A modern approach to predicting the quality of embryos in ART programs is the search for promising biomarkers in follicular fluid.
OBJECTIVE
To determine the composition of follicular fluid and blood serum in women with infertility and evaluate its effect on the quality of embryos.
MATERIAL AND METHODS
A pilot prospective cohort study was conducted on 26 patients aged 27 to 44 years who were undergoing infertility treatment at the ART department of the D.O. Ott Research Institute from June 2023 to September 2023. Inclusion criteria: primary and secondary infertility. Exclusion criteria: contraindications to the use of ART methods. Samples of follicular fluid (FF) and blood serum obtained on the day of follicle puncture were examined for 26 indicators: vitamins B12, B9, vitamin D, magnesium, phosphorus, iron, copper, zinc, total calcium, homocysteine, glucose, total protein, albumin, urea, uric acid, creatinine, cholesterol, LDL, ferritin, transferrin, latent iron-binding capacity, total iron-binding capacity, transferrin iron saturation coefficient, cystatin C, C-reactive protein, albumin-globulin ratio. The patients were divided into two groups depending on the obtained embryos: group 1 — with optimal embryo quality; group 2 — with embryos of suboptimal quality.
RESULTS
The levels of homocysteine, vitamin B12, glucose, creatinine, total protein, albumin, LDL, cholesterol, transferrin, ferritin, iron, total iron-binding capacity, transferrin saturation coefficient with iron, magnesium, copper, zinc, total calcium between FF and blood serum are statistically significantly different (p<0.0001). In serum, the median of the listed substances is higher than in FF. Also, a statistically significant difference was observed between the levels in the FF and in the blood: vitamin D, cystatin C, CRP, albumin-globulin ratio, urea (p< 0.0001) and phosphorus (p=0.04). In the FF, the median of the listed substances is higher than in the blood.
As a result of the analysis of FF and serum parameters in women with infertility, depending on the quality of the embryos, a statistically significant difference was obtained in the follicular fluid for homocysteine (p=0.004), uric acid (p=0.015), comparing the serum/FF ratio for folic acid (p=0.004), vitamin D (p=0.007), glucose (p=0.009), phosphorus (p=0.016), cystatin C (p=0.036).
CONCLUSION
The composition of the studied biochemical parameters in the FF was determined. Levels of homocysteine, uric acid in FF and assessment of the serum/FF ratio for folic acid, vitamin D, glucose, phosphorus, cystatin C can serve as biomarkers for predicting the quality of embryos.
