International Journal of Science and Research (IJSR) ISSN (Online): 2319-7064 Index Copernicus Value (2013): 6.14 | Impact Factor (2015): 6.391 Volume 5 Issue 10, October 2016 www.ijsr.net Licensed Under Creative Commons Attribution CC BY Follicular Fluid IL-6 Levels in Prediction of Successful Pregnancy Outcome in Women Undergoing IVF-ET Cycles - A Prospective Study Yogesh Kumar 1, 2 , Saumya Prasad 3 , Syed Akhtar Husain 2 , Ritu Goyal 1 , Mohammad Aasif Khan 2 , Shashi Sharma 4 , Sudha Prasad 1 1 IVF & Reproductive Biology Centre, Department of Obstetrics and Gynecology, Maulana Azad Medical College, New Delhi, India 2 Human Genetics Laboratory, Department of Biosciences, Jamia Millia Islamia, New Delhi, India 3 Vardhman Mahavir Medical College & associated Safdarjung Hospital, New Delhi, India 4 Division of Epidemiology, Institute of Cytology and Preventive Oncology (ICMR) Sector -39 NOIDA, Uttara Pradesh, India Abstract: Objective : To investigate expediency of quantitative levels of interleukin-6 (IL-6) detected in follicular fluid (FF) of women underwent in-vitro fertilization-embryo transfer (IVF-ET) cycles. Design : Prospective observational study. Method : Study comprises evaluation of IVF/ICSI-ET cycles in relation to contribution of quantitative levels of IL-6. FF samples were collected on day of oocyte retrieval by pooling ovarian follicles of size ≥15mm for each woman (n=168). Enzyme-linked immunosorbent assay (ELISA) technique was applied for measuring quantitative level of IL-6. Demography, cycle characteristics, endometrial thickness, number of oocytes, fertilization rate, grading of embryos and IL-6 levels were compared between pregnant and non-pregnant groups of women. Student T- test, Mann Whitney U-test, Chi-squares test and logistic regression were applied as appropriate. Statistical significant level was calculated at P<0.05. Results : The women (n=168) were divided into pregnant (Group-A; n=75) and non-pregnant (group-B; n=93) groups. The median level of IL-6 was found lower in group-A as compared to women in group-B [33.9 pg/mL (0.1-199.8) versus 92.9 pg/mL (0.3-199.8); P<0.001 respectively]. Conclusions : Lower concentration of IL-6 in follicular fluid was found associated with positive pregnancy outcome and served as reliable predictive marker of successful pregnancy outcome in women underwent assisted reproduction. Keywords: Infertile-women, Follicular-fluid, Interleukins, IVF-ET and Pregnancy-outcome 1. Introduction Infertility affects millions of couples all over the world. Childlessness is a life crisis and impaired fertility has been reported to affect 10-15% of couples owing to various explained and unexplained reasons [1]. World Health Organization (WHO) reported 3% of women with primary infertility and 8% women with secondary infertility including nearly 12 million infertile couples from India [2], [3]. Assisted reproductive technology (ART) has great relevance to conquer infertility and provides opportunity to cater the need of infertile couples. However, implantation failure is a concomitant aspect of ART, which is surprisingly not very well understood. During in-vitro fertilization/intra- cytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) treatment cycles women succeed to produce healthy embryos but unfortunately at the level of implantation somewhat goes wrong because of unresolved and perplexing reasons [4, 5]. Association of implantation failure has also proven with ovarian de-regulation in relation to anatomic anomalies, impaired endocrinal milieu and immunological complications generated during systemic events of IVF-ET cycles [6], [7]. In past two decades, increasing recognition has been given to the contribution of immune system in regulation of ovarian functions, including success/failure of implantation. Immuno-molecular mechanism involves during implantation that makes uterus amenable (receptive) to embryo for subsequent apposition, adhesion and invasion altogether are known as successful implantation [8]. Cytokines are one of the most important immuno-competent molecules, which are found allied with implantation. These are low molecular weight water-soluble protein and glycoprotein molecules secreted by immune cells. Based on their functions, cellular origin and target sites cytokines are classified as lymphokines, chemokines and interleukins [9]. Interleukins were originally perceived as lymphocyte’s derived products mediate interactions between leukocytes. However interleukins have wide array of functions, appropriately related to endothelial fibroblasts, luteal cells and granulosa cells [10]. Ovarian interleukins, secreted by granulosa cell and other immune cells within the ovary and follicles regulate diverse functions including folliculogenesis, oogenesis, ovulation, fertilization, embryo development, implantation, corpus luteum formation and regression [11], [12, [13], [14], [15]. In view of existing knowledge, present study was conducted to address the association of follicular fluid levels of IL-6 with prediction of successful implantation in women undergoing assisted reproduction. 2. Literature Survey Cytokines are very essential immune-molecular components found allied also with the several reproductive events such Paper ID: ART20162410 1724 DOI: 10.21275/ART20162410