Abstract
The current study aimed to determine the role of hormonal disturbances in infertility, moreover assessing variations at the molecular level that could affect this disease. The study examined 90 blood samples, 30 patients with primary infertility, 30 patients with secondary infertility and 30 healthy women as control. FSH and LH were measured using Electrochemiluminescence assay. DNA was isolated for molecular detection of polymorphisms at the nucleotide level (rs6166 and rs28928870) in FSHR gene using ASO PCR technique and identification mutations in LH gene using PCR technique followed by sequencing. The results showed no significant differences in FSH levels (6.95±4.55 mIU/ml, 5.48±4.64 mIU/ml and 5.52±3.07 mIU/ml) between control, primary and secondary respectively, while LH showed significant differences between primary and secondary groups (14.23±12.17 mIU/ml and 8.54±5.62 mIU/ml) respectively. A significant positive correlation was found between FSH and LH. The molecular study showed different polymorphisms at different positions in LH gene detected by sequencing. Regarding FSHR polymorphisms our results showed that the OR (95% CI) for AA and AG genotypes of Asn680Ser polymorphism (rs6166) was 3.32 (0.14-78-49) and 1.00 (0.06-15.99) respectively for primary infertility. Moreover, the OR (95% CI) for AA and AG of this polymorphism was 1.00 (0.07-17.59) and 3.0 (0.13-70.59) respectively for secondary infertility. While regarding Thr449Ile (rs28928870) only the wild type was detected in the studied group. In conclusion, AG genotype ofAsn680Ser is more prevalent in the Iraqi studied women. Furthermore, A allele is a risk factor for the disease as the (OR: 1.49 95% CI: 0.44-5.03) for the primary group and (OR: 1.22 95% CI: 0.35-4.23) for secondary group.
Highlights
Infertility according to the World Health Organization is "a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse" (Zegers-Hochschild et al, 2009)
Infertility in women can be divided into two groups; primary infertility in couples who have never been conceived and secondary infertility that is related to couples who have previously conceived and have difficulty in conceiving again
A case-control study was conducted in Fallujah city involved a total of 90 women. They were divided into three groups; 30 women with primary infertility, 30 with secondary infertility and 30 as control group. 5 ml of venous blood was collected for both hormonal analysis and molecular detection
Summary
Infertility according to the World Health Organization is "a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse" (Zegers-Hochschild et al, 2009). Infertility in women can be divided into two groups; primary infertility in couples who have never been conceived and secondary infertility that is related to couples who have previously conceived and have difficulty in conceiving again. This group includes full term pregnancy and miscarriages, abortions etc. The primary fertility hormones that affect the reproductive function are follicle stimulating hormone and luteinizing hormone. These gonadotropins are the key drivers of the menstrual cycle.
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