Resistin and follistatin levels have been found to be high in polycystic ovarian syndrome (PCOS) patients, that play role in pathophysiology of PCOS and pregnancy status of women having ICSI cycle. This study aimed to determine the relationship between the hormone levels and pregnancy outcome in PCOS and non-PCOS women undergoing intracytoplasmic sperm injection (ICSI) program. The study was done at Higher Institute for Infertility Diagnosis and Assisted Reproductive Technologies from 2022 to 2023. Eighty infertile women participating in the IVF/ICSI treatment. They were split to control (40 non-polycystic ovarian syndrome-PCOS women) and 40 women for PCOS group. They were subdividing to subgroups’ according to body max index (BMI; normal and overweight / obese). ELISA method was used to measure hormone level at day 2 and follicular fluid and serum at day of ova pick up. About 38.8% of study participants were got pregnant. Means of serum resistin and follistatin in day 2 and OPU were significantly higher in patients with PCOS and normal BMI level while follistatin at day 2 and in follicular fluid (FF) were significantly higher in participants who got pregnant. Follistatin level at day 2 > 9.89 ng/ml and in FF > 15.06 ng/ml and might be as a predictor for occurrence of pregnancy after ICSI. The cutoff point of follistatin level in the serum at day two and in FF at the day OPU was found to be a predictor of pregnancy following ICSI, while no correlation was found between resistin and pregnancy outcome.
Background: Recently the reproductive hormones, Anti-Mullerian hormone (AMH), activin A, and follistatin (FS) have been found to play an important role in folliculogenesis, oocyte maturation and corpus luteum function by changing the pattern of granulosa cell expression which in turn affects the success of fertilization potential. Objectives: To examine the relation of in vivo concentrations of AMH, activin A, and FS hormones on the ovaries status in the phases of menstrual cycle and to elucidate the relationship of these hormones with pregnancy rate following intrauterine insemination(IUI). Materials and methods: Seventy seven infertile couples were recruited from infertility clinic population at the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies through the period from September 2011 to May 2012. Those infertile couples were divided to 3 groups according to the infertility cause (male factors causes, anovulatory causes and unexplained causes of infertility). Measurements of AMH, activin A, and FS hormones levels were done at cycle day (CD25-). Then measurements of activin A, and FS hormones levels were done only at preovulatory cycle(CD1214-) when the size of the Graffian follicle range between 1824-mm and at least one follicle was present and before hCG injection and at day 28 of the cycle (CD28). IUI was performed 3640- hours after hCG injection then measurement of the three hormones was performed after successful IUI. The result of successful pregnancy was recorded and statistical relation with AMH, activin A and FS hormones was assessed. Results: There was a positive significant correlation between endometrial thickness (ET) and pregnancy rate and the best ET to predict pregnancy is more than 7mm. There was no significant relation (P>0.05) between AMH level and pregnancy rate. A significant correlation was found between follistatin levels in preovulatory (CD 1214-) with a cutoff value 0.20ng/ml to predict pregnancy. There was a significant relation between activin-A level and pregnancy rate with a predictive cut off value 397.5 ng/ml on (CD 28) only. Conclusions: Activin-A can be regarded as a biomarker candidate for diagnosing very early pregnancy at luteal phase following IUI. Follistatin preovulatory (average CD13) has the most predictive value for pregnancy following IUI.