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Purpose <p>This study aimed to determine whether the mitochondrial DNA to genomic DNA (mtDNA/gDNA) ratio in spent culture medium (SCM) can reliably predict embryo quality and clinical pregnancy outcomes in in vitro fertilization (IVF). Current embryo selection methods rely primarily on morphological assessment, which has limitations in predicting implantation success and cannot distinguish aneuploid embryos.</p> Methods <p>A prospective clinical trial was conducted from July 2022 to July 2023 involving 174 women with unexplained infertility undergoing IVF-ICSI at CHA University, Korea. Day 5 blastocyst culture media were analyzed for mtDNA/gDNA ratio using quantitative real-time PCR. Embryos were evaluated using a blastocyst scoring system (BS) categorizing them as good (BS 3–5), fair (BS 6–9), or poor (BS 10–14). Statistical analyses included correlation analysis and ROC curve analysis to assess the predictive value for clinical pregnancy rates.</p> Results <p>Higher mtDNA/gDNA ratios correlated significantly with lower embryo quality grades (good: 1.12, fair: 1.15, poor: 2.14; <i>p</i> &lt; 0.001). ROC analysis confirmed the mtDNA/gDNA ratio as a reliable predictor of clinical pregnancy rates with AUC &gt; 0.8 (<i>p</i> &lt; 0.001) across all age groups. No significant differences in clinical pregnancy rates were observed across different age groups (p = 0.392).</p> Conclusion <p>The mtDNA/gDNA ratio in SCM shows promising potential as a non-invasive indicator of embryo quality and clinical pregnancy outcomes. However, given the exploratory nature of this study and current methodological limitations, further validation with larger, independent cohorts and standardized analytical protocols is required before clinical application.</p>

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Mitochondrial DNA to genomic DNA ratio in embryo spent culture medium as a predictive marker for in vitro fertilization outcomes: a pilot study

  • 期刊论文

  • 发表日期：

    2026年2月26日

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  • Jeong Eun Lee,
  • Tae Hyung Kim,
  • Jin Hee Eum,
  • Ji Hye Jeong,
  • Sol A Yoon,
  • Jee Hyun Kim,
  • E Jung Han,
  • Min Kyoung Kim,
  • Se Jeong Kim,
  • Haeng Jun Jeon,
  • Yoo Ra Ko,
  • Jin Kyeong Ha,
  • Se Yul Han,
  • Hee Jun Lee

摘要

Purpose

This study aimed to determine whether the mitochondrial DNA to genomic DNA (mtDNA/gDNA) ratio in spent culture medium (SCM) can reliably predict embryo quality and clinical pregnancy outcomes in in vitro fertilization (IVF). Current embryo selection methods rely primarily on morphological assessment, which has limitations in predicting implantation success and cannot distinguish aneuploid embryos.

Methods

A prospective clinical trial was conducted from July 2022 to July 2023 involving 174 women with unexplained infertility undergoing IVF-ICSI at CHA University, Korea. Day 5 blastocyst culture media were analyzed for mtDNA/gDNA ratio using quantitative real-time PCR. Embryos were evaluated using a blastocyst scoring system (BS) categorizing them as good (BS 3–5), fair (BS 6–9), or poor (BS 10–14). Statistical analyses included correlation analysis and ROC curve analysis to assess the predictive value for clinical pregnancy rates.

Results

Higher mtDNA/gDNA ratios correlated significantly with lower embryo quality grades (good: 1.12, fair: 1.15, poor: 2.14; p < 0.001). ROC analysis confirmed the mtDNA/gDNA ratio as a reliable predictor of clinical pregnancy rates with AUC > 0.8 (p < 0.001) across all age groups. No significant differences in clinical pregnancy rates were observed across different age groups (p = 0.392).

Conclusion

The mtDNA/gDNA ratio in SCM shows promising potential as a non-invasive indicator of embryo quality and clinical pregnancy outcomes. However, given the exploratory nature of this study and current methodological limitations, further validation with larger, independent cohorts and standardized analytical protocols is required before clinical application.