Détermination de l'antigène HLA-G soluble dans le liquide folliculaire et dans le milieu de culture d'embryons comme indicateur du succès d'un traitement par FIV-ICSI [Soluble human leukocyte antigen-G (sHLA-G) in follicular fluid and embryo culture medium and its impact on pregnancy prediction in IVF-ICSI treatment]

In IVF around 70% of embryos fail to implant. Often more than one embryo is transferred in order to enhance the chances of pregnancy, but this is at the price of an increased multiple pregnancy risk. In the aim to increase the success rate with a single embryo, research projects on prognostic factors of embryo viability have been initiated, but no marker has found a routine clinical application to date. Effects of soluble human leukocyte antigen-G (sHLA-G) on both NK cell activity and on Th1/Th2 cytokine balance suggest a role in the embryo implantation process, but the relevance of sHLA-G measurements in embryo culture medium and in follicular fluid (FF) are inconsistent to date. In this study, we have investigated the potential of sHLA-G in predicting the achievement of a pregnancy after IVF-ICSI in a large number of patients (n = 221). sHLA-G was determined in media and in FF by ELISA. In both FF and embryo medium, no significant differences in sHLA-G concentrations were observed between the groups "pregnancy" and "implantation failure", or between the groups "ongoing" versus "miscarried pregnancies". Our results do not favour routine sHLA-G determinations in the FF nor in embryo conditioned media, with the current assay technology available

What is the optimal means of preparing the endometrium in frozenthawed embryo transfer cycles? A systematic review and meta-analysis

<p>Frozenthawed embryo transfer (FET) enables surplus embryos derived from IVF or IVF-ICSI treatment to be stored and transferred at a later date. In recent years the number of FET cycles performed has increased due to transferring fewer embryos per transfer and improved laboratory techniques. Currently, there is little consensus on the most effective method of endometrium preparation prior to FET.</p><p>Using both MEDLINE and EMBASE database a systematic review and meta-analysis of literature was performed. Case-series, casecontrol studies and articles in languages other than English, Dutch or Spanish were excluded. Those studies comparing clinical and ongoing pregnancy rates as well as live birth rates in (i) true natural cycle FET (NC-FET) versus modified NC-FET, (ii) NC-FET versus artificial cycle FET (AC-FET), (iii) AC-FET versus artificial with GnRH agonist cycle FET and (iv) NC-FET versus artificial with GnRH agonist cycle FET were included. Forest plots were constructed and relative risks or odds ratios were calculated.</p><p>A total of 43 publications were selected for critical appraisal and 20 articles were included in the final review. For all comparisons, no differences in the clinical pregnancy rate, ongoing pregnancy rate or live birth rate could be found. Based on information provided in the articles no conclusions could be drawn with regard to cancellation rates.</p><p>Based on the current literature it is not possible to identify one method of endometrium preparation in FET as being more effective than another. Therefore, all of the current methods of endometrial preparation appear to be equally successful in terms of ongoing pregnancy rate. However, in some comparisons predominantly retrospective studies were included leaving these comparisons subject to selection and publication bias. Also patients preferences as well as cost-efficiency were not addressed in any of the included studies. Therefore, prospective randomized studies addressing these issues are needed.</p>