Prostacyclin enhances human IVF sucess

Abstract

Prostacyclin is produced in large quantity by the human and the mouse oviducts (Huang et al, 2002, 2004a). Its stable analogue, Iloprost, enhances mouse embryo hatching, implantation, and live births (Huang et al, 2004b). The development of thawed human zygotes to blastocysts is enhanced by Iloprost (Grunert et al, 2005). Phase I study (NCT 301838) shows Iloprost enhances blastocyst formation and quality (Dunn et al, 2011). Here we report the effect of Iloprost on embryo implantation and IVF pregnancy. A prospective clinical trial. The study was conducted between February, 2010 and September, 2012. The inclusion criteria were: no PGD, no TESE, and patient/donor age< 40. The assignment to control or intervention was based on a computer generated random table. The end points were implantation and pregnancy. The pregnancy rates (positive hCG and fetal heart, respectively) were analyzed based on the intent to treat model. Embryos were cultured in the BlastAssist Media (Medicult) supplemented with saline (control) or 1 μM Iloprost (experimental). Fisher's Exact Test was used for statistical analysis. Ninety-five patients consented to the study: 47 in the control and 48 in the experimental group. Five patients were considered best to have their embryos frozen: four in the control and one in the Iloprost group.Tabled 1ImplantationPregnancyDay 3 ETDay 5 ETTotal(+) hCGClincalControl1/21 (5%)23/70 (33%)24/91 (26%)18/47 (42%)17/47 (40%)Iloprost7/23 (30%)41/75 (55%)48/98 (49%)30/48 (64%)28/48 (60%)Analysisp < 0.05p <0.01p <0.005p < 0.05p <0.05ET: embryo transfer; (+) hCG p<0.05, clinical pregnancy p=0.057 when 5 patients not receiving ET were excluded. Open table in a new tab ET: embryo transfer; (+) hCG p<0.05, clinical pregnancy p=0.057 when 5 patients not receiving ET were excluded. Prostacyclin analogue enhances embryo implantation and IVF success.