Impact of spontaneous preterm birth on amniotic fluid NF-κB, IL-6, TNF-α and IL-1β levels in singleton pregnancies conceived after IVF/ICSI treatment or natural conception

P. Kirici, F.T. Cagiran, Z. Kali

Department of Obstetric and Gynecology, Adıyaman University School of Medicine Adıyaman, Turkey. pinarkiricidr@hotmail.com

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• Gynecology
• Obstetrics

OBJECTIVE: The aim of our study was to compare the amniotic fluid NF-κB, TNF-α, IL-1β and IL-6 levels of patients who developed spontaneous preterm birth (sPTB) after IVF/ICSI or natural pregnancy, among themselves and with the pregnant women who gave term birth.

PATIENTS AND METHODS: A total of 43 patients who had spontaneous preterm birth before 37 weeks were included in the study. While 23 out of 43 patients conceived after IVF/ICSI, the remaining 20 patients conceived spontaneously. Women in both participant groups delivered by cesarean section or vaginally. Ten patients who did not have a history of preterm labor were accepted as the control group. Amniotic fluid was taken with the aid of a 10 cc injector following spontaneous or artificial rupture of membranes from patients who presented with spontaneous preterm labor with intact membranes and started normal labor. Samples of amniotic fluid accumulated in the speculum were collected from patients with ruptured membranes at the first admission. Amniotic fluid was collected with the help of an injector just before the amniotic membrane was cut in patients who decided to have a cesarean section. NF-κB, IL-6, TNF-α and IL-1β concentrations in amniotic fluid samples were measured quantitatively by enzyme-linked immunosorbent assay (ELISA) using human NF-κB, IL-6, TNF-α, and IL-1β ELISA kits.

RESULTS: The maternal age, parity and gestational age at the time of delivery, fetal birth weight were similar in the IVF/ICSI and natural conception groups. The amniotic fluid NF-κB, TNF-α, IL-1β and IL-6 levels of sPTB patients in the IVF/ICSI group and those in the natural conception group were found to be similar. The tendency to increase in cytokine levels in term pregnant women compared to sPTB groups did not reach significance. Amniotic fluid proinflammatory cytokine levels of sPTB patients in both natural conception and IVF/ICSI groups were found to be similar to healthy controls with term delivery. Amniotic fluid proinflammatory cytokine levels of sPTB patients in both natural conception and IVF/ICSI groups were found to be similar to healthy controls with term delivery. There was no difference between the amniotic fluid proinflammatory cytokine levels of the patients who delivered vaginally or by cesarean section.

CONCLUSIONS: Whether sPTB develops after ICSI or after natural conception, the mechanism is the same and largely overlaps with the term birth mechanism.

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