Evaluation of Plasminogen Activator Inhibitor-1 (PAI-1) Levels in Blood Serum and Follicular Fluid (Predictive Marker) and its effect on Embryo quality in Iraqi Infertile Females Undergoing ICSI Protocol
Samhar F. Alwan*¹, Hayder A. L. Mossa², Rana A.R. Al Saadi²
1Elwah Hospital for Obstetrics and Gynecology, (Bagdad, Iraq)
2High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University, (Baghdad, Iraq)
Samhar F. Alwan
Abstract: Background: Expression of Plasminogen Activator Inhibitor-1 in serum and follicular fluid has a direct role in embryo implantation and successful pregnancy outcome, which plays a crucial role in regulating fibrinolysis during pregnancy period by inhibits the action of other protein called plasminogen activators. Objective: Evaluate of PAI-1 level in blood serum and follicular fluid as predictive marker and it’s effected on embryo quality in an infertile females undergoing ICSI protocol. Materials and Methods: This study included Sixty-nine infertile female with mean age was (33.03 ±5.97) years, attended to High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University (Baghdad / Iraq), they underwent ICSI program, during a period from October 2022 till February 2023. All infertile female has same inclusion and exclusion criteria. Also, every female was asked some information including age, duration of infertility, body mass index (kg/m²), type of infertility, causes of infertility and hormonal assay, virology assay, husband’s seminal fluid analysis, and ultrasonography picture. All females undergone ovarian stimulation with antagonist protocol and received recombinant follicle stimulating hormone, at the cycle day two. The serum and follicular fluid was collected from each female at the day of oocyte retrieval, for PAI estimation using Elisa kit (Diagnostic/ USA). The data were analyzed using Statistical Package for Social Sciences (SPSS) version 23.0 and Microsoft office 2010. Results: The results showed that serum PAI-1 levels at the day of oocytes retrievals were significantly lower in positive pregnancy women comparison with non-pregnant women (p < 0.05); Yet no significant follicular fluid PAI-1 levels were noted in comparison with non-pregnant women. There was a negative significant correlation (p > 0.05) of serum and follicular fluid PAI-1 levels at the day of oocytes retrieval according to Embryo ICSI outcome. Conclusions: The results of current study concluded that evaluation of serum PAI-1 levels can be used as a promising parameter for the prediction of pregnancy outcome between pregnant and non-pregnant females. So indicating lower levels of serum PAI-1 at the day of oocytes retrievals are predictors of positive pregnancy. It is assumed that pregnancy rate was affected by PAI-1level during ICSI cycles.
Keywords: Plasminogen Activator Inhibitor-1 PAI-1, ICSI program, Implantation.