Follicular fluid insulin like growth factor-1 (FF IGF-1) is a biochemical marker of embryo quality and implantation rates in in vitro fertilization cycles.
Follicular fluid insulin like growth factor-1 (FF IGF-1) is a biochemical marker of embryo quality and implantation rates in in vitro fertilization cycles.
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DOI：
10.4103/0974-1208.117171
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发表时间：
2013-04
影响因子：
--
通讯作者：
Nath NM
中科院分区：
文献类型：
--
作者：
Mehta BN;Chimote NM;Chimote MN;Chimote NN;Nath NM
胰岛素样生长因子-1（IGF-1）已被报道在人类卵泡和胚胎发育中发挥作用。然而，早期的研究主要在动物模型或补充有IGF-1的培养基中进行，无法将IGF-1与胚胎质量直接联系起来。到目前为止，IGF-1与妊娠结局相关的结果也不明确。本研究的目的是发现在体外受精（IVF）周期中，原位卵泡液中IGF-1水平是否可预测胚胎质量和植入率。在不孕妇女中进行120个周期的常规IVF胚胎移植的前瞻性研究。在取卵当天，估计合并卵泡液中的IGF-1浓度。每天在不同的发育阶段评估胚胎质量。根据测量值的中位数将周期分为低和高卵泡液胰岛素样生长因子-1（FF IGF-1）组。胚胎质量、临床妊娠率和种植率是主要结局指标。Graph-pad Prism 5统计软件包。FF IGF-1与胚胎质量（Pearson r = 0.3894，r2 = 0.1516，P > 0.0001）和临床妊娠（Pearson r = 0.5972，r2 = 0.36，P > 0.0001）相关。高FF IGF-1组的受精率、卵裂率、囊胚形成率和优质胚胎率均显著高于低FF IGF-1组。高FF IGF-1组的临床妊娠率（38.33 vs. 20%，P = 0.0272）和胚胎着床率（21.6 vs. 10.32%，P = 0.0152）也显著高于低FF IGF-1组。FF IGF-1临床妊娠阈值为<58.50 ng/mg蛋白（受试者操作特征AUC：0.85 ± 0.03，95% CI：0.78-0.91）。FF IGF-1是胚胎质量和植入率的合理生化标志物，并与常规IVF周期的临床妊娠率相关。
Insulin-like growth factor-1 (IGF-1) has been reported to play a role in human follicular and embryonic development. However, earlier studies carried out mostly in animal models or in culture mediums supplemented with IGF-1 have been unable to directly link IGF-1 with embryo quality. Results correlating IGF-1 with pregnancy outcome have also been ambiguous so far. The aim of this study is to find if in situ follicular-fluid level of IGF-1 is predictive of embryo quality and implantation rates in in vitro fertilization (IVF) cycles. Prospective study involving 120 cycles of conventional IVF-embryo transfer in infertile women. IGF-1 concentrations were estimated in pooled follicular-fluid on the day of oocyte-pickup. Embryo quality was assessed daily at different developmental stages. Cycles were sorted into low and high follicular fluid insulin-like growth factor-1 (FF IGF-1) groups according to the median value of measurement. Embryo quality, clinical pregnancy and implantation rate were the main outcome measures. Graph-pad Prism 5 statistical package. FF IGF-1 correlates with embryo quality (Pearson r = 0.3894, r2 = 0.1516, P > 0.0001) and clinical pregnancy (Pearson r = 0.5972, r2 = 0.36, P > 0.0001). High FF IGF-1 group shows significantly higher rates of fertilization, cleavage, blastocyst formation and top grade embryos compared with low FF IGF-1 group. Clinical pregnancy rates (38.33 vs. 20%, P = 0.0272) and embryo implantation rates (21.6 vs. 10.32%, P = 0.0152) are also significantly higher in the high versus low FF IGF-1 group. Threshold value of FF IGF-1 for clinical pregnancy is <58.50 ng/mg protein (receiver operating characteristics AUC : 0.85 ± 0.03, 95% CI: 0.78-0.91). FF IGF-1 is a plausible biochemical marker of embryo quality and implantation rate and correlates with clinical pregnancy rates in conventional IVF cycles.