Evaluation of SFRP5 Role in Relevance to BMI in Prediction of Pregnancy in a Sample of Iraqi Infertile Females Undergoing ICSI
DOI:
https://doi.org/10.28969/IJEIR.v14.i1.r8.24Keywords:
Intracytoplasmic sperm injection (ICSI)Abstract
Background: Adipose tissue macrophage infiltration and obesity are related. These macrophage cells influence adipose tissue by releasing many bioactive chemicals, including the wingless-type MMTV integration site family 5a (wnt5a) glycopeptides and the more traditional cytokines. Healthy adipocytes can release the wnt5a inhibitor Secreted frizzled-related protein 5(SFRP5). However, this protective effect was found to be reduced in obesity. This study aimed to assess the effect of follicular and serum levels of SFRP5 as well as serum and follicular levels of wnt5a on ICSI outcome and determine the potential roles of SFRP5 as a predictor of positive pregnancy in Iraqi infertile females undergoing ICSI with different body mass index.
Patients and methods: Ninety infertile females who received intracytoplasmic sperm injection and had various infertility factors between 18 and 45 years participated in this prospective clinical cross-sectional study. The study was conducted in the "High Institute of Infertility Diagnosis and Assisted Reproductive Technologies/Reproductive Physiology/Al- Nahrain University/Baghdad/Iraq" infertility clinic from September 2021 to July 2023. Three groups of those patients were created based on the patient's body mass index scores. Antagonist ovarian hyperstimulation protocol was applied to all enrolled infertile women. The total gonadotrophin dose used was calculated. Follicular fluid, serum SFRP5, and serum and follicular fluid wnt5a levels were measured for all participants on the day of ovum pickup. In addition, ICSI outcomes were determined.
Results: There was a significant difference in the mean total gonadotrophin dose used among the three studied groups (p = 0.023), higher in overweight and obese females than normal-weight females. There was a positive significant correlation between serum plus follicular fluid wnt5a and total gonadotropin dose used (r= 0.286 and p-value=0.006, r=0.247 and p = 0.0.019, respectively). Serum and follicular fluid SFRP5 levels were significantly higher (p < 0.001) in normal-weight females. There were higher serum (p-value=0.002) and follicular fluids (p-value=0.005) SFRP5 levels in pregnant females. The cutoff values for serum and follicular fluid SFRP5 were ≥15.86 (ng/ml) and ≥ 11.3(ng/ml), respectively, as predictors of positive pregnancy in women undergoing IVF/ICSI cycles.
Conclusion: Both SFRP5 and wnt5a glycoproteins were detected in infertile women's serum and follicular fluid. Serum and follicular fluid secreted frizzled-related protein 5 level positively associated with ICSI outcome. The cutoff values for serum and follicular fluid SFRP5 were ≥15.86 (ng/ml) and ≥ 11.3(ng/ml), respectively, as predictors of positive pregnancy in women undergoing IVF/ICSI cycles.
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