A study of Inhibin a-16C>T gene polymorphism and other reproductive hormones in the diagnosis of Premature Ovarian Failure in Egyptian Women undergoing ICSI

Abstract

Background: Premature ovarian failure (POF) or poor ovarian response is a syndrome characterized by amenorrhea for duration of 4-6 months or more, hypo-estrogenism and elevated serum FSH concentration (FSH > 40 IU/1) before age of 40 years. The POF may arise through different events including: reduction of primordial follicle pool; acceleration of follicular atresia; alteration of primordial follicles maturation/recruitment Inhibin is a product of granulosa cells. Onset of POF can be a result of inhibin alpha genetic abnormalities, the most extensively studied genetic abnormality is 16C>T polymorphism. Objectives: The present study was undertaken to evaluate whether INHa-16C>T gene polymorphism could be a predictive marker for POF in the Egyptian females undergoing ICSI. Also, to identify role of the ovarian hormones like; FSH, LH, estradaiol, progesterone, anti-mullarian hormone, activin and inhibin in the dignosis of POF. Patients and methods: All cases were recurted from the Gynecology and Obstetric Department, Mansoura University, Egypt. All women were subjected to history taking including demographic data, menstrual and reproductive characteristics and history of hormonal therapy. The study group included 50 women with symptoms and signs suggestive of ovarian failure; their mean age was 31.5± 4.88 years. The control group included 50 healthy women with normal hormonal profile with male factors infertility, their mean age 29.05+3.3 years. Venous blood samples were collected for assay of follicle stimulating hormone (FSH), luteinizing hormone (LH), anti-mullarian hormone (AMH), inhibin and activin using enzyme linked immunosorbent assay. Genomic DNA was isolated from EDTA-anticoagulated peripheral blood using DNA extraction kit. Results: Women with POF showed a highly significant increase in the mean FSH and LH levels compared to control group. There is a statistically significant decrease of the mean serum inhibin and inhibin/activin ratio in women with POF compared to control women. In women with POF, the frequencies of homozygous genotypes CC, heterozygote genotypes CT and homozygote genotypes TT of the INHa-16C>T polymorphism were 70% (35/50), 24% (12/50) and 6% (3/50). The C allele was present in 82% of patients with POF and in 73% of the control group, whereas the T allele was present in 12% and 27% respectively. Conclusion: INHa-16C>T gene polymorphisms is not considered as a risk factor for POF among Egyptian women.