Utilisation of Transcriptome-Based Biomarkers for Single Embryo Transfer

Currently in in vitro fertilisation (IVF) cycles, oocytes and embryos are assessed by different morphological parameters. However, there is growing evidence that oocyte and embryo competence are not optimally predicted by morphology alone. For this reason, non-invasive, objective, and reliable markers to identify oocytes and embryos with the highest reproductive potential, without compromising the success of IVF procedures in single embryo transfer (SET), are needed. In this chapter, we describe the role and developments in transcriptomic analysis of oocytes, granulosa and cumulus cells, endometrium, and embryos. So far, many studies on these fields have revealed some promising biomarker genes for the use in reproductive medicine. Further well-designed validational studies are necessary in order to reach consensus and to isolate biomarker(s) with high sensitivity and specificity. In order to overcome pitfalls of translating discovered biomarkers into clinical utility of SET, validational studies should have large samples and be multi-centre, with clear standard operating procedures for sample selection, storage, handling, analysis, and data interpretation. At present, the proposed biomarkers have not provided the required sensitivity and specificity to be used routinely in clinical practice for elective SET without lowering success rate of IVF procedures. We may conclude that it is likely that a combinatorial evaluation of different parameters will be needed for the development of universally applicable biomarker(s) for the use of SET.