Objective: To investigate relationships between cumulus-oocyte complex (COC) morphology, protein patterns of cumulus-corona (CC) cell-conditioned media, and pregnancy outcome in IVF-ET cycles.
Design: Retrospective study.
Setting: Private university IVF center.
Patient(s): One hundred twenty infertile women who underwent IVF-ET procedures.
Intervention(s): None.
Main outcome measure(s): COC grading, analysis of CC cell morphology and conditioned media, and pregnancy rate (PR).
Result(s): After IVF and embryo transfer, cultured CC cells were classified as high (HA) or low (LA) on the basis of their adhesive properties. Neither adhesion activity nor fertilization rates and embryo quality were correlated with COC grading. PR in cycles with HA cells was 38%, but 14% of cycles showing LA activity also had positive outcome. To find more meaningful parameters of CC cells useful to predict fertilization and pregnancy, the electrophoretic protein patterns of media conditioned by HA or LA cells were studied. Retrospective analysis showed that all cycles in which replaced embryos were associated with the presence of a 31-kD band in conditioned media failed implantation, whereas 83% of cycles lacking this band resulted in positive, ongoing pregnancy.
Conclusion(s): Pregnancy prediction cannot rely simply on CC cell morphological analysis. Screening of conditioned media may provide more reliable parameters.