Evaluation of Oxidative and Nitrosative Stress Markers Related To Inflammation in The Cumulus Cells and Follicular Fluid of Women Undergoing Intracytoplasmic Sperm Injection: A Prospective Study

Oxidative/nitrosative stress in the oocyte microenvironment could have an impact on intracytoplasmicsperm injection (ICSI) outcomes. The presence of reactive oxygen species (ROS) and reactive nitrogen species (RNS) canstimulate the secretion of pro-inflammatory cytokines, leading to chronic inflammation and potentially affecting embryo aswell as oocyte quality. This study aimed to examine the relationship of lipid peroxidation [measured by the malondialdehyde(MDA) assay] with protein carbonyl [measured by the 2,4 dinitrophenylhydrazine (DNPH) assay] levels in cumulus cells(CCs), as well as nitric oxide (NO), peroxynitrite (ONOO-), and C-reactive protein (CRP) levels in follicular fluid (FF).The potential relationship of these levels with ICSI outcomes was also evaluated. In this prospective study, 63 FF samples and their corresponding CCs were collected forICSI procedures. Spectrophotometry was used to assess levels of DNPH, MDA, NO, and ONOO-. CRP levels wereevaluated using an immunoturbidimetric assay. The patients under 37 years with normal ovarian reserve had significantly lower levels of MDA, DNPH,NO, ONOO-, and CRP compared to those over 37 years. Additionally, we observed higher levels of MDA, DNPH,NO, ONOO-, and CRP in the group with an oocyte maturity rate of less than 60%. No significant difference was observedbetween the DNPH levels and factors such as infertility duration, embryo quality, pregnancy, or the number ofretrieved oocytes. A higher level of MDA, NO, ONOO-, and CRP was found to be significantly related to the lowernumber of retrieved oocytes, longer periods of infertility, poor embryo quality, and negative pregnancy outcomes. Oxidative/nitrosative stress, linking to inflammation in the oocyte microenvironment, can be consideredas a potentially useful biomarker for assessing the development and competence of oocytes and embryos and predictingICSI outcomes.