ABSTRACT
OBJECTIVE: Follicle-stimulating hormone (FSH) is essential for folliculogenesis, acting through the follicle-stimulating hormone receptor (FSHR) that is present on the membrane of granulosa cells. Polymorphisms in the FSHR gene may lead to an altered pattern of receptor expression on the cell surface or to changes in affinity for FSH. The aim of this prospective study was to detect any association between the follicle-stimulating hormone receptor (FSHR) gene Ala307Thr polymorphism (rs6165) and ovarian reserve, ovarian response or clinical results in IVF/ICSI treatment. METHODS: This prospective cohort study included 450 women who underwent IVF/ICSI cycles. DNA was extracted from peripheral blood, and the Ala307Thr FSHR polymorphism (rs6165) was genotyped using the TaqMan SNP genotyping assay. Participants were divided into three groups according to their Ala307Thr FSHR genotype: Thr/Thr (n:141), Thr/Ala (n=213) and Ala/Ala (n=96). The results were tested for associations with age, anti-Mullerian hormone (AMH) levels, antral follicle count (AFC), total dose of r-FSH, follicle size, number of retrieved oocytes, and clinical outcome of IVF/ICSI cycles. The statistical analyses were performed using Fisher's exact test and the KruskalâWallis test. RESULTS: An association between the genotype of the FSHR (Ala307Thr) polymorphism and the dose of r-FSH was observed. Patients with the Ala/Ala genotype received a higher r-FSH dose than patients with the Ala/Thr (p=0.0002) and Thr/Thr (p=0.02) genotypes. No other correlation was observed. CONCLUSION: The Ala/Ala genotype was associated with the use of higher doses of recombinant FSH (r-FSH), suggesting that homozygosis of this allelic variant (Ala) provides lower sensitivity to r-FSH.
Subject(s)
Receptors, FSH , Sperm Injections, Intracytoplasmic , Female , Animals , Receptors, FSH/genetics , Receptors, FSH/metabolism , Prospective Studies , Ovulation Induction/methods , Follicle Stimulating Hormone/therapeutic use , Follicle Stimulating Hormone, Human/therapeutic use , Fertilization in Vitro/methodsABSTRACT
Recently, a new technology known as the Noninvasive Preimplantation Genetic Testing for Aneuploidy (niPGT-A) emerged, using cell-free DNA present in the spent culture media of human blastocysts. Unlike PGT-A, in which only trophectoderm cells are used, niPGT-A reflects the ploidy state of these cells and internal cell mass, suggesting that this new technology may be less prone to error, being more reliable than the invasive test. The aim of the present study was to report the first occurrence of childbirth following niPGT-A in Brazil.
Subject(s)
Aneuploidy , Chromosome Disorders/diagnosis , Genetic Testing , Preimplantation Diagnosis , Adult , Brazil , Chromosome Disorders/genetics , Female , Humans , Male , PregnancyABSTRACT
OBJECTIVE: To investigate an association between polymorphisms related to the implantation process that together could help in the prediction of recurrent implantation failure (RIF). DESIGN: Cohort study. SETTING: Private fertility center and reproductive genetics laboratory. PATIENT(S): Forty-four women presenting RIF, who were included in study group (RIF group), and two control groups, one with 63 women who were attended at our service and became pregnant after the first IVF/intracytoplasmic sperm injection attempt (control group I) and other with 65 fertile women who had at least two children without any treatment and no history of miscarriage (control group II). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Genotyping was performed in the intron region of TP63, VEGFA, MMP2, ESR1, and ESR2 genes and in the 3' untranslated region of the LIF gene on genomic DNA using real-time polymerase chain reaction. RESULT(S): The presence of ESR1/AA (rs12199722) and LIF/GT (rs929271) genotypes was more frequent in the RIF group, leading to a 7.9-fold increase in the chance of women presenting with RIF when compared with women who became pregnant on their first cycle of IVF/intracytoplasmic sperm injection and a 2.8-fold increase when compared with women who became pregnant without treatment. CONCLUSION(S): The association between ESR1 and LIF polymorphisms can help in the prediction of RIF.
Subject(s)
Embryo Implantation/genetics , Embryo Transfer/adverse effects , Estrogen Receptor alpha/genetics , Fertilization in Vitro/adverse effects , Infertility, Female/genetics , Infertility, Female/therapy , Leukemia Inhibitory Factor/genetics , Polymorphism, Single Nucleotide , 3' Untranslated Regions , Adult , Case-Control Studies , Female , Gene Frequency , Genetic Predisposition to Disease , Humans , Infertility, Female/diagnosis , Infertility, Female/physiopathology , Introns , Middle Aged , Phenotype , Pregnancy , Real-Time Polymerase Chain Reaction , Sperm Injections, Intracytoplasmic/adverse effects , Treatment FailureABSTRACT
It's known that the members of the TP53 family are involved in the regulation of female reproduction. Studies in mice showed that the TP73 gene (member of this family) plays a role in the size of follicular pool, ovulation rate and maintenance of genomic stability. In the present study we analyzed data from 605 patients with ≤ 37 years attending their first intracytoplasmic sperm injection (ICSI). The association between the TP73 polymorphism (rs4648551, A>G) and the following parameters related to ovarian reserve, like age, antral follicular count (AFC), anti-Mullerian hormone levels (AMH) and ovarian response prediction index (ORPI) was evaluated. Our results showed an association of the AA genotype with diminished ovarian reserve (AMH <1, AFC ≤9). Women presenting the AA genotype had a 2.0-fold increased risk for having AMH <1 and AFC ≤9 (OR 2.0, 95% CI 1.23-3.31, P = 0.005). Patients presenting AA genotype had the lowest levels of AMH (P = 0.02), the lowest number of antral follicles (P = 0.01) and the lowest ORPI (P = 0.007). Analyzing the alleles, we can see an enrichment of the A allele in the group of diminished ovarian reserve (OR 1.4, 95%CI 1.02-1.83, P = 0.04). To the best of our knowledge, the present study is the first to analyze this polymorphism in humans for assessing the numbers of ovarian follicles and AMH levels and, therefore, the ovarian reserve. Our findings can contribute to the use of this polymorphism as a potential marker of diminished ovarian reserve.
Subject(s)
Alleles , DNA-Binding Proteins/genetics , Genetic Association Studies , Nuclear Proteins/genetics , Ovarian Reserve/genetics , Polymorphism, Single Nucleotide , Tumor Suppressor Proteins/genetics , Adult , Anti-Mullerian Hormone/blood , Brazil , Case-Control Studies , Female , Gene Frequency , Genotype , Humans , Ovarian Follicle , Ovary , Ovulation Induction , Tumor Protein p73ABSTRACT
OBJECTIVE: To assess the viability of the early diagnosis of fetal gender in maternal plasma before 7 weeks of pregnancy by real-time polymerase chain reaction (real-time PCR), starting at 5 weeks of pregnancy. METHOD: Peripheral blood was collected from pregnant women, starting at 5 weeks of gestation. After centrifugation, plasma was separated for fetal DNA extraction. DNA was analyzed by quantitative real-time PCR for two genomic regions, one on the Y chromosome (DYS-14) and the other shared by both sexes (ss-globin), by the TaqMan Minor Groove Binder (MGB) probe assay. The results of the examinations were compared to fetal gender determined after delivery. RESULTS: A total of 79 examinations of fetal DNA in maternal plasma were performed for 52 pregnant women. Accuracy according to gestational age was 92.6% (25 of 27 cases) at 5 weeks, and 95.6% (22 of 23 cases) at 6 weeks. These results also demonstrate that fetal DNA is present at low concentrations in maternal plasma at 5 weeks (8.5 genome equivalents (GE)/mL) and 6 weeks (34.1 GE/mL) of pregnancy. CONCLUSION: Quantitative real-time PCR and TaqMan MGB probes specific for the detection of fetal gender in maternal plasma starting at 5 weeks of gestation have good sensitivity and excellent specificity.
Subject(s)
DNA/blood , Fetus/embryology , Pregnancy Trimester, First/blood , Sex Determination Analysis/methods , Chromosomes, Human, Y , DNA/genetics , Female , Gestational Age , Humans , Male , Maternal-Fetal Exchange , Pregnancy , Pregnancy Trimester, First/genetics , Pregnancy-Specific beta 1-Glycoproteins/genetics , Reproducibility of Results , Reverse Transcriptase Polymerase Chain Reaction , Sensitivity and SpecificityABSTRACT
OBJETIVO: avaliar a possibilidade do diagnóstico precoce do sexo fetal no plasma materno pela técnica da reação em cadeia da polimerase em tempo real (PCR em tempo real) a partir da 5ª semana de gestação. MÉTODOS: nesse estudo prospectivo foi coletado sangue periférico de gestantes com feto único a partir da 5ª semana de gestação. Após centrifugação do sangue, 0,4 mL de plasma foi separado para extração de DNA fetal. O DNA foi analisado em duplicata por PCR em tempo real para duas regiões genômicas (uma do cromossomo Y e outra comum a ambos os sexos) pelo método de TaqMan®, o qual utiliza um par de primers e uma sonda fluorescente. Foram excluídos da amostragem os casos que evoluíram para aborto. Para o cálculo da sensibilidade e especificidade, usamos o método de comparação com padrão-ouro, que foi o sexo ao nascimento. RESULTADOS: foram realizados 79 exames de DNA fetal no plasma materno de 52 gestantes. O resultado dos exames foi comparado com o sexo da criança após o parto. O índice de acerto conforme a idade gestacional foi de 92,6 por cento (25 de 27 casos) na 5ª semana, conferindo sensibilidade de 87 por cento e 95,6 por cento (22 de 23 casos) na 6ª semana, com sensibilidade de 92 por cento. A partir da 7ª semana de gestação o acerto foi em 100 por cento (29 de 29 casos). A especificidade foi de 100 por cento independente da idade gestacional. CONCLUSÕES: a técnica de PCR em tempo real para detecção do sexo fetal a partir da 5ª semana no plasma materno possui boa sensibilidade e excelente especificidade. Houve concordância do resultado em 100 por cento dos casos em que o diagnóstico foi masculino, independente da idade gestacional, e no caso de feminino, a partir da 7ª semana de gestação.
PURPOSE: to verify the viability of early diagnosis of fetal gender in maternal plasma by the real-time polymerase chain reaction (real-time PCR) starting at the 5th week of pregnancy. METHODS: peripheral blood was collected from pregnant women with single fetus starting at the 5th week of gestation. After centrifugation, 0.4 mL plasma was separated for fetal DNA extraction. The DNA was analyzed in duplicate by real-time PCR for two genomic regions, one of the Y chromosome and the other common to both sexes, through the TaqMan® method, which uses a pair of primers and a fluorescent probe. Patients who aborted were excluded. RESULTS: a total of 79 determinations of fetal DNA in maternal plasma were performed in 52 pregnant women. The results of the determinations were compared to fetal gender after delivery. Accuracy according to gestational age was 92.6 percent (25 of 27 cases) at 5 weeks with 87 percent sensitivity, and 95.6 percent (22 of 23 cases) at 6 weeks with 92 percent sensitivity. Starting at the 7th week of pregnancy, accuracy was 100 percent (29 of 29 cases). Specificity was 100 percent regardless of gestational age. CONCLUSION: real-time PCR for the detection of fetal gender in maternal plasma starting at the 5th week of gestation has good sensitivity and excellent specificity. There was agreement of the results in 100 percent of the cases in which male gender was diagnosed, regardless of gestational age, and from the 7th week of gestation for female gender diagnosis.
Subject(s)
Humans , Female , Pregnancy , Gestational Age , Prenatal Diagnosis , Polymerase Chain Reaction/methods , Sex Determination AnalysisABSTRACT
Os autores determinaram em 38 pacientes os níveis plasmáticos de estradiol (E2) por radioimunoensaio (RIE) e enzimaimunoensaio (EIE) no momento da administraçäo de hCG exógeno. O nível limite para näo usar hCG foi de E2 2000pg/ml por RIE ou E2 2419pg/ml por EIE.1Adotando-se esse critério näo ocorreu síndrome de hiperestimulaçäo ovariana. Por outro lado, observou-se uma alta correlaçäo (r=0.93) entre os valores de E2 obtidos por RIE e EIE
Subject(s)
Humans , Female , Adult , Estradiol/blood , Ovarian Hyperstimulation Syndrome/prevention & control , Chorionic Gonadotropin/administration & dosage , Immunoenzyme Techniques , Ovulation Induction , RadioimmunoassayABSTRACT
No presente trabalho, os autores relatam um caso de gravidez após inseminaçäo tubária indireta utilizando espermatozóide incubados com líquido folicular humano pela técnica de "swim-up"
