Endometrial BCL6 testing for the prediction of in vitro fertilization outcomes: a cohort study

Aberrant epithelial BCL6 expression in endometrium of women with unexplained infertility is a useful prognostic factor for in vitro fertilization outcome.

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Volume 108, Issue 6, Pages 1063–1069

Authors:

Laura D. Almquist, M.D., Creighton E. Likes, M.D., Benjamin Stone, B.S., Kaitlin R. Brown, B.S., Ricardo Savaris, M.D., Ph.D., David A. Forstein, D.O., Paul B. Miller, M.D., Bruce A. Lessey, M.D., Ph.D.

Abstract:

Objective

To evaluate endometrial BCL6 expression as a prognostic biomarker for IVF outcome in women with unexplained infertility (UI) before ET.

Design

Prospective cohort study.

Setting

University-associated infertility clinic.

Patient(s)

Women with UI for >1 year.

Intervention(s)

We studied women with UI who underwent testing for endometrial BCL6, in an LH-timed midluteal phase biopsy and completed an IVF cycle and ET.

Main Outcome Measure(s)

Clinical pregnancy rate (PR) and live birth rate per transfer was compared for women positive or negative for BCL6 expression. An abnormal BCL6 result was defined by an histologic score (>1.4).

Result(s)

Women with normal and abnormal BCL6 and those who conceived or not had similar characteristics. Women with low levels of BCL6 expression had a significantly higher clinical PR (11/17; 64.7%; 95% confidence interval [CI] 41.3–82.6) compared with women with abnormal (high) BCL6 expression (9/52; 17.3%; 95% CI 9.3–30.8). These results yield a relative risk of 0.267 (95% CI 0.13–0.53; P=.0004) for those with normal BCL6 expression, an absolute benefit of 47.4% (95% CI 22.5–72.0). Live birth rate was also significantly higher in women with low BCL6 expression (10/17; 58.8%; 95% CI 36.0–78.4) compared with women with abnormal BCL6 expression (6/52; 11.5%; 95% CI 5.4–23.0). The relative risk was 0.19 (95% CI 0.08–0.45; P=.0002), yielding an absolute benefit of 47.3% (95% CI 21.8–67.8).

Conclusion(s)

Aberrant BCL6 expression (histologic score, >1.4) was strongly associated with poor reproductive outcomes in IVF cycles in women with UI.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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