Impact of the Follicular Inflammatory-Proteolytic Axis (IL-۶/Cathepsin B) on Oocyte Competence and ICSI Success

Background & Objective: The follicular microenvironment plays a critical role in determining oocyte competence and ICSI outcomes. Inflammatory cytokines and proteolytic enzymes, such as Interleukin-۶ (IL-۶) and cathepsin B, are key mediators of cellular remodeling, immune regulation, and follicular dynamics. The present study was conducted with aim to evaluate serum and follicular fluid levels of IL-۶ and cathepsin B and their association with ovarian response, hormonal profiles, oocyte characteristics, and pregnancy outcomes in women undergoing ICSI. Materials & Methods: In this prospective comparative study, a total of ۱۲۰ infertile women undergoing ICSI were classified into poor, normal, and hyper responders (n=۴۰ each). Serum samples were collected at Oocyte Retrieval Day (ORD) and Embryo Transfer Day (ETD), and follicular fluid was obtained during oocyte retrieval. IL-۶ and cathepsin B levels were measured and analyzed in relation to ovarian response, hormonal parameters, oocyte and embryo characteristics, and pregnancy outcomes using non-parametric statistical methods. Results: Both IL-۶ and cathepsin B levels differed significantly across ovarian response groups (P<۰.۰۰۱), with the highest levels observed in hyper responders. Significant positive correlations were identified between both biomarkers and reproductive hormones as well as oocyte characteristics, including total and mature oocytes. However, neither biomarker showed significant differences between pregnancy-positive and negative groups (P>۰.۰۵). Notably, follicular fluid IL-۶ demonstrated moderate predictive ability for pregnancy outcomes (AUC=۰.۷۱۴), with high sensitivity but limited specificity. Conclusion: IL-۶ and cathepsin B are closely associated with ovarian response and follicular activity, reflecting inflammatory and proteolytic processes within the follicular microenvironment. However, their predictive value for pregnancy outcomes is limited, with IL-۶ showing only moderate diagnostic potential. These findings highlight the role of inflammatory pathways in follicular development rather than implantation success.

کلیدواژه ها:

IL-۶ ، Cathepsin B ، ICSI ، Ovarian Response ، follicular fluid ، Inflammation ، Proteolysis ، Embryo Development