The Role of Tumor Necrosis Factor-308 Polymorphism on Pregnancy Rate in Women Undergoing Intracytoplasmic Sperm Injection Program

Abstract

Background: Multiple pregnancies are frequent after the use of Assisted Reproductive Technologies. The presence of the TNF-308A allele is associated with high implantation and multiple pregnancy rates in women without known infertility factors after ovarian hyperstimulation with exogenous FSH. Aim of the Work: to evaluate the effect of tumor necrosis factor-308 genotypes (A and G) on embryo implantation and clinical pregnancy rates in women undergoing ICSI. Patients and Methods: This prospective observational cohort study was conducted at the Assisted Reproduction Technology Unit (ARTU) of Ain Shams University Maternity Hospital on 100 infertile women who were planned to perform ICSI due to tubal factor after obtaining an informed written consent from each patient. Results: Out of the 100 patients included in the study; 46 patients had positive serum ß-hCG 2 weeks after embryo transfer but only 38 patients of them had intra uterine gestational sac (s) with positive fetal pulsations by u/s scan 2 weeks later. There was a statistically significant correlation between TNF-308 AA + AG genotype and implantation rate 27.2% (P value: <0.001). The predictive value of serum TNF-308 genotypes for both chemical and clinical pregnancy rates, after applying multivariable binary logistic regression analysis were showed that, TNF-308 AA+ AG allele, and a grade 1 embryo were independent predictors of both chemical and clinical pregnancy rates., the results showed that, TNF-308 AA + AG allele, was the only independent predictor of clinical pregnancy. Conclusion: There is an association between the TNF-308 A allele and a high implantation and pregnancy rates. These data indicate that the serumTNF-308 A/G polymorphism may be a potential non-invasive biomarker for implantation and subsequently pregnancy in patients undergoing ICSI.