PLASMA AND FOLLICULAR FLUID LEVELS OF HIGH SENSITIVITY C REACTIVE PROTEIN (HS- CRP) AND INTERLEUKIN 6 (IL-6) IN WOMEN UNDERGOING IN-VITRO FERTILIZATION (IVF)

PLASMA AND FOLLICULAR FLUID LEVELS OF HIGH SENSITIVITY C REACTIVE PROTEIN (HS- CRP) AND INTERLEUKIN 6 (IL-6) IN WOMEN UNDERGOING IN-VITRO FERTILIZATION (IVF)

Abstract

Background: Nigeria lies within the infertility belt where the incidence of infertility is at the
highest. In-vitro fertilization is the treatment option that has produced the highest pregnancy
rates for infertile couples worldwide. Success rates of In-vitro Fertilization (IVF) procedures,
are low, ranging from 11-46% Worldwide, with implantation failure commonest cause of IVF
failure. The role of inflammatory mediators in implantation outcome and their use in
follicular fluid as markers of oocyte quality is currently being investigated in IVF procedures
with the aim of improving IVF outcome. This study is aimed at investigating the relationship
between plasma and follicular fluid levels of high sensitivity C – reactive protein (hs-CRP),
interleukin-6 (IL-6) with plasma levels of β-hCG (β-hCG).
Method: This was a prospective cohort study consisting of 150 women slated for IVF
treatment. Base-line plasma levels of hs-CRP and IL-6 were measured prior to
commencement of down regulation. Follicular fluid levels of hs-CRP and IL-6 were also
measured during oocyte retrieval and these were compared with plasma levels of β-hCG
measured on the 14th day post embryo transfer.
Results: Baseline median plasma hs-CRP level was 6.00mg/L (IQR=6.81) in study
population, 7.48mg/L (IQR = 7.50) and 3.62mg/L (IQR = 7.17) in study subjects with
negative and positive implantation outcome respectively. The difference was insignificant,
p–value =0.259. Baseline median plasma IL-6 level was 4.98pg/mL (IQR = 6.81) in study
population, 5.01 pg/mL (IQR=11.01) and 4.63 pg/mL (IQR= 9.93) in study subjects with
negative and positive implantation outcome respectively. p-value = 0.97 and insignificant.
Baseline median follicular fluid (FF) hs-CRP was 3.69mg/L (IQR = 5.18) in the study
population, 4.72mg/L (IQR = 5.18) and 2.25mg/L (IQR = 5.01) in subjects with a negative
implantation outcome, and positive implantation outcome respectively. This difference was
statistically significant with a p- value of 0.035. Median FF IL-6 level was 28.55pg/mL (IQR
= 90.13) in study population, 28.53pg/mL (IQR = 126.74), and 28.55pg/mL (IQR = 45.31) in
subjects with negative and positive implantation outcome respectively. The p- value was
insignificant at 0.922. Positive implantation outcome (β-hCG ≥ 200mIU/L) was observed in
55 subjects (36.7%), while 95 subjects (63.3%) had a negative implantation outcome (β-hCG
< 200IU/mL).
Conclusion: Baseline plasma hs-CRP and IL-6 levels were not significantly different
between the study subjects with positive and negative implantation outcome. Implantation
rate was found to be 37% in this study. Higher FF level of hs-CRP was obtained in subjects
with a negative implantation outcome than in subjects with positive implantation outcome,
however FF IL-6 levels were not significantly different between patients with a positive and
those with negative implantation outcome.

PLASMA AND FOLLICULAR FLUID LEVELS OF HIGH SENSITIVITY C REACTIVE PROTEIN (HS- CRP) AND INTERLEUKIN 6 (IL-6) IN WOMEN UNDERGOING IN-VITRO FERTILIZATION (IVF)

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