P–236 The evaluation of apoptosis and luteinization process in cumulus cell culture of IVF patients in terms of embryo development and pregnancy

Abstract

Abstract Study question Is there any relationship between apoptosis rate and progesterone levels in terms of the degree of embryo quality and clinical pregnancy success? Summary answer The cumulus cell apoptosis and progesterone levels measured at the hCG day were associated with embryo quality and clinical pregnancy success. What is known already The high rate of apoptosis at cumulus cells led to poor embryo development with the clinical pregnancy failure. Study design, size, duration It is prospective study carried out with 40 healthy women diagnosed as the male factor between September 2017 and April 2018. Participants/materials, setting, methods 40 healthy women aged between 27–38 and diagnosed as the male factor who were undergoing IVF participated the study. The cumulus cells were taken after denudation and cultured. The rate of the apoptosis were measured using with TUNEL method every 24 hours for 96 hours. In concominant with the apoptosis evaluation, the embryo progession and clinical pregnancy rate were also monitored. Progesterone levels taken at the hCG day were also measured. Main results and the role of chance In this study, it was shown that cumulus cell apoptosis was lower in the pregnant group compared to the non-pregnant group (p = 0.023), and progesterone value on the hCG day was higher in non-pregnant group (p = 0.021). From the data obtained at the end of the 4th day of culture showed that the apoptosis rate showed a higher tendency in non-pregnant women and this was statistically significant (p = 0.009). In our study, it was found that the ratio of apoptotic cells up to the 4th day showed a positive correlation with the progesterone levels on the hCG day (p = 0.001). Briefly, these results were obtainedfrom this current study that 1) The increase in the rate of apoptotic cells of cumulus cell culture has a negative effect on pregnancy rates, 2) The progesterone levels measured on the day of hCG has a significant negative effect on pregnancy, 3) The increase in progesterone levels acts as a messenger about the apoptosis rate of cumulus cells, 4) The luteinization is strictly associated with the apoptosis of cumulus cells. Limitations, reasons for caution: This was a single center study. Results need to be validated across different centers and high numbered different study population. Wider implications of the findings: The increase in progesterone value acts as a messenger about the rate of apoptosis of cumulus cells may be the prominent indicator to obtain high grade embryo with high clinical pregnancy success. Trial registration number 2017/5–8