The effect of glycodelin-A, granulocyte colony-stimulating factor and L-selectin on pregnancy outcomes in in-vitro fertilization/embryo transfer cycles

Objective: To investigate the benefits of glycodelin-A, G-CSF (Granulocyte Colony-Stimulating Factor) and L-selectin levels, which indicate endometrial receptivity in IVF-ET (in-vitro fertilization/embryo transfer) cycles, in prediction of pregnancy.Design: Prospective cohort studySetting: University academic IVF centerPatient(s): March 2007 to May 2007, fiftysix IVF-ET cyclesMethods: In our study, we examined the levels of glycodelin-A, G-CSF and L-selectin, which are markers of the implantation window phase, in IVF-ET cycles. The glycodelin-A, G-CSF and L-selectin levels in cervical mucus and blood samples were measured. Cervical mucus samples were obtained during oocyte pick-up and embryo transfer. Blood samples were collected during embryo transfer only. The results were then compared with pregnancy rates.Results: The mean G-CSF levels, which had been measured during embryo transfer, were significantly higher in clinical pregnancy positive women than in women with negative results (p=0.024). When a value of 1365 pg/ml was set as the cut-off point, sensitivity was calculated as 76% and specificity as 61.3 %. On the other hand, a significant relationship was not determined between the glycodelin-A and L-selectin levels in the cervical mucus, which had been calculated during embryo transfer, and pregnancy outcomes. It was determined that the G-CSF (p=0.04) and L-Selectin (p=0.002) levels in the cervical mucus, which had been measured during the embryo transfer, were significantly higher than those measured during oocyte pick-up.Conclusions: Investigating markers of endometrial receptivity in the cervical mucus during embryo transfer is a non-invasive and efficient method in IVF cycles. G-CSF may be an important marker in predicting implantation.Key Words: IVF-ET, endometrial receptivity, G-CSF, L-selectin, glycodelin-A