Reprodu??o & Climatério最新文献

Introduction

Controlled ovarian stimulation is an essential part of in vitro fertilization (IVF) cycles. The aim of this process is to permit follicular aspiration of approximately 8–10 oocytes. Individual women have different ovarian responses based on their ovarian reserves. Low doses of exogenous follicle-stimulating hormone (FSH) may lead to cancelation of an IVF cycle as a result of insufficient response, and high doses may also lead to cancelation due to the risk of ovarian hyperstimulation syndrome. Knowing the patient's ovarian response permits the use of individually tailored doses of gonadotropin, resulting in decreased occurrence of inappropriate ovarian responses.

Objective

To conduct a systematic review of antral follicle count (AFC) performance in adjusting the dose of gonadotropins to prevent inadequate responses in IVF cycles.

Method

A systematic review was conducted of studies published in the last 13 years that appraised AFC performance in adjusting the dose of gonadotropins to prevent inadequate responses in IVF cycles. The databases consulted were Medline, LILACS, SciELO and Pubmed. Search descriptors were “antral follicle count” and “ovarian hyperstimulation syndrome”.

Results

131 articles were found. Five articles published between 2000 and 2013 were selected.

Conclusion

AFC appears to perform well in adjusting the dose of exogenous gonadotropins to prevent inappropriate responses in IVF cycles.

Objectives

The aim of the study was to compare eight oxidative stress (OS) markers in serum and follicular fluid (FF) of infertile women with and without endometriosis (E) undergoing controlled ovarian stimulation (COS) for intracytoplasmic sperm injection (ICSI).

Material and methods

Eight‐seven serum samples (43 with E and 44 without E ‐ with male or tubal factor) and 61 FF samples (29 with E and 32 without E) were collected in the day of oocyte retrieval. Total hydroperoxides (FOX₁), malondialdehyde (MDA), advanced oxidation protein products (AOPP), glutathione (GSH), superoxide dismutase (SOD) and the total antioxidant capacity (TAC) were determined by spectrophotometry, vitamin E (Vit E) by high performance liquid chromatography, and 8‐hydroxy‐2’–deoxyguanosine (8 OHdG) by ELISA.

Results

We observed higher serum concentrations of GSH (220.32 ± 43.2 nmol/g pt) and SOD (677.9 ± 282.21 U/mL), lower serum concentrations of TAC (0.34 ± 0.17 mEq Trolox/L), and higher follicular concentrations of 8 OHdG (23.19 ± 6.8 ng/mL) and Vit E (13.0 ± 5.33 μmol/L) in infertile women with E compared to those without E (193.92 ± 43.25 nmol/g pt, 563.04 ± 169.82 U/mL, 0.46 ± 0.15 mEq Trolox/L, 17.22 ± 5.6 ng/mL and 8.71 ± 2.51 μmol/L, respectively).

Conclusions

We evidenced the occurrence of systemic and follicular OS in infertile patients with E undergoing COS for ICSI. We suggest that the OS may be involved in the etiopathogenesis of infertility‐related disease

The cytotoxic action of antineoplastic treatments very frequently implies serious damage to the gonads, and consequences due to the hypoestrogenism, such as osteoporosis, infertility and premature ovarian failure, are expected. Oncofertility appears as a new multidisciplinary area, which is dedicated to the development of strategies for the reduction of therapeutic sequels in cancer survivals, ultimately aiming the maintenance of their quality of life and the possibility of biological procreation. This article aims to present an overview of possible options for female fertility preservation after cancer and future perspectives in oncofertility.

Objectives

To assess emotional stress in infertile outpatient couples candidates for Assisted Fertilization, and compare the stress factor load between men and women.

Material and methods

Transversal, descriptive study involving 31 infertile couples (n = 62). All participants that accepted taking part in the study were assessed individually with the Fertility Problems Inventory (FPI). Non parametric tests with a significance level p < 0.05 were employed as analysis tools. Mann Whiteney statistical test was used to analyse data with p ≤ 0.05.

Results

Women's ages ranged from 18 to 39 years (mean: 29.67) and men's from 18 to 49 years (mean: 28.45). Couples had been trying to conceive for more than four years. FPI mean scores were–social problems: 43.09 for women and 41.09 for men; conjugal problems: 36.96 for women and 36.77 for men; motherhood/fatherhood need: 29.16 for women and 27.87 for men; rejection to a way of life without children: 47.32 for women and 45.48 for men; global stress: 159.90 for women and 151.77 for men.

Conclusions

There were no significant differences on FPI scores between men and women on this study and global stress scores showed a moderate association between stress and infertility.

Justification

The response to ovarian stimulation is a keyelement in assisted reproduction (AR). Despite recent advances in the techniques, patients with low ovarian reserve have poor prognosis and represent a challenge in reproductive medicine.

Objective

To propose a strategy to improve reproductive prognosis of women older than 38 years or young women with low antral follicle count, through the use of testosterone prior to ovarian stimulus.

Material and methods

Survey data from the scientific literature in the field of reproductive medicine.

Results and conclusions

The use of androgens in stages preceding ovarian stimulation in IVF cycles seems to be great tool for improving oocyte response inoocyte controlled stimulation of patients older than 38 years or with diminished ovarian reserve, improving both quantity and quality of oocytes and increasing rates of pregnancy and live‐born.

Violence against women is widely recognized as a serious public health problem. The pregnancy is a risk factor for increasing the violence, especially when it is related to socio-economic conditions. The objective of this work is to ascertain the relation between violence against women during pregnancy in developed countries and in developing countries. It was performed a systematized review. It was proceeded a search of the literature through online databases MEDLINE and SciELO in December 2013, only with articles published between January 1, 2003 and November 30, 2013. The following descriptors were used for searching on the database “domestic violence” (Medical Subject Headings [MeSH]); “violence against women” (Health Sciences Descriptors [DeCS]); and “pregnancy” (Keyword). The Search strategies resulted in 71 studies. After analysis of the titles and abstracts of articles found for eligibility based on inclusion criteria, 43 articles were deleted and 28 articles were included in the final sample. The study revealed the predominance of researches developed about violence against women during pregnancy in developing countries, strengthening the strong socio-economic character related to victims and aggressors.

Type 2 diabetes has been an of public health concern and therefore has its diagnosis and treatment delayed in clinical practice. Although, its treatment has improved in the last decades by better pathophysiology understanding and development of medicines that act in different phases and levels, the increase of new cases of diabetes claim for knowledge about newest terapheutics targets in order to prevent and treat this disease. Accumulated evidences from crossover and longitudinal studies suggested a potencial participation of Vitamin D in diabetes pathophysiology. However, the results are based on clinical studies with a few sample and do not consider specifical populations like post menopausal women as did not determine dose of vitamin D that need to be offered. Early diagnosis, treatment and relieve of disorders and diseases that compromise the quality of life are extremely usefull in face to longest aging. We bring up an atualization about how vitamin D could take part on diabetes pathophysiology and some studies results.

Contamination may be present in the embryos culture arising from various sources boards, given that the materials collected male and female cannot be sterilized. This contamination can compromise embryo viability, gestational cause infection, bringing fetal malformation. Antifungal and antibiotics are increase to the culture media in an attempt to stop this microbiological growth. Preventive methods still under study should be evaluated. The contamination must be identified to guide the legislation that regulates protocols executed during assisted reproduction to ensure maternal fetal protection against pathogenic microorganisms of importance. Should evaluate the interference of contamination for the embryos, fetuses and infants, in an attempt to establish specific causes and consequences.

Objective

To review the literature about the reliability of the antral follicle count using the 2 D and 3 D ultrasonography.

Method

A systematic review of studies published over the last 13 years that aimed to evaluate the intra and interobserver variability of the antral follicle count using the 2 D and 3 D ultrasonography in the databases Medline, Lilacs and Scielo. The keywords used in the search were antral follicle count, ovarian reserve, and automated ultrasound.

Results

It was found that there were 1.057 published articles. Of these six studies were related to of intra‐ and interobserver variability of antral follicle count using 2 D and 3 D ultrasound that respected the inclusion criteria established.

Conclusion

Most studies agreed that the 2 D mode provides follicle identification and its diameter measures manually and subjectively. It allows a greater variability intra‐ and interobserver. The post‐processing with the possibility of follicular recount and review of the images helps to improve the reliability of the 3 D ultrasound but increases the total time of the exam.