Abstract
A balance within the immune system is necessary for the proper development of ovarian follicles. Numerous cytokines were detected in follicular fluid, the role of which in reproductive physiology seems crucial. They influence the development and maturation of the follicle, ovulation, and corpus luteum formation, as well as embryo implantation and maintenance of pregnancy. The analysis of follicular fluid requires its collection by puncturing of the ovary, which is usually executed in connection with various gynaecological procedures. When interpreting such test results, clinical indications for a given procedure and the method of patient preparation should be taken into account. This review revealed the results of currently available studies on the concentration of pro-inflammatory cytokines in follicular fluid in various forms of infertility. Additionally, it presented cytokines, whose concentration has a significant impact on the size of ovarian follicles, their number, the effectiveness of in vitro fertilisation, development of the embryo, and chances of correct implantation. Despite the many recent publications, the knowledge of follicular fluid immunology in the context of reproductive pathology is superficial and further research is required to extensively understand the roles of individual cytokines in reproductive pathology. In the future, this knowledge may enable patients’ individual qualifications to individual methods of infertility treatment, as well as the possible adjustment of the treatment regimen to the patient’s immune profile.
Highlights
A balance within the immune system is necessary for the proper development of follicles
An extremely interesting study was published by Sarapik et al, who presented an analysis of pro- (IL-1β, IL-6, IL-18, IFN-γ, IFN-α, TNF-α, IL-12, and IL-23) and antiinflammatory cytokines (G-CSF), in addition to which selected chemokines (MIP-1α, MIP-1β, MCP-1, RANTES, and interleukin 8 (IL-8)) in follicular fluid (FF) were collected from women undergoing in vitro fertilisation (IVF)
Gutman et al found that the concentration of IL-18, both in the blood serum and FF, positively correlated with the number of oocytes collected from patients qualified for IVF [20]
Summary
A balance within the immune system is necessary for the proper development of follicles. Cytokines promote proper oocyte maturation, timely rupture of follicles, and neoangiogenesis, indirectly contributing to the supply of oxygen, nutrients, and substrates for subsequent steroidogenesis [1]. The analysis of the cytokine and hormonal profile of follicular fluid (FF) in natural and stimulated physiological cycles is crucial in the assessment of its role in follicle development [2]. The central role of cytokines suggests that any modulation during follicle development and oocyte maturation may have a significant impact on the development of physiological conditions for fertilisation. Expanding the knowledge on the role of various cytokines in particular phases of the cycle and follicular maturation may help in establishing an individual approach to the fertility treatment
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