New Immunological Indexes for the Effect of Systemic Inflammation on Oocyte and Embryo Development in Women With Unexplained Infertility: Systemic Immune Response Index and Pan-Immune-Inflammation Value

IF 2.5 3区医学 Q3 IMMUNOLOGY American Journal of Reproductive Immunology Pub Date : 2024-09-02 DOI:10.1111/aji.13923

Serap Topkara Sucu, Berrin Goktuğ Kadioglu, Burak Elmas, Mehmet Caner Ozer, Ulaş Fidan, Mustafa Ozturk, Seyit Temel Ceyhan

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Abstract

Problem

Predicting the impact of systemic inflammation on oocyte and embryonic development in unexplained infertile women using the new immunological indexes.

Method of Study

This retrospective cohort study was conducted using the records of the In Vitro Fertilization Department of Ankara Gülhane Training and Research Hospital. After reviewing the records of patients who had undergone in vitro fertilization (IVF) for unexplained infertility (UI) and excluding all known factors that could cause systemic immune inflammation, the systemic immune response index (SIRI), and pan-immune score were calculated from the pre-treatment hemogram parameters between the embryo arrest (EA) group and the embryo transfer group. It was investigated whether there was a statistical difference between the two groups and whether an SIRI value affecting embryo quality was found. A receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off values for inflammatory markers to predict EA.

Results

The 108 EA group (embryos that were arrested during their development and could not be transferred) and the 140 embryo transfer group showed statistically significant differences in the parameters of systemic inflammatory index (SII), SIRI, pan-immune inflammation value (PIV), and neutrophil/lymphocyte ratio (NLR) (p < 0.05). These inflammatory parameters, which were examined before ovulation induction, also correlated positively with the required total dose of gonadotropin and negatively with the ovarian sensitivity index (OSI). SII, SIRI, PIV, and NLR have specific cut-off values with ROC analysis and determine the effect of the inflammatory status of the environment in which the oocyte develops on EA (p < 0.005).

Conclusion

In women with UI, high levels of systemic immune inflammation have a negative impact on oocyte and embryo development, and treatments to suppress inflammation may improve IVF success.

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不明原因不孕妇女全身炎症对卵母细胞和胚胎发育影响的新免疫学指标：系统免疫反应指数和泛免疫炎症值。

问题：利用新的免疫学指标预测全身炎症对不明原因不孕妇女卵母细胞和胚胎发育的影响：这项回顾性队列研究使用了安卡拉居尔哈尼培训与研究医院体外受精科的记录。在审查了接受体外受精（IVF）治疗的不明原因不孕症（UI）患者的病历并排除所有可能导致全身免疫炎症的已知因素后，根据胚胎停育（EA）组和胚胎移植组治疗前的血液图参数计算了全身免疫反应指数（SIRI）和泛免疫评分。研究了两组之间是否存在统计学差异，以及是否发现了影响胚胎质量的 SIRI 值。为了确定预测 EA 的最佳炎症标志物临界值，进行了接收者操作特征（ROC）曲线分析：结果：108 例 EA 组（胚胎在发育过程中停滞，无法移植）和 140 例胚胎移植组在全身炎症指数 (SII)、SIRI、泛免疫炎症值 (PIV) 和中性粒细胞/淋巴细胞比值 (NLR) 等参数上存在显著统计学差异（P < 0.05）。在诱导排卵前检查的这些炎症参数还与所需的促性腺激素总剂量呈正相关，与卵巢敏感性指数（OSI）呈负相关。通过 ROC 分析，SII、SIRI、PIV 和 NLR 具有特定的临界值，可确定卵母细胞发育环境的炎症状态对 EA 的影响（P < 0.005）：在患有子宫内膜异位症的妇女中，高水平的全身免疫炎症会对卵母细胞和胚胎的发育产生负面影响，抑制炎症的治疗可提高试管婴儿的成功率。

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来源期刊

American Journal of Reproductive Immunology 医学-免疫学

CiteScore

6.20

自引率

5.60%

发文量

314

审稿时长

2 months

期刊介绍： The American Journal of Reproductive Immunology is an international journal devoted to the presentation of current information in all areas relating to Reproductive Immunology. The journal is directed toward both the basic scientist and the clinician, covering the whole process of reproduction as affected by immunological processes. The journal covers a variety of subspecialty topics, including fertility immunology, pregnancy immunology, immunogenetics, mucosal immunology, immunocontraception, endometriosis, abortion, tumor immunology of the reproductive tract, autoantibodies, infectious disease of the reproductive tract, and technical news.