EMBRYO QUALITY PREDICTIVE MODELS BASED
ON CUMULUS CELLS GENE EXPRESSION Devjak R, Burnik Papler T, Verdenik I, Fon Tacer K, Vrtačnik Bokal E *Corresponding Author: Rok Devjak, M.D., Ph.D., Division of Medical Oncology, Institute of Oncology,
Zaloška 2, 1000 Ljubljana, Slovenia. Tel: +386-1-5879-282; Fax: +386-1-5879-303. E-mail: rdevjak@onko-i.si page: 5 download article in pdf format
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Abstract
Since the introduction of in vitro fertilization
(IVF) in clinical practice of infertility treatment,
the indicators for high quality embryos were investigated.
Cumulus cells (CC) have a specific gene
expression profile according to the developmental
potential of the oocyte they are surrounding, and
therefore, specific gene expression could be used as a
biomarker. The aim of our study was to combine more
than one biomarker to observe improvement in prediction
value of embryo development. In this study,
58 CC samples from 17 IVF patients were analyzed.
This study was approved by the Republic of Slovenia
National Medical Ethics Committee. Gene expression
analysis [quantitative real time polymerase chain
reaction (qPCR)] for five genes, analyzed according
to embryo quality level, was performed. Two prediction
models were tested for embryo quality prediction:
a binary logistic and a decision tree model. As
the main outcome, gene expression levels for five
genes were taken and the area under the curve (AUC)
for two prediction models were calculated. Among
tested genes, AMHR2 and LIF showed significant
expression difference between high quality and low
quality embryos. These two genes were used for the
construction of two prediction models: the binary
logistic model yielded an AUC of 0.72 ± 0.08 and
the decision tree model yielded an AUC of 0.73 ±
0.03. Two different prediction models yielded similar
predictive power to differentiate high and low quality
embryos. In terms of eventual clinical decision
making, the decision tree model resulted in easy-tointerpret
rules that are highly applicable in clinical
practice.
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