Pervin KARLI, Ayşe Zehra ÖZDEMİR, Cagri GULUMSER

Do inflammation and hormone parameters have effects on IVF results in patients with unexplained infertility?

Aim: To invastigate the inflammatory process and hormone parameters as a result of underlying cause of unexplained infertility (UI)Metarial and Methods: In total 153 patients with UI who underwent to intracytoplasmic sperm injection (ICSI) were included in thestudy. The blood hormones levels were obtained on the 2nd or 3rd day of the menstruation. Other blood count examinations weretaken on the day of HCG administration. Relationship regarding embryo grade was also investigated.Results: Of those 153 patients, only 42 of them got pregnant. Mean maternal age was 29.08±3.5 and mean duration of the infertilitywas 8.19±3.1 years, respectively. There was no statistically significant difference between pregnancy rate, embriyo grade, and FSH,progesterone, fT3, fT4, TSH levels (p>0.05). Also no significant difference was found between pregnancy rate, embriyo grade andhemoglobin, hemotocrit, platelet, mean platelet volume, neutrophil, lymphocyte counts, neutrophil lymphocyte ratio and plateletlymphocyte ratio (PLR) (p>0.05). However, a significant difference was found between embriyo grade and estradiol values (p

PDF

___

1. Karimpour A, Esmaeelnezhad Moghadam A, Moslemizadeh N, et al. Incidence and main causes of infertility in patients attending the infertility center of Imam Khomeini Hospital in 2002-2004. J Mazandaran Univ Med Sci 2005;15:44-9.
2. Kazem M, Ali A. An overview of the epidemiology of primary infertility in Iran. J Reprod Infertility 2009;10:213-16.
3. Jaiswar SP, Sachan R, Singh RK, et al. Free radicals in female infertility. J Obstet Gynecol India 2006;56:64-7.
4. Kumari P, Jaiswar SP, Shankhwar P, et al. Leptin as a predictive marker in unexplained infertility in north indian population. J Clin Diagn Res 2017;11:QC28-31.
5. Te Velde ER, Eijkemans R, Habbema HD. Variation in couple fecundity and time to pregnancy, an essential concept in human reproduction. Lancet 2000;355:1928-29.
6. Collin JA, Rowe TC. Age study of the female partner is aprognostic factor in prolonged unexplained infertility: A multicentre study. Fertil Steril 1989;52:15-20.
7. Tola EN. The association between in vitro fertilization outcome and the inflammatory markers of complete blood count among nonobese unexplained infertile couples. Taiwan J Obstet Gynecol 2018;57:289-94.
8. Blacker CM, Ginsburg KA, Leach RE, et al. Unexplained infertility: evaluation of the luteal phase; results of the National Center for Infertility Research at Michigan. Fertil Steril 1997;67:437-42.
9. Guzick DS, Carson SA, Coutifaris C, et al. Efficacy of super ovulation and intrauterine insemination in the treatment of infertility, National Cooperative Reproductive Medicine Network. N Engl J Med 1999;340:177-83.
10. Leach RE, Moghissi KS, Randolph JF, et al. Intensive hormone monitoring in women with unexplained infertility: evidence for subtle abnormalities suggestive of diminished ovarian reserve. Fertil Steril 1997;68:413-20.
11. Vitek WS, Galarraga O, Klatsky PC, et al. . Management of the first in vitro fertilization cycle for unexplained infertility: a costeffectiveness analysis of split in vitro fertilization-intracytoplasmic sperm injection. Fertil Steril 2013;100:1381-8.
12. Repaci A, Gambineri A, Pasquali R. The role of low-grade inflammation in the polycystic ovary syndrome. Mol Cell Endocrinol 2011;335:30-41.
13. Turan V, Sezer ED, Zeybek B, et al. Sendag F. Infertility and the presence of insülin resistance are associated with increased oxidative stress in young, non-obese Turkish women with polycystic ovary syndrome. J Pediatr Adolesc Gynecol 2015;28:11-23.
14. Hyderali BN, Mala K. Oxidative stress and cardiovascular complications in polycystic ovarian syndrome. Eur J Obstet Gynecol Reprod Biol 2015;191:15-22.
15. Orio Jr F, Palomba S, Cascella T, et al. The increase of leukocytes as a new putative marker of low-grade chronic inflammation and early cardiovascular risk in polycystic ovary syndrome. J Clin Endocrinol Metab 2005;90:2-5.
16. Letterio JJ, Roberts AB. Regulation of immune responses by TGF-beta. Annu Rev Immunol 1998;16:137-61.
17. An LF, Zhang XH, Sun XT, et al. Unexplained infertility patients have increased serum IL-2, IL-4, IL-6, IL-8, IL-21,
TNFalpha, IFNgamma and increased Tfh/CD4 T cell ratio: increased Tfh and IL-21 strongly correlate with presence of autoantibodies. Immunol Invest 2015;44:164-73.
18. Practice Committee of the American Society for Reproductive Medicine. Effectiveness and treatment for unexplained infertility. Fertilsteril 2006;86:111.
19. Vitek WS, Galarraga O, Klatsky PC, et al. Management of the first in vitro fertilization cycle for unexplained infertility: a costeffectiveness analysis of split in vitro fertilization-intracytoplasmic sperm injection. Fertil Steril 2013;100:1381-8.
20. Spritzer PM, Lecke SB, Satler F, et al. Adipose tissue dysfunction, adipokines, and low-grade chronic inflammation in polycystic ovary syndrome. Reproduction 2015;149:219-27
21. Hoffman M, Blum A, Baruch R, et al. Leukocytes and coronary heart disease. Atherosclerosis 2004;172:1-6
22. Silfeler DB, Kurt RK, Yengil E, et al. Evaluation of Mean Platelet Volume values in lean women with polycystic ovary syndrome. Pak J Med Sci 2014;30:589-92
23. Letterio JJ, Roberts AB. Regulation of immune responses by TGF-beta. Annu Rev Immunol 1998;16:137e61.24.
24. Verit FF, Cetin O, Yildirim O, et al. Neutrophil to lymphocyte ratio is superior to platelet to lymphocyte ratio as an early predictor of moderate/severe ovarian hyperstimulation syndrome. J Obstet Gynaecol 2014;34:639-43.
25. Fornari MC, Sarto A, Berardi VE, et al. Effect of ovaric hyper-stimulation on blood lymphocyte subpopulations, cytokines,leptin and nitrite among patients with unexplained infertility. Am J Reprod Immunol 2002;48:394-403.
26. Işikci T, Hassa H, Aydin Y, Açıklanamayan infertilite olgularında ivf başarısı predikte edilebilir mi?. Turkiye Klinikleri J Gynecol Obstet 2014;24:104-9.
27. Cakiroglu Y, Vural F, Vural B. The inflammatory markers in polycystic ovary syndrome: association with obesity and IVF outcomes. J Endocrinol Invest 2016;39:899-907.
28. An LF, Zhang XH, Sun XT, et al. Unexplained infertilitypatients have increased serum IL-2, IL-4, IL-6, IL-8, IL-21, TNFalpha, IFNgamma and increased Tfh/CD4 T cell ratio: increased Tfh and IL-21 strongly correlate with presence of autoantibodies. Immunol Invest 2015;44:164-73.
29. Gasparyan AY, Ayvazyan L, Mikhailidis DP, et al. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des 2011;17:47-58.
30. Jasper MJ, Tremellen KP, Robertson SA. Primary unexplained infertility is associated with reduced expression of the T-regulatory cell transcription factor Foxp3 in endometrial tissue. Mol Hum Reprod 2006;12:301-8.
31. Balta S, Celik T, Mikhailidis DP, et al. The relation between atherosclerosis and the neutrophil-lymphocyte ratio. Clin Appl Thromb Hemost 2016;22:405-11.