| Description: |
Background In ART, embryo selection traditionally relies on morphological assessment, which has limited predictive value for developmental potential. Cumulus cells offer a non-invasive source of biomarkers for oocyte quality. This study investigated whether three candidate genes, CALM1 , PSMD6 , and AK124742 , could serve as predictive biomarkers for pregnancy outcomes, particularly in the context of PCOS. Methods This cross-sectional prospective study included 66 patients (33 PCOS and 33 controls) undergoing IVF or ICSI treatment. Gene expression in cumulus cells was analyzed using qRT-PCR with GAPDH as reference. Pregnancy outcomes were monitored through β-hCG testing and confirmed by ultrasound imaging of fetal cardiac activity. Results All three genes showed elevated expression in the pregnant versus non-pregnant group, with PSMD6 (p < 0.001) and AK124742 (p < 0.05) reaching statistical significance. Independent of pregnancy status, PCOS patients exhibited significantly higher CALM1 and AK124742 expression (p = 0.003, p < 0.001) and lower PSMD6 expression (p = 0.002) compared to controls. Age-adjusted analysis revealed CALM1 was significantly elevated in pregnant patients (p < 0.05). PCOS patients yielded significantly more oocytes (14.15 vs. 9.03, p = 0.005), but this did not correlate with higher pregnancy rates. IVF achieved significantly higher success rates than ICSI (85.7% vs. 43.3%, p = 0.007). Sperm morphology showed a significant correlation with fertilization rates (r²=0.337, p < 0.001). Conclusion In PCOS patients, three genes showed potential as embryo competence biomarkers, but their expression was significantly altered. PCOS had a stronger impact on gene expression than pregnancy outcome, indicating that ovarian pathophysiology affects cumulus cell molecular signatures. This underscores the need to consider ovarian health for personalized fertility treatments. |