Abstract Study question Does intermittent fasting affect sperm viscosity and motility? Summary answer The obtained results demonstrate that intermittent fasting significantly improves sperm viscosity and motility, and might be considered as a potential therapeutic approach for sperm hyperviscosity. What is known already Numerous factors influence sperm quality, functionality, and, consequently, male fertility. In the last decade, nutritional deficiency and lifestyle, have been grouped as popular factors that affect human sperm function and fertilization processes. Semen hyperviscosity which occurs in 12-29% of ejaculates is another condition that can contribute to male subfertility, as it is associated with changes in the chemical and physical characteristics of semen. Additionally, semen hyperviscosity contributes as well to poor sperm motility. Based on the aforementioned facts, focusing on identifying factors to enhance sperm viscosity and motility is crucial for improving IVF outcomes. Study design, size, duration The present study was based on semen analyses of 60 samples from 30 IVF patients. Following the purpose of the study and inclusion criteria, all 30 patients were diagnosed with abnormal sperm viscosity. Out of this number, 13 patients had asthenozoospermia, 4 patients were diagnosed with asthenoteratozoospermia, 7 patients were diagnosed with teratozoospermia and 6 patients had normozoospermia. All patients followed 4 days of sexual abstinence. All specimens were analyzed within 1 hour of collection. Participants/materials, setting, methods Sperm analysis including sperm viscosity was processed according to the WHO laboratory manual sperm criteria (Sixth edition 2021). For the study purpose, all the participants followed an intermittent fasting period of 14-16 hours for 30 days. Samples were analyzed twice, the first time before fasting and the second time after 30 days of fasting. Most of the patients did not consume food from 6 pm until 8 or 10 am. Main results and the role of chance The average age of the patients included in the study was 37.53 ± 4.6 years, while the BMI ranged from 21.26 to 32.28 kg/m2. Abnormal viscosity (hyperviscosity) was diagnosed when the drop formed a thread more than 2 cm long, while normal liquefied ejaculate fell as small discrete drops. The obtained results indicated that sperm parameters were improved after intermittent fasting. The most significant difference was observed in semen viscosity where out of the 30 patients who were diagnosed with abnormal semen viscosity after 30 days of intermittent fasting only 9 patients still had viscose semen (p<0.0001). Additionally, a significant difference was revealed in sperm motility before and after the fasting period as well(33.73±12.15 vs 44.10 ±11.54; respectively p < 0.001). Among the 17 subjects initially diagnosed with abnormal motility, following the implementation of intermittent fasting, 11 demonstrated a sperm improvement and were diagnosed with normal motility. The difference in sperm viability (52.8± 7.71 vs 61.3±8.37; respectively p < 0.01) and Ph values before and after fasting as well were statistically significant. On the other side, although sperm concentration (Mil/ml) was increased after fasting, the difference was not statistically significant (39.03±19.52 vs 41.53±19.19; respectively p = 0.92). Additionally, intermittent fasting did not affect sperm morphology either. Limitations, reasons for caution The limitation of the presented study was a relatively small patient cohort. Further research should link intermittent fasting with IVF outcomes. Wider implications of the findings Until today there are no clear dietary guidelines created for infertile males. As far as we know this is the first research, that includes a comparison of sperm parameters, based on intermittent fasting, and the obtained results confirm that intermittent fasting can be used as a potential therapeutic approach. Trial registration number not applicable

Abstract Study question Does the concentration of amphiregulin in the follicular fluid affect oocyte maturation and embryo quality in patients with polycystic ovarian syndrome? Summary answer The concentration of amphiregulin affects oocyte maturity and embryo quality in patients with polycystic ovarian syndrome and can be used as a predictive biomarker. What is known already Polycystic ovary syndrome (PCOS) is a common metabolic dysfunction and heterogeneous endocrine disorder in women of reproductive age. Epidermal growth factor receptors and their ligands, such as amphiregulin, which are expressed in female reproductive tissues, have been shown to regulate various important reproductive functions. Amphiregulin is reportedly involved in oocyte maturation through autocrine and paracrine mechanisms, however, the impact of amphiregulin on oocyte maturity end embryo quality in patients diagnosed with POCS which goes under controlled ovarian stimulation remains unknown. Determination of potential biomarkers might be the key to successful IVF outcomes. Study design, size, duration The study consisted of a total of 87 oocytes obtained from 30 patients who underwent ICSI at UKS Homburg (Germany) between October 2021 and March 2022. Fifteen patients were diagnosed with polycystic ovary syndrome while the other fifteen were fertile without any diagnosis. For the study purpose, follicles were aspirated separately, and the follicular fluid was centrifuged for 5 min at 1,500×g. After the preparation, the supernatant was removed and stored at -20 °C until analysis. Participants/materials, setting, methods Concentrations of amphiregulin in follicular fluid were determined by using a commercially available sandwich ELISAkit (Duo Set; R&D Systems Inc., Minneapolis) in accordance with the manufacturer’s instructions. Good embryo quality (GQE) on day 3 was defined as a 7-9 cell stage embryo with less than 25% of fragmentation and with equally sized blastomeres. Between-group comparisons were conducted with a Mann-Whitney test. Logistic regression analysis was used to determine the influence of amphiregulin on studied parameters. Main results and the role of chance The mean age of all patients was 33.5 (±5.2) years. Patients included in the study were stimulated according to a gonadotropin-releasing hormone (GnRH) antagonist protocol. Out of the 87 oocytes, 59 (67.8%) were at MII stadium, 13 (14.9%) were at MI and 8 (9.1%) were at GV stadium. ICSI was done only with MII and MI oocytes and the fertilization rate was 70.1% (61 oocytes were fertilized out of 72). Obtained results showed that concentrations of amphiregulin were significantly lower in follicular fluid of PCOS patients [(107.00(51.95-131.00) ng/mL vs 115.27(43.19-209.51) ng/mL) respectively; p = 0.024]. Data comparisons between mature and immature oocytes indicated that amphiregulin concentration was significantly higher in follicles where mature oocytes were developed [(117.50 (65.99-209.51) ng/mL vs 81.75(43.19-128.20) ng/mL) respectively; p < 0.0001]. Additionally, logistic regression analysis confirmed the positive effect of amphiregulin concentration on oocyte maturity (p < 0.001). Out of the 61 fertilized oocytes, 36 (59.0%) formed good-quality embryos. Additional analysis indicated that oocytes that developed into good-quality embryos came from follicles where amphiregulin concentrations were significantly higher compared to those that developed into poor-quality embryos [(124.05 (91.88-209.51) ng/mL. vs 86.72(43.19-109.40) ng/mL) respectively; p < 0.001]. Logistic regression analysis confirmed the positive effect of amphiregulin concentration on embryo quality (p < 0.01). Limitations, reasons for caution The limitation of the presented study was the relatively small patient cohort. Although the pregnancy rate in the presented study was 27.8 % , single embryo transfer was not performed, therefore further research should link amphiregulin concentrations with the pregnancy rate as well. Wider implications of the findings Results obtained in the study might be useful for further handling of PCOS patients since the literature already confirmed that PCOS patients produce an increased number of mature oocytes, so culture medium-containing amphiregulin might be a future solution for those patients. Trial registration number 146/19

Abstract Study question Does the concentration of amphiregulin in follicular fluid affect survival rate and embryo quality after the vitrification process? Summary answer The concentration of amphiregulin affects development potential and embryo quality after zygote vitrification and can be used as a predictive biomarker. What is known already Epidermal growth factor receptors and its ligands, such as amphiregulin(AR), which are expressed in female reproductive tissues, have been shown to regulate various important reproductive functions. Amphiregulin concentration in follicular fluid is correlated with human oocyte developmental competence and IVF outcomes. Unlike other countries, Germany has a specific Embryo Protection Act (EPA), where the choice of embryos that have the highest potential for successful implantation must be made at the pronuclear stage(PN); in addition, all supernumerary fertilized oocytes are cryopreserved on the zygote stage. Due to EPA, the determination of potential biomarkers is key for successful IVF outcomes in Germany. Study design, size, duration This study consisted a total of 43 vitrified 2PN stage zygotes from 19 patients who underwent ICSI at UKS Homburg, (Germany) between April 2020 and November 2020. For the study purpose, follicles were aspirated separately, and the follicular fluid (FF) was centrifuged for 5 min at 1,500×g, after that supernatant was removed and stored at -20. Zygote vitrification was performed according to company guidelines (RapidVit Omni, Vitrolife). Participants/materials, setting, methods Concentrations of AR in FF were determined by using a commercially available sandwich ELISA kit (DuoSet Kit; R&D Systems Inc., Minneapolis) in accordance with the manufacturer’s instructions. Good embryo quality on day 3 was defined as a 7-9 cell stage embryo with less than 25% of fragmentation and with equally sized blastomeres. Between-group comparisons were tested using a t-test. Logistic regression analysis was used to determine the influence of amphiregulin on vitrification outcomes. Main results and the role of chance The mean age of all patients was 31.6 (±3.5) years. Patients included in the study were stimulated according to a gonadotropin-releasing hormone (GnRH) antagonist protocol. All zygotes were frozen 20h after injection. Out of the 43 frozen zygotes, 38 (88.3%) survived the thawing process and continued development. Obtained results showed that concentrations of amphiregulin were significantly higher in FF where zygote continued the development [(95.88±37.02 ng/mL vs 79.19±9.92 ng/mL) respectively; p < 0.05]. In addition, 26 (68.4%) vitrified zygotes developed into good-quality embryos, while 17 (31.6%) embryos had poor quality. Data comparisons between good and poor-quality embryos indicated that good-quality embryos came from follicles where amphiregulin concentration was significantly higher [(113.52 ±30.36 ng/mL. vs 63.98 ±1.93 ng/mL) respectively; p < 0.0001]. What is more, logistic regression analysis confirmed the positive effect of amphiregulin concentration on embryo quality (p < 0.01). Limitations, reasons for caution The limitation of the presented study was a relatively small patient cohort. Although the pregnancy rate in the presented study was 36.8 % single embryo transfer was not performed, therefore further research should link amphiregulin concentrations with blastocyst quality and pregnancy rate as well. Wider implications of the findings The literature already confirmed a lower development potential of vitrified zygotes compared to cleaved embryos or blastocyst. Therefore, obtained findings might be helpful for the success of the vitrification process in Germany. Additionally, our findings can be a basis for the future study of amphiregulin as a biomarker. Trial registration number not applicable

Abstract Study question Does the total cytoplasmic volume (TCV) of the zygote and time of pronuclei disappearance (tPNf) affect blastocyst development potential and blastocyst quality? Summary answer The total cytoplasmic volume of zygote and the time of pronuclei disappearance strongly affect blastocyst development as well as blastocyst quality. What is known already Extended embryo culture with blastocyst transfer is considered a useful method for selecting embryos with a high implantation potential. One of the main concerns in the German Embryo Protection Act is that the choice of embryos that have a high potential for successful implantation must be made at the pronucleus stage. The introduction of time-lapse technology enabled comprehensive information regarding the morphology and kinetics of the embryo. Although for the past years, strong correlations between embryo morphokinetics and positive outcomes have been demonstrated, some disagreement concerning the wide application of these parameters into an early-stage embryo selection is still present. Study design, size, duration The injection time of ICSI was designated as “time zero”, and computer software was used to calculate the time frame between the injection and the moment of pronuclei disappearance (tPNf). The total cytoplasmic volume was calculated 16–18 h after injection based on manually drawn diameters of the zygotes, by the computer. Obtained measurements were later associated with the blastocyst formation potential as well as with blastocyst quality. Participants/materials, setting, methods A total of 187 oocytes from 34 patients undergoing the antagonist cycle for ICSI treatment were evaluated. All blastocysts were cultured in Embryoscope™ according to the manufacturer’s specifications (Vitrolife, Sweden). The Gardner and Schoolcraft scoring system was used to describe blastocyst quality. Statistical analyses were performed using IBM SPSS version 24. Data were reported as median and range. Differences between groups were tested using the Mann-Whitney U test. Statistical significance was defined as p < 0.05. Main results and the role of chance Obtained data showed that the total cytoplasmic volume values were significantly higher in zygotes that reached the blastocyst stage compared with those that did not [708376,268µm³ (560564,412µm³ - 838602,605µm³) vs 674349,917 (415749,353- 823640,638) respectively; p < 0.0001]. Furthermore, this parameter as well significantly affect blastocyst quality where zygotes which formed better blastocyst quality had smaller cytoplasmic volume [685568,079 µm³ (560564,412- 790112,397µm³) vs 745514,662 µm³ (616581,339- 838602,605) respectively; p < 0.0001]. Time of pronuclei disappearance (tPNf) was significantly different (p < 0.0001) in successfully formed blastocysts [22.00h (17–29 h)] versus arrested or non-blastulating embryos [23.00h (17–56 h)]. Zygotes who had a shorter time frame between injection and pronuclei disappearance showed better blastocyst quality values compared with those who had longer time frame [21.00h (17–28h) vs 23.00h (18–29h) respectively; p < 0.01]. Limitations, reasons for caution The limitation of the presented study was that due to the double-embryo transfer correlation between morphokinetic parameters and pregnancy rate was not possible to be calculated. Further research should link these morphokinetic parameters with pregnancy rate and live birth rate as well. Wider implications of the findings: The potential of the present findings is considerable, especially for countries with strict Embryo Law Regulation. Obtained results might be highly useful for selecting embryos with high implantation potential. In addition, the present work illustrates the possibility of additional information that can potentially be incorporated into an embryo classification model. Trial registration number Not applicable

The topic of fertility preservation has been gaining increasing importance since the beginning of this century. The reasons for this development are the advances in oncological therapy over the past few decades, with cure rates of approximately over 90%, and the fact that starting families is increasingly postponed in later periods of life in industrialized countries. Since March 2020 the whole medical and non-medical world experiences a pandemic due to Covid-19 (coronavirus disease 2019) which has never been seen before. This created a plenty of challenges for both, the patients and healthcare providers. This review article presents the fertility-protective methods currently available for women and men suffering from cancer with their clinical approach, value, advantages and disadvantages. Besides, it focuses on the changes and special considerations which have to be taken into account during pandemic times including preventive measures as well as the patient's access to the fertility preserving options. In conclusion every premenopausal woman and every man with incomplete family planning suffering from cancer should be counselled about the existing fertility preserving techniques before commencing cancer therapy.

Abstract Study question Does the spatial arrangement of blastomeres and the start of blastulation affect blastocyst quality? Summary answer Better blastocyst quality is associated with the spatial arrangement of the embryo and the shorter time frame of blastulation (cavitation). What is known already The ability to select the human embryo with the highest implantation potential remains one of the greatest challenges in the management of In Vitro Fertilization patients. Several publications have proposed that additional morphological evaluations of blastomere arrangement and the dynamics of late-stage embryonic divisions might be a useful non-invasive way for embryo selection. In the last decade, the introduction of time-lapse technology enables continuous monitoring of embryo development, which leads to better outcomes than a selection based on the traditional morphology assessment. Study design, size, duration The spatial arrangement was defined as tetrahedrally if the cleavage planes were perpendicularly orientated, while embryos with rather parallelly orientated cleavage axes were considered as non-tetrahedral embryos. The injection time of ICSI was designated as “time zero” (t0), and EmbryoViewer software was used to calculate the time duration between injection and start of blastulation (cavitation). Obtained results were later correlated with the embryo’s capability to form a blastocyst as well as with blastocyst quality. Participants/materials, setting, methods A total of 195 oocytes from 40 patients undergoing the antagonist cycle for ICSI treatment were evaluated. All blastocysts were cultured in Embryoscope™ according to the manufacturer’s specifications (Vitrolife, Sweden). The Gardner and Schoolcraft scoring system was used to describe blastocyst quality. Statistical analyses were performed using IBM SPSS version 24. Data were reported as median and range. Differences between groups were tested using the Mann-Whitney U test. Statistical significance was defined as p < 0.05. Main results and the role of chance Obtained data showed that 83.6% (61/73) of embryos with tetrahedral arrangement formed blastocysts compared to 42.4% (50/116) of embryos with the non-tetrahedral arrangement (p < 0,001). Moreover, tetrahedral embryos more frequently formed good quality blastocyst compare to the non-tetrahedral [59% (36/61) vs 18 (9/50)% respectively; p < 0,001]. In addition, we found that good quality blastocyst had a significantly shorter time frame between injection and blastulation start, compared with blastocysts which did not reach good quality [95.00h (84–118) vs 102h (77–121) respectively; p = 0,006]. Limitations, reasons for caution The limitation of the present study was that due to the double-embryo transfer correlation between those morphokinetic parameters and pregnancy rate can not be calculated. Further research should link these morphokinetic parameters with pregnancy rate and live birth rate as well. Wider implications of the findings: The potential of our findings is considerable, especially for countries with strict Embryo Law Regulation. Obtained results might be highly useful for selecting embryos with high implantation potential. In addition, the present work illustrates the possibility of additional information that can potentially be incorporated into an embryo classification model. Trial registration number Not applicable

Background: Insufficient nutrition and inappropriate diet have been related to many diseases. Although the literature confirms the hypothesis that particular nutritional factors can influence the quality of semen, until today, there are no specific dietary recommendations created for infertile males. Since the male contribution to the fertility of a couple is crucial, it is of high importance to determine the dietary factors that can affect male fertility. Aim: The aim of the present study was to evaluate differences in sperm quality parameters, sperm oxidative stress values and sperm acrosome reaction between vegan diet consumers and non-vegans. Setting and Design: Prospective study in a University Medical School. Materials and Methods: The present study was undertaken to evaluate the sperm quality parameters of vegan diet consumers (10 males who had a strictly vegetable diet with no animal products) and compare them with non-vegans (10 males with no diet restrictions). Semen quality was assessed following the World Health Organization (2010) criteria. Acrosome and DNA integrity has been evaluated using the immunofluorescence technique. Statistical Analysis: All variables were analysed by IBM SPSS version 24. Mean differences among groups were compared by Mann–Whitney U-test. Results: Obtained results showed that total sperm count (224.7 [117–369] vs. 119.7 [64.8–442.8]; P = 0.011) and the percentage of rapid progressively motile sperm were significantly higher in the vegan group compared with the non-vegan group (1 [0–7] vs. 17.5 [15–30]; P < 0.0001). Furthermore, the oxidation-reduction potential (0.4 [0.3–0.9] vs. 1.5 [0.6–2.8]; P < 0.0001) and the proportion of spermatozoon with DNA damage (14.7 [7–33.5] vs. 8.2 [3–19.5]; P = 0.05) were significantly higher in the non-vegan group in comparison to the vegan group. Conclusions: Results obtained in this study provide additional evidence about the favourable effect of a plant-based diet on sperm parameters. To confirm our preliminary findings, further studies including larger cohorts are warranted.

Zielsetzung Das primäre Ziel der Studie war die Untersuchung der prädiktiven Wertigkeit der Sec62-Expression im Hinblick auf das Ansprechen auf eine neoadjuvante Chemotherapie bei Patientinnen mit primärem Mammakarzinom. Sekundär wurden die Sec62-Expressonsmuster der einzelnen Mammakarzinomsubtypen analysiert.

Zielsetzung Vergleich des geburtshilflichen und perinatalen Outcomes von deutschen Frauen und syrischen Geflüchteten, die in Homburg/Saar entbunden haben.

Zielsetzung Dickkopf-1 (DKK-1) ist ein löslicher Inhibitor des Wnt-Signalwegs. Im Bereich Mammakarzinom scheint es eine Funktion bei der Pathogenese und Progression der Erkrankungen zu haben. In Vorarbeiten der eigenen Arbeitsgruppen konnte eine Bedeutung des DKK1 für die Metastasierung vor allem bei ossär metastasierten Patientinnen nachgewiesen werden. Bereits belegt worden ist, dass die Serumkonzentration des Dkk-1 durch die Therapie mit Tamoxifen vermindert wird.

Background Prenatal measurement of placental biomarkers was able to improve screening and diagnosis of preeclampsia. Little is known about the clinical role of placental biomarkers in the postpartum period. Methods This study is a prospective monocentric trial that included a total of 30 women with preeclamptic pregnancies. Serum placental biomarkers including soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF) were measured before and 2 h after delivery by Enzyme-Linked Immunosorbent Assay (ELISA) using commercially available kits according to manufacturer's instructions and correlated with the postpartum outcome. Results Postpartum higher serum PlGF level was associated with postpartum elevation of the systolic blood pressure. Yet, the placental biomarkers were not able to predict general worsening of postpartum preeclampsia or other individual clinical or laboratory parameters. Conclusion Serum concentrations of sFlt-1 and PlGF or their ratio in our study cohort did not completely predict the occurrence of postpartum preeclampsia. Yet, postpartum higher serum PlGF level was associated with postpartum elevation of the systolic blood pressure.

Breast cancer (BC) is the most common malignant tumor disease of women worldwide. Approximately 15 – 20% of patients have a specific subtype defined by the lack of expression of the estrogen receptor and progesterone receptor as well as Her2. This subtype is called triple-negative breast carcinoma (TNBC) and is associated with bad outcomes including early metastasis, early relapse, and poor overall survival. Since neither antihormonal- nor a Her2-neu directed antibody therapy is possible, the treatment options in these cases are very limited. Therefore, further prognostic markers are needed to better adapt the treatment strategy to the disease. SEC62, a gene located at chromosomal region 3q26.2 that encodes an endoplasmic reticulum (ER) transmembrane protein, is found to be overexpressed and significantly associated with a worse prognosis in various cancer types such as non-small cell lung cancer, thyroid cancer, and head and neck squamous cell carcinoma. Therefore, we aimed in this study to investigate SEC62 expression in TNBC to evaluate its possible role as a prognostic and predictive biomarker in this tumor entity.

Mammakarzinom ist die häufigste bösartige Tumorerkrankung der Frau. Etwa 15 – 20% der Patientinnen haben triple-negatives Mammakarzinom (TNBC). Dieser Subtyp ist mit besonders schlechtem Gesamtüberleben vergesellschaftet. Die daran erkrankten Patientinnen erleben eine besonders frühe Metastasierung, ein frühes Rezidiv und leiden unter einer reduzierten Lebenserwartung. Da weder eine antihormonelle- noch eine Her2-neu gerichtete Antikörper-Therapie möglich ist, sind die Behandlungsmöglichkeiten in diesen Fällen sehr eingeschränkt. Die Chemotherapie ist die einzige therapeutische Möglichkeit. Einige Studien konnten zeigen, dass die Biologie des TNBC sehr heterogen ist sowohl biologisch als auch klinisch. Die triple-negativen Tumore können in 6 molekularen Subgruppen eingeteilt werden: basal-like 1, basal-like 2, immunmodulatory, mesenchymal, mesenchymal-stem-like and luminal/AR tumours und zeigen die beschriebene Heterogenität. Basal-like 1 und 2 Tumore sind häufig mit einer BRCA Mutation assoziiert. Wissenschaftlich interessant wäre es, anhand von Prognosefaktoren herauszufinden, welche Patientin welches Outcome hat. Es ist unserer Arbeitsgruppe gelungen den Her2 neu Score als Prognosefaktor zu identifizieren. Wir konnten zeigen, dass ein Her2 neu Score von 0 in TNBC mit einem signifikant schlechterem Gesamt- und krankheitsfreiem Überleben vergesellschaftet ist, verglichen mit einem Her2 neu Score von 1 oder 2. Doch weitere Forschung auf diesem Gebiet ist nötig. Eine 2013 veröffentliche Studie zeigte, dass auch die Expression von Vimentin als möglicher prognostischer Faktor fungieren kann. Ebenso gibt es Daten, dass die Expression des Androgenrezeptors bezüglich des Outcomes eine Rolle spielt genauso wie verschiedene Cytokine wie CK5/6, CK14/17, p53 etc. Ziel dieser Studie war die Identifikation weiterer Prognosefaktoren beim TNBC.

In vorausgehenden Studien haben wir gezeigt, dass SEC62 eine essentielle Funktion in der Zellmigration, epithelial-mesenchymalen Transition und der intrazellulären Stresstoleranz von Tumorzellen hat. Es wurde eine Korrelation zwischen erhöhtem SEC62-Proteinspiegel und Lymphknotenmetastasen, sowie einem schlechteren Gesamtüberleben (OS) bei verschiedenen Tumorentitäten (nicht-kleinzelligem Lungenkarzinom, Schilddrüsenneoplasien, Kopf- und Hals-Plattenepithelkarzinom) gefunden. In dieser Studie untersuchten wir die SEC62 Expression und deren mögliche Rolle als prognostischer und prädiktiver Biomarker beim Mammakarzinom.

Etwa 15 – 20% der Patientinnen haben triple-negatives Mamma-karzinom (TNBC). Dieser Subtyp ist mit besonders schlechtem Gesamtüberleben vergesellschaftet. Einige Studien konnten zeigen, dass die Biologie des TNBC sehr heterogen ist sowohl biologisch als auch klinisch, denn nicht alle Patientinnen mit einem TNBC haben eine schlechte Prognose. Wissenschaftlich interessant wäre es, anhand von Prognosefaktoren herauszufinden, welche Patientin welches Outcome hat. Unserer Arbeitsgruppe konnte bereits den Her2-neu Score als Prognosefaktor identifizieren. Wir konnten zeigen, dass ein Her2-neu Score von 0 in TNBC mit einem signifikant schlechterem Gesamt- und krankheitsfreiem Überleben vergesellschaftet ist, verglichen mit einem Her2 neu Score von 1 oder 2 (Schmidt et al., 2016). Doch weitere Prognosefaktoren werden benötigt. Die Expression von Vimentin könnte ebenfalls als möglicher prognostischer Faktor fungieren wie eine 2013 veröffentliche Studie von Yamashita et al zeigte. Dies wurde an unserem Studienkollektiv geprüft.

Wissenschaftlich wurde belegt, dass ein präpartal erhöhter sFlt-1/PlGF Quotient die Entwicklung einer Präeklampsie vorhersagen kann. Postpartal können bei Präeklampsie Komplikationen, z.B. HELLP Syndrom oder Eklampsie auftreten. Unbekannt ist, ob postpartal die anti- und angiogenetische Biomarker den postpartalen Verlauf vorhersagen können, welches Ziel dieser Arbeit ist.