(179) Mitochondrial DNA to Genomic DNA Ratio in Embryo Spent Culture Medium Predicts IVF Outcomes

Jeong Eun Lee¹; Hee Jun Lee²

¹ Fertility Center of CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea;
² Fertility Center of CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Republic of Korea

Abstract Text:

Introduction
Selecting embryos with the highest implantation potential is critical for successful in vitro fertilization (IVF). While morphological assessment is widely used, non-invasive biomarkers could improve embryo selection. This study investigates whether the mitochondrial DNA to genomic DNA (mtDNA/gDNA) ratio in embryo spent culture medium (SCM) can predict embryo quality and IVF outcomes.

Methods
In a prospective trial (July 2022–July 2023), 174 IVF-ICSI cycles were analyzed. Day 5 blastocyst SCM was collected using contamination-controlled protocols. Quantitative real-time PCR measured mtDNA/gDNA levels using β2M and mtMinArc genes. Embryos were morphologically graded (Blastocyst Score, BS) and categorized as good (BS 3–5), fair (BS 6–9), or poor quality (BS 10–14). Clinical outcomes included implantation and pregnancy rates.

Results
mtDNA/gDNA ratio was significantly lower in high-quality embryos (good: 1.12 ± 0.21; fair: 1.15 ± 0.32; poor: 2.14 ± 0.44; p< 0.001). Implantation and clinical pregnancy were more likely in embryos with low mtDNA/gDNA ratios. Receiver operating characteristic analysis confirmed strong predictive value (AUC=0.84).

Conclusion
The mtDNA/gDNA ratio in SCM reflects embryo developmental potential and correlates with IVF success. This non-invasive biomarker may complement current embryo selection methods, aiding personalized IVF strategies.