A Study of Plasma and Follicular Fluid Levels of High-Sensitivity C-Reactive Protein in Women Undergoing In-Vitro Fertilization Treatment at National Hospital, Abuja: A Prospective Cohort Study

Abstract

Context

The prevalence of infertility is increasing globally. In-vitro fertilization (IVF) offers the highest pregnancy rates for infertile couples worldwide; however, success rates remain relatively low (11–46%). Implantation failure is the most common cause of IVF failure. The role of inflammatory mediators in implantation outcomes—particularly the potential use of follicular fluid biomarkers as indicators of oocyte quality—is currently under investigation.

Aim

To investigate the relationship between plasma and follicular fluid levels of high-sensitivity C-reactive protein (hs-CRP) and implantation outcome in women undergoing IVF treatment.

Settings and Design

A prospective cohort study involving 150 women undergoing IVF treatment at National Hospital, Abuja.

Methods and Materials

• Plasma levels of hs-CRP were measured at down-regulation.

• Follicular fluid (FF) levels of hs-CRP were measured during oocyte retrieval.

• Implantation outcome was assessed using plasma β-hCG levels measured on the 14th day post-embryo transfer.

• Statistical analysis was conducted using the Statistical Package for Social Sciences (SPSS), Version 20 (Chicago, Illinois, USA).

Results

• Plasma hs-CRP:

  • Median level (overall): 6.00 mg/L (IQR = 6.81)

  • Negative implantation outcome: 7.48 mg/L (IQR = 7.50)

  • Positive implantation outcome: 3.62 mg/L (IQR = 7.17)

  • Difference: Not statistically significant (p = 0.259)

• Follicular Fluid hs-CRP:

  • Median level (overall): 3.69 mg/L (IQR = 5.18)

  • Negative implantation outcome: 4.72 mg/L (IQR = 5.18)

  • Positive implantation outcome: 2.25 mg/L (IQR = 5.01)

  • Difference: Statistically significant (p = 0.035)

Conclusion

Follicular fluid hs-CRP levels were significantly higher in women with negative implantation outcomes than in those with positive implantation outcomes. This suggests that elevated FF hs-CRP may be associated with poorer implantation success, highlighting its potential role as a biomarker for IVF outcomes.