Prediction of successful embryo implantation during in vitro fertilization based on morphological and immunocytochemical assessment of granulosa cells from follicular fluid

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. 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. 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. 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.

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