Derici Mehmet Kursat, Yıldırım Engin
Department of Medical Pharmacology, Gulhane Faculty of Medicine, University of Health Sciences, Ankara, Turkey.
Department of Obstetrics and Gynecology, Faculty of Medicine, Malatya Turgut Özal University, Malatya, Turkey.
Med Sci Monit. 2025 Jul 4;31:e947895. doi: 10.12659/MSM.947895.
BACKGROUND Infertility is defined as the absence of pregnancy despite unprotected, regular sexual intercourse of couples of reproductive age for at least 1 year. Infertility may be unexplained or linked to anovulation/polycystic ovary syndrome (PCOS). PCOS can involve the processes of inflammation, insulin resistance, and metabolic syndrome. This study compared serum levels of afamin, asprosin, and pentraxin3 (PTX3) between women with PCOS and women with unexplained infertility to elucidate underlying pathophysiological mechanisms. MATERIAL AND METHODS Our study included 106 women: 55 with unexplained infertility and 51 with PCOS. Using the electrochemiluminescence immunoassay method, we assessed the levels of estradiol, follicle-stimulating hormone, luteinizing hormone, and anti-Mullerian hormone. Afamin, asprosin, and PTX3 levels were measured by ELISA. RESULTS Age, fasting glucose levels, and body mass index (BMI) of the groups were statistically similar. Anti-Mullerian hormone, antral follicle count, and LH levels were higher (P<0.05) in the PCOS group. Afamin and PTX3 levels were higher in the PCOS group (P<0.05), while asprosin levels were similar. CONCLUSIONS Our study demonstrates the importance of afamin associated with oxidative stress and the PTX3, which plays a role in the regulation of humoral immune responses, in the etiology of infertility cases. Afamin and PTX3 should be evaluated in ovulatory and non-ovulatory PCOS cycles to facilitate treatment and to elucidate the ovulation and implantation processes in PCOS. These recommendations specifically include dividing PCOS patients into subgroups such as diabetogenic, obese, and hirsute, and re-examining biochemical markers accordingly.
不孕症的定义是育龄夫妇在未采取保护措施、规律进行性生活至少1年后仍未怀孕。不孕症可能原因不明,或与无排卵/多囊卵巢综合征(PCOS)有关。PCOS可能涉及炎症、胰岛素抵抗和代谢综合征等过程。本研究比较了PCOS女性和不明原因不孕症女性血清中载脂蛋白A、脂肪因子和五聚体3(PTX3)的水平,以阐明潜在的病理生理机制。
我们的研究纳入了106名女性:55名不明原因不孕症患者和51名PCOS患者。采用电化学发光免疫分析法,我们评估了雌二醇、促卵泡激素、促黄体生成素和抗苗勒管激素的水平。通过酶联免疫吸附测定法测量载脂蛋白A、脂肪因子和PTX3的水平。
两组的年龄、空腹血糖水平和体重指数(BMI)在统计学上相似。PCOS组的抗苗勒管激素、窦卵泡计数和促黄体生成素水平较高(P<0.05)。PCOS组的载脂蛋白A和PTX3水平较高(P<0.05),而脂肪因子水平相似。
我们的研究表明,载脂蛋白A与氧化应激相关,PTX3在体液免疫反应调节中起作用,它们在不孕症病因中具有重要意义。应在PCOS的排卵和非排卵周期中评估载脂蛋白A和PTX3,以促进治疗并阐明PCOS的排卵和着床过程。这些建议具体包括将PCOS患者分为致糖尿病型、肥胖型和多毛型等亚组,并相应地重新检查生化标志物。