Author/Authors :
Mumtaz، Aaida نويسنده Medical College, Aga Khan University, Karachi, Pakistan , , Khalid، Aqsa نويسنده Medical College, Aga Khan University, Karachi, Pakistan , , Jamil، Zehra نويسنده Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan , , Fatima، Syeda Sadia نويسنده Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan. , , Arif، Sara نويسنده G.C. University , , Rehman، Rehana نويسنده Department of Physiology, Bahria University Medical and Dental College, Karachi, Pakistan ,
Abstract :
Background: Kisspeptin (KP) is a neuropeptide that causes the release of the gonadotropin
releasing hormone, which controls hypothalamo pituitary ovarian axis and exerts
a number of peripheral effects on reproductive organs. The primary objective of this
study was to compare baseline KP levels in females with different types of infertility and
identify possible correlations with risk of failure to conceive, preclinical abortion and
pregnancy after intracytoplasmic sperm injection (ICSI).
Materials and Methods: A longitudinal cohort study was carried out from August 2014
until May 2015 by recruiting 124 female patients undergoing ICSI, after obtaining ethical
approval from the Australian Concept Infertility Medical Center. Cause of infertility due
to male, female and unexplained factors was at a frequency of 32 (24%), 33 (31%) and 59
(45%) among the individuals respectively. KP levels were measured by ELISA assay before
the initiation of the ICSI treatment protocol. Outcome of ICSI was categorized into
three groups of non-pregnant with beta-human chorionic gonadotropin (B-hCG) < 5-25
mIU/ml, preclinical abortion with B-hCG > 25 mIU/ml and no cardiac activity, and clinical
pregnancy declared upon confirmation of cardiac activity. Results based on cause of
infertility and outcome groups were analyzed by one-way ANOVA.
Results: Females with unexplained infertility had significantly lower levels of KP
when compared with those with male factor infertility (176.69 ± 5.03 vs. 397.6 ± 58.2,
P=0.001). Clinical pregnancy was observed in 28 (23%) females of which 17 (71%) had
a female cause of infertility. In the non-pregnant group of 66 (53%) females, common
cause of infertility was unexplained 56(85%). A weak positive correlation of KP levels
with fertilized oocytes and endometrial thickness was observed (P=0.04 and 0.01 respectively).
Conclusion: Deficiency of KP in females with unexplained infertility was associated with
reduced chances of implantation after ICSI.
