Comparative Study of Follicular Fluid Inflammatory Cytokines and Post-IVF Pregnancy Outcomes in Women with Polycystic Ovary Syndrome (PCOS)

The process of reproduction is complex and requires optimum functioning of interconnected physiological mechanism. However, any disconnect or failure in ovarian cellular communication between the key cells involved in follicular development may result in infertility. Cytokines, which are important in cellular signaling, play an important role in mechanisms that results in a follicular development, implantation and also in the progression of a pregnancy to live birth. In other to understand the effect of chronic inflammation on follicular development in endocrine diseases such as polycystic ovary syndrome (PCOS), it seems logical to evaluate follicular fluid inflammatory biomarkers which is in direct contact with the follicular cells. This study aims to compare follicular fluid cytokine levels and post In-vitro Fertilization (IVF) pregnancy outcomes. Embryo development was assessed, revealing that women with PCOS had a higher number of oocytes retrieved on day 0, but a lower number of fertilized oocytes and embryos progressing to the cleavage stage and blastocyst stage compared to the control group. Cytokine analysis showed no significant difference in IL-6, IL-12, and TNFα concentrations between subjects with less than 50% oocyte fertilization rate, although IL-18 concentrations were higher in this group. Conversely, IL-12 and TNFα were significantly higher in women with more than 50% oocyte fertilization rate. Further analysis indicated that IL-12 and TNFα concentrations were associated with blastocyst development, with higher levels observed in women with more than two blastocysts. IL-12 was also identified as a discriminating cytokine for positive pregnancy outcomes, with significantly elevated levels in women who achieved pregnancy. No significant differences were found in IL-6, IL-18, and TNFα concentrations between women with positive and negative pregnancy outcomes. These findings suggest that specific cytokines, particularly IL-12 and TNFα, may play a crucial role in oocyte fertilization and embryo development in women undergoing fertility treatment.