Document Type : Original articles


1 High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al- Nahrain University, Bagdad, Iraq

2 Assist. Prof. at the High Institute of Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University, Baghdad, Iraq


Background: Secreted frizzled-related protein 5 (SFRP5) is an adipokine that inhibits the noncanonical Wingless Type (Wnt) signalling pathway. It may have anti-inflammatory and insulin-sensitizing effects, but the evidence is conflicting.
Objectives: This study examined the influence of serum and follicular fluid levels of SFRP5 and Wnt5a on intracytoplasmic sperm injection (ICSI) outcomes in infertile women, considering their relationship to insulin sensitivity.
Materials and Methods: Ninety infertile women aged 18 to 45 years undergoing ICSI for various reasons were enrolled in this prospective cross-sectional study at the infertility centre of the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University, Baghdad, Iraq, from September 2021 to July 2023. They received antagonist ovarian hyperstimulation treatment and had their blood fasting sugar, serum fasting insulin, serum and follicular fluid SFRP5, and serum and follicular fluid Wnt5a measured on ovum pickup. The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) was calculated.
Results: Serum and follicular fluid SFRP5 levels were higher in normal-weight women (P-value < 0.001), while serum and follicular fluid Wnt5a levels were insignificantly higher in obese women (P-value > 0.05). HOMA-IR was higher in the obese group (P-value < 0.001). Insulin resistance markers were lower in pregnant women (P-value < 0.05), while serum and follicular fluid SFRP5 levels were higher in pregnant women (P-value < 0.01). Serum and follicular fluid SFRP5 levels were negatively correlated with insulin resistance markers and positively correlated with oocyte quality, quantity, fertilization rate, and embryo grade (P-value < 0.05).
Conclusion: SFRP5 and Wnt5a were detected in infertile women's serum and follicular fluid. Serum and follicular fluid SFRP5 levels were associated with lower insulin resistance, a lower body mass index, and better ICSI outcomes.


Main Subjects

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