دراسة الحركات المناعية 12٫5 و 18 لدى الاناث العقيمات : الارتباط مع مستوى هرمونات الخصوبة , نضوج البيوض و تطورالجنين في دورة أطفال الأنابيب والحقن المجهري

Study of Interleukins 5, 12 and 18 in Infertile Female: Correlation with Reproductive Hormonal Levels, Oocyte Maturity and Embryonic Development IVF-ICSI Cycle

Summary
Infertility is the incapacity to fulfill pregnancy after reasonable time of sexual intercourse with no contraceptive measures taken. Ovulation disorders are one of the female factors that causes of infertility, including polycystic ovaries Syndrome (PCOS) and poor Ovarian reserve (POR). The ovarian tissue in addition to the immune cells produces Cytokines. Cytokine function in the ovary described as promoting processes of follicular growth, steroidogenesis, recruitment and activation of leukocytes necessary for ovulation and tissue remodelling during ovulation, luteinization, and luteolysis. The current study has aimed to evaluate interleukin 5 (IL-5), interleukin 12 (IL-12) and interleukin 18 (IL-18) in follicular fluid and serum and studied the correlation between these markers and Intracytoplasmic sperm injection (ICSI) outcomes.
This study is a cross sectional and subjects of this study are divided into three groups : infertility due to male factor (n=40), PCOS (n=30) and POR (n=30) enrolled in AL-Sader Teaching Medical City, Al-Kafeel Super-speciality hospital and Al-Ameer International Center for Fertilization and IVF during the period from November 2022 to April 2023. The samples of blood were collected at cycle day two and detected the level of follicle stimulating hormone, luteinizing hormone, prolactin hormone, estradiol hormone, anti-mullerian hormone and estradiol hormone at day hCG injection by MINI VIDS. Serum and follicular fluid collected at oocytes retrieval day and detected levels of IL-5, IL-12 and IL-18 by ELISA technique.
The result of present study showed that day 2; FSH was higher level while, E2, AMH and Estradiol hormone (E2) at day of HCG injection were lower level in POR and there were significantly different from male factor and PCOS cases with (P=0.005, P=0.008, P=0.005, P=0.005) respectively. LH was low level in Male factor cause and there was significantly different from PCOS and POR patients with (P=0.006). While, prolactin was high level in PCOS cause and there was significantly different from male factor and POR causes with (P=0.005). In addition, the low mean of Total follicle number, Embryo Grade l (GI), Embryo Grade ll (GII) of POR cases were significantly different from male factor and PCOS cases with (P=0.005, P=0.005 and P=0.003) respectively. Whereas, the high mean of Embryo Grade III (Glll) of PCOS cases was significantly different from male factor and POR patients with (P= 0.030), the low mean of Transferred embryo in POR was significantly different from male factor and PCOS patients with (P=0.015).
Regarding, the serum and follicular levels of cytokines (IL-5, IL-12 and IL-18), there were no significant difference between groups except higher median of IL-12 level in the follicular fluid and serum of Male factor was significantly different from PCOS and POR patients with (P=0.005). Also, about the low mean of transferred embryo in non pregnant women, there was a significant difference between B-HCG groups with (P=0.013). Furthermore, higher median of follicular fluid and serum levels of IL-5 in negative group were a significant difference between B. HCG groups with (P=0.005). In addition, higher median of the follicular fluid and serum levels of IL- 18 in positive group were a significant difference between B-HCG groups with (P=0.005).
Moreover, in this study there were a positive correlation between IL- 18 serum level and fertilization rate in male factor cases with (P= 0.033). While in PCOS women, there were a negative correlation between IL-5 in follicular fluid and fertilization rate with (P= 0.020) and a positive correlation between IL12 in follicular fluid and embryo grade II with (P= 0.014). Concerning the POR there were a negative correlation between IL-5 in follicular fluid and embryo grade II with (P= 0.033) and positive correlation between IL-18 in follicular fluid and embryo grade II with (P= 0.021), also, positive correlation between IL-5 serum level with maturity rate with (P=0.044). About IL-12 serum level, there was a negative correlation with fertilization rate with (P= 0.002), while, IL-18 serum level was positive correlation with embryo grade II with (P= 0.024).
The results of this study have shown a non significant difference between groups regarding cytokines levels in follicular fluid and serum except elevation of IL-12 level in follicular fluid and serum for male factor patients compared with PCOS and POR patients . Therefore, these markers might have no important role in the intracytoplasmic sperm injection (ICSI) outcomes.