A Comparative Study of Leptin, Oxidant/Antioxidant Status and Some Trace Elements in Women of Healthy Control and Unexplained Infertility in Basrah-Iraq

Adnan Jassim Mohammed Al-Fartosy, Nadhum Abdulnabi Awad, Rsha Abdulradha Mahmood


BACKGROUND: To date, there is no study regarding women with unexplained infertility in the province of Basrah, Iraq. This study was conducted to compare the level of leptin, oxidant/antioxidant status, and some trace element levels in women of healthy control and unexplained infertility.

METHODS: From total 96 women subjects, 32 subjects had primary unexplained infertility, 31 had secondary unexplained infertility, while 33 fertile women were taken as controls. The body mass index (BMI) of subjects was calculated with standard procedures. The level of fasting serum leptin, luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin (PRL), thyroid-stimulating hormone (TSH), 4-hydroxynonenal (4-HNE), lipid hydroperoxide (LOOH), glutathione (GSH), superoxide dismutase (SOD), catalase (CAT) and the total antioxidant capacity (TAC) were determined by enzyme-linked immunosorbent assay (ELISA) methods. Magnesium (Mg) and zinc (Zn) were measured by flame, copper (Cu) by flameless atomic absorption spectrometry, while Selenium (Se) in whole blood was determined using hydride generation method.

RESULTS: Non-significant changes (p>0.05) were seen in the level of BMI, leptin, TSH, FSH, LH and LH/FSH ratio. Level of 4-HNE, LOOH and Cu were significantly increased (p<0.01), while level of GSH, SOD, CAT, TAC, Se, Zn and Mg were significantly decreased (p<0.01) in primary and secondary type of unexplained infertility, compared to control.

CONCLUSION: Serum leptin hormone is significantly associated with BMI and physical activity in both groups. The significant difference in oxidant/antioxidants status between unexplained infertile and fertile women may suggests a possible additional role of oxidative stress mechanisms in pathophysiology of unexplained infertility.

KEYWORDS: unexplained infertility, leptin, oxidative stress, antioxidants, trace elements


Full Text:



Somigliana E, Paffoni A, Busnelli A, Filippi F, Pagliardini L, Vigano P, et al. Age-related infertility and unexplained infertility: an intricate clinical dilemma. Hum Reprod. 2016; 31: 1390-6, CrossRef.

Sadeghi MR. Unexplained infertility, the controversial matter in management of infertile couples. J Reprod Infertil. 2015; 16: 1-2, PMID.

Al-Fartosy AJM, Mohammed IM. Study the biochemical correlation of insulin resistance with HbA1c and sex hormones in NIDDM patients/Meisan-Iraq. J Diab Mel. 2017; 7: 302-15, CrossRef.

Rajeshwary P, Nagaprasanth M, Mahaboob SR, Obulesu G. Evaluation of oxidative stress markers in infertile women. Int Arch Integr Med. 2016; 3: 239-44, article.

Agarwal A, Aponte-Mellado A, Premkumar BJ, Shaman A, Gupta S. The effects of oxidative stress on female reproduction: a review. Reprod Biol Endocrinol. 2012; 10: 49, CrossRef.

Broughton DE, Moley KH. Obesity and female infertility: potential mediators of obesity's impact. Fertil Steril. 2017; 107: 840-7, CrossRef.

Tong Q, Yong Xu. Central leptin regulation of obesity and fertility. Curr Obes Rep. 2012; 1: 236-44, CrossRef.

Faramarzi M, Salmalian H. Association of psychologic and nonpsychologic factors with primary dysmenorrhea. Iran Red Crescent Med J. 2014; 16: 1-9, CrossRef.

Saruhan BG, Erdoğan S, Topaloğlu U, Akbalık ME, Bayram B, Ketani MA, et al. Expression and biological activity of ghrelin, obestatin, and leptin in deferent ducts of the bull and RAM. Slov Vet Res. 2018; 55: 151-9, CrossRef.

Kamyabi Z, Gholamalizade T. A comparative study of serum and follicular fluid leptin concentrations among explained infertile, unexplained infertile and fertile women. Int J Fertil Steril. 2015; 9: 150-6, CrossRef.

Infertility Workup for The Women’s Health Specialist. ACOG committee opinion no. 781. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2019; 133: e377-84, CrossRef.

Al-Fartosy AJM, Shanan SK, Awad NA. Biochemical study of the effects of some heavy metals on oxidant/antioxidant status in gasoline station workers/Basra-Iraq. Int J Sci Res Public. 2017; 7: 83-94, article.

Al-Fartosy AJM, Awad NA, Abdalemam DJ. Biochemical study of the effect of insulin resistance on adiponectin, lipid profile and some antioxidants elements with relation to obesity in type 2 diabetic patients/Basrah-Iraq. Amer J Biochem. 2017; 7: 73-82, CrossRef.

Ekka CD, Jain A, Puri M. Role of hormones in unexplained infertility. Indian J Med biochem. 2016; 20: 34-7, CrossRef.

Callahan T, Caughey AB. Puberty, the menstrual cycle, and the menopause. Infertility and assisted reproductive technologies. In: Blueprints Obstetrics and Gynecology. 7th edition. Philadelphia: Wolters Kluwer Health; 2018. p.212-22, NLMID.

Kumari P, Jaiswar SP, Shankhwar P, Deo S, Ahmad K, Iqbal B, et al. Leptin as a predictive marker in unexplained infertility in north indian population. J Clin Diagn Res. 2017; 11: 28-31, CrossRef.

Ajala OM, Ogunro PS, Elusanmi GF, Ogunyemi OE, Bolarnide AA. Changes in serum leptin during phases of menstrual cycle of fertile women: relationship to age groups and fertility. Int J Endocrinol Metab. 2013; 11: 27-33.

Tafvizi F, Masomi M. Comparison of serum leptin level in women with unexplained infertility and fertile women in Iran. J Obstet Gynecol India. 2016; 66: 466-70, CrossRef.

Rehman KA, Awan FR. Leptin resistance: a possible interface between obesity and pulmonary-related disorders. Int J Endocrinol Metab. 2016; 14: 1-6, CrossRef.

Farooq R, Lutfullah S, Ahmed M. Serum leptin levels in obese infertile men and women. Pak J Pharm Sci. 2014; 27: 67-71, PMID.

Tafvizi F, Masomi M. Association of body mass index with leptin and other hormonal parameters in women with unexplained infertility and fertile women. J Fas Univ Med Sci. 2016; 6: 44-51, article.

Irandust KH, Rahmani Nia F, Mohebbi H. The effect of aerobic exercise on plasma ghrelin and leptin concentrations in obese and normal weight women. Olympic. 2011; 50: 87-100.

Fakor F, Sharami SH, Milani F, Mirblouk F, Kazemi S, Pourmarzi D, et al. The association between level of maternal serum leptin in the third trimester and the occurrence of moderate preterm labor. J Turk Ger Gynecol Assoc. 2016; 17: 182-5, CrossRef.

Jungheim S, Travieso JL, Carson KR, Moley KH. Obesity and reproductive function emily. Obstet Gynecol Clin North Am. 2012; 39: 479-93, CrossRef.

Shoaib OM, ELhashimi EH. A study of serum thyroid stimulating hormone and prolactin levels of infertile females. Inter J Sci Res. 2016; 5: 836-9, CrossRef.

Hivre MD, Bhale DV, Mahat RK, Bujurge AA. Study of serum TSH and prolactin levels in patients of female infertility. Int J Rec Tre Sci Tech. 2013; 9: 144-5, article.

Safarnavadeh T, Rastegarpanah M. Antioxidants and infertility treatment, the role of Satureja Khuzestanica: a mini-systematic review. Iran J Reprod Med. 2011; 9: 61-70, PMID.

Murto T, Bjuresten K, Landgren BM, Stavreus-Evers A. Predictive value of hormonal parameters for live birth in women with unexplained infertility and male infertility. Reprod Bio Endoc. 2013; 11: 61, CrossRef.

Premkumar BJ, Aponte A, Shaman A, Agarwal A. Reactive oxygen species and female infertility. Syst Biol Fre Radic Antiox. 2014; 3: 2743-72, CrossRef.

Nunez-Calonge R, Cortés S, Gutierrez Gonzalez LM, Kireev R, Vara E, Ortega L, et al. Oxidative stress in follicular fluid of young women with low response compared with fertile oocyte donors. Reprod Biomed Online. 2016; 32: 446-56, CrossRef.

Al-Mulla A, Fazari ABE, Elkhouly M, Moghaddam N. Role of antioxidants in female fertility. Open J Obstet Gynecol. 2018; 8: 85-91, CrossRef.

Sansone A, Lombardo F, Lenzi A. Free radicals and reproductive health. Syst Biol Fre Radic Antios. 2014; 3: 2723-42, CrossRef.

Al-Fartosy AJM, Awad NA, Zearah SA. Assessment the effect of Zn and Mg supplementation on total antioxidant capacity in type 2 diabetic patients. Basrah J f Sci. 2011; 28: 94-100, article.

Arhin SK, Zhao Y, Lu XS, Chetry M, Lu JQ. Effect of micronutrient supplementation on IVF outcomes: a systematic review of the literature. Reprod Biomed Online. 2017; 35: 715-22, CrossRef.

Awrahman ZA. Screening of metals such as copper (Cu), zinc (Zn), nickel (Ni) and lead (Pb) in the human blood. Kurdistan Acad J. 2015; 11: 81-7.

Fallah A, Mohammad-Hasani A, Colagar AH. Zinc is an essential element for male fertility: a review of Zn roles in men’s health, germination, sperm quality, and fertilization. J Reprod Infertil. 2018; 19: 69-81, PMID.

Pieczynska J, Grajeta H. The role of selenium in human conception and pregnancy. J Trace Elem Med Biol. 2015; 29: 31-8, CrossRef.

Vasudevan DM, Sreekumari S. Mineral metabolism. In: Vasudevan DM, Sreekumari S, editors. Textbook of Biochemistry for Medical Students. 7th ed. New Delhi: Jaypee Brothers Medical Publishers; 2013. p.305-6, CrossRef.

Wu J, Wu S, Xie Y, Wang Z, Wu R, Cai J, et al. Zinc protects sperm from being damaged by reactive oxygen species in assisted reproduction techniques. Reprod Biomed Online. 2015; 30: 334-9, CrossRef.

Liang H, Miao M, Chen J, Chen K, Wu B, Dai Q, et al. The association between calcium, magnesium, and ratio of calcium/magnesium in seminal plasma and sperm quality. Biol Trace Elem Res. 2016; 174: 1-7, CrossRef.

DOI: https://doi.org/10.18585/inabj.v11i3.915

Indexed by:






The Prodia Education and Research Institute