniques, biomarkers predicting their outcome prior to IVF initiation are lacking. We investigated whether serum levels of the stress-inducible soluble major histocompatibility complex Class I chain-related molecule, MICA, (sMIC), a regulator of cellular immunity, can be predictive of implantation or pregnancy failure after IVF.
METHODS: sMIC serum levels, evaluated during the follicular phase of the cycle preceding in vitro fertilization, in a cohort of 170 infertile women with 22.3% IVF success rate were analyzed in association with implantation/pregnancy failure or live birth outcomes after IVF.
RESULTS: sMIC serum levels, detected in 38% of all women undergoing IVF, were shown to be predictive both of implantation failure (
2.45 ng/ml cut off, odds ratio (OR) = 4.6; 95% confidence interval (CI) = 1.08 – 19.79; P = 0.031) and successful pregnancy (< 2.45 ng/ml, OR = 13.8; 95% CI = 2.03–118.3; P = 0.002). When successful implantation occurred, sMIC levels > 3.2 ng/ml were predictive of spontaneous abortion (OR = 35; 95% CI = 1.74–703; P = 0.026).
CONCLUSIONS: sMIC is thus to be considered as a novel blood biomarker which, when quantified prior to initiation of IVF, anticipates chances for infertile women to give birth to a viable baby. Considering medical and psychological cost of IVF, this non-invasive assay may thus contribute to better counseling, treatment and care of infertile couples prior to IVF.
Key words: natural killer/major histocompatibility complex Class I chain-related/IVF/implantation failure/assisted pregnancy
Submitted on August 11, 2006; resubmitted on March 12, 2007; accepted on March 27, 2007.