Cumulative live birth rate and assisted reproduction: impact of female age and transfer day.

BACKGROUND: Many studies on assisted reproductive technology examine live birth rate per cycle. However, after a cycle fails, couples often want to know what their chances are of having a live birth if they continue treatment. From a patients' perspective, the cumulative probability of live birth is more informative. MATERIALS AND METHODS: This study includes patients who underwent fresh, frozen and non-donor ICSI cycles at our IVF unit between 2006-2012. Patients were divided into two groups; Group 1 represented those who underwent only Day 5 transfers, Group 2 represented only Day 3 transfers. Patients who underwent both were excluded. -Cycles were analyzed until the first live birth or the end of the 3rd cycle. Using Kaplan-Meier analysis, we estimated the cumulative live birth rates for each group and according to female age. RESULTS: The mean age for Group 1 was significantly lower than for Group 2. After 3 cycles, Group 1's CLBR was 79% versus 66% in Group 2. When analyzing the live births by age and group, there was a significant difference in the CLBR after 3 cycles with the women less than 35 years having the highest CLBR and the women 40 years or older having the lowest CLBR. CONCLUSION: In women less than 35 years, excellent CLBR can be achieved irrespective of the transfer day. For women 40 years and above, better results of CLBR are observed with Day 5 transfers. Our findings may impact the counseling of couples considering IVF treatment.

A role for the small GTPase Rac in polyomavirus middle-T antigen-mediated activation of the serum response element and in cell transformation.

The oncogenic proteins encoded by papovaviruses, the tumor antigens, have been extensively used as model systems to study mitogenic signaling and cell transformation. These proteins stimulate cell growth in cultured cells and induce tumors in virus infected or transgenic animals. One of these proteins, polyomavirus middle-T, acts like a constitutively activated tyrosine growth factor receptor. Middle-T recruits several cellular enzymes into a multifunctional complex located at cellular membranes. This results in the activation of cellular enzymes involved in the regulation of cell signaling, like tyrosine kinases of the Src family, a phosphatidylinositol 3-kinase and a GDP/GTP exchange factor for Ras. These activities are all required for stimulation of cell growth by middle-T and activate members of the MAP kinase family. Here we investigate the role of T antigen-activated pathways in the stimulation of transcription of immediate early genes. These genes are essential for progression of resting cells into S phase. Our data show that Rho family GTPases play an essential role in cell transformation by middle-T. Furthermore, we demonstrate that the c-fos promoter is activated by two Ras-initiated signaling cascades. One is Raf-dependent and requires binding of SHC and PI 3-kinase to the middle-T complex. This pathway signals via ternary complex factor (TCF) to the serum response element (SRE) of the c-fos promoter. Signaling to TCF by Raf also depends on functional Rac, but not CDC42, as demonstrated in luciferase reporter assays with an ETS domain-containing promoter. The second pathway is Raf-independent, does not require SHC but functional PI 3-kinase, and transduces signals via Rac to serum response factor (SRF). Microinjection of dominant negative Rac1 blocks nuclear translocation of ERK1 in middle-T-expressing cells. This lends support to the idea that the two signaling cascades initiated by Ras show crosstalk at the level of MAP kinase-mediated signaling to nuclear transcription factors.

Urokinase-type plasminogen activator gene regulation by polyomavirus middle-T antigen.

Expression of polyomavirus middle-T antigen (middle-T) is involved in the formation of various tumors in vivo, e.g. hemangiomas and mammary gland tumors. Several genes have been shown to be activated in middle-T-expressing cells, but the underlying mechanisms have only been partially elucidated. Among the genes regulated by middle-T, the urokinase-type plasminogen activator (uPA) gene seems to be of primary importance for the development of the transformed phenotype. We have found that the uPA gene is highly expressed in eEnd2 cells derived from a hemangioma expressing middle-T. NIH3T3 cells show negligible levels of uPA mRNA but its expression was highly induced by infecting with a middle-T-expressing retrovirus. Middle-T did not affect uPA mRNA stability. Transient cotransfection experiments using a uPA-receptor gene construct and a middle-T expression vector showed that high uPA mRNA levels are due to increased uPA promoter activity. Analyses of various signaling molecules by transient cotransfection assays and in vitro kinase assays established that a signaling pathway involving c-Src, SOS, Ras, Raf-1 and ERK is activated by middle-T in NIH3T3 cells, resulting in the activation of the uPA gene promoter via PEA3/AP1 elements. In contrast, in eEND2 cells uPA gene induction is only partially dependent on this pathway, suggesting the involvement of additional signaling molecules in endothelial cells.

Activation and nuclear translocation of mitogen-activated protein kinases by polyomavirus middle-T or serum depend on phosphatidylinositol 3-kinase.

Several cellular signal transduction pathways activated by middle-T in polyomavirus-transformed cells are required for viral oncogenicity. Here we focus on the role of phosphatidylinositol 3-kinase (PI 3-kinase) and Ras and address the question how these signaling molecules cooperate during cell cycle activation. Ras activation is mediated through association with SHC.GRB2.SOS and leads to increased activity of several members of the mitogen-activated protein (MAP) kinase family, while activation of PI 3-kinase results in the generation of D3-phosphorylated phosphatidylinositides whose downstream targets remain elusive. PI 3-kinase activation might also ensue as a direct consequence of Ras activation. Oncogenicity of middle-T requires stimulation of both Ras- and PI 3-kinase-dependent pathways. Mutants of middle-T incapable to bind either SHC.GRB2.SOS or PI 3-kinase are not oncogenic. Sustained activation and nuclear localization of one of the MAP kinases, ERK1, was observed in wild type but not in mutant middle-T-expressing cells. Wortmannin, an inhibitor of PI 3-kinase, prevented MAP kinase activation and nuclear localization in middle-T-transformed cells. PI 3-kinase activity was also required for activation of the MAP kinase pathway in normal serum-stimulated cells, generalizing the concept that signaling through MAP kinases requires not only Ras-but also PI 3-kinase-mediated signals.

Domains in middle-T antigen that cooperate in polyomavirus-mediated oncogenic transformation.

Middle-T antigen is the oncogenic protein of Polyomavirus and associates with several cellular enzymes involved in signal transduction, e.g., Src tyrosine kinases, phosphatidylinositol 3-kinase (PI 3-kinase), protein phosphatase 2A (PP2A), and Shc, an SH2 domain-containing adapter protein. We have shown earlier that middle-T is a target of a cell cycle-regulated serine/threonine-specific kinase, presumably p34cdc2. Phosphorylation of middle-T by p34cdc2 results in increased apparent M, weight of the protein on SDS-polyacrylamide gels. Two threonine residues in positions 160 and 291, respectively, were identified in the middle-T sequence as putative targets of a cyclin-dependent kinase. Replacement of threonine 160 by alanine resulted in a transformation-defective mutant protein that was still capable of forming all the complexes with cellular proteins, suggesting that additional characteristics of middle-T are required for cell transformation. In the present study we report that the defect of the T160A middle-T mutant is compensated by mutations introduced into a domain encompassing amino acids 253 to 302. In particular, mutating serine 283, a canonical phosphorylation site for a cyclin-dependent kinase, to an alanine residue rendered the T160A middle-T mutant wild type. Based on these results we suggest that cell cycle-specific phosphorylation of specific serine and threonine residues by cyclin-dependent kinases regulates middle-T function.