Korkmaz, OyaKarabulut, SedaMacit, Pelin2026-03-152026-03-1520260040-816610.1016/j.tice.2026.1033702-s2.0-105029582701https://doi.org/10.1016/j.tice.2026.103370https://hdl.handle.net/20.500.14517/8929Background: Ovarian response to controlled ovarian stimulation varies considerably among women and may be influenced by inflammatory activity within the follicular microenvironment. Objective: To examine the relationship between ovarian response and follicular inflammatory activity by evaluating IL-1 beta, IL-17, and IL-18 levels, granulosa cell expression, and markers of chromatin integrity and apoptosis in IVF cycles. Methods: A total of 150 women undergoing controlled ovarian stimulation were grouped as low, normal, or high ovarian response (n = 50 each). Follicular fluid cytokine levels were measured by ELISA/CLIA, granulosa cell cytokine expression was assessed immunohistochemically, and chromatin integrity and DNA fragmentation were evaluated using Toluidine Blue and TUNEL assays. Results: Follicular fluid levels and granulosa cell immunopositivity of IL-1 beta, IL-17, and IL-18 increased progressively from low to high ovarian response groups (p < 0.05). Chromatin integrity was best preserved in the normal responder group, whereas both Toluidine Blue-positive and TUNEL-positive granulosa cell ratios were significantly higher in low and high responders (p < 0.01). IL-18 levels showed positive correlations with oocyte number, serum estradiol levels, and MII oocyte ratio (p < 0.05). Notably, granulosa cell IL-18 expression was inversely correlated with DNA fragmentation, suggesting a potential cytoprotective role under physiological inflammatory conditions. Conclusion: These findings demonstrate that follicular cytokine balance is closely associated with ovarian response and granulosa cell integrity during IVF. IL-18 emerges as a key regulator linking physiological inflammation to oocyte competence, highlighting its potential relevance for individualized ovarian stimulation strategies.eninfo:eu-repo/semantics/closedAccessInflammationFollicular FluidCytokinesGranulosa CellOvarian ResponseArticle