A prospective study to evaluate whether serum kisspeptin is a marker predictive of the first-trimester miscarriage of women who conceive in IVF

• Published in: Journal of assisted reproduction and genetics Vol. 41; no. 1; pp. 79 - 85
• Main Authors: Li, He, Zhang, Wenbi, Sun, Xiaoxi
• Format: Journal Article
• Language: English
• Published: New York Springer US 2024; Springer Nature B.V
• Subjects: Abortion, Spontaneous - diagnosis; Embryo transfer; Female; Fertilization in Vitro; Gynecology; Human Genetics; Humans; Kiss1 protein; Kisspeptins; Medicine; Medicine & Public Health; Miscarriage; Pregnancy; Pregnancy Rate; Pregnancy Trimester, First; Prospective Studies; Reproductive Medicine; Reproductive Physiology and Disease; Retrospective Studies; Kisspeptin; IVF; Frozen-thawed embryo transfer; Miscarriage
• ISSN: 1058-0468; 1573-7330
• DOI: 10.1007/s10815-023-02974-x

Purpose
Kisspeptin is an emerging biomarker for the discrimination of viable pregnancy. The aim of the study is to determine whether serum kisspeptin can predict the first-trimester miscarriage and compare it with serum HCG in the prediction of the first-trimester miscarriage.
Methods
This study is a prospective case–control design including 178 women who had experienced early miscarriage (
n
 = 21) and viable single pregnancy (
n
 = 157), following frozen-thawed embryo transfer (FET) from May to December 2019. Serum samples on 14 days, 21 days, and 28 days after FET were collected for kisspeptin and HCG detection. Trial registration number: NCT03940495.
Results
On day 21 after FET, serum kisspeptin levels were significantly lower in the early miscarriage group [0.260 (0.185–0.375)] vs in the viable single-pregnancy group [0.370 (0.280–0.495)] (
p
 = 0.005). Similar results were shown on day 28 after FET, the serum kisspeptin levels were significantly lower in the early miscarriage group [0.270 (0.200–0.330)] vs in the viable single pregnancy group [0.670 (0.455–1.235)] (
p
 < 0.001). But on day 14 after FET, serum kisspeptin levels were comparable in the early miscarriage group [0.260 (0.210–0.325)] and in the viable single-pregnancy group [0.280 (0.215–0.340)] (
p
 = 0.551). Serum kisspeptin levels on days 21 and 28 have a poor predictive value of miscarriage compared with serum HCG levels. [Day 21: AUC = 0.687 (kisspeptin) and 0.816 (HCG); Day 28: AUC = 0.896 (kisspeptin) and 0.909 (HCG)].
Conclusions
Serum kisspeptin on day 14 failed to discriminate between miscarriage and ongoing pregnancies, and days 21 and 28 had poor predictive values of miscarriage.