Table_5_The impact of soluble HLA-G in IVF/ICSI embryo culture medium on implantation success.docx

The HLA-G molecule is widely accepted as an important factor for pregnancy success. Its expression has been detected in the extravillous trophoblasts. Soluble HLA-G (sHLA-G) was found in the genital tract, pre-implanted embryos as well as in seminal fluid. In this study, we investigated the concentration of sHLA-G (sHLA-G1 and sHLA-G5) in media from 344 single cultured embryos following in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). The level of sHLA-G (U/ml) was tested with a sandwich enzyme-linked immunosorbent assay (ELISA) kit. We correlated sHLA-G secretion with ovarian stimulation protocols, the type of embryo transfer (fresh or frozen cycle) and the quality of the embryos. The ovarian stimulation protocol affects the secretion of sHLA-G by the embryo. Embryos obtained from the long agonist protocol secreted more sHLA-G than those originating from the short antagonist protocol (p = 0.0001). Embryos whose transfer resulted in a clinical pregnancy and/or live birth secreted more sHLA-G compared to those whose transfer ended without pregnancy. This was particularly observable in embryos following the long ovarian stimulation protocol and from a frozen embryo cycle. In conclusion, sHLA-G secreted by the embryo has an impact on implantation and live birth and could be a developmental potential marker of the embryo. Its concentration depends on the ovarian stimulation protocol used.

人类白细胞抗原G（HLA-G）是公认的妊娠成功的重要影响因素。该分子的表达已在绒毛外滋养层细胞中被检出。可溶性人类白细胞抗原G（sHLA-G）可在生殖道、植入前胚胎以及精液中检测到。本研究针对344例经体外受精/卵胞浆内单精子注射（in vitro fertilization/intracytoplasmic sperm injection，IVF/ICSI）后单独培养的胚胎，分析了其培养基中sHLA-G（包括sHLA-G1与sHLA-G5）的浓度。研究采用夹心酶联免疫吸附试验（sandwich enzyme-linked immunosorbent assay，ELISA）试剂盒检测sHLA-G水平，检测单位为U/ml。我们将胚胎的sHLA-G分泌量与卵巢刺激方案、胚胎移植类型（新鲜周期或冷冻周期）以及胚胎质量进行了相关性分析。结果显示，卵巢刺激方案可影响胚胎的sHLA-G分泌：采用长效激动剂方案获取的胚胎，其sHLA-G分泌量高于短效拮抗剂方案获取的胚胎（p=0.0001）。移植后实现临床妊娠和/或活产的胚胎，其sHLA-G分泌量高于移植后未发生妊娠的胚胎；该差异在采用长效卵巢刺激方案以及冷冻胚胎周期来源的胚胎中尤为显著。综上，胚胎分泌的sHLA-G对胚胎着床与活产结局具有调控作用，可作为评估胚胎发育潜能的标志物；其浓度与所采用的卵巢刺激方案密切相关。