Growth Differentiation Factor-9 and Bone Morphogenic Protein-15 as Predictors of Oocyte and Embryo Quality in Sub-Fertile Women Undergoing Assisted Reproduction

Abstract

Background: Oocyte-secreted proteins can provide evidence about folliculogenesis and express the quality of oocytes and the quality of the resulting embryos. Objective: To evaluate the ability of serum and follicular fluid growth differentiation factor 9 (GDF-9) and bone morphogenic protein 15 (BMP-15) in predicting oocyte and embryonic quality, subsequent embryonic development and pregnancy rate. Methods: A prospective cohort study involved 114 sub-fertile females who sought intracytoplasmic sperm injection (ICSI) to treat infertility. They are 18 to 43 years old, and their body mass index (BMI) ranged from 19 to 30 kg/m2. Before ICSI, there was controlled ovarian stimulation and pituitary downregulation. Following oocyte collection, microscopic assessment of oocyte and embryo quality was done. Serum was collected on the second day of the menstrual cycle, while follicular fluid was collected on the day of oocyte collection, and GDF-9 and BMP-15 were measured in both using a special kit by ELIZA. Results: The pregnancy rate was 35.2%. Follicular fluid GDF-9, serum and follicular fluid BMP-15 showed significant positive correlations with the total number of mature oocytes. Follicular fluid BMP-15 showed significant positive correlations with total oocyte count and fertilization rate. Follicular fluid BMP-15 showed a significant and positive correlation to the total embryo quality count. Conclusions: Serum and follicular fluid BMP-15 are good predictors of oocyte number and quality but have no role in predicting embryonic quality, blastocyst count or pregnancy rate.