Urine neopterin concentrations as a marker for successful blastocyst implantation after assisted reproductive technologies
Received 16 March 2009; received in revised form 7 July 2009; accepted 21 December 2009. published online 08 March 2010.
Abstract
Successful blastocyst implantation requires intricately orchestrated adaptation processes involving maternal and fetal mediators. The pivotal role of distinct immune response pathways in early pregnancy is widely acknowledged. Pro-inflammatory cytokines, e.g. interferon-γ (IFN-γ), are the primary inducers of tryptophan-degrading enzyme indoleamine 2,3-dioxygenase (IDO) and of neopterin biosynthesis by GTP-cyclohydrolase I. IDO activity has been proposed to be of high clinical relevance in the context of pregnancy. To date, insights arising from clinical studies on IDO activity and neopterin concentration during the very early days of pregnancy are still few. Early morning urinary neopterin concentrations in 61 women undergoing assisted reproduction treatment (72 cycles in total) were examined, upon exclusion of infections, daily over a period of 2weeks after embryo transfer. Twenty of the study participants (28%) became successfully pregnant, and four women experienced abortion. Neopterin concentrations significantly increased after blastocyst transfer when implantation was successful (chi-squared=23.291, P<0.01; Friedman test), opposed to non-significant changes of neopterin in women with unsuccessful treatment (chi-squared=8.203). The steady increase of neopterin concentrations upon blastocyst transfer indicates that heightened production of neopterin in very early phases of pregnancy may serve as an early predictor of successfully progressing pregnancies in humans.
Declaration: The authors report no financial or commercial conflicts of interest.
aDivision of Biological Chemistry, Biocenter, Innsbruck Medical University, Innsbruck, Austria
bDepartment of Obstetrics and Gynaecology, Innsbruck Medical University, Innsbruck, Austria
cReproductive Immunology Research Group, Department of Internal Medicine, Biomedical Research Center, Campus Virchow, Charité, Berlin, Germany
dClinical Department of Endocrinology and Sterility, Innsbruck Medical University, Innsbruck, Austria
Corresponding author.
Dietmar Fuchs graduated in chemistry in 1980 from the University of Innsbruck, Austria. After employment at the Institute of Medical Chemistry and Biochemistry, he became Reader in Medical Chemistry (1986), and Associate Professor and co-director of the Ludwig Boltzmann Institute for AIDS-Research at the Medical Faculty. He was Honorary Visiting Fellow (Aston University, Birmingham, UK) and Honorary Senior Research Fellow (University of Birmingham) from 1994–1998. His scientific interests lie in the fields of Clinical Biochemistry and Clinical Immunology focusing on the metabolism of neopterin and tryptophan. He has published 730 articles in peer-reviewed scientific journals and received several national and international awards.
ABSTRACT
Dietmar Fuchs graduated in chemistry in 1980 from the University of Innsbruck, Austria. After employment at the Institute of Medical Chemistry and Biochemistry, he became Reader in Medical Chemistry (1986), and Associate Professor and co-director of the Ludwig Boltzmann Institute for AIDS-Research at the Medical Faculty. He was Honorary Visiting Fellow (Aston University, Birmingham, UK) and Honorary Senior Research Fellow (University of Birmingham) from 1994–1998. His scientific interests lie in the fields of Clinical Biochemistry and Clinical Immunology focusing on the metabolism of neopterin and tryptophan. He has published 730 articles in peer-reviewed scientific journals and received several national and international awards.