Predictive Biomarkers in Assisted Reproductive Technology
Summary
Predictive biomarkers are measurable biological indicators used before or during assisted reproductive technology (ART) cycles to forecast outcomes such as implantation success, clinical pregnancy and live birth. These markers encompass maternal serum hormones, endometrial receptivity signatures, embryo developmental parameters and emerging molecular profiles. Established predictors include anti-Müllerian hormone (AMH) and antral follicle count to gauge ovarian reserve and response to stimulation, alongside dynamic oestradiol monitoring during stimulation to adjust gonadotrophin dosing. Non-invasive assessment of embryos via time-lapse morphokinetics and spent culture media metabolomics has enhanced selection of developmentally competent embryos. Endometrial receptivity assays based on gene expression and integrin profiles aid timing of embryo transfer to optimise implantation. Advances in proteomic and transcriptomic profiling of follicular fluid, uterine lavage and spent media are expanding the repertoire of candidate biomarkers, including microRNAs and epigenetic marks. The integration of multivariate biomarker panels with clinical parameters offers personalised prognostication, aiming to increase success rates, reduce multiple gestations and tailor luteal support. Global research efforts are consolidating threshold values and algorithmic tools for real-time clinical decision-making, bridging laboratory discovery with bedside application in ART programmes.
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Predictive Biomarkers in Assisted Reproductive Technology publication trend
The graph below shows the total number of articles in predictive biomarkers in assisted reproductive technology across all publications each year (not limited to Nature Index journals).
Technical terms
Biomarker: A biological molecule indicating physiological or pathological processes or therapeutic responses.
β-human chorionic gonadotrophin (β-hCG): A glycoprotein hormone produced by trophoblast cells, used to assess early pregnancy viability.
Oestradiol (E2): A form of oestrogen measured to evaluate ovarian response and endometrial development.
Anti-Müllerian Hormone (AMH): A hormone secreted by ovarian follicles that reflects ovarian reserve and predicts response to stimulation.
Biochemical pregnancy: A transient pregnancy confirmed by hormonal assay without ultrasound evidence of a gestational sac.
Endometrial receptivity: The state of the uterine lining characterised by molecular and morphological markers indicating optimal implantation window.
Blastocyst: An embryo at five to six days post-fertilisation, featuring a fluid-filled cavity and distinct inner cell mass and trophectoderm layers.
References
- Combined analysis of estradiol and β-hCG to predict the early pregnancy outcome of FET: a retrospective study. Journal of Ovarian Research (2024).
- Diagnostic value of a single β-hCG test in predicting reproductive outcomes in women undergoing cleavage embryo transfer: a retrospective analysis from a single center. Reproductive Health (2022).
- Single day 14 serum hCG values allow prediction of viable pregnancy and are significantly higher in frozen as compared to fresh single blastocyst transfer. Journal of Assisted Reproduction and Genetics (2024).
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