Approach to evaluation of sex hormones, pro-inflammatory cytokines, and oxidative stress biomarkers in female infertility
Abstract
Background. A combination of sex hormones, pro-inflammatory cytokines and oxidative stress markers is associated with female infertility, affect reproductive function and is responsible for poor fertility outcomes. The purpose was to evaluate a broad spectrum of sex hormones, pro-inflammatory cytokines and oxidative stress markers in women with infertility and to relate them to the pathogenetic mechanisms of the disease, as well as clinical outcomes. Materials and methods. A case-control study was conducted between March 2015 and February 2016 in 140 women (95 infertile, 45 controls). We took 5 mL of blood, separated the serum and stored it at –20 °C. Sex hormones (follicle-stimulating hormone, luteinizing hormone, estrogen, progesterone, prolactin) and cytokines (interleukin-6, tumor necrosis factor-alpha, interleukin-1 beta) were measured with ELISA kits (BioTechne, USA). Oxidative stress indices, such as malondialdehyde, superoxide dismutase, glutathione peroxidase and total antioxidant capacity, were evaluated by conventional spectrophotometric and colorimetric techniques. Results. There was no significant difference in age, body mass index or smoking status (P > 0.05) indicating baseline comparability. Infertile women showed a high level of hormonal imbalance, having more follicle-stimulating hormone, luteinizing hormone, and prolactin, and less estrogen and progesterone (P < 0.01). The levels of pro-inflammatory cytokines (interleukin-6, tumor necrosis factor-alpha, interleukin-1 beta) and malondialdehyde increased significantly (P < 0.001), whereas the levels of antioxidant markers (superoxide dismutase, glutathione peroxidase and total antioxidant capacity) decreased. There were significant correlations among hormones, cytokines and oxidative stress markers showing a strong interaction between endocrine dysfunction and inflammation and oxidative stress in infertility. Conclusions. Hormonal imbalance, elevated inflammatory cytokines and oxidative stress are found in female infertility. These alterations reflect the multi-faceted roles of endocrine, inflammatory and antioxidant deficits, and indicate they may be diagnostic and therapeutic targets.