Evaluation of serum TNF-alpha levels in infertile women compared to the normal population

INTRODUCTION: According to a statement released by the World Health Organization (WHO) in April 2023, infertility is defined as the inability of a couple to achieve pregnancy despite regular, unprotected intercourse for at least 12 months (1). Infertility is classified into two types: primary and secondary. Individuals categorized as having primary infertility have no previous history of pregnancy, while those with secondary infertility have at least one previous pregnancy history. There are many causes of infertility, and some infertile women are classified as having unexplained infertility. Tumor necrosis factor-alpha (TNF-α), also known as cachexin, is a cytokine primarily synthesized by monocytes and macrophages. It has significant properties in initiating and maintaining inflammation in various diseases and pathological conditions. Many conditions can trigger TNF-α synthesis and release. It exerts its effects through TNF receptor 1, which bears its name, and plays a role in certain aspects of inflammatory diseases (9). This study aims to investigate the relationship between infertility and TNF-alpha levels. MATERIALS AND METHODS: This study was conducted at the Infertility/IVF Clinic of Yozgat Bozok University Research and Practice Hospital between October 2023 and October 2024. Approval was obtained from the Yozgat Bozok University Ethics Committee with the decision number 2017-KAEK-189_2023.19_09 dated October 19, 2023 (Appendix 1). A total of 84 individuals were selected using simple random sampling. Diagnostic and follow-up tests for infertile patients, including Follicle Stimulating Hormone (FSH), Estradiol (E2), Thyroid Stimulating Hormone (TSH), Prolactin, Luteinizing Hormone (LH), DHEA, fasting blood glucose, and fasting insulin, were recorded from the archives. Serum blood samples collected for TNF-alpha were centrifuged, transferred to Eppendorf tubes, and stored at -80˚C until the day of analysis. Data on age, height, weight, smoking status, known diseases, current medical treatments, surgical history, and obstetric history of all patients were recorded. Body mass indices (BMI) were calculated in kg/m². RESULTS: The relationship between TNF-alpha and infertility was found to be statistically insignificant (p>0.05). The relationship between FSH levels and infertility was also statistically insignificant (p>0.05). The relationship between LH and infertility, when evaluated statistically, was not found to be significant (p>0.05). Similarly, the relationship between Estradiol and infertility was statistically insignificant (p>0.05). The relationship between Prolactin levels and infertility, when analyzed, was found to be statistically insignificant for the participants in this study (p>0.05). However, a statistically significant relationship between TSH (Thyroid Stimulating Hormone) values and infertility was observed. The relationship between DHEA (Dehydroepiandrosterone) values and infertility was found to be statistically insignificant (p>0.05). The relationship between insulin resistance, fasting blood glucose levels, and fasting insulin levels, as well as the HOMA-IR value calculated, was found to be statistically significant with infertility (p<0.05). CONCLUSION: The results of our study indicate that there was no statistically significant difference between the TNF-alpha levels of infertile patients and those of the control group. We hope that this study may provide a new perspective for future research exploring the relationship between TNF-alpha, other inflammatory cytokines, and infertility. Keywords: Infertility, Inflammation, TNF-Alpha Contact Address: Department of Obstetrics and Gynecology, Faculty of Medicine, Bozok University / Yozgat, 66200