The Interplay of p53 Gene Expression and Inflammatory Markers as Predictors of ART Success

Background & Objective: Infertility affects 10-15% of couples globally, with ART improving success rates. However, implantation failure remains a challenge, influenced by p53 gene expression and inflammatory markers (TNF-α, IL-6). Understanding their interplay could enhance ART outcomes. The present study was conducted with aim to examine how p53 gene expression and inflammatory markers influence endometrial receptivity and implantation.Materials & Methods: This case-control study was conducted on 600 adults from hospitals across Kerala, with 150 infertile couples (cases) and 150 fertile couples (controls) matched by age (34.5±4.9 years). IL-6 and TNF-α levels were measured using enzyme immunoassays, while p53 gene expression was assessed via Real-Time PCR. The associations between inflammatory markers, p53 expression, and implantation failure were evaluated. Data were analyzed using Stata 17.0 and RStudio, with P<0.05 considered significant.Results: Significant differences were observed between cases and controls, with elevated TNF-α, IL-6, and p53 expression in both sexes (P<0.001). ROC analysis showed that IL-6 and p53 had moderate predictive power for implantation failure. Stepwise regression indicated that IL-6 and TNF-α contributed to male infertility, while IL-6 had a strong correlation in females.Conclusion: Elevated IL-6 and TNF-α correlate with increased p53 expression, impacting implantation. While excessive p53 may hinder implantation, controlled inflammation supports receptivity. Targeted interventions, such as anti-inflammatory therapies or p53 modulators, could improve ART outcomes. A deeper understanding of these interactions may lead to personalized treatments for enhanced reproductive success.