Abstract

EFFECT OF AGE AND DURATION OF INFERTILITY ON LEVELS OF INTERLEUKIN-18 AND CORRELATION TO PREGNANCY RATE FOR WOMEN UNDERGOING ICSI PROGRAM

Huda Malik Muhammed*, Ula Muhammed Alkawaz and Muhammad-Baqir M-R. Fakhrildin

Abstract

Background: Interleukin-18 (IL-18) is a cytokine which belongs to the interleukin-1 (IL-1) superfamily. Although initially thought to be synthesized mainly by the macrophage and adiposity, now it has been found that IL-18 mRNA is expressed in a variety of cells that include Kupffer cells, T and B cells, osteoblasts and dendritic cells. It is essential to follicular growth and oocyte maturation and it was observed that concentration of IL-18 in serum and follicular fluid increased with raised body mass index. Polycystic Ovarian Syndrome (PCOS) is heterogeneous disorder. They hypothesized that metabolic and inflammatory biomarkers might be increased in PCOS women and PCOS offspring at a young age. Objective: To study the effect of age and duration of infertility on levels of interleukin -18 in PCOS patients undergoing ICSI. Subjects, Materials and Methods. This prospective study was undertaken in the High Institute of Infertility Diagnosis and Assisted Reproductive Technologies / Al- Nahrain University / Baghdad/Iraq, during the period from November 2015 to May 2017. A total of sixty infertile patients were recruited (thirty one patients with PCOS and non PCOS treated with long agonist protocol and twenty nine patients with PCOS and non PCOS treated with antagonist protocol) all undergoing controlled ovarian stimulation for ICSI technique. Serum and follicular fluid levels of IL-18 were measured at the day of oocyte retrieval by Enzyme linked immune sorbent assay (ELISA). Comparison in serum and follicular fluid IL- 18 levels between the groups and their correlation to pregnancy rate was done to all cases. Results: No significant association was found between age of infertile women and serum level of IL-18 levels (P˃0.05), while significant association was found with its follicular fluid level (P˂0.05). According to this study significant difference (P˂0.05) in the serum IL-18 levels with the duration of infertility but not in its follicular fluid level. In addition, there was no significant difference in its levels with the two ovulation induction protocols. Also no significant association was noticed in the levels of interleukin- 18 and pregnancy outcome (P˃0.05). Conclusion: Serum level of IL-18 showed no significant association with increase age. While its follicular fluid level was significantly associated. In addition, there was no significant correlation between follicular fluid levels of IL-18 and duration of infertility but significant correlation was found with its serum level. At the same time, there was neither significant correlation between levels of IL-18 and the two types of ovulation induction protocols nor with the pregnancy rate.

Keywords: ICSI, IL-18, Ovulation, Pregnancy, Infertility.