10Oct 2017

ROLE OF HEPARIN BINDING EPIDERMAL GROWTH FACTOR IN THE SERUM AND FOLLICULAR FLUID IN PREDICTION OF PREGNANCY OUTCOME OF INFERTILE WOMEN WITH AND WITHOUT PCOS.

  • Biotechnology Research Center, Al-Nahrain University , Baghdad-Iraq.
  • Kamal Al-Samarai IVF Hospital, Ministry of Health, Baghdad Iraq.
  • High Institute For Infertility Diagnosis and ART, Al-Nahrain University , Baghdad-Iraq.
  • Abstract
  • Keywords
  • References
  • Cite This Article as
  • Corresponding Author

Background: Successful implantation requires an intricate succession of molecular and genetic interactions. The implantation process is controlled by number of molecules like ovarian hormones, cytokines and growth factors which play an important role in regulating embryo differentiation, invasion and adhesion. During this time any breach in the communication between the endometrium and the embryo leads to implantation failure. Aim of the study: to evaluate the role of Heparin binding epidermal growth factor (HB-EGF), measured in serum and follicular fluid in prediction of pregnancy outcome of infertile women with and without PCOS. Patients and methods: A convenient sample of 100 infertile women undergoing intracytoplasmic sperm injection (ICSI) were intentionally divided, according to the cause of infertility, into 50 infertile women with polycystic ovary syndrome (PCOS) and 50 infertile women without PCOS. Heparin binding epidermal growth factor was measured on early follicular phase of the cycle (CD2-3) and at the day of ovarian pick up. Results: Highly significant(P<0.001) increase were reported between PCOS and non-PCOS groups regarding estradiol (E2) and HB-EGF levels in the serum follicular phase (day 2-3) and in the FF on day of ova pickup (OPU).In PCOS women , HBEGF in the serum of follicular phase and at day of OPU with its level in the FF at day of OPU were all significantly (P<0.05) higher in women with positive pregnancy outcome than those with negative pregnancy outcome. Conclusion: Serum HB-EGF level is more valuable in predicting pregnancy out come in infertile PCOS women than non-PCOS women, and that serum HB-EGF level is more helpful than follicular fluid HB-EGF level in predicting pregnancy outcome in infertile PCOS women.


  1. Cong J, Li P, Zheng L, Tan J. Prevalence and Risk Factors of Infertility at a Rural Site of Northern China. Handelsman DJ, ed. PLoS ONE. 2016;11(5):e0155563.
  2. Hawkins SM, Matzuk MM. Menstrual Cycle: Basic Biology. Annals of the New York Academy of Sciences. 2008;1135:10-18.
  3. Aflalo ED, Sod-Moriah UA, Potashnik G, Har-Vardi I. Expression of plasminogen activators in preimplantation rat embryos developed in vivo and in vitro. Reprod Biol Endocrinol : RB&E. 2005;3:7.
  4. Zhang S, Lin H, Kong S, et al. Physiological and molecular determinants of embryo implantation. Molecular aspects of medicine. 2013;34(5):939-980.
  5. Cakmak H, Taylor HS. Implantation failure: molecular mechanisms and clinical treatment. Human Reproduction Update. 2011;17(2):242-253.
  6. Ai Z, Jing W, Fang L. Cytokine-Like Protein 1(Cytl1): A Potential Molecular Mediator in Embryo Implantation. Shen W, ed. PLoS ONE. 2016;11(1):e0147424.
  7. Tuteja N. Signaling through G protein coupled receptors. Plant Signaling & Behavior. 2009;4(10):942-947.
  8. Lemmon MA, Schlessinger J. Cell signaling by receptor-tyrosine kinases. Cell. 2010;141(7):1117-1134.
  9. Zeng F, Harris RC. Epidermal growth factor, from gene organization to bedside. Seminars in cell & developmental biology. 2014;0:2-11.
  10. Lim HJ, Dey SK. HB-EGF: a unique mediator of embryo-uterine interactions during implantation. Experimental cell research. 2009;315(4):619-626.
  11. Aghajanova L, Giudice LC. Molecular Evidence for Differences in Endometrium in Severe Versus Mild Endometriosis. Reproductive Sciences. 2011;18(3):229-251.
  12. Mitwally MF, Casper RF, Diamond MP. The role of aromatase inhibitors in ameliorating deleterious effects of ovarian stimulation on outcome of infertility treatment. Reprod Biol Endocrinol. 2005;3:54.
  13. Sirmans SM, Pate KA. Epidemiology, diagnosis, and management of polycystic ovary syndrome. Clinical Epidemiology. 2014;6:1-13.
  14. Barthelmess EK, Naz RK. Polycystic ovary syndrome: current status and future perspective. Frontiers in bioscience (Elite edition). 2014;6:104-119.
  15. Lane DE. Polycystic ovary syndrome and its differential diagnosis. Obst Gynecol Surv. 2006;61(2):125?135.
  16. Pandian Z, Templeton A,Serour G ?Bhattacharya Number of embryos for transfer after IVF and ICSI: a Cochrane review? Hum Reprod, 2005. 20(10): 2681?2687.
  17. Lerchbaum E, Schwetz V, Rabe T, Giuliani A, Obermayer-Pietsch B. Hyperandrogenemia in Polycystic Ovary Syndrome: Exploration of the Role of Free Testosterone and Androstenedione in Metabolic Phenotype. Eller P, ed. PLoS ONE. 2014;9(10):e108263.
  18. Glover, T.and Mitchell, K.(2008).An introduction to Biostatistics, 2nd Waveland press .Inc.
  19. Al-Dujaily SS and Alwan N S. Relationship between antiM?llerian ovarian hormone, activin-A, and follistatin hormones levels with pregnancy rate following intrauterine insemination. Iraqi J. Embryos and Infertility Researches. 2013; 3(6): 9-14.
  20. Al-Hakeim HK and Ridha MA. Study of Activin A and Inhibin A Hormones levels in Polycystic Ovarian Syndrome and their Correlation with Other Biochemical Parameters. Magazin of Al-Kufa University for Biology. 2013; 5 (2): 1-9.
  21. Ji S Z, Xiao-Ping C, Xiang WW, et al. Correlation analysis of inhibin B, follistatin and activin A in patients with polycystic ovary syndrome. African Journal of Microbiology Research. 2010; 4(12): 1295-1298.
  22. Al-Hakeim H K and Ridha M A. Study of Activin A and Inhibin A Hormones levels in polycystic ovarian syndrome and their correlation with other biochemical parameters. Magazin of Al-Kufa University for Biology. 2013; 5 (2): 1-9.
  23. Eldar-Geva T, Spitz IM, Groome NP, Margalioth EJ, Homburg R. Follistatin and activin A serum concentrations in obese and non-obese patients with polycystic ovary syndrome. Hum Reprod. 2001;16:2552?2556.
  24. V?nttinen T, Liu J, Hyd?n-Granskog? and? Voutilainen . Biphasic regulation of activin A secretion bygonadotropins in cultured human ovarian granulosa-luteal cells leads to decreasing activin:inhibin ratios during continuing gonadotropin stimulation. Journal of Endocrinology. 2002; 172: 557?563 .
  25. Lessey BA,?Gui Y,?Apparao KB,?Young SL,?Mulholland J. Regulated expression of heparin-binding EGF-like growth factor (HB-EGF) in the human endometrium: a potential paracrine role during implantation. Mol Reprod Dev.2002 ;62(4):446-55

[Saad Salih Al-Dujaily, May Abdul-Kareem and Mohammad Oda Selman. (2017); ROLE OF HEPARIN BINDING EPIDERMAL GROWTH FACTOR IN THE SERUM AND FOLLICULAR FLUID IN PREDICTION OF PREGNANCY OUTCOME OF INFERTILE WOMEN WITH AND WITHOUT PCOS. Int. J. of Adv. Res. 5 (Oct). 70-77] (ISSN 2320-5407). www.journalijar.com


Saad Salih Al-Dujaily
Biotechnology Research Center, Al-Nahrain University , Baghdad-Iraq.

DOI:


Article DOI: 10.21474/IJAR01/5508      
DOI URL: https://dx.doi.org/10.21474/IJAR01/5508