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Surgery on Children

Surgery on Children Journal aims to publish issues related to Pediatric Surgery, Pediatric Neurosurgery, Pediatric Plastic Surgery, Pediatric Cardiovascular Surgery, Pediatric Orthopedic Surgery, Pediatric Vascular Surgery, Pediatric Gynecology and Obstetrics, Pediatric Ear Nose Throat, Ophthalmology, Pediatric Anesthesiology and Reanimation, Pediatric Urology, Pediatric Surgical Intensive Care Clinic, and other clinical surgery fields on children of the highest scientific and clinical value at an international level and accepts articles on these topics.

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Original Article
Cytochrome C in in vitro fertilization: a promising tool for distinguishing spent embryo culture fluids of normoresponder, diminished ovarian reserve, and polycystic ovarian syndrome
Abstract
Aims: Cytochrome C (Cyt C) is a small heme protein located in the mitochondria, playing a dual and crucial role in cellular physiology as cellular respiration and apoptosis. This study aimed to investigate Cyt C gene expression in spent embryo culture fluid (SECF) as a non-invasive biomarker for distinguishing between Normoresponder (NOR), Early-Diminished Ovarian Reserve (E-DOR), Advanced-Diminished Ovarian Reserve (A-DOR), and polycystic ovarian syndrome (PCOS) patients undergoing in vitro fertilization (IVF).
Methods: SECF samples were collected from patients at Bahçeci Health Group Umut IVF Laboratory, İstanbul, with informed consent and ethical approval (2023/19-22). Forty-eight samples from each group (NOR, E-DOR, A-DOR, PCOS) were analyzed. Ovarian stimulation followed an antagonist protocol, and embryos were cultured individually. On day 3, embryos were morphologically graded. Total RNA was isolated from SECF, converted to cDNA, and Cyt C gene expression was quantified using RT-PCR, with GAPDH as an internal control. Statistical analyses included the Kolmogorov-Smirnov and Shapiro-Wilk tests for normality, Sidak for multiple comparisons, and the Pearson correlation test for group relationships.
Results: Compared to NOR samples, Cyt C gene expression was significantly upregulated in A-DOR samples, while E-DOR samples showed downregulation (p<0.001). No statistical difference was observed between NOR and PCOS samples (p>0.05). Pearson correlation revealed a significant relationship only between NOR and A-DOR SECF samples (r<0.01).
Conclusion: These findings suggest that Cyt C expression in SECF can differentiate between early and advanced stages of diminished ovarian reserve, with age-related differences in apoptosis mechanisms. PCOS cases, characterized by a high quantity but low quality of oocytes, showed no significant variation in Cyt C expression, likely due to less active apoptotic pathways. Monitoring Cyt C in SECF may provide a valuable, non-invasive tool for assessing embryo quality and optimizing IVF outcomes. Further research is needed to validate these findings and establish clinical protocols.

Keywords : Cytochrome C, diminished ovarian reserve, in vitro fertilization, normoresponder, polycystic ovarian syndrome, spent embryo culture fluid

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Article available in :
Volume 3, Issue 1, 2026
Page : 12-15
https://doi.org/10.51271/SOC-0059
Article Information
Received : 28 Nov 2025
Accepted : 12 Dec 2025
Published : 17 Jan 2026
Corresponding Author :

Çağrı Öner: Department of Medical Biology, Faculty of Medicine, Kırklareli University, Kırklareli, Turkiye

[email protected]
Citation : Kütük D, Kılıç NÖ, Öner Ç, Çolak E. Cytochrome C in in vitro fertilization: a promising tool for distinguishing spent embryo culture fluids of normoresponder, diminished ovarian reserve, and polycystic ovarian syndrome. Surg Child. 2026;3(1):12-15.

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