Pekel Aslıhan, Gönenç Aymelek, Turhan Nilgün Öztürk, Kafalı Hasan
IVF Clinic, Department of Obstetrics and Gynecology, Faculty of Medicine, Turgut Özal University, Ankara, Turkey.
J Assist Reprod Genet. 2015 Feb;32(2):233-41. doi: 10.1007/s10815-014-0396-8. Epub 2014 Dec 9.
The Fas-Fas Ligand interaction is one of the essential events for the induction of apoptosis whereas the exact role of their soluble forms in the reproductive system is still not fully understood. Also oxidative stress in the pathogenesis of infertility causing diseases in women and has been suggested as one of the important factors that negatively affect IVF outcome. In this study, our aim was to evaluate serum and follicular fluid levels of soluble Fas soluble Fas Ligand, malondialdehyde, superoxide dismutase and total antioxidant capacity in patients undergoing IVF and compared with controls.
This study included 109 patients. Patients were classified as unexplained infertility (N = 31), PCOS (N = 19), tubal factor (N = 9) and endometriosis (N = 10) and compared with male factor infertility (N = 40) that was the control group. sFas and sFasL levels were measured by immunoassay method. MDA, SOD and TAC levels were measured by colorimetric method.
Patients with unexplained infertility, PCOS and tubal factor had significantly lower sFas levels compared with their controls (respectively, p < 0.01, p < 0.05, p < 0.05). However, SOD activity in unexplained infertility, PCOS and endometriosisgroupswere significantly higher than control group (p < 0.01).Decreased follicular fluid TAC levels were found in all patient groups compared with controls (respectively, p < 0.01, p < 0.05, p < 0.01, p < 0.01).Patients with tubal factor had significantly higher serum sFasL (p < 0.05), but lower follicular fluid sFasL levels (p < 0.05) compared with unexplained infertility. Tubal factor and endometriosis groups had lowerfollicular fluid TAC levels compared to unexplained infertility and PCOSgroups (p < 0.01).
CONCLUSION(S): In this study, serum and follicular fluid sFas levels were decreased and antioxidant activity was impaired in infertility, possibly implying increased apoptosis. Especially in unexplained infertility group changes in this parametres more remarkable.
Fas-Fas配体相互作用是诱导细胞凋亡的关键事件之一，但其可溶性形式在生殖系统中的具体作用仍未完全明确。此外，氧化应激在女性不孕症致病机制中起作用，并且被认为是对体外受精（IVF）结果产生负面影响的重要因素之一。在本研究中，我们的目的是评估接受IVF治疗的患者血清和卵泡液中可溶性Fas、可溶性Fas配体、丙二醛、超氧化物歧化酶和总抗氧化能力水平，并与对照组进行比较。
本研究纳入109例患者。患者分为不明原因不孕症组（N = 31）、多囊卵巢综合征（PCOS）组（N = 19）、输卵管因素组（N = 9）和子宫内膜异位症组（N = 10），并与作为对照组的男性因素不孕症组（N = 40）进行比较。采用免疫测定法测量可溶性Fas（sFas）和可溶性Fas配体（sFasL）水平。采用比色法测量丙二醛（MDA）、超氧化物歧化酶（SOD）和总抗氧化能力（TAC）水平。
不明原因不孕症、PCOS和输卵管因素患者的sFas水平显著低于其对照组（分别为p < 0.01、p < 0.05、p < 0.05）。然而，不明原因不孕症、PCOS和子宫内膜异位症组的SOD活性显著高于对照组（p < 0.01）。与对照组相比，所有患者组的卵泡液TAC水平均降低（分别为p < 0.01、p < 0.05、p < 0.01、p < 0.01）。与不明原因不孕症相比，输卵管因素患者的血清sFasL显著升高（p < 0.05），但卵泡液sFasL水平较低（p < 0.05）。与不明原因不孕症和PCOS组相比，输卵管因素和子宫内膜异位症组的卵泡液TAC水平较低（p < 0.01）。
在本研究中，不孕症患者血清和卵泡液中的sFas水平降低，抗氧化活性受损，可能意味着细胞凋亡增加。特别是在不明原因不孕症组，这些参数的变化更为显著。
