zdorПроблемы здоровья и экологииHealth and Ecology Issues2220-09672708-6011Gomel State Medical University10.51523/2708-6011.2025-22-2-02zdor-2857Research ArticleКЛИНИЧЕСКАЯ МЕДИЦИНАCLINICAL MEDICINEПрогнозирование успешной имплантации эмбриона при экстракорпоральном оплодотворении, основанное на морфологической и иммуноцитохимической оценке гранулезных клеток фолликулярной жидкостиPrediction of successful embryo implantation during in vitro fertilization based on morphological and immunocytochemical assessment of granulosa cells from follicular fluidhttps://orcid.org/0009-0006-7271-993XМотолянецП. М.MotolyanetsP. M.

Мотолянец Павел Михайлович - врач-патологоанатом (заведующий) патологоанатомического отделения.

Минск

Pavel M. Motolyanets - Pathologist (Head) of the Pathology Department, Republican Clinical Medical Center of the Administration of the President of the Republic of Belarus.

Minsk

motolyan@mail.ruhttps://orcid.org/0000-0001-7623-0601ЮдинаО. А.YudinaO. A.

Юдина Ольга Анатольевна - к.м.н., доцент, врач-патологоанатом патологоанатомического отделения.

Минск

Olga A. Yudina - Candidate of Medical Sciences, Associate Professor, Pathologist at the Pathology Department, Republican Clinical Medical Center of the Administration of the President of the Republic of Belarus.

Minsk

o.yudina@inbox.ruhttps://orcid.org/0000-0003-3898-5071СмоленскийА. З.SmolenskyA. Z.

Смоленский Андрей Зенонович - к.м.н., врач-патологоанатом патологоанатомического отделения.

Минск

Andrei Z. Smolensky - Candidate of Medical Sciences, Pathologist at the Pathology Department, Republican Clinical Medical Center of the Administration of the President of the Republic of Belarus.

Minsk

zenonich@gmail.comhttps://orcid.org/0000-0002-9014-4184ХилькоО. В.KhilkoO. V.

Хилько Ольга Владимировна - преподаватель кафедры статистики.

Минск

Olga V. Khilko - Lecturer at the Department of Statistics, Educational Institution, Belarusian State Economic University.

Minsk

kurilo_lelya@tut.byРеспубликанский клинический медицинский центр Управления делами Президента Республики БеларусьRepublican clinical medical center of the Administration of the President of the Republic of BelarusБелорусский государственный экономический университетBelarusian State Economic University2025290620252221825Copyright © Мотолянец П.М., Юдина О.А., Смоленский А.З., Хилько О.В., 20252025Мотолянец П.М., Юдина О.А., Смоленский А.З., Хилько О.В.Motolyanets P.M., Yudina O.A., Smolensky A.Z., Khilko O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.gsmu.by/jour/article/view/2857Цель исследования

Цель исследования. Определить прогностическую значимость цитоморфологических характеристик гранулезных клеток (ГК) фолликулярной жидкости (ФЖ) для оценки наступления имплантации эмбриона (ИЭ) при экстракорпоральном оплодотворении (ЭКО).

Материалы и методы

Материалы и методы. Исследованы образцы ФЖ, полученной при аспирации ооцит-кумулюсных комплексов для проведения ЭКО в связи с бесплодием. Исследуемые группы (ИГ): ИГ1 — ИЭ не наступила (n = 61), ИГ2 — успешная ИЭ (n = 54). Произведены подсчет количества ГК в препаратах и измерение среднего диаметра ядер. Выполнена оценка экспрессии белков FSHR, ERβ и PR в ГК иммуноцитохимическим (ИЦХ) методом.

Результаты

Результаты. Установлены статистически значимые различия между ИГ1 и ИГ2 по интенсивности экспрессии белков FSHR (р = 0,001), ERβ (р = 0,031), PR (р = 0,024), количеству ГК в препаратах (р = 0,005) и средним размерам ядер ГК ФЖ (p = 0,0001). При ROC-анализе установлено, что при успешной имплантации средний размер ядер ГК, интенсивность экспрессии FSHR и ERβ характеризуются лучшими диагностическими чувствительностью (86,4, 78,6 и 77,19 % соответственно), специфичностью (77,4, 80,95 и 83,33 % соответственно) и эффективностью (81,9, 79,78 и 80,26 % соответственно). Построена прогностическая модель методом бинарной логистической регрессии. С учетом выбора оптимального порогового значения результативной переменной Y (0,610) достигнуты значения диагностической чувствительности (94,4 %), диагностической специфичности (93,4 %), прогностической значимости (93,9 %).

Заключение

Заключение. Потенциальные предикторы успешной ИЭ при ЭКО выявлены при изучении морфологических характеристик и гормонорецепторного статуса ГК ФЖ. Разработанная прогностическая модель может быть использована для оценки вероятности наступления ИЭ.

Objective

Objective. To determine the prognostic value of cytomorphological characteristics of granulosa cells (GCs) in follicular fluid (FF) for assessing embryo implantation (EI) in in vitro fertilization (IVF).

Materials and methods

Materials and methods. FF samples obtained during aspiration of oocyte-cumulus complexes for IVF due to infertility were studied. Studied groups (SG): SG1 – EI did not occur (n=61), SG2 – successful EI (n=54). The number of GCs in the preparations was counted, and the average nuclear diameter was measured. The expression of FSHR, ERβ, and PR proteins in GCs was assessed by immunocytochemical (ICC) method.

Results

Results. Statistically significant differences were found between SG1 and SG2 in the expression intensity of FSHR (p=0,001), ERβ (p=0,031), and PR (p=0,024) proteins, the number of GCs in the preparations (p=0,005), and the average nuclear size of FF GCs (p=0,0001). ROC analysis showed that successful implantation was associated with the average nuclear size of GCs and the expression intensity of FSHR and ERβ, which had the best diagnostic sensitivity (86,4%, 78,6%, and 77,19%, respectively), specificity (77,4%, 80,95%, and 83,33%, respectively), and efficiency (81,9%, 79,78%, and 80,26%, respectively). A prognostic model was constructed using binary logistic regression. Considering the selection of the optimal threshold value of the resultant variable Y (0,610), diagnostic sensitivity (94,4%), diagnostic specificity (93,4%), and predictive value (93,9%) were achieved.

Conclusion

Conclusion. Potential predictors of successful EI in IVF were identified by studying the morphological characteristics and hormone receptor status of FF GCs. The developed prognostic model can be used to assess the probability of EI.

гранулезные клеткииммуноцитохимиярецепторы гормоновпрогнозированиеgranulosa cellsimmunocytochemistryhormone receptorspredictionИсследование выполнено в рамках проекта «Разработать и внедрить метод медицинской профилактики осложнений, связанных с имплантацией эмбрионов у женщин после экстракорпорального оплодотворения, основанный на оценке фолликулярной жидкости» государственной программы научных исследований «Научно-техническое обеспечение качества и доступности медицинских услуг», подпрограмма «Здоровье матери и ребенка» (№ госрегистрации 20221386 от 15.08.2022).The study was carried out as part of the project “ To develop and implement a method for the medical prevention of complications associated with embryo implantation in women after in vitro fertilization, based on the assessment of follicular fluid” within the state scientific research program “Scientific and technical support for the quality and accessibility of medical services”, subprogram “Maternal and Child Health” (State registration No. 20221386 dated 15.08.2022).ReferencesРоссийская Ассоциация Репродукции Человека. 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The authors declare that there are no conflicts of interest present.