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Perez JI, Diaz-Nuñez M, Clos-García M, Lainz L, Iglesias M, Diez-Zapirain M, Rabanal A, Lozano J, Marigorta U, Gonzalez E, Royo F, Aransay A, Subiran N, Matorras R, Falcon-Perez J. O-259 Free and extracellular vesicle-associated microRNAs from endometrial fluid as non-invasive diagnostic biomarkers of implantative endometrium. Hum Reprod 2022. [DOI: 10.1093/humrep/deac106.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Is it possible to use free and extracellular vesicle-associated microRNAs from endometrial fluid as non-invasive biomarkers for implantative endometrium?
Summary answer
It is feasible to use free and extracellular vesicle-associated miRNAs as non-invasive tools for the detection of an implantative endometrium.
What is known already
MicroRNAs (miRNAs) and extracellular vesicles (EVs) from endometrial fluid (EF) have been described as mediators of embryo-endometrial crosstalk. Therefore, the miRNA analysis of EF could provide a non-invasive technique for recognizing an implantative endometrium and consequently improve implantation rates.
Study design, size, duration
A cohort of 162 women who assisted the human reproduction unit from January 2018 to February 2021. Of them, 72 participated in the setup and samples were collected before starting any fertility treatment in natural cycles. For the discovery of the predicted models (n = 30) and validation (n = 60), the EF was obtained from women undergoing frozen embryo transfer on day 5 and the sample was collected immediately before embryo transfer.
Participants/materials, setting, methods
We compared five different methodologies, two of which consisted of direct RNA extraction while the other three had EV enrichment prior to RNA extraction. A smallRNA-seq was performed to determine the most efficient method and to find a predictive model to differentiate between implantation and non-implantation endometrium. The models were confirmed by qPCR in two set of samples, discovery and validation cohorts with a different implantation outcome.
Main results and the role of chance
Our results showed that EV-enrichment protocols permit detection of a higher number of miRNAs. In addition, we obtained two predictive models based on three miRNAs that allow us to differentiate between an implantative and non-implantative endometrium. Results for model 1 in discovery cohort were: AUC=0.93; p-value = 0.003 and in validation cohort were: AUC= 0.69; p-value = 0.019. Results for model 2 in discovery cohort were: AUC=0.92; p-value = 0.0002 and in validation cohort were: AUC= 0.78; p-value= 0.0002.
Limitations, reasons for caution
One limitation to consider is the inherent variability of both the women involved in the trial and the embryos transferred. In our study, we have previously selected embryos based on morphology but we lacked genetic and molecular studies, a good complement that will certainly improve our test’s accuracy.
Wider implications of the findings
This study introduces new protocols to analyze miRNAs from very small volumes of EF, which could be implemented in clinical practice for the assessment of the endometrial status using miRNA-based non-invasive tools. Our results suggest that with model-2 it is possible to identify a non-implantative endometrium with 0.6-sensitivity and 0.93-specificity.
Trial registration number
not applicable
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Affiliation(s)
- J. Ibañez Perez
- Cruces University Hospital, Human Reproduction Unit , Baracaldo, Spain
- CIC bioGUNE-BRTA, Exosomes Laboratory , Derio, Spain
| | - M Diaz-Nuñez
- Cruces University Hospital, Human Reproduction Unit , Baracaldo, Spain
| | - M Clos-García
- University of Copenhagen, Novo Nordisk Foundation Center for Basic Metabolic Research CBMR- Faculty of Health and Medical Sciences , Copenhagen, Denmark
| | - L Lainz
- Cruces University Hospital, Human Reproduction Unit , Baracaldo, Spain
| | - M Iglesias
- Cruces University Hospital, Human Reproduction Unit , Baracaldo, Spain
| | - M Diez-Zapirain
- Cruces University Hospital, Human Reproduction Unit , Baracaldo, Spain
| | - A Rabanal
- Cruces University Hospital, Human Reproduction Unit , Baracaldo, Spain
| | - J.J Lozano
- Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas CIBEReh- Spain ., Bioinformatics platform , Madrid, Spain
| | - U.M Marigorta
- CIC bioGUNE-BRTA, Integrative Genomics Laboratory , Derio, Spain
| | - E Gonzalez
- CIC bioGUNE-BRTA, Exosomes Laboratory , Derio, Spain
| | - F Royo
- CIC bioGUNE-BRTA, Exosomes Laboratory , Derio, Spain
| | - A.M Aransay
- CIC bioGUNE-BRTA, Genome Analysis Platform , Derio, Spain
| | - N Subiran
- University of the Basque Country UPV/EHU, Department of Physiology- Faculty of Medicine and Dentistry , Leioa, Spain
| | - R Matorras
- Instituto Valenciano de Infertilidad IVI Bilbao - , Baracaldo, Spain
- IVIRMA / Cruces University Hospital, Human Reproduction Unit Bilbao - , Baracaldo, Spain
| | - J.M Falcon-Perez
- IKERBASQUE- Basque Foundation for Science / CIC bioGUNE-BRTA, Exosomes Laboratory-Metabolomics Platform , Derio, Spain
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Prieto B, Diaz-Nuñez M, Lainz L, Vendrell A, Rabanal A, Iglesias M, Jauregui T, Corcostegui B, Matorras A, Perez S, Matorras R. Aspiration of excess follicles before intrauterine insemination in high response cycles. Reprod Med Biol 2022; 21:e12470. [PMID: 35781922 PMCID: PMC9241166 DOI: 10.1002/rmb2.12470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 05/12/2022] [Accepted: 05/23/2022] [Indexed: 11/11/2022] Open
Abstract
Purpose To assess the outcome of excess follicle aspiration before intrauterine insemination (EFABI) in intrauterine insemination (IUI) cycles with 4-6 follicles ≥14 mm. Methods A retrospective case-control study with 1559 patients undergoing IUI (donor and husband's sperm), of whom 86 underwent EFABI. We studied also an historical series of 2213 patients before EFABI implementation. For 3.5 years, all women undergoing IUI developing 4-6 follicles ≥14 mm were offered EFABI on the day of hCG administration. Pregnancy rates (PRs), multiple PRs, and adverse effects were measured. Results EFABI was associated with a similar multiple PR (17.8% vs 17.5% in non-EFABI cases), with no triplets in EFABI patients. Live birth rates were significantly higher in EFABI cycles in IUI overall (25.5% vs 15.2%). When considered separately, the performance of EFABI resulted in significantly increased live birth rates in IUI-donor cycles (32.5% vs 18.5%), whereas the differences in IUI-husband cycles (19.5% vs 12.9%) did not reach statistical significance. The PR was 21.2% during the EFABI implementation period and 19.4% in the pre-EFABI period. Conclusions EFABI in cycles in which 4-6 follicles reach ≥14 mm is a simple option that reduces cycle cancellation rates, results in higher PRs than cycles with 1-3 follicles, and lowers the risk of multiple pregnancy.
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Affiliation(s)
- Begoña Prieto
- Human Reproduction Unit Cruces University Hospital Barakaldo Spain.,Faculty of Medicine University of the Basque Country Lejona Spain.,Biocruces Bizkaia Health Research Institute Barakaldo Spain.,Instituto Valenciano de Infertilidad (IVI) Leioa Spain
| | - Maria Diaz-Nuñez
- Human Reproduction Unit Cruces University Hospital Barakaldo Spain.,Biocruces Bizkaia Health Research Institute Barakaldo Spain
| | - Lucia Lainz
- Human Reproduction Unit Cruces University Hospital Barakaldo Spain.,Biocruces Bizkaia Health Research Institute Barakaldo Spain
| | | | - Aintzane Rabanal
- Human Reproduction Unit Cruces University Hospital Barakaldo Spain.,Faculty of Medicine University of the Basque Country Lejona Spain
| | - Maria Iglesias
- Human Reproduction Unit Cruces University Hospital Barakaldo Spain.,Biocruces Bizkaia Health Research Institute Barakaldo Spain
| | - Teresa Jauregui
- Human Reproduction Unit Cruces University Hospital Barakaldo Spain
| | | | - Ana Matorras
- European University of Madrid Villaviciosa de Odón, Madrid Spain
| | - Silvia Perez
- Biocruces Bizkaia Health Research Institute Barakaldo Spain
| | - Roberto Matorras
- Human Reproduction Unit Cruces University Hospital Barakaldo Spain.,Faculty of Medicine University of the Basque Country Lejona Spain.,Biocruces Bizkaia Health Research Institute Barakaldo Spain.,Instituto Valenciano de Infertilidad (IVI) Leioa Spain
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