The Comparison of the Effect of Recombinant FSH in Antagonist Protocol on Serum and Follicular Fluid Kisspeptin between PCOS and non-PCOS Infertile Women during ICSI

Abstract

Background: Reproduction is a highly delicate organized process accomplished by the controlled interaction of the higher centers in the brain, the gonads, and different body parts. Kisspeptin is a neuropeptide that acts as a key regulator controlling the hypothalamic-pituitary-gonadal axis and organizing the reproduction process. Gonadotropins treatment used in controlled ovarian hyperstimulation increases the follicular count in an attempt to improve the pregnancy rate. However, one of its drawbacks is the increase in ovarian hyperstimulation syndrome risk. Published data proved that kisspeptin has a fundamental role in regulating follicular growth and maturation at central and peripheral levels highlighting its possible role in diagnosing and treating infertility problems. Objective: To study the influence of gonadotropin (recombinant FSH medication) used in ovarian hyperstimulation program on the level serum and follicular fluid kisspeptin level in PCOS and non-PCOS patients. Subject, Materials, and Method: This is a cross-sectional study performed in the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al-Naharin University, from September 2020 to July 2021. The study includes a sample of (80) infertile Iraqi women aged (18–40 years) scheduled for an intracytoplasmic sperm injection program after being stimulated by GnRH antagonist protocol. On the day of oocytes retrieval, blood and follicular fluid samples were drawn from each participant to measure kisspeptin level using ELIZA technique. Results: In PCOS patients, significant positive correlations were found between recombinant FSH medication with serum and follicular fluid kisspeptin level (p is less than 0.05). Serum kisspeptin was insignificantly higher in the PCOS patient (p = 0.838) while follicular fluid kisspeptin was insignificantly lower in the PCOS women (p = 0.651). There were significant correlations between serum and follicular kisspeptin in the PCOS and the control groups (p = 0.000) and (p = 0.002), respectively. Conclusions: Serum and follicular fluid kisspeptin are positively correlated with the cumulative recombinant FSH medication used by infertile polycystic ovarian syndrome women undergoing ICSI, addressing the possible role of kisspeptin in improving the pregnancy rate in PCOS patients with a lower incidence of ovarian hyperstimulation syndrome.