Role of P53 p.Arg72Pro Variant in Recurrent Pregnancy Loss, Recurrent Implantation Failure and IVF Outcome

The role of p53 p.Arg72Pro variant in recurrent pregnancy loss, recurrent implantation failure and IVF outcome is controversial and research so far has yielded inconsistent results. This systematic review aims to summarise the literature on the role of TP53 p.Arg72Pro variant in recurrent pregnancy loss following natural and assisted conception. A comprehensive literature search was conducted on MEDLINE, EMBASE and CENTRAL electronic databases for literature published between 1998 and April 2020. Inclusion and exclusion criteria and search terms were established. References of retrieved articles were hand searched to identify other relevant papers including conference abstracts. In total, 9 case control studies (1041 patients), 6 case control studies (382 patients) and 7 studies (3403) were included examining the role of TP53 p.Arg72Pro variant in recurrent pregnancy loss, recurrent implantation failure and IVF outcome respectively. Combined genotype frequencies suggest that there may be an association between Pro/Pro genotype and recurrent pregnancy loss and Arg/Pro genotype and recurrent implantation failure. However, the association between TP53 p.Arg72Pro variant and recurrent pregnancy loss, recurrent implantation failure or IVF outcomes has not been clearly established. In conclusion, genotyping patients for the TP53 variant may enable us to identify an aetiology for patients experiencing unexplained recurrent pregnancy loss and detect individuals at risk of recurrent implantation failure before IVF treatment is initiated. Furthermore, exploring the mechanisms of action of the p53 protein may provide us with an insight into potential treatments.