IL-6 and IGFII in normal ovulatory; anovulatory pcos and controlled ovarian hyperstimulation cycles

ABSTRACT

Cytokine interleukin-6 [IL-6] and insulin like growth factor II [IGF-II] are polyfunctional regulatory peptides. They have a wide variety of biological activities including ovulation regulation of gonadal steroid secretion by the ovaries, corpus luteum function and embryo implantation. To investigate their role in normal ovulation, polycystic ovary syndrome [PCOS] and controlled ovarian hyperstimulation [COH] this study is conducted. Department of Obstetrics and Gynecology and Clinical Pathology, Assiut University Hospital, Assiut, Egypt. Sixty women were included in this study from 3 groups of patients; 20 women in each group. First group includes women with normal ovulatory cycle and a second group includes women with anovulatory PCOS cycle and a third group of women prepared for assisted reproduction by [ICSI]. Three blood samples from each women were obtained at day 3 of the cycle day 12 or day of ovum pick up and day 22 of the cycle. Follicular Fluid [FF]collected at the day of ovum pick up from women undergoing [ICSI]. Blood and FFsamples were assayed for IL-6 and IGF-II as well as E2, FSH, LH and P, using [ELISA] technique. The mean values of IL-6 level in the early follicular phase in normal ovulatory, PCOS and COH groups were 12.93 +/- 0.77, 101.99 +/- 32.04 and 12.86 +/- 0.88 [pg/ml], respectively. There is highly significant increase in PCOS group in comparison to normal ovulatory and COH groups. IL-6 significantly increased in patients with increased number of follicles than those of low number of follicles in COH group. The mean values of IL-6 in late follicular phase were 11.4 +/- 0.88, 99.7 +/- 4.0, 27.3 +/- 8.0 in the three groups, respectively. The level is only significanlly increased in those patients with COH than the level in early follicular phase inside each group. The mean values of IL-6 in the mid luteal phase were 176.6 +/- 29.7 and 68.7 +/- 52.3 [pg/ml] in normal ovulatory and PCOS groups. There was highly significant increase in the ovulatory than the anvulatory cycle. There was a significant increase of IL-6 in FF at the time of ovum pick up over the serum samples taken at the same time. The mean values of IGF-II level in late follicular phase were 589.97 +/- 22.58, 466.4 +/.- 41.74 and 770.7 +/- 79.38 [ng/ml] in normal ovulatory, PCOS and COH group, respectively. The increase of IGF-II in cases of COH than normal ovulatory cycle shows its significant role in steroidogenesis which is important for the elevated E2 level in this group. IL-6 may be an early predictor for the ovarian responce and the development of ovarian Hyper stimulation syndrome [OHSS] with the othor hormonal and US parameters. IL-6 may be taken in consideration as a maker for corpus luteum function in conjunction with progesterone in day 22. The elevation of IL-6 in day 3 in PCOS patients than in the normal ovulatory cycle may partially explain the increased liability to OHSS in these patients. The significant reduction in IGF-II in cases of PCOS may play a role in anovulation