Is a high serum copper concentration a risk factor for implantation failure?

Area of Science:

• Reproductive Endocrinology
• Trace Element Metabolism

Background:

• Copper-containing contraceptives are linked to endometrial copper deposition and implantation failure.
• Wilson's disease patients with copper accumulation show subfertility, suggesting endometrial copper's role.
• Zinc treatment in Wilson's disease improves fertility, indicating copper absorption interference.

Purpose of the Study:

• To investigate the relationship between serum copper concentrations and in vivo human embryo implantation (pregnancy) rates.
• To explore if elevated copper levels contribute to implantation failure in infertile patients.
• To assess copper and zinc levels in relation to pregnancy outcomes.

Main Methods:

• Retrospective analysis of 269 women (<40 years) undergoing single embryo transfer in hormone replacement cycles.
• Serum hCG, copper, and zinc levels measured 16 days post-progesterone initiation.
• Comparison of pregnant (n=96) and non-pregnant (n=173) groups.

Main Results:

• No significant differences in age or BMI between pregnant and non-pregnant groups.
• Significantly higher serum copper concentrations in the non-pregnant group (193.2 μg/dL) vs. pregnant group (178.1 μg/dL).
• The copper/zinc (Cu/Zn) ratio was a better predictor of clinical pregnancy (AUC 0.64) than copper or zinc alone.

Conclusions:

• Elevated serum copper concentrations, indicated by a high Cu/Zn ratio, are associated with implantation failure.
• High Cu/Zn ratio may serve as a risk factor for unsuccessful embryo implantation.
• Further research is warranted to confirm these findings and explore clinical implications.