Elevated serum interleukin 1β levels and interleukin 1β to interleukin 1 receptor antagonist ratio 1 week after embryo transfer are associated with ectopic pregnancy

Capsule:
Elevated early luteal phase interleukin-1b serum levels and interleukin-1b-to-interleukin-1 receptor antagonist ratio were associated with ectopic pregnancy after an in vitro fertilization cycle.

Authors:
Jovana P. Lekovich, M.D., Steven S. Witkin, Ph.D., Georgios Doulaveris, M.D., Theofano Orfanelli, M.D., Brittney Shulman, M.D., Nigel Pereira, M.D., Zev Rosenwaks, M.D., Steven D. Spandorfer, M.D.

Volume 104, Issue 5, Pages 1190-1194

Abstract:

Objective:
To investigate whether interleukin-1β (IL-1β) and interleukin-1 receptor antagonist (IL-1RA) serum levels in the early luteal phase differ in IVF cycles that result in an ectopic pregnancy (EP) when compared with other outcomes.

Design:
Retrospective cohort.

Setting:
Outpatient.

Patient(s):
A total of 307 women whose serum samples were available, with the following IVF outcomes: 103 live births, 80 negative pregnancy tests, 52 biochemical pregnancies, 47 EPs, and 25 miscarriages.

Intervention(s):
Serum samples were obtained on cycle days 24 and 28 (cycle day 14 = day of egg retrieval). Levels of IL-1β and IL-1RA were determined by quantitative ELISA performed by blinded personnel.

Main Outcome Measure(s):
IL-1β and IL-1RA levels, IL-1β-to-IL-1RA ratio versus cycle outcome.

Result(s):
The IL-1β levels were predictive of an EP. At cycle days 24 and 28 the mean IL-1β levels were higher in patients with an EP (127.1 pg/mL and 166.9 pg/mL, respectively) than in women with any other IVF outcome (15.8–55.3 pg/mL and 14.8–75.5 pg/mL, respectively). At cycle day 24 the IL-1β-to-IL-1RA ratio was 0.18 in the ectopic group versus 0.01–0.09 in the other groups.

Conclusion(s):
Elevated IL-1β levels and IL-1β-to-IL-1RA ratio as early as 4 days before the first pregnancy test are associated with an EP. If confirmed by prospective studies, clinical application of these findings could potentially improve EP detection.

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