Comparison of the effects of recombinant hCG and GnRH agonist on follicular fluid pentraxin 3, NF-kB and redox balance

Objectives To compare the effects of ovulation triggering with recombinant human chorionic gonadotropin (hCG) or GnRH agonist on follicular fluid (FF) long pentraxin 3 (PTX3), nuclear factor kappaB (NF-kB), and redox balance markers in infertile patients. Materials and Methods A total of 40 patients under the age of 35 who were planned for assisted conception were included in the study. Participants were grouped according to their infertility etiology as PCOS (n = 13), uni- or bilateral endometrioma (n = 9), male factor (n = 11), and recurrent implantation failure (RIF, n = 7).The selection of which patient would be triggered with hCG or agonist was done randomly. PTX3 mRNA expression and NF-kB protein analysis were performed in FF samples collected from metaphase II mature oocytes. Follicular unit redox balance was determined by total oxidant status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI). Results In the rhCG-triggered group, FF-NF-kB protein concentration was significantly higher than in the GnRH agonist-triggered group. Similarly, while FF-TAS levels were higher in the rhCG group, FF-TOS and OSI values ​​were significantly higher than in the agonist group.FF-PTX3 mRNA expression in the rhCG-triggered group was significantly higher than the GnRH agonist group. A 5-fold up-regulation in the relative expression of FF-PTX3 mRNA was detected in the hCG group compared to the GnRH agonist group (1.02 ± 0.26 vs. 5.39 ± 0.29, p < 0.001). When PTX3 mRNA expression was evaluated according to subgroups, significant downregulation was detected in the PCOS group compared to the other three groups. The relative FF-PTX3 mRNA expression of the endometrioma group was higher than all groups. Relative gene expression levels of male factor and RIF groups were similar. Conclusions rhCG induces ovulation more effectively than GnRHa agonists by providing a clearer balance between proinflammatory cytokines and redox balance markers.