Abstract
Purpose
Hormonal stimulation prior to IVF influences the ovarian environment and therefore impacts oocytes and subsequent embryo quality. Not every patient has the same response to the same treatment and many fail for unknown reasons. Knowing why a cycle has failed and how the follicles were affected would allow clinicians to adapt the treatment accordingly and improve success rate. This study examines the hypothesis that transcriptomic analysis of follicular cells from failed IVF cycles reveals potential reasons for failure and provides new information on the physiological mechanisms related to IVF failure.
Methods
Follicular cells (granulosa cells) were obtained from IVF patients of four Canadian fertility clinics. Using microarray analysis, patients that did not become pregnant following the IVF cycle were compared to those that did. Functional analysis was performed using ingenuity pathway analysis and qRT-PCR was used to validate the microarray results in a larger cohort of patients.
Results
The microarray showed 165 differentially expressed genes (DEGs) in the negative group compared to the pregnancy group. DEGs include many pro-inflammatory cytokines and other factors related to inflammation, suggesting that this process might be altered when IVF fails. Overexpression of several factors, some of which act upstream from vascular endothelial growth factor (VEGF), also indicates increased permeability and vasodilation. Some DEGs were related to abnormal differentiation and increased apoptosis.
Conclusions
Our results suggest that failure to conceive following IVF cycles could be associated with an imbalance between pro-inflammatory and anti-inflammatory mediators. The findings of this study identify potential failure causes and pathways for further investigation. Stimulatory protocols personalized according to patient response could improve the chances of later success.
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Acknowledgements
The authors thank Isabelle Dufort for her support and assistance in the lab, and Scot Hamilton, Marie-Claude Léveillé, Martin Laforest, and Hanane Lachgar for their involvement in the collection of follicle cell samples.
Authors’ roles
Fortin, C.: conception and design of the study, sample processing, data acquisition, data analysis and interpretation, drafting the article, approval of the final manuscript.
Leader, A.: data acquisition, critical discussion, reading and approval of the final manuscript.
Mahutte, N.: data acquisition, critical discussion, reading and approval of the final manuscript.
Hamilton, S.: data acquisition, critical discussion, reading and approval of the final manuscript.
Léveillé, M.C.: data acquisition, critical discussion, reading and approval of the final manuscript.
Villeneuve, M.: data acquisition, critical discussion, reading and approval of the final manuscript.
Sirard, M.A.: conception and design of the study, data analysis and interpretation, improvement of the draft, reading and approval of the final manuscript.
Funding
This work was supported by the Merck Serono Grant for Fertility Innovation (GFI).
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The authors declare that they have no conflict of interest. A GFI grant was received in support of this work. This article does not contain any data or conclusion relating to any commercial product.
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This project was approved by Université Laval REB (2014-102/08-09-2014) for the collection and use of human tissues.
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The data discussed in this publication are accessible through GEO Series accession number GSE87545.
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Fortin, C., Leader, A., Mahutte, N. et al. Gene expression analysis of follicular cells revealed inflammation as a potential IVF failure cause. J Assist Reprod Genet 36, 1195–1210 (2019). https://doi.org/10.1007/s10815-019-01447-4
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DOI: https://doi.org/10.1007/s10815-019-01447-4