Association of Serum and Follicular Fluid G-CSF and CRH Levels with Ovarian Response During Assisted Reproduction

Background & Objective: Controlled ovarian response to stimulation represents an important aspect determining the success of ICSI (Intracytoplasmic Sperm Injection). Current data suggest that the microenvironment of follicles is regulated by interactions between various immune and neuroendocrine factors. Among these, Granulocyte Colony Stimulating Factor (G-CSF) and Corticotropin-Releasing Hormone (CRH) may play crucial role in follicular development, ovum maturation, and hormonal regulation. This study was conducted with aim to estimate the influence of G-CSF and CRH on serum and follicular fluids levels in patients with different ovarian responses and to examine the possible correlations between these factors with hormonal levels, and oocyte characteristics in ICSI patients. Materials & Methods: This prospective comparative study was conducted at Iraq's "High Institute of Infertility Diagnosis and Assisted Reproductive Technologies/Al-Nahrain University/Baghdad/Iraq" infertility center The study included ۱۲۰ infertile females who underwent Intracytoplasmic Sperm Injection procedure. Women were divided into poor, normal, and hyper ovarian responders (n=۴۰ each). Levels of G-CSF and CRH in the sera and follicular fluids were evaluated at Oocyte Retrieval Day (ORD) and Embryo Transfer Day (ETD). Considering non-normal data distribution, results were presented as medians and interquartile ranges with statistical analysis using non-parametric methods. Correlations were established among all studied biomarkers. Results: The levels of both G-CSF and CRH significantly differed in serum and follicular fluids depending on ovarian response group (P<۰.۰۰۱). The highest levels were observed in hyper responders while the lowest- in poor responders. G-CSF showed a high positive correlation with AMH, estrogen, and luteinizing hormones as well as a negative one with FSH level. In follicular fluid CRH level positively correlated with AMH and LH levels. Moreover, both studied hormones showed significant correlation with oocyte number, MII oocytes and fertilized eggs as indicators of follicle maturity and competence. The negative correlation was established between studied biomarker levels and age of patients implying decrease in follicular activity with age. Conclusion: Serum and follicular fluid concentrations of G-CSF and CRH were significantly associated with ovarian response, hormonal profiles, and oocyte characteristics in women undergoing ICSI. These findings suggest that both biomarkers may reflect important aspects of the follicular microenvironment and ovarian function. However, further studies with larger populations and multivariable analyses are needed to clarify their independent clinical significance.

کلیدواژه ها:

ICSI ، Ovarian Response ، G-CSF ، CRH ، oocyte features ، infertility