NOBOX Gene Expression and Its Association with Hormonal and Inflammatory Markers in Women with Premature Ovarian Failure

Background & Objective: Premature Ovarian Failure (POF), or Primary Ovarian Insufficiency (POI), causes amenorrhea, hormonal imbalance, and infertility before age 40. The NOBOX gene, vital for follicle development and oocyte survival, may play a role in POF, but its links with hormonal and inflammatory markers remain unclear. The present study was conducted with aim to evaluate NOBOX gene expression and its association with reproductive hormones and inflammation in infertile women with POF.Materials & Methods: This case-control study was conducted on 120 infertile women with POF and 120 fertile controls aged 20-40 years. Serum levels of FSH, LH, estradiol, AMH, and IL-6 were measured by ELISA. NOBOX gene expression was quantified using real-time PCR (2^–ΔΔCT method). Data were analyzed using t-test, ROC curve, and quantile regression in Stata 17. P<0.05 was considered significant.Results: Women with POF showed significantly higher FSH and IL-6 levels and lower estradiol, AMH, and NOBOX expression compared to controls (P<0.001). ROC curve indicated high diagnostic accuracy for FSH (AUC 0.95), estradiol (0.94), AMH (0.91), and NOBOX (0.82). FSH and IL-6 levels were inversely correlated with NOBOX expression, suggesting that hormonal and inflammatory dysregulation contributes to gene downregulation in POF.Conclusion: Reduced NOBOX expression is linked to hormonal imbalance and inflammation in POF, supporting its potential as a molecular marker for POF-related infertility and warranting further research.