No abstract

This prospective study aimed to determine the status of circulating levels of C-reactive protein (CRP), tumor necrosis factor α (TNF-α), IL-27, IL-35, IL-37, α-1 acid glycoprotein in patients with polycystic ovary syndrome (PCOS) compared with controls and to evaluate their relation with hyperandrogenism and obesity. Forty-eight patients with PCOS (29 obese, 19 lean) and 40 healthy controls (20 obese, 20 lean) were enrolled. CRP, TNF-α, IL-27, IL-35, IL-37, α-1 acid glycoprotein, sex hormone-binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEA-S) levels were measured. Levels of total testosterone, A4, DHEA-S were significantly higher in patients with PCOS than in controls both in the obese and lean groups, while levels of SHBG were significantly lower in all patients with PCOS than in all (p < 0.05). Free androgen index (FAI) values were significantly higher in all patients with PCOS than in all controls (all p < 0.05). Levels of CRP, TNF-α, α-1 acid glycoprotein were significantly increased in all patients with PCOS compared with all controls (all p < 0.001). FAI had a positive correlation with CRP, TNF-α, α-1 acid glycoprotein, a negative correlation with IL-27, IL-25, IL-37 (all p < 0.01). Body mass index had a negative correlation with IL-27, IL-35, IL-37, a positive correlation with α-1 acid glycoprotein, FAI (p < 0.05). The findings confirm the proinflammatory state of PCOS. Moreover, obesity along with PCOS significantly elevates the inflammatory status and hyperandrogenism.

103 down-regulated genes (P<0.05). Nine genes involving adipogenesis were up-regulated (WARS2, CXCL5, CYP26B1, CYP4V2, TBX3, GPX3, CXCL2, SCD and APOC1) and 6 genes were down-regulated (HHIP, WNT5A, WISP1, SEMA3A, ITGA6 and GREM1). Differential canonical pathways between the two female groups included (i) Liver X Receptor/Retinoid X Receptor (LXR/RXR) activation (P¼0.001), (ii) Notch signaling (P¼0.002), (iii) epithelial-mesenchymal regulation (P¼0.006), (iv) Vitamin D Receptor/ Retinoid X Receptor (VDR/RXR) activation (P¼0.013) and (v) human embryonic stem cell pluripotency (P¼0.05), all of which involve adipogenesis and ECM formation. TGFb1 was identified as the master upstream regulatory gene (P¼0.004), governing genes affecting adipogenesis (SCD, TBX3, WNT5A, ITGA6, SEMA3A and WISP1) and ECM formation (CH13L1, TNC, MYO10, JAG1, SOX4 and ANKRD1). Interestingly, miRNA array identified miRNAs controlling gene regulation of adipogenesis and ECM formation, including hsa-miR-4709-3p (GREM1 and SEMA3A), hsa-miR-532-3p (CYP26B1), hsa-miR-532-5p (CXCL2), hsa-miR-23c (WARS2), hsa-miR-299-5p (SOX4) and hsa-miR-298 (GPX3) (P<0.05).

Objective: Hysteroscopy is frequently performed in infertile women and thought to improve pregnancy rates. The data obtained from studies investigating the effect of hysteroscopy in in-vitro fertilization (IVF) cycles is variable. We aimed to evaluate the effect of hysteroscopy on pregnancy outcomes of fresh and frozen-thawed embryo transfers (FET) performed during IVF cycles. Material and Methods: The data of the 765 patients, who had IVF treatment between January 2015 and July 2017 in an infertility center, were retrospectively analyzed. Of those, 586 (76.6%) patients underwent fresh embryo transfer, while 179 (23.4%) patients underwent FET. Hysteroscopy performed by a single experienced surgeon was scheduled two months before transfer. Hysteroscopy was performed in 101/586 (17.2%) in those undergoing fresh embryo transfer and 44/179 (24.6%) patients in the FET group. Pregnancy outcomes of the groups were compared respectively within their own group. Results: The mean age was similar in patients in the fresh and FET groups (p=0.365, respectively). There was no difference in the number of transferred embryos between the groups (p=0.218). In the fresh embryo group there were 246 pregnancies, of which 44 had undergone diagnostic hysteroscopy while 202 had not, (p=0.516) and 79 pregnancies in the FET group, of which 20 had undergone diagnostic hysteroscopy while 59 had not (p=0.711). There was no statistical difference according to pregnancy rate between the groups (p=0.538). Conclusion: Performing diagnostic hysteroscopy before fresh or FET does not improve the pregnancy rates.