Comparative Analysis of Afamin, Asprosin, and Pentraxin 3 Levels in Women with PCOS and Women with Unexplained Infertility

Abstract

BACKGROUND Infertility is defined as the absence of pregnancy despite unprotected, regular sexual intercourse of couples of reproductive age for at least 1 year. Infertility may be unexplained or linked to anovulation/polycystic ovary syndrome (PCOS). PCOS can involve the processes of inflammation, insulin resistance, and metabolic syndrome. This study compared serum levels of afamin, asprosin, and pentraxin3 (PTX3) between women with PCOS and women with unexplained infertility to elucidate underlying pathophysiological mechanisms. MATERIAL AND METHODS Our study included 106 women: 55 with unexplained infertility and 51 with PCOS. Using the electrochemiluminescence immunoassay method, we assessed the levels of estradiol, follicle-stimulating hormone, luteinizing hormone, and anti-Mullerian hormone. Afamin, asprosin, and PTX3 levels were measured by ELISA. RESULTS Age, fasting glucose levels, and body mass index (BMI) of the groups were statistically similar. Anti-Mullerian hormone, antral follicle count, and LH levels were higher (P<0.05) in the PCOS group. Afamin and PTX3 levels were higher in the PCOS group (P<0.05), while asprosin levels were similar. CONCLUSIONS Our study demonstrates the importance of afamin associated with oxidative stress and the PTX3, which plays a role in the regulation of humoral immune responses, in the etiology of infertility cases. Afamin and PTX3 should be evaluated in ovulatory and non-ovulatory PCOS cycles to facilitate treatment and to elucidate the ovulation and implantation processes in PCOS. These recommendations specifically include dividing PCOS patients into subgroups such as diabetogenic, obese, and hirsute, and re-examining biochemical markers accordingly.