Endometrial secretion analysis identifies a cytokine profile predictive of pregnancy in IVF
Endometrial secretion analysis identifies a cytokine profile predictive of pregnancy in IVF
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DOI：
10.1093/humrep/dep011
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发表时间：
2009-06-01
影响因子：
6.1
通讯作者：
Macklon, N. S.
中科院分区：
文献类型：
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作者：
Boomsma, C. M.;Kavelaars, A.;Macklon, N. S.
人类子宫-胚胎相互作用的研究由于子宫内膜样本采集对着床过程本身的破坏性影响而变得复杂。子宫内膜分泌物分析是一种新的技术，对植入无干扰。这项前瞻性队列研究的主要目的是探讨是否可以在IVF后胚胎移植前立即抽吸的子宫内膜分泌物中鉴定出预测着床和临床妊娠的细胞因子谱。使用多重免疫测定法分析了210名接受IVF的妇女胚胎移植前立即抽吸的子宫内膜分泌物中17种可溶性着床调节因子，即白细胞介素（IL）-1 β、IL-5、IL-6、IL-10、IL-12、IL-15、IL-17、IL-18、肿瘤坏死因子（TNF）-α、干扰素（IFN）-γ、巨噬细胞迁移抑制因子、嗜酸性粒细胞趋化因子、IFN-γ诱导的10 kDa蛋白（IP-10）、单核细胞化学引诱蛋白-1（MCP-1）、Dickkopf同源物1，肝素结合表皮生长因子和血管内皮生长因子（VEGF）。为了检测着床，在胚胎移植后每天收集尿液样本，通过免疫测定法分析人绒毛膜促性腺激素（hCG）浓度。（分别为负相关和正相关）IL-1 β（P = 0.047）和TNF-α（P = 0.023）水平与临床妊娠之间。IL-1 β和TNF-α对妊娠的预测价值被观察到与胚胎质量的预测价值相当，子宫内膜分泌细胞因子谱提供了一种新的、非破坏性的方法来研究子宫内膜在人类胚胎植入中的作用，并确定了一种似乎有利于临床妊娠的谱。
The study of human endometrial-embryonic interactions is complicated by the disruptive impact of endometrial sample collection on the process of implantation itself. Endometrial secretion analysis is a novel technique, non-disruptive to implantation. The primary aim of this prospective cohort study was to explore whether a cytokine profile predictive of implantation and clinical pregnancy can be identified in endometrial secretions aspirated immediately prior to embryo transfer following IVF.Endometrial secretions, aspirated immediately prior to embryo transfer from 210 women undergoing IVF, were analyzed using a multiplex immunoassay for 17 soluble regulators of implantation, namely interleukin (IL)-1 beta, IL-5, IL-6, IL-10, IL-12, IL-15, IL-17, IL-18, tumor necrosis factor (TNF)-alpha, interferon (IFN)-gamma, macrophage migration inhibitory factor, eotaxin, IFN-gamma-inducible 10 kDa protein (IP-10), monocyte chemo-attractant protein-1 (MCP-1), Dickkopf homolog 1, heparin-binding epidermal growth factor and vascular endothelial growth factor (VEGF). In order to detect implantation, daily urine samples were collected after embryo transfer, and human Chorionic Gonadotropin (hCG) concentrations were analyzed by an immunoassay.Multivariable logistic regression analysis revealed significant associations (negative and positive association, respectively) between MCP-1 (P = 0.005) and IP-10 (P = 0.037) levels and implantation, and between IL-1 beta (P = 0.047) and TNF-alpha (P = 0.023) levels and clinical pregnancy. The predictive value for pregnancy of IL-1 beta and TNF-alpha was observed to be equivalent and additive to that of embryo quality.Endometrial secretion cytokine profiling offers a novel, non-disruptive approach to study the role of the endometrium in human embryo implantation and identifies a profile which appears to be conducive to clinical pregnancy.