Evaluation of Copper /Zinc Ratio, Total Protein, Albumin and Reproductive Hormones among Infertile Women in Port Harcourt, Nigeria

Infertility in females is a devastating problem whose solution has posed a lot of challenges due to the difficulty and complexity of identifying the exact cause and etiology among different individuals. This study evaluated copper/zinc ratio, total protein, albumin and reproductive hormones in infertile females in Port Harcourt. This was a case-control study, carried out among residents of Port Harcourt. A total of 130 female subjects within the age of 18 and 49 years were recruited for the study; 65 infertile subjects and 65 apparently healthy fertile control subjects. Approximately 10 mL of blood was collected using standard venipuncture technique from each subject on day 3 and 21 of the menstrual cycle. Samples for copper, zinc, total protein and albumin were analyzed using colorimetric methods, while the reproductive hormones were analyzed using Enzyme-Linked Immunosorbent Assay. Data generated were analyzed using Graph-Pad Prism version 8.0.2 and P≤0.05 was considered statistically significant. This study revealed a significant increase on day 3 and 21 in mean copper 27.68±10.78 and 20.29 ± 16.41 (P<0.001 and P=0.043) levels in infertile women when compared to the mean copper 16.82±4.52 and 15.20 ±5.29 of control group respectively. Copper/zinc ratio was also increased in the infertile group with mean levels of 11.40±1.82 and 3.27 ±0.59 on days 3 and 21 compared to the control group with mean levels of 4.53±0.76 and 1.46 ±0.12 (P=0.010 and P=0.004) respectively.   There was significant decrease on day 3 of Menstrual cycle in Mean ± SD levels of Total Protein 72.62 ±7.84 in infertile group and 77.23 ±4.71 in control group (P< 0.001), and albumin 40.54 ±4.79 in infertile group and 44.82 ±3.64 in control group (P=< 0.001) respectively. There was no significant difference in mean zinc level (P=0.402) on day 3, but mean zinc level 10.74 ±4.58 was significantly decreased on day 21 in infertile females compared to the control 12.91 ±4.73 group (P=0.009). There was also significant increase in mean levels of Luteinizing hormone 8.64 ±4.32 infertile and 7.16 ±2.21 control (P=0.016), prolactin 27.02 ±18.55 infertile and 12.28 ±6.44 control (p<0.001), and testosterone 0.74 ±0.25 infertile and 0.38 ±0.18 control (P<0.001) respectively.   There was a significant decrease in mean levels of estrogen 28.66 ±10.34 infertile and 41.79 ±4.55 control (P<0.001), and progesterone 7.71 ±6.38 infertile and 15.63 ±6.57 control (P<0.001) respectively. However, there was no significant difference in mean levels of follicle stimulating hormone (P=0.519).  The findings in this study indicate that a high copper/zinc ratio is associated with alterations in levels of reproductive hormones. Hence, micronutrient supplementation to maintain optimum levels will be beneficial for infertile females.