Yonsei Med J.  2011 Nov;52(6):967-971. 10.3349/ymj.2011.52.6.967.

Soluble Human Leukocyte Antigen G Level in Fluid from Single Dominant Follicle and the Association with Oocyte Competence

• Jee BC
• Suh CS
• Kim SH
• Moon SY

• KMID: 1058817
• DOI: http://doi.org/10.3349/ymj.2011.52.6.967

Abstract

PURPOSE
To investigate the direct relationship between the follicular fluid (FF) level of soluble human leukocyte antigen G (HLA-G) and fertilizability of the corresponding oocyte as well as the morphological quality of the corresponding embryo.
MATERIALS AND METHODS
Sixty-three patients were stimulated with recombinant FSH combined with gonadotropin-releasing hormone (GnRH) agonist long (n=5) or antagonist protocol (n=58) for standard in vitro fertilization (IVF). At the time oocyte retrieval, follicular fluid was obtained from single dominant follicle in 63 patients, and the level of soluble HLA-G was measured by sandwich enzyme-liked immunosorbent assay (ELISA). Normal fertilization and individual embryo quality were evaluated, and were graded to four categories by morphological criteria (the embryo with symmetrical blastomeres and no fragmentation were assigned as grade A). Good-quality embryo was defined as those with grade A or B.
RESULTS
Soluble HLA-G was not detected in 15 FF samples. In the group with positive FF soluble HLA-G (sHLA-G) (n=48), high levels of sHLA-G (>117.758 U/mL) could predict the failure of fertilization with statistical significance {area under the curve (AUC) 0.676, 95% confidence interval (CI) 0.525-0.804}. However, the FF sHLA-G level was not related with the formation of good-quality embryo.
CONCLUSION
High level of FF sHLA-G could predict the fertilization failure of the corresponding oocyte, but was not related with the formation of good-quality embryo.

Keyword

HLA-G; follicular fluid; oocyte quality; embryo

MeSH Terms

Adult
Enzyme-Linked Immunosorbent Assay
Female
Follicular Fluid/*metabolism
HLA-G Antigens/*metabolism
Humans
Oocytes/*cytology/physiology
Ovarian Follicle/*cytology/physiology

Figure

• 

  Fig. 1 Left panel: the median concentration of follicular fluid soluble HLA-G was 35.5 U/mL (6.1, 118.2) in normal fertilization group and 173.3 U/mL (55.1, 187.8) in fertilization failure group (p=0.140, Wilcoxon test). Right panel: ROC curve analysis showed that high level of sHLA-G (>117.758 U/mL) could predict the failure of fertilization with a statistical significance (AUC 0.676, 95% CI 0.525-0.804, sensitivity 71.4%, specificity 75.6%, positive LR 2.93, negative LR 0.38). HLA-G, human leukocyte antigen G; ROC, receiver operating characteristic; AUC, area under curve; CI, confidence interval; LR, likelihood ratio.

Reference

1. LeMaoult J, Le Discorde M, Rouas-Freiss N, Moreau P, Menier C, McCluskey J, et al. Biology and functions of human leukocyte antigen-G in health and sickness. Tissue Antigens. 2003. 62:273–284.

2. Hviid TV. HLA-G in human reproduction: aspects of genetics, function and pregnancy complications. Hum Reprod Update. 2006. 12:209–232.

3. Pfeiffer KA, Rebmann V, Pässler M, van der Ven K, van der Ven H, Krebs D, et al. Soluble HLA levels in early pregnancy after in vitro fertilization. Hum Immunol. 2000. 61:559–564.

4. Rizzo R, Andersen AS, Lassen MR, Sørensen HC, Bergholt T, Larsen MH, et al. Soluble human leukocyte antigen-G isoforms in maternal plasma in early and late pregnancy. Am J Reprod Immunol. 2009. 62:320–338.

5. Rizzo R, Stignani M, Melchiorri L, Baricordi OR. Possible role of human leukocyte antigen-G molecules in human oocyte/embryo secretome. Hum Immunol. 2009. 70:970–975.

6. Rizzo R, Fuzzi B, Stignani M, Criscuoli L, Melchiorri L, Dabizzi S, et al. Soluble HLA-G molecules in follicular fluid: a tool for oocyte selection in IVF? J Reprod Immunol. 2007. 74:133–142.

7. Shaikly VR, Morrison IE, Taranissi M, Noble CV, Withey AD, Cherry RJ, et al. Analysis of HLA-G in maternal plasma, follicular fluid, and preimplantation embryos reveal an asymmetric pattern of expression. J Immunol. 2008. 180:4330–4337.

8. Rizzo R, Dal Canto MB, Stignani M, Fadini R, Fumagalli D, Renzini MM, et al. Production of sHLA-G molecules by in vitro matured cumulus-oocyte complex. Int J Mol Med. 2009. 24:523–530.

9. Choi YS, Kim SH, Ku SY, Jee BC, Suh CS, Choi YM, et al. Efficacy of ER-alpha polymorphisms and the intrafollicular IGF system for predicting pregnancy in IVF-ET patients. Gynecol Obstet Invest. 2009. 67:73–80.

10. Mendoza C, Cremades N, Ruiz-Requena E, Martinez F, Ortega E, Bernabeu S, et al. Relationship between fertilization results after intracytoplasmic sperm injection, and intrafollicular steroid, pituitary hormone and cytokine concentrations. Hum Reprod. 1999. 14:628–635.

11. Revelli A, Delle Piane L, Casano S, Molinari E, Massobrio M, Rinaudo P. Follicular fluid content and oocyte quality: from single biochemical markers to metabolomics. Reprod Biol Endocrinol. 2009. 7:40.