The effect of the biochemical marker soluble human leukocyte antigen G on pregnancy outcome in assisted reproductive technology a multicenter study

Data from 2,040 intracytoplasmic sperm injection patients combining embryo morphology with expression of sHLA-G (a noninvasive embryo marker) show improved pregnancy outcome and the theoretical potential to reduce multiple pregnancies.


Dirk Kotze, Ph.D., Thinus F. Kruger, M.B.Ch.B., M.Phar.Med., M.Med., M.D., Ph.D., F.R.C.O.G. D.Sc., Carl Lombard, Ph.D., Trishanta Padayachee, M.Sc., Levent Keskintepe, D.V.M., Ph.D., Geoffrey Sher, M.B., Ch.B.

Volume 100, Issue 5, Pages 1303-1309, November 2013



To determine whether the presence of soluble human leukocyte antigen G (sHLA-G) affects implantation and pregnancy outcomes in vitro.


A multicenter retrospective study.


Six certified in vitro fertilization (IVF) units.


Embryos obtained from 2,040 patients from six different IVF clinics.


Soluble HLA-G determination on day-2 embryos after intracytoplasmic sperm injection, with embryos transferred on day 3 using the sHLA-G data.

Main Outcome Measure(s):

Ongoing pregnancy rate (10- to 12-week ultrasound finding).


All embryos were individually cultured, and a chemiluminescence enzyme-linked immunosorbent assay was used to detect the presence of sHLA-G in the culture medium surrounding the embryos. Embryos were selected based on a positive sHLA-G result and a graduated embryo scoring (GES) score >70, or on embryo morphology if the test was negative. In all centers, a positive sHLA-G result was associated with an increase in the odds of an ongoing pregnancy. The incidence of an ongoing pregnancy was 2.52 times greater in embryos transferred on day 3 with a positive sHLA-G test result than the incidence of an ongoing pregnancy in embryos with a negative sHLA-G test result.


Data from this multicenter study confirm that sHLA-G expression is a valuable noninvasive embryo marker to assist in improving pregnancy outcomes, with the theoretical potential to reduce multiple pregnancies.

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