Researchers have found that high levels of the protein BCL6 in women with unexplained infertility (UI), for which endometriosis is a major cause, were strongly associated with poor reproductive results after undergoing in vitro fertilization (IVF) treatment.
The study titled, “Endometrial BCL6 testing for the prediction of in vitro fertilization outcomes: a cohort study,” was published in the journal Fertility and Sterility.
Currently, in the United States alone, IVF is performed 200,000 times per year. Unfortunately, the success rate for this procedure in terms of live births is less than 50%. One of the major reasons for the low success rate is that almost 50% of embryos fail to implant in the endometrium. These results suggest that there is an underlying issue in the endometrium of women undergoing this procedure.
While some studies have indicated that endometriosis has no effect on IVF outcomes, others have shown the opposite. One particular study showed that most women with IVF failure due to endometriosis were able to conceive, naturally or through IVF, after surgical treatment.
Another recent study showed that women with UI have increased expression of BCL6, which is a promising biomarker for diagnosis of endometriosis. Therefore, researchers set out to study whether the overexpression of BCL6 could predict IVF outcomes in women who have UI.
Researchers recruited women who were experiencing infertility after undergoing IVF for one year or more. The study was conducted over eight years. Of the recruits, 75% tested positive for high BCL6, while 25% had normal BCL6 levels.
Results from the study showed that women who had low levels of BCL6 had a significantly higher pregnancy rate, at 64.7%. On the other hand, women who had high expression of BCL6 had a pregnancy rate of only 17.3%. Furthermore, the live birth rate was also significantly higher in women with low BCL6 expression, at 58.8%, compared with women with high BCL6 expression, at only 11.5%.
Therefore, high BCL6 expression is correlated with poor pregnancy outcomes, the researchers stated.
“High levels of BCL6 expression in this cohort suggests that undiagnosed endometriosis may be a common factor that needs to be considered in women before undergoing IVF,” the authors concluded.
CiceroDx, a clinical diagnostics company, offers a BCL6 diagnostic test called ReceptivaDx, which can be used to test patients for BCL6 prior to their first IVF treatment.
Bruce Lessey, co-author of this study, said in a press release that, “This test provides an opportunity for couples to better understand the basis of their infertility and will provide more options and higher success rates.”
Once the physicians are aware of the presence of endometriosis in their UI patients, many treatment options are available including laparoscopy to remove the endometriosis or hormone therapy to decrease inflammation.
The ReceptivaDx test is available in over 100 IVF centers across North America, Europe, and South America.