PTX3 as a key modulator of functional ovarian response in PCOS: evaluation alongside TSG-6 and ITI.

IF 4.2 3区医学 Q1 REPRODUCTIVE BIOLOGY

Journal of Ovarian Research Pub Date : 2025-09-26 DOI:10.1186/s13048-025-01798-w

Zercan Kalı, Ümran Karabulut, Tuba Memur, Fatma Tanılır Çağıran, Nihal Mavral, Pınar Kırıcı

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引用次数: 0

Abstract

Objective: To investigate the relationship between follicular fluid pentraxin 3 (PTX-3) levels and ovarian response, embryo quality, and insulin resistance (IR) in patients with polycystic ovary syndrome (PCOS) undergoing IVF/ICSI.

Methods: A total of 130 women were enrolled and categorized into three groups: lean PCOS (n = 43), overweight PCOS (n = 42), and unexplained infertility (UEI, n = 45). Patients with endocrine disorders, chronic inflammatory diseases, or recent hormonal therapy (within 3 months) were excluded. Follicular fluid (FF) and serum PTX-3 levels were measured using ELISA. Subgroup analyses were performed according to BMI and HOMA-IR status. Correlations between FF PTX-3 and clinical, hormonal, and embryological parameters were assessed. ROC curve analysis and multivariate linear regression were used to evaluate the diagnostic and predictive value of FF biomarkers for follicular output rate (FORT).

Results: FF PTX-3 levels were significantly higher in both lean (23.31 ± 1.33 ng/mL) and overweight PCOS patients (12.54 ± 1.05 ng/mL) compared to UEI controls (7.01 ± 0.54 ng/mL; p = 0.029). Notably, PTX-3 remained elevated in lean PCOS despite a lower BMI, supporting its role in intrinsic ovarian inflammation. FF PTX-3 showed significant positive correlations with total testosterone (r = 0.580), AFC (r = 0.598), and oocyte count (r = 0.532), but was inversely associated with high-quality embryo number (r = - 0.482), 2PN count (r = - 0.312), and FORT (r = - 0.418). ROC analysis demonstrated moderate diagnostic performance of PTX-3 for predicting suboptimal FORT (AUC = 0.77; cut-off: 20.4 ng/mL). In multivariate analysis, FF PTX-3 (β = - 0.65, p = 0.001), TSG-6 (β = - 0.42), and ITI (β = - 0.37) were independent negative predictors of FORT, while AFC was positively associated.

Conclusion: Elevated follicular PTX-3 levels are linked to hyperandrogenism and ovarian reserve in PCOS, but may impair embryo quality and functional follicular response. PTX-3 may serve as a potential biomarker of ovarian inflammation and compromised oocyte competence, independent of BMI or systemic insulin resistance.

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PTX3作为PCOS患者功能性卵巢反应的关键调节剂：与TSG-6和ITI一起评估。

目的：探讨多囊卵巢综合征（PCOS）体外受精（IVF/ICSI）患者卵泡液中戊烯醌3 （PTX-3）水平与卵巢反应、胚胎质量和胰岛素抵抗（IR）的关系。方法：共纳入130名女性，将其分为3组：瘦型PCOS （n = 43）、超重型PCOS （n = 42）和不明原因不孕（UEI, n = 45）。排除内分泌失调、慢性炎症性疾病或最近接受激素治疗（3个月内）的患者。采用ELISA法检测卵泡液（FF）和血清PTX-3水平。根据BMI和HOMA-IR状态进行亚组分析。评估FF PTX-3与临床、激素和胚胎学参数的相关性。采用ROC曲线分析和多元线性回归评价FF生物标志物对卵泡排出率（FORT）的诊断和预测价值。结果：瘦PCOS患者（23.31±1.33 ng/mL）和超重PCOS患者（12.54±1.05 ng/mL）的FF PTX-3水平均显著高于UEI对照组（7.01±0.54 ng/mL, p = 0.029）。值得注意的是，尽管BMI较低，PTX-3在瘦型多囊卵巢综合征中仍然升高，支持其在卵巢内源性炎症中的作用。FF PTX-3与总睾酮（r = 0.580）、AFC （r = 0.598）、卵母细胞计数（r = 0.532）呈显著正相关，与优质胚胎数（r = - 0.482）、2PN计数（r = - 0.312）、FORT （r = - 0.418）呈负相关。ROC分析显示PTX-3在预测次优FORT方面具有中等诊断性能（AUC = 0.77; cut-off: 20.4 ng/mL）。在多变量分析中，FF PTX-3 （β = - 0.65, p = 0.001）、TSG-6 （β = - 0.42）和ITI （β = - 0.37）是FORT的独立负相关预测因子，而AFC呈正相关。结论：PCOS患者卵泡PTX-3水平升高与高雄激素和卵巢储备有关，但可能影响胚胎质量和卵泡功能反应。PTX-3可能作为卵巢炎症和卵母细胞能力受损的潜在生物标志物，独立于BMI或全身胰岛素抵抗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Ovarian Research REPRODUCTIVE BIOLOGY-

CiteScore

6.20

自引率

2.50%

发文量

125

审稿时长

>12 weeks

期刊介绍： Journal of Ovarian Research is an open access, peer reviewed, online journal that aims to provide a forum for high-quality basic and clinical research on ovarian function, abnormalities, and cancer. The journal focuses on research that provides new insights into ovarian functions as well as prevention and treatment of diseases afflicting the organ. Topical areas include, but are not restricted to: Ovary development, hormone secretion and regulation Follicle growth and ovulation Infertility and Polycystic ovarian syndrome Regulation of pituitary and other biological functions by ovarian hormones Ovarian cancer, its prevention, diagnosis and treatment Drug development and screening Role of stem cells in ovary development and function.