Follicular fluid cytokine phenotypes reflect underlying etiologies for infertility.

To determine if the follicular fluid (FF) cytokine phenotype reflects underlying etiologies for infertility and oocyte/embryo quality. The study subjects comprised infertile women with diminished ovarian reserve (DOR, n = 42), tubal factor infertility (TFI, n = 72), and repeated implantation failures (RIF, n = 15). Controls were women with male factor infertility (MFI, n = 30). Tumor necrosis factor-α (TNF-α), interferon-gamma (IFN-γ), IL-4, IL-10, IL-17, and transforming growth factor beta1(TGF-β1) levels in the FF were measured by the enzyme-linked immunosorbent assay (ELISA). The results showed that TNF-α and TGF-β 1 levels in the DOR group were higher than in the MFI group (P = 0.028, P = 0.031, respectively). The IFN-γ/IL-4 and IFN-γ/IL-10 ratios were significantly lower in the TFI group. (P = 0.026, P = 0.016, respectively) than in the MFI group. TNF-α and IL-17 levels and TNF-α/IL-10 ratios in the RIF group were higher in the RIF group than in the MFI (P = 0.006, P = 0.002, P = 0.009, respectively). All six cytokine levels in the high-quality cleavage stage embryo group tend to be higher than those in the low-quality cleavage stage embryo group regardless of their underlying etiologies (P > 0.05). The FF cytokine phenotype may reflect the underlying immunopathology of infertile women undergoing ART cycles. DOR is associated with elevated FF TNF-α and TGF-β1, which may participate in the progression of DOR. FF of TFI has Th2 bias, while Th1 and Th17 bias was present in FF of RIF. Decrease FF cytokine levels may predict reduced oocyte/embryo quality.