A proteomic analysis of IVF follicular fluid in women ≤32 years old

Objective: To address the lack of predictors of IVF success by using proteomic biometrics. Design: Experimental study of follicular fluid specimens from a prospective cohort of IVF patients. Setting: Academic research laboratory and IVF program. Patient(S): Women <= 32 years old with <11 oocytes retrieved and no pregnancy were matched to women who had >= 11 oocytes and live birth (10 pairs). Year of cycle start and IVF down-regulation protocol were also matched. Intervention(S): Follicular fluid was separated by two-dimensional polyacrylamide gel electrophoresis followed by Sypro Ruby staining and comparison with PDQuest software. Logistic regression was incorporated to calculate the likelihood of live birth in relation to the protein spot of interest. Main Outcome Measure(s): Protein markers. Result(s): Liquid chromatography-tandem mass spectrometry and searching of sequence databases revealed 11 potential protein candidates. Haptoglobin alpha, predominantly fetal expressed T1 domain, mitochondrial integrity genome (ATPase), apolipoprotein H (beta-2 glycoprotein I), dihydrolipoyl dehydrogenase, lyzozyme C, fibrinogen alpha-chain, and immunoglobulin heavy chain V-III (region BRO) were found to have increased expression in the live birth group, whereas antithrombin, vitamin D-binding protein, and complement 3 were decreased. An ELISA confirmed a significantly lower level of antithrombin. Conclusion(s): Proteomic evaluation of follicular fluid is able to identify potential biomarkers of good versus poor responders in matched pairs of IVF patients. (Fertil Steril (R) 2009;92:1569-78. (C) 2009 by American Society for Reproductive Medicine.)