Predictive value of pregnancy of follicular fluid fetuin-A and-B levels in infertile women after intra-cytoplasmic sperm injection
Abstract
AimWe aimed to investigate the value of follicular fluid Fetuins-A and -B to predict successful IVF and pregnancy outcomes in infertile women with poor, normal, and high ovarian reserve. MethodsThe follicular fluid of 96 infertile women who underwent intra-cytoplasmic sperm injection (ICSI) procedure was analyzed. Fetuins-A and -B levels were examined and compared in those who could achieve pregnancy and those who could not. ROC curve analyzes were used to determine cut-off and statistically significant associations for fetuins-A and -B.ResultsFollicular fluid Fetuin-A levels were higher in cases with weak ovarian reserve (OR) (p<0.05) and higher in patients who did not achieve clinical pregnancy (p<0.05). Conversely, the follicular fluid Fetuin-B levels were lower in cases with poor OR (p<0.05) and were lower in patients who did not achieve a clinical pregnancy (p<0.05). A follicular fluid Fetuin-A concentration ≤19.12 ng/mL had a sensitivity and specificity of 94.74% and 93.1%, respectively, at predicting clinical pregnancy. While the follicular fluid Fetuin-B concentration >24.7 ng/mL had sensitivity and specificity of 71.1% and 51.7%, respectively, for clinical pregnancy prediction.ConclusionsOverall, high levels of follicular fluid Fetuin-A are independently associated with unsuccessful IVF irrespective of OR grouping. A low level of follicular Fetuin-B was also associated with failed IVF. The sensitivity and specificity were found to be higher for Fetuin-A in predicting clinical pregnancy. Therefore, the follicular fluid Fetuin-A may be more predictive for successful IVF and clinical pregnancy outcomes than follicular fluid Fetuin-B.Trial registration: This trial was registered at ClinicalTrials.gov as NCT04201847.