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Multicenter Study
. 2010 Jul;25(7):1691-8.
doi: 10.1093/humrep/deq120. Epub 2010 May 19.

Soluble HLA-G is an independent factor for the prediction of pregnancy outcome after ART: a German multi-centre study

V Rebmann  1 , M Switala, I Eue, H Grosse-Wilde
Affiliations
Multicenter Study

Soluble HLA-G is an independent factor for the prediction of pregnancy outcome after ART: a German multi-centre study

V Rebmann et al. Hum Reprod. 2010 Jul.

Abstract

Background: Soluble HLA-G (sHLA-G) has been suggested as a non-invasive marker for embryo selection to improve pregnancy rates after assisted reproduction technique (ART). Our study aimed at the identification of parameters influencing the detection of sHLA-G in embryo cultures (ECs) and at the prognostic relevance of sHLA-G in a multi-centre study.

Methods: In total 4212 EC from 2364 cycles were randomly collected from 29 German ART centres and analysed for sHLA-G by Luminex-based technology.

Results: Among test and culture conditions, only the cleavage stage of the embryo was identified as an independent factor for sHLA-G detection (P < 0.001). Overall, sHLA-G was significantly associated with pregnancy after ART [P < 0.001; odds ratio: 2.0 (95% CI: 1.7-2.4)], suggesting that sHLA-G testing might improve the pregnancy rate from 30 to 40%. Importantly, the sHLA-G status of embryos could be associated with pregnancy after single embryo transfer [P = 0.002; odds ratio: 3.3 (95% CI: 1.5-6.8)] doubling the probability of pregnancy rate to 26% after sHLA-G testing. The patient's age, number of transferred embryos, morphological grading [EXP(B): 4.3 (95% CI: 2.1-8.9)] of embryos and sHLA-G status [EXP(B): 2.3 (95% CI: 1.8-3.1)] were independent predictors of pregnancy, with the latter two being most powerful.

Conclusions: This study provides significant evidence that the morphological scoring system is still the best strategy for the selection of embryos but that sHLA-G might be considered as a second parameter if a choice has to be made between embryos of morphologically equal quality.

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