TNFΑ, IL-6, 25 (OH) VITAMIN D LEVELS IN FOLLICULAR FLUID AS PREDICTORS OF PREGNANCY IN POLYCYSTIC OVARY SYNDROME

Changes in cytokine levels and 25(OH) vitamin D in follicular fluid may be a prediction of the pregnancy. The purpose of this study is to identify associations between follicular fluid levels of TNFα, IL-6, IFNγ, IL-10, and 25(OH) vitamin D in PCOS and IVF outcomes. Materials and methods: 48 women were examined, including 24 women with PCOS (group 1 (study)) and 24 women without PCOS (women with tubal factor infertility) (group 2 (control). Women in both groups were comparable for age and BMI. TNFα, IL-6, IFNγ, IL-10, and 25(OH) vitamin D were analyzed in follicular fluid obtained after transvaginal follicle puncture in the IVF program. The Mann-Whitney U test was used. ROC curve analysis was used to assess discriminatory ability in predicting outcome. Differences were considered statistically significant at p < 0.05. Results: TNFα in group 1 was 5,9 times higher, IL-6 2.4 times higher compared to the control group (p < 0.001). IFNγ and IL-10 did not differ between groups (p > 0.05). 25(OH) vitamin D in group 1 was 2.1 times lower compared to group 2 (p < 0.0001). A moderate inverse relationship was found in patients of group 1 (r = – 0.455, p = 0.026) between the level of 25 (OH) vitamin D and TNFα and an inverse moderate relationship in group 1 (r = – 0.398, p < 0.05) between the level of 25 (OH) vitamin D and IL-6. The onset of pregnancy was predicted by the following values: TNFα – 12.9 pg/ml (AUC = 0.908; 95% CI: 0.818 – 0.999, p < 0.001). IL-6 – 10.4 pg/ml (AUC = 0.916; 95% CI: 0.829 – 1.000, p < 0.001), 25 (OH) vitamin D – 26.6 ng/ml (AUC = 0.986; 95% CI: 0.953 – 1.000, p < 0.001). Conclusions: To improve the outcomes of the IVF program in PCOS, it is necessary to determine TNFα, IL-6, 25 (OH) vitamin D in follicular fluid during oocyte retrieval, which can affect the positive prognosis for pregnancy.