Elevation of Complement C3/C4, Immunoglobulins, and hs-CRP in Women with Recurrent Implantation Failure: Insights from a Cross-Sectional Analysis

Rahim  Rostami; Jamileh  Jahanbakhsh; Shirin  Salehi; Soudabeh  Fallah

doi:10.18502/abi.v3i3.20590

Rahim Rostami Department of Clinical Biochemistry, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Jamileh Jahanbakhsh Infertility Ward, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Shirin Salehi Infertility Ward, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Soudabeh Fallah Department of Clinical Biochemistry, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

DOI: https://doi.org/10.18502/abi.v3i3.20590

Keywords: Recurrent Implantation Failure; Infertility, IVF; complement C3; complement C4; Immunoglobulins, CRP

Abstract

Objectives: Serum levels of complement proteins C3, C4, immunoglobulins (IgGs), andC-reactive protein (CRP) are crucial in understanding the pathophysiology of recurrentimplantation failure (RIF). This study aims to quantify these biomarkers and exploretheir clinical significance.

Methods: We conducted a cross-sectional study at Arash Hospital from December 2021to December 2023, involving 50 women with a history of RIF after in vitro fertilization(IVF) and a control group of 50 healthy, fertile women. Serum levels of C3, C4, IgG,IgM, IgA, CRP, and hs-CRP were measured using immunoturbidimetric assays andELISA.

Results: Serum levels of complement components C3 and C4, IgG, IgA, CRP, andhs-CRP were significantly elevated in women with RIF compared to fertile controls.A positive correlation existed between C3 and C4 in the RIF group, but no significantcorrelations were found for IgG, IgA, or IgM. In contrast, significant associationsbetween IgG, C3, C4, and CRP, with IgG levels also correlating with IgA were observedin fertile controls. ROC curve analysis indicated strong discriminatory power for IgG,IgA, C3, and C4. CRP AUC was 0.962, and hs-CRP AUC was 0.994, distinguishing RIFfrom fertile women, with CRP showing 94% sensitivity and 92% specificity at 5.3 mg/dL, and hs-CRP showing 98% sensitivity and specificity at 2.92 mg/L.

Conclusion: The findings suggest that elevated serum levels of C3, C4, IgG, and IgA inthe RIF group may be associated with the underlying mechanisms of RIF.