EMMPRIN (Basigin) is a potent inducer of matrix metalloproteinases (MMPs). Expression of EMMPRIN in the uterus has a very important role in implantation of embryo, this study was conducted to evaluate the relationship of pregnancy rates with EMMPRIN levels in follicular fluid and serum of intracytoplasmic sperm injection patients. The study was cross sectional study analyzed the serum and follicular fluid samples of 58 patients undergo ICSI procedure. The serum and follicular fluid samples were collected from infertile women aged 20 to 42 years. However, the levels of EMMPRIN were measured in the serum and follicular fluid samples and these samples were obtained during oocytes retrieval and another serum samples were collected at the day of embryo transfer. All women have ovarian stimulation with recombinant follicle stimulating hormone (FSH) at the second or third day of the cycle. Result: The pregnancy rate was 27.6 %. The present study showed that EMMPRIN in serum and follicular fluid at day of ova pickup and its level at embryo transfer day, are significantly low in pregnant women (p < 0.05) compared to non-pregnant women. The statistical analysis showed no significant correlation between serum and follicular fluid EMMPRIN with endometrial thickness (p > 0.05). EMMPRIN level can be used as a promising parameter for the prediction of pregnancy rate in ICSI cycles.
There is a relation between adipose tissue and macrophages. 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 .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. 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. 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. Serum and follicular fluid SFRP5 levels were significantly higher in normal-weight females. There were higher serum (p-value=0.002) and follicular fluids (p-value=0.005) SFRP5 levels in pregnant females. 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. Obesity, BMI, SFRP5, wnt5a, ICSI Outcome
Plasminogen Activator Inhibitor-1 expression in serum and follicular fluid plays a crucial role in regulating fibrinolysis during the pregnancy period by blocking the action of other proteins called plasminogen activators. The aim is to assess the Plasminogen Activator Inhibitor-1 level in blood serum and follicular fluid as a predictive marker of pregnancy. This study included Sixty-nine infertile females undergone ovarian stimulation with antagonist protocol and received recombinant follicle-stimulating hormone, at the cycle day two. The serum and follicular fluid were collected from each female on the day of oocyte retrieval, for PAI estimation using the Elisa kit. The data were analyzed using version 23.0 SPSS and Microsoft Office 2010. The serum PAI-1 levels at the day of oocyte retrievals were significantly lower in positive pregnancy women in comparison with non-pregnant women (p < 0.05), Yet no significant follicular fluid PAI-1 levels were noted in comparison with non-pregnant women. There was a negative significant correlation (p > 0.05) between serum and follicular fluid PAI-1 levels on the day of oocyte retrieval according to oocyte ICSI outcome. The evaluation of serum PAI-1 levels can be used as a promising parameter for the prediction of pregnancy outcomes of ICSI patients. It is assumed that the pregnancy rate was affected by PAI-1 level during ICSI cycles. The concentration of PAI-1 in serum and follicular fluid at the retrieval day is not correlated with the oocyte's maturity.
The estimation of oocyte quality in human in vitro fertilization (IVF) is an important point for the embryologists. Oocyte selection and the identification of the best oocytes may help to limit an overproduction of embryos and to improve the results of oocyte cryopreservation programs. The follicular fluid (FF) can be provided easily during oocyte pick-up and known to represents an optimal source for non-invasive biochemical predictors of oocyte quality. However, till now no substance was found to be used as reliable markers of oocyte competence to fertilization, embryo development and pregnancy. Metabolism and ATP levels within the oocyte and adjacent cumulus cells are associated with quality of oocyte and optimal development of a healthy embryo. Lipid metabolism provides a potent source of energy and its importance during oocyte maturation is being increasingly recognised. Objectives: To determine the effect of lipids (Cholesterol. Triglyceride and HDL) level in serum and follicular fluid in predicting oocyte quality, embryo quality and outcome in patients undergoing intracytoplasmic sperm injection program Patients and Methods: Fifty eight (58) infertile women with an age range 21-41 years old undergoing intracytoplasmic sperm injection cycles were included in this study. Lipids (Cholesterol. TG and HDL.,) levels in serum and follicular fluid were measured by auto analyzer for biochemistry (Flexor El_200) and correlation with oocyte quality, embryo quality and ICSI outcome was done. Results: The results of this study showed no significant (p<0.05) difference in lipid levels in serum and follicular fluid between pregnant and non pregnant females as well as non significant correlation was found between lipid level in serum and follicular fluid in relation to oocyte quality and embryo quality. Conclusions: Serum and follicular fluid lipids are not good predictors of oocyte quality, embryo quality or ICSI outcome in women undergoing IVF/ICSI cycles. Accordingly, these biomarkers would be less reflective of the follicular environment and that the effect of maternal metabolic disorders on oocyte quality and fertility outcome is complex and of a multifactorial kind.
Kisspepetin is considered as a key regulator of reproduction, through its direct role in controlling the hypothalamic pituitary gonadal axis necessary for controlling the ovulatory process and indirectly by impacting glucose heamostasis and metabolism. We aimed to examin the correlation between body mass index and level of Kisspeptin in serum and follicular fluid. This study is a cross sectional study done on (80) infertile Iraqi patients aged (18-40 years) scheduled for fresh intracytoplasmic sperm injection cycle. This study is conducted in the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies of Al-Naharin University, from September 2020 to May 2021. For each participant, the GnRH antagonist protocol was used to hyperstimulate the ovaries, and samples from serum and follicular fluid were obtained at day of oocytes retrieval for measuring Kisspeptin level using enzyme linked immunosorbent assay (ELIZA) technique. Serum and follicular fluid Kisspeptin were insignificantly increasing with the increase in the BMI (p value =0.406) (p value = 0.352) respectively. Serum and follicular kisspetin were positively and significantly correlated (r = 0.536, p value= 0.000). Serum and follicular fluid kisspeptin were numerically increasing with the body mass index of infertile women, although this increament is statically insignificant, serum kisspeptin can be used as a mirror image to follicular fluid kisspeptin as there was a statistical association between them in this study.
Pregnancy-Associated Plasma Protein (PAPP-A) is a zinc metalloproteinase in the insulin growth factor system (IGFs) produced by the syncytiotrophoplast region of the placenta. It plays a critical function in the cleavage of IGFBP4. In the ovary IGFs, it regulates follicular and oocyte maturation, and steroidogenesis. While in polycystic ovarian syndrome (PCOS) Hyperinsulinemia and hyperandrogenemia it causes follicular environment changes and early ovulation resulting in lower oocyte and embryo quality in patients and this will decrease the success of pregnancy in women enrolled in the ICSI cycle. The present study aimed to assess the relationship of PAPP-A levels in serum and follicular fluid in women with PCOS and non-PCOS with oocyte and embryo quality in women undergoing ICSI cycle. 45 infertile Iraqi women were enrolled. Women with PCOS had to meet at least two of the three criteria set by the Rotterdam ESHRE/ASRMS criteria, the age of the included women ranged between 20-45 years. In non-PCOS patients, PAPP-A has higher level in serum and follicular fluid but without a statistically significant difference matching with PCOS group. In addition, there was no significant correlation between PAPP-A levels in serum and follicular fluid with oocytes and embryo characteristics. However, PAPP-A levels are higher in serum and follicular fluid in women with positive pregnancy but without significant differences. PAPP-A had no correlation with oocyte and embryo quality.
Placenta growth factor is, VEGF family member, a Pleiotropic Factor affects a variety of cell types and regulates various biological responses. PlGF is similar in structure and function to VEGF, and it amplifies VEGF's angiogenic actions. Ovulation stimulation during cycles of in vitro fertilization (IVF) for the management of infertility results in ovarian hyperstimulation syndrome (OHSS), an iatrogenic side effect. Considering potential roles of PlGF and its receptor (sflt-1) in angiogenesis, the association of these factors with OHSS among study women during controlled ovarian stimulation have evaluated in the present study. Comparative cross-sectional study including of 60 women who go through controlled ovarian stimulation. On oocyte retrieval day, their serum and follicular fluid were taken. The concentrations of PlGF and sFlt-1 were assessed using ELISA .Eighteen patients presented with ovarian hyperstimulation syndrome (OHSS) and 42 patients were no OHSS. There was significantly higher serum PIGF in women with OHSS patients as compared to women with no OHSS, 141.4 ± 11.8 versus 91.9 ± 5.4 respectively (p<0.001). Furthermore, Follicular fluid PlGF there was significantly higher in women with OHSS patients as compared to women with no OHSS, 163.4 ± 7.2 versus 91.1 ± 5.5 respectively (p<0.001). Additionally Follicular fluids PlGF/sFlt ratio significantly higher in women with OHSS patients as compared to women with no OHSS, 0.034 ± 0.01 versus 0.026 ± 0.01 respectively (p<0 . 001). On the contrary there was significantly lower serum and follicular fluid sFlt in ovarian hyper-stimulated patients These statistics show that serum and FF PlGF and PlGF to sFlt ratio higher in women with ovarian hyperstimulation syndrome (OHSS) patients as compared to women with no OHSS. So, the PlGF may be played an important a role in angiogenesis dysregulation.
Endometriosis is a chronic inflammatory gynecological disease and a leading cause of female infertility, characterized by Th1/Th2 cytokine imbalance. Interleukin-13 (IL-13) and Interferon-gamma (IFN-gamma) are cytokines mediating anti-inflammatory and pro- inflammatory pathways, respectively, and were investigated in this study in infertile women with endometriosis undergoing Intracytoplasmic Sperm Injection (ICSI).To explore the potential impact and prognostic value of Interleukin-13 (IL-13) and Interferon- gamma (IFN-gamma) on ICSI outcome and to confirm their role in endometriosis-related infertility .A prospective case-control study was conducted involving 80 infertile women aged 18-40 years, including (n=40) women laparoscopically confirmed with endometriosis and (n=40) infertile women without endometriosis serving as controls. Both groups enrolled in ICSI cycles, and on the day of oocyte retrieval, serum and follicular fluid were collected; then concentrations of IFN-γ and IL-13 were quantified using enzyme-linked immunosorbent assay (ELISA). Ovarian stimulation characteristics, oocyte maturity, embryo quality, maturation rate, fertilization rate, and pregnancy rate were compared between groups using appropriate statistical analyses to investigate their association with endometriosis and their impact on ICSI outcomes. Elevated IFN-γ and IL-13 levels in both serum and follicular fluid are strongly associated with impaired ovarian response and poor ICSI outcomes in women with endometriosis. These findings suggest that inflammatory cytokine imbalance contributes to reduced oocyte developmental competence and embryo quality. Assessment of IFN-γ and IL-13 may provide clinically valuable biomarkers for predicting ART outcomes and could facilitate individualized therapeutic strategies targeting immune-mediated reproductive dysfunction.
Activin is a member of the transforming growth factor-beta superfamily and is a polypeptide growth factor. Activin regulates follicle growth, gonadotropin responsiveness, steroidogenesis, oocyte maturation, ovulation, and corpus luteum function in the ovary via a local autocrine/paracrine effect. Activin measurement A level in serum and follicular fluid during the preovulatory stage in PCOS women undergoing an IVF/ICSI cycle to predict fertilization capacity earlier Fifty infertile couples, 25 with PCOS and 25 without PCOS, who attended Al Nahrain University in Baghdad, Iraq's High Institute of Infertility Diagnosis and Assisted Reproductive Technologies. The females that participated were between the ages of 18 and 40. On the day of oocyte retrieval, the level of Activin A in serum and follicular fluid was measured. Activin A levels in PCOS women's serum (activin A=1274 77.9) and follicular fluid (activin A =1038 50.3) compared to non-PCOS women's serum (activin A=453 25.74) and follicular fluid (Activin A=450 23.73). The study shows no correlation between activin A hormone with oocytes characteristics and fertilization rate in PCOS women with a significant increase of activin A hormone in the serum and FF of PCOS women compared to non PCOS women. Activin A level can predict a diagnosis of PCOS in addition to positive predictive pregnancy but not indicator of fertilization capacity in PCOS women.
Successful implantation needs a receptive endometrium, a functional and normal embryo at the stage of blastocyst developmental and a synchronized dialogue between embryonic tissues and maternal tissues. The current study was planned and conducted to investigate the potential role of vaginal pessary of hyaluronic acid on intracytoplasmic sperm injection (ICSI) outcome. This study included 63 infertile women (32 women as study group receiving hyaluronic acid and 31 control group) who were subjected to ovulation induction programs with gonadotropin releasing hormone (GnRH) antagonist protocols for in vitro fertilization (IVF)/ intracytoplasmic sperm injection (ICSI) procedures. Blood samples were taken by Vacutainer tubes and centrifuged according to the manufacturer’s instructions for the preparation of serum samples. Serum samples for Lymphatic vessel endothelial hyaluronan receptor 1 (LYVE1) were obtained from each patient when the basal hormonal status was determined. The second time point is when the samples were obtained on the day of ova pickup, after that the G1 embryos will be transferred inside the uterine cavity. Then performance of endometrial receptivity parameters or patterns evaluation and patients were followed up to do pregnancy test after14 days after embryo transfer. On the day of human chorionic gonadotropin (hCG), there was no significant difference in mean serum Lymphatic vessel endothelial hyaluronan receptor 1 (LYVE1) between hyaluronic acid group and reference group, respectively (p = 0.824). There was no significant difference in mean follicular fluid Lymphatic vessel endothelial hyaluronan receptor 1 (LYVE1) between the hyaluronic acid group and reference group, 0.92 ±0.36 pg/ml versus 0.82 ±0.22 pg/ml, respectively (p = 0.223). Treatment with the hyaluronic acid resulted in non-significant increase in serum and follicular fluid Lymphatic vessel endothelial hyaluronan receptor 1 (LYVE1), and this increment is not related to Lymphatic vessel endothelial hyaluronan receptor 1 (LYVE1) improvement in local blood endometrial blood flow as reflected by reduction in resistive index and pulsatility index with eventual improvement in pregnancy outcome.
Serum chemerin levels are associated with body fat percentage and BMI, and elevated chemerin levels are associated with metabolic problems and inflammatory shifts. This study aimed to evaluate the effect of BMI in serum and follicular fluid chemerin and Leptin levels on patients undergoing ICSI . This study was performed by 44 women who underwent ICSI procedures and divided into two groups based on BMI: the non-obese group, with a BMI<30 and the obese group, with a BMI>30. The result in the non-obese group showed a significant positive correlation was found between Serum chemerin levels, indicating a strong effect size (p< .001). This suggests that as Serum chemerin levels rise, so will FF chemerin. A significant positive correlation of r =0.92 was found between the oocytes retrieved and the Number of metaphases II, indicating a strong effect size (p<.001, This shows that the number of metaphase II oocytes increases as the number of retrieved oocytes increases. A significant positive correlation of 0.66 was found between the number of embryos and the G1 embryo, indicating a large effect size. Conclusion: Serum chemerin had a significant correlation with oocyte maturity and embryo grading, and there was no significant difference between obese and non-obese patients regarding serum chemerin pregnancy.
In human-assisted reproduction both partners need to be evaluated during counseling because causes of infertility are due to male factors and female factors. some body hormones play important role in fertile women and cortisol one of these hormones which is essential for normal ovulation, cortisol usually increases during the follicular phase of the menstrual cycle, play a role in the early stages of follicular development by their interaction with aromatase activity and granulose cell functions. To investigate the correlation of cortisol hormonal level in serum and in follicular fluid that relationship with age in women under Intracytoplasmic sperm injection outcome. Its randomized prospective clinical trial study performance conducting in the Higher Institute for Infertility Diagnosis and Assisted Reproductive Technologies / Al-Nahrain University, Baghdad-Iraq, during the period from November2021to June 2022. a total of Sixty-three Infertile Iraqi women, who planned to inter intrasytoplasmic sperm injection program. The blood sample and follicular fluid sample obtained from all infertile women inter intracytoplasmic sperm injection program to measure cortisol hormonal level at specific days of this study. There was increase in cortisol level in women aged between (30-40) years, So there was significant finding between cortisol level and this age group and there was increase in cortisol level in women aged < 30 years at the same day and no significant difference in cortisol level in women age more than 40. Significant differences in cortisol level appear in group of women age between (30-40) years, also the same result appears in group of women age more than > 40 years and no significant differences in cortisol level in women aged < 30. No significant differences in cortisol level in all age women group (30-40) years, <30 years ,and the women age > 40 years.
Infertility is the disability of a couple to obtain pregnancy after one year of sexual intercourse that is unprotected and regular. Bisphenol A is an industrial chemical spread worldwide, that is a raw material utilized in multiple industries. Bisphenol A is assorted as an endocrine-disrupting chemical, which can interfere with hormone activity. This study aimed to assess the effect of BPA levels in serum on ICSI outcomes. The study was conducted at the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies / Al-Nahrain University during the period from October 2021 to April 2022. sixty infertile women enrolled in this study. BPA levels were analyzed through an enzyme-linked immunosorbent assay (ELISA) technique. Mean serum BPA was not significantly higher in non-pregnant women in comparison with that of pregnant women. Serum BPA was positively correlated to immature oocytes (MI) and abnormal oocytes. Also, BPA inversely correlated to Grade1 embryos and positively correlated to Grade 3 embryos. Bisphenol A can be detected in sera of infertile female undergoing ICSI. High BPA level in serum may impact oocyte quality and embryo grading
Polycystic ovarian syndrome (PCOS) is a group of clinically distinct endocrine conditions. Insulin resistance-related proteins are involved in PCOS pathogenesis. Irisin is a new myokine that functions similarly to adipokines. Irisin has been linked to insulin resistance and metabolic syndrome. There have been conflicting findings regarding irisin levels and their connection to hormonal and metabolic alterations in PCOS .This study aimed to compare the levels of irisin in follicular fluid and serum between women with PCOS and healthy women and correlate them with oocyte and embryo quality in women undergoing the ICSI cycle .Ninety infertile Iraqi women were enrolled, 46 women with PCOS and 44 weight-matched non-PCOS controls, in whom ICSI was done for them and evaluated the level of follicular fluid, serum Irisin, and insulin level with measure of Homeostasis Model of Assessment-Insulin Resistance (HOMA-IR) and correlate them to with oocyte and embryo quality. HOMA-IR, FF, and serum irisin levels in PCOS considerably increased. (P ≤ 0.01). In addition, there was a significant negative correlation between Irisin levels in follicular fluid and serum with MII oocyte, oocyte maturity rate, and grade 1 embryo. The serum, follicular fluid Irisin, and HOMA-IR were significantly higher in PCOS than in control cases, which may cause a reduction in oocyte maturation, embryo quality, and pregnancy outcome.
Glycotoxins termed as advanced glycation endproducts (AGEs) are made endogenously and exogenously. Maillard reaction is a chemical non-enzymatic process, between sugars and a free amino acid group of nucleic acids, proteins, and lipids which happens exogenously when handled with high temperature for a prolonged period and in a dry environment, resulting in glycotoxins (AGEs) formations. This reaction is responsible for the taste, color, and smell of food. Glycotoxins derived from food are absorbed in the intestine and store in cells and tissues. Also, glycotoxins are derived exogenously from smoking. While endogenous glycotoxins are generated by normal body physiology. Obesity and insulin resistance may induce glycotoxins (AGEs) accumulation. The objective of this study was to evaluate the relationship between glycotoxins (AGEs) and obesity. 66 infertile females who were undergoing intracytoplasmic sperm injection ICSI. These females were classified into three groups according to their body mass index. On the day of ova pick up the collect serum and follicular fluid for subsequent measurement of glycotoxins (AGEs) by ELISA kits. there was a significant difference in the concentration of glycotoxins in follicular fluid and serum between the three ICSI groups of patients. As well as there was a significant difference in the concentration of glycotoxins (AGEs) in follicular fluid and serum in the same ICSI groups of patients. there is a significant positive relation between glycotoxins (AGEs) and increase BMI.
Granulosa cells produce most ovarian function indicators in infertile women like estradiol, AMH, and inhibin B. Female peptide hormone insulin-like factor 3 is produced by theca cell. Signaling of insulin-like factor 3 from theca cell stimulates antral follicle development and theca androgen production. To investigate how INSL3 levels may be a theca cell marker of ovarian reserve and the association with current markers of ovarian reserve, including AFC, FSH, E2, and AMH, in infertile women undertaking assisted reproduction. In this cross-sectional study, 75 Iraqi infertile couples were chosen at Al-Nahrain University's High Institute for Infertility Diagnosis and Assisted Reproductive Technologies from October 2022 to April 2023 for the ICSI cycle. Based on the levels of INSL3 in the serum on the day 2 of the menstrual cycle and on the day of retrieving oocyte in the follicular fluid. A comparison was made with current ovarian reserve markers (AFC, FSH, E2, and AMH) .From 75 infertile women undergoing intracytoplasmic sperm injection (ICSI), 21 of them achieved pregnancy. Positive Significant relations were found between serum INSL3 levels and anti-mullerian hormone (AMH and antral follicle count. there were no significant relationships between follicular fluids INSL3 with serum LH, FSH and E2 . The study provides compelling evidence for the significant role of INSL3 in female fertility and its association with the success of intracytoplasmic sperm injection (ICSI). Positive correlations between serum INSL3 levels and anti-mullerian hormone (AMH) and Antral follicle count AFC indicate its potential involvement in ovarian reserve and hormonal regulation.
Infertility is described as a couple's failure to conceive for at least a year, using unprotected sex. Even though all anesthetic chemicals have been revealed in the follicular fluids, general anesthesia is still used in many IVF centers for patients who want to get pregnant. This study included 60 infertile women randomly divided into two groups under general anesthesia. 30 patients were given a Ketamine dose of 0.5 mg/Kg and the other 30 patients were received Remifentanil dose of 0.5 µg/Kg for induction of anesthesia. We collected serum for Reactive Oxygen Species (ROS) levels assessment for all patients before and after starting general anesthesia. Routine ICSI procedures was performed on all participants, including clinical evaluation (history, examination, and investigation), controlled ovarian and ovulation stimulation, oocyte retrieval under general anesthesia, follicular fluid collection for postoperative anesthesia medication concentration (Remifentanil and Ketamine), oocyte stripping, oocyte maturity assessment, intra-oocyte sperm injection into mature cells (MII), fertilization and division evaluation and embryo categorization, embryo selection and transfer, luteal phase support, and beta-hCG determination. ROS concentrations were compared between the Remifentanil and Ketamine groups. There was no significant difference in embryo features between Remifentanil and Ketamine, indicating that neither one is superior to the other in this regard. When Remifentanil or Ketamine was taken, there was no significant difference in ROS levels in serum or follicular fluid.
It is well known that oocyte quality is essential in the determination of the developmental potential of the fertilized oocytes. The oocyte developmental potential decreases in all species with increasing age. Use of serum and follicular fluid concentration of GDF9 as biomarkers of oocyte and embryo quality and their relation to pregnancy rate. Eighty-eight women were included in this study are selected from those undergoing intra-cytoplasmic sperm injection. Positive pregnancy was achieved by 14 women. The difference in mean serum and follicular GDF9 between pregnant and non-pregnant women was not significant. MI oocyte count was not significantly correlated to serum and follicular GDF9 (p > 0.05). MII oocyte count showed a non-significant correlation to serum and follicular GDF9 (p > 0.05). Grade 1 embryo count showed a non-significant correlation to serum and follicular GDF9. Grade 2 embryo count showed a non-significant correlation to serum and follicular GDF9. Also, grade 3 embryo count showed a non-significant correlation to serum and follicular GDF9. The current study revealed that serum and follicular GDF9 could not be used as indicators for oocyte maturity, embryo quality, or pregnancy rate.
Amphiregulin, a growth factor inspired by LH surge, promotes oocyte maturation and follicular rupture. This study investigated whether amphiregulin growth factor levels in follicular fluid and blood serum can predict oocyte maturation and positive pregnancy rates in ICSI patients . Methods: The study included 50 women and they did ICSI from October 2024 to February 2025. Each woman got antagonist ovarian stimulation and recombinant follicle stimulating hormone. Blood samples were taken on cycle day two for infertility hormone assessment and on oocyte retrieval day for Elisa Amphiregulin growth factor estimate . Follicular fluids amphiregulin growth factor levels were significantly higher among pregnant females; however there was no significant difference of serum amphiregulin growth factor between pregnant and non- pregnant females. Out of 50 females, 11 females were had positive pregnancy test (Pregnancy rate = 22.0 %), there was a solitary positive correlation between follicular fluids amphiregulin growth factor with metaphase II oocytes count (r=0.800& p=0.003); however follicular fluids amphiregulin showed no significant correlations with other ICSI parameters. There were also no significant correlations between serum amphiregulin with all ICSI parameters. The current study found that elevated Amphiregulin (AREG) levels are linked to successful pregnancy outcomes in ICSI cycles