Studying the effect of ovulation stimulation by using clomiphene citrate on serum level of tumor necrosis factor alpha and interleukin-1ß in sub-fertile women in Holy Kerbala Province

Abstract

Objectives The overall goal of this study was to figure out the effect of ovulation induction on the levels of TNF-α and IL-1ß, and to investigate the possible interaction between the cytokines and hormones in respect to anovulation.
Methods The study comprised of 53 women; 33 sub-fertile and 20 fertile. Their ages ranged from 17–39 years. The anovulation in the subfertile group were diagnosed based on the standard criteria (clinical and laboratory investigations). All patients were scheduled for the induction of ovulation by treatment with clomiphene citrate. The blood samples have been drawn on the 2nd day of the menstrual cycle.
The hormones and cytokines were measured. 2–4 weeks after commencing the treatment with clomiphene citrate (clomiphene, a nonsteroidal compound, structurally similar to oestrogen, blocks oestrogenic hypothalamic receptors, resulting in blinding of the hypothalamus– pituitary axis to endogenous circulating oestrogen), the second sample of blood was drawn again to re-measure the levels of the same cytokines measured before the treatment. By SPSS software for windows, version 20, IBM, US, 2010, data of all participants have been entered, descriptive data analysis, paired sample T test, one way ANOVA test and person’s correlations have been used as appropriate.
Results In this study, the levels of TNF-α and IL-1ß before treatment were lower than those in after treatment; however, these differences were significant only in case of TNF-α (P = 0.041). These results indicate that clomiphene citrate has a specific effect on TNF-α expression and to a lesser extent on other cytokines.
Conclusion The results of this study may implicate a direct role of TNF-α in the fertility and, thus, could raise questions about the possibility of using immune modulation in the treatment of sub-fertility.