The effect of serum and follicle fluid fetuin-B levels on oocyte quality between polycystic ovary syndrome, poor ovarian response, unexplained infertility patient groups

Objective: In this study, it was aimed to show whether the level of fetuin-B in serum and follicle fluids of patients who applied for infertility differs between PCOS, unexplained infertile individuals and infertile patients with poor ovarian response and how it affects oocyte quality. Material and Methods: The study was prospectively controlled, November 1, 2021 and November 1, 2022 in a 1-year period, with 25 women meeting the criteria for infertility of unknown cause, 25 women meeting the diagnostic criteria for infertile PCOS, and 25 women meeting the diagnostic criteria for infertile poor ovarian response. A total of 75 women in three groups were included in the study. Oocyte pick-up was performed following the ovulation induction. During the procedure, patients' blood serum and follicle fluids from the oocyte collection process were collected. Fetuin-B levels in serum and follicle fluid were studied by the ELIZA method. The number and quality of picked up oocytes, the number, and the quality of embryos were determined by the embryologist. On the 14th day after embryo transfer, biochemical pregnancy was determined according to human chorionic gonadotropin hormone positivity and clinical pregnancy was determined in those with gestational sac on ultrasound. Results: The age, height, weight and BMI values of the patient groups were not statistically significant (P>0,05). Irregular periods were seen in 12% of the unexplained group, 96% of the PCOS group, and 20% of the poor ovarian response group, and the differences between the groups were statistically significant (P<0,05). Menstrual cycle duration was statistically significantly higher in the PCOS group (P<0,05). Number of menstrual days were similar in all three groups (P>0,05). Right and left follicle values in the unexplained group were statistically significantly higher than the poor ovarian response group (P<0,05). Ferriman - Gallwey score and AMH level were significantly higher in PCOS group (P<0,05). Numbers of, total oocytes, M2 oocytes, G6 oocytes, PN2 oocytes and 2nd day embryo values were statistically significantly higher in the PCOS group (P<0,05). The difference embryo transfer data was not statistically significant (P>0,05). In all three groups, the differences between the distributions of fetuin-B value measured from the follicle fluid were not statistically significant (P>0,05). On the other hand, fetuin B level in serum was statistically significantly higher in PCOS group than in the poor ovarian response group (P<0,05). According to the results of Mann Whitney U test performed as Post Hoc, only the differences between PCOS and poor ovarian response were statistically significant (P<0,05). The diagnostic value of serum fetuin-B level on PCOS was not statistically significant (AUC: 0,616; P>0,05). Conclusion: No statistically significant relationship was found between fetuin-B in serum and fetuin-B in follicular fluid and PCOS. However, a statistically significant and negative correlation was found between the level of fetuin-B in follicular fluid and the number of biochemical pregnancies in the unexplained infertility group. Again, in the unexplained infertility group, a statistically significant and negative correlation was found between serum fetuin-B level and the number of clinical pregnancies. Feutin-B level may have predictive value in estimating the outcomes of the IVF process in unexplained pregnancies in this regard.