Abstract

Despite ongoing progresses of IVF techniques, biomarkers predicting their outcome prior to IVF initiation are lacking. We investigated whether serum levels of the stress-inducible soluble major histocompatibility complex Class I chain-related molecule, MICA, (sMIC), a regulator of cellular immunity, can be predictive of implantation or pregnancy failure after IVF. sMIC serum levels, evaluated during the follicular phase of the cycle preceding in vitro fertilization, in a cohort of 170 infertile women with 22.3% IVF success rate were analyzed in association with implantation/pregnancy failure or live birth outcomes after IVF. sMIC serum levels, detected in 38% of all women undergoing IVF, were shown to be predictive both of implantation failure (> or = 2.45 ng/ml cut off, odds ratio (OR) = 4.6; 95% confidence interval (CI) = 1.08 - 19.79; P = 0.031) and successful pregnancy (< 2.45 ng/ml, OR = 13.8; 95% CI = 2.03-118.3; P = 0.002). When successful implantation occurred, sMIC levels > 3.2 ng/ml were predictive of spontaneous abortion (OR = 35; 95% CI = 1.74-703; P = 0.026). sMIC is thus to be considered as a novel blood biomarker which, when quantified prior to initiation of IVF, anticipates chances for infertile women to give birth to a viable baby. Considering medical and psychological cost of IVF, this non-invasive assay may thus contribute to better counseling, treatment and care of infertile couples prior to IVF.

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