CART (Cocaine- and Amphetamine-Regulated Transcript): A New Identified Intrafollicular Mediator in Ovulation Induction Protocols

The present study investigates the relationship between cocaine- and amphetamine-regulated transcript (CART) expression, leptin, and hormone profiles (progesterone, testosterone, androstenedione, estradiol, FSH, and hCG) across four ovulation induction protocols (HMG, HMG/hCG, rFSH, and rFSH/hCG), as well as the association between FSH receptor (FSHR) Ser680Asn polymorphisms, CART expression, and IVF outcomes. Data were acquired from 94 women who underwent controlled ovarian stimulation (COS). The outcomes showed no significant variations in BMI between the four stimulation protocols (p-values ranged from 0.244 to 0.909). CART expression had no significant correlation with hormone levels in the entire cohort (progesterone, testosterone, androstenedione, FSH, hCG, and estradiol; p > 0.05). However, CART levels were shown to be adversely linked with the number of follicles >12 mm (r = -0.251, p = 0.018), total oocytes (r = -0.247, p = 0.019), and oocyte maturity (r = -0.212, p = 0.048). A significant negative association was also revealed between CART expression and the thyroid hormone T3 (r = -0.319, p = 0.048). In terms of FSHR polymorphisms, the SER/SER genotype was linked to greater CART levels (mean 4.198 ± 2.257) than the SER/ASN and ASN/ASN groups (p = 0.031). These data indicate that CART expression and FSHR polymorphisms may affect ovarian response and oocyte quality in IVF patients.