PGrowth Differentiation Factor – 8 (GDF-8) as a predictor of clinical pregnancy in GnRH-agonist ICSI cycles: a prospective cohort study

ABSTRACT

Objective. The objective of this study was to assess the reliability of serum growth differentiation factor-8 (GDF-8) as a predictor of clinical pregnancy after IVF-ET and to investigate the relationship between serum GDF-8 and progesterone (P4) for more understanding of the function of GDF-8 in controlling serum P4 during controlled ovarian stimulation (COS).
Methods. We conducted a prospective cohort study, recruiting 42 women from a single fertility center in Alexandria, Egypt, who underwent intracytoplasmic sperm injection (ICSI) from May 2023 to January 2024. The conventional long agonist protocol was used for COS, and the serum levels of P4 and GDF-8 were measured at different time points. Serum human GDF-8 ELISA kits were used in accordance with the manufacturer’s protocol.
Results. GDF-8 and P4 serum levels on the day of trigger administration and 2 weeks after embryo transfer (ET) showed a highly statistically significant negative correlation (p < 0.001), and there was a highly significant positive correlation between the decline in GDF-8 and the rise in P4 serum levels (from the day of hCG to the day of oocyte retrieval). A GDF-8 level ≥ 3.9 ng/ml on the trigger day has a sensitivity of 94.3% in predicting pregnancy following ICSI-ET.
Conclusions. During controlled ovarian stimulation, GDF-8 level exhibits a dynamic pattern in conjunction with serum progesterone level. High serum levels of GDF-8 (≥ 3.9 ng/ml), followed by a decline in this level (by ≥ 1.35 ng/ml), might be a reliable predictor of pregnancy after ICSI-ET.