Cited2 protein level in cumulus cells is a biomarker for human embryo quality and pregnancy outcome in one in vitro fertilization cycle

Higher Cited2 level in human cumulus cells is associated with decreasing embryo quality and pregnancy outcome in IVF patients, which may be attributed to apoptosis and abnormal gluconeogenesis in cumulus cells.


Yuan Fang, Ph.D., Wei Shang, M.M., De-Li Wei, M.S., Shen-Ming Zeng, Ph.D.

Volume 105, Issue 5, Pages 1351-1359



To determine whether the levels of CBP/p300 interacting transactivator with ED-rich tail 2 (Cited2) protein in cumulus cells (CCs) derived from patients undergoing IVF related to infertility factors, embryo quality, and clinical outcomes in one IVF cycle.


Retrospective analysis of human CCs.


Public hospital and university.


A total of 103 (conventional) IVF patients and 32 intracytoplasmic sperm injection patients.


All CCs from each patient’s oocytes were considered as one sample. The patients were divided into two groups according to whether the Cited2/β-actin levels in their CCs were above or below the mean level detected for all patients.

Main Outcome Measure(s):

Embryo quality and clinical outcomes of IVF patients.


The oocytes derived from the group of patients whose CCs showed lower Cited2 levels displayed higher fertilization, transferable embryo, and implantation rates. Moreover, the patients in this group were more likely to have a successful pregnancy outcome. Among different infertility factors, a total of 78.6% of patients with polycystic ovary syndrome had a higher Cited2 level in CCs. Additionally, patients with a lower basal FSH level belonged to the higher Cited2 levels group. The expression of two genes (phosphoenolpyruvate carboxykinase 1 [PCK1] and progesterone receptor [PR]) and the glucose content in CCs were also markedly increased in CCs derived from patients with higher Cited2 levels.


The present findings imply that Cited2 level in CCs is associated with polycystic ovary syndrome, embryo quality, and pregnancy outcome of IVF patients.

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