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CDC42 deficiency leads to endometrial stromal cell senescence in recurrent implantation failure. CDC42 缺乏会导致子宫内膜基质细胞衰老,造成反复种植失败。
IF 6 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-01 DOI: 10.1093/humrep/deae246
Xinyi Tang, Yingchun Zhu, Zhiwen Cao, Xiaoying Wang, Xinyu Cai, Yurun Tang, Jidong Zhou, Min Wu, Xin Zhen, Lijun Ding, Guijun Yan, Haibin Wang, Haixiang Sun, Ruiwei Jiang
<p><strong>Study question: </strong>Does the downregulation of cell division cycle 42 (CDC42) protein in endometrial stroma lead to endometrial senescence in patients with recurrent implantation failure (RIF), and what is the potential mechanism?</p><p><strong>Summary answer: </strong>CDC42 deficiency causes endometrial stromal senescence and decidualization defects, impairing uterine receptivity of RIF patients, via activation of Wnt signaling pathway.</p><p><strong>What is known already: </strong>Uterine aging is unique due to the cyclic remodeling and decidualization of endometrial tissue. Several transcriptomic studies have reported increased senescence in the endometrium in young patients with RIF. Our previous transcriptomic sequencing study discovered that endometrium from women with RIF showed downregulation of CDC42, which is an essential molecule affected by various senescence-related diseases.</p><p><strong>Study design, size, duration: </strong>The endometrial samples of a total of 71 fertile control patients and 37 RIF patients were collected to verify the association between CDC42 expression and endometrial senescence of RIF patients. Primary endometrial stromal cells (EnSCs) were isolated from endometrial biopsies taken from patients without any endometrial complications and planning to undergo IVF, then subjected to adenovirus-mediated CDC42 knockdown and decidualization induction to explore the detailed mechanism by which CDC42 governs stromal senescence and decidualization. Wnt inhibitor XAV-939 was used to correct the endometrial senescence and decidualization defect.</p><p><strong>Participants/materials, setting, methods: </strong>Senescence was determined by cell cycle arrest markers (e.g. P16, P21, and P53), SASP molecules (e.g. IL6 and CXCL8), and SA-β-gal staining. Masson's staining and Sirius Red staining were used to detect the endometrial fibrosis. Decidualization was evaluated by the mRNA expression and protein secretion of PRL and IGFBP1, F-actin immunostaining, and the BeWo spheroids 'in vitro implantation' model. Methods used to assess cell function included adenovirus transduction, RNA-sequencing, bioinformatic analysis, western blotting, RT-qPCR, ELISA, and immunofluorescence.</p><p><strong>Main results and the role of chance: </strong>Here, we observed remarkably increased levels of stromal senescence and fibrosis, along with stromal CDC42 deficiency, in the endometrium of patients with RIF (P < 0.001). Knockdown of CDC42 effectively induced premature senescence in EnSCs, leading to aberrant accumulation of senescent EnSCs and collagen deposition during decidualization. CDC42 deficiency in EnSCs restrained the decidualization differentiation and receptivity to trophoblast cells. Transcriptomic analysis revealed Wnt signaling activation as a critical downstream alteration in CDC42-deficient EnSCs. Mechanistically, CDC42 interacted with AKT competitively to impede the binding of GSK3β to AKT. Knockdown of CDC42 inc
研究问题:细胞分裂周期42(CDC42)蛋白在子宫内膜基质中的下调是否会导致复发性着床失败(RIF)患者的子宫内膜衰老,其潜在机制是什么?CDC42 缺乏会导致子宫内膜基质衰老和蜕膜化缺陷,通过激活 Wnt 信号通路损害 RIF 患者的子宫接受能力:由于子宫内膜组织的周期性重塑和蜕膜化,子宫衰老具有独特性。一些转录组研究报告称,RIF 年轻患者的子宫内膜衰老程度增加。我们之前的转录组测序研究发现,RIF女性患者的子宫内膜显示出CDC42的下调,而CDC42是受各种衰老相关疾病影响的重要分子:研究设计、规模和持续时间:为了验证 CDC42 表达与 RIF 患者子宫内膜衰老之间的关系,研究人员收集了 71 名育龄对照组患者和 37 名 RIF 患者的子宫内膜样本。从无任何子宫内膜并发症且计划进行试管婴儿的患者子宫内膜活检组织中分离出原代子宫内膜基质细胞(EnSCs),然后对其进行腺病毒介导的CDC42基因敲除和蜕膜化诱导,以探索CDC42调控基质衰老和蜕膜化的详细机制。Wnt抑制剂XAV-939用于纠正子宫内膜衰老和蜕膜化缺陷:衰老通过细胞周期停滞标志物(如 P16、P21 和 P53)、SASP 分子(如 IL6 和 CXCL8)和 SA-β-gal 染色来确定。马森氏染色和天狼星红染色用于检测子宫内膜纤维化。通过PRL和IGFBP1的mRNA表达和蛋白分泌、F-肌动蛋白免疫染色和BeWo球体 "体外植入 "模型来评估蜕膜化情况。评估细胞功能的方法包括腺病毒转导、RNA测序、生物信息学分析、Western印迹、RT-qPCR、ELISA和免疫荧光:在这里,我们观察到RIF患者的子宫内膜基质衰老和纤维化水平显著增加,同时基质CDC42缺乏(P 大比例尺数据):本研究中生成的 RNA-seq 数据集已存入 NCBI 数据库,BioProject 编号为 PRJNA1102745:本研究基于体外细胞培养。研究结果的广泛意义:除了发现RIF中的子宫内膜衰老外,我们的发现还强调了CDC42在调节EnSC衰老以维持蜕膜功能方面的重要性,并建议将Wnt信号抑制剂作为缓解子宫内膜衰老的潜在治疗药物:本研究得到了国家自然科学基金[82271698(R.J.)、82030040(H.S.)、82288102(H.W.)和82371680(G.Y.)]、江苏省自然科学基金[BK20231117(R.J.)]和南京市卫生局医学科技发展基金[YKK23097(Y.Z.)]的资助。作者声明无潜在利益冲突。
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引用次数: 0
Nonlinear correlation between serum vitamin D levels and the incidence of endometrial polyps in infertile women. 不孕妇女血清维生素 D 水平与子宫内膜息肉发病率之间的非线性相关性。
IF 6 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-01 DOI: 10.1093/humrep/deae241
Ruiqiong Zhou, Zhenghong Zhu, Mei Dong, Zhaoyi Wang, Li Huang, Songlu Wang, Xiqian Zhang, Fenghua Liu
<p><strong>Study question: </strong>Are serum vitamin D levels associated with the incidence of endometrial polyps (EPs) in infertile patients?</p><p><strong>Summary answer: </strong>Serum 25(OH)D levels were nonlinearly correlated with the incidence of EPs in infertile women.</p><p><strong>What is known already: </strong>EPs are a common condition that may affect the receptivity of the endometrium in women of reproductive age. Vitamin D regulates cell proliferation and differentiation, apoptosis, angiogenesis, anti-inflammation, and immunomodulation, in addition to its well-known functions in balancing calcium and phosphorus. Previous studies have shown that vitamin D concentrations are associated with reproductive outcomes, and that low vitamin D levels are associated with the incidence of colorectal polyps and nasal polyps. There is little evidence regarding the relationship between EPs and serum vitamin D levels.</p><p><strong>Study design, size, duration: </strong>We conducted a cross-sectional study using data from Guangdong Women and Children Hospital from January 2019 to October 2023, enrolling 3107 patients.</p><p><strong>Participants/materials, setting, methods: </strong>A total of 3107 infertile patients who underwent hysteroscopy were included in this study; 642 patients had endometrial polyps and 2465 had a normal uterine cavity. Hysteroscopy findings included risk of EPs, polyp size, percentage of multiple polyps, and incidence of chronic endometritis (CE). Serum vitamin D were assessed by measuring total 25(OH)D using chemiluminescence. According to international guideline recommendations for vitamin D deficiency, patients were divided into two groups: the <50 nmol/l group and the ≥50 nmol/l group. Univariable and multivariable logistic regression models, stratified analyses, and smooth curve fitting were used to examine the relationship between serum 25(OH)D levels and risk of EPs.</p><p><strong>Main results and the role of chance: </strong>Of all patients, 23.8% (740/3107) were vitamin D deficient (<50 nmol/l). The incidence of EPs was significantly higher in the 25(OH)D < 50 nmol/l group than in the ≥50 nmol/l group (24.9% vs 19.3%; P = 0.001). However, there were no differences in polyp size, proportion of multiple polyps, and presence of CE between the two groups. After controlling for confounders, 25(OH)D ≥ 50 nmol/l (compared with <50 nmol/l) was negatively associated with risk of EPs (adjusted OR, 0.733; 95% CI, 0.598-0.898). Other variables that had an impact on polyp incidence included BMI, type of infertility, CA125, and CD138-positive plasma cells. In addition, a linear regression model between age and serum 25(OH)D levels showed a positive linear association. Subgroup analyses were performed for different age groups, and the risk of EPs was significantly higher in the 25(OH)D < 50 nmol/l group than in the ≥50 nmol/l group, both in the younger subgroup (23.8% vs 19.1%) and in the older subgroup (28.0% vs 19.9%). The smo
研究问题:血清维生素D水平与不孕患者子宫内膜息肉(EPs)的发病率是否相关?血清25(OH)D水平与不孕妇女子宫内膜息肉的发病率呈非线性相关:EPs是一种可能影响育龄妇女子宫内膜接受能力的常见疾病。维生素 D 除了众所周知的平衡钙和磷的功能外,还能调节细胞增殖和分化、细胞凋亡、血管生成、抗炎和免疫调节。以往的研究表明,维生素 D 浓度与生殖结果有关,维生素 D 水平低与结肠直肠息肉和鼻息肉的发病率有关。有关 EPs 与血清维生素 D 水平之间关系的证据很少:我们利用广东省妇女儿童医院2019年1月至2023年10月的数据进行了一项横断面研究,共纳入3107名患者:本研究共纳入3107例接受宫腔镜检查的不孕患者,其中642例患者患有子宫内膜息肉,2465例患者宫腔正常。宫腔镜检查结果包括EPs风险、息肉大小、多发性息肉比例和慢性子宫内膜炎(CE)发病率。血清维生素 D 通过化学发光法测定总 25(OH)D 进行评估。根据维生素 D 缺乏的国际指南建议,将患者分为两组:主要结果组和偶然作用组:在所有患者中,23.8%(740/3107)的患者缺乏维生素 D(局限性、需谨慎的原因:在解释我们的研究结果时应谨慎,因为这是一项相关性研究,不能从我们的结果中推断因果关系。此外,由于有严格的纳入和排除标准,我们的结果可能无法推广到未选择的人群,包括绝经前妇女或其他种族的妇女:这项研究首次证明,维生素 D 缺乏是不孕患者发生 EPs 的一个独立风险因素。确定可改变的风险因素(如维生素 D 缺乏)有助于制定治疗息肉或防止息肉发展的新策略。需要进一步开展临床干预试验和实验室研究,以评估维生素D对EP发展的影响并阐明其机制:本研究由国家自然科学基金(82101718)和广东省自然科学基金(2022A1515010776)资助。本研究不涉及任何利益冲突。试验注册号:不适用。
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引用次数: 0
Early menstrual cycle impacts of oestrogen and progesterone on the timing of the fertile window. 月经周期早期雌激素和孕激素对受孕窗口时间的影响。
IF 6 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-01 DOI: 10.1093/humrep/deae236
René Ecochard, Thomas Bouchard, Rene Leiva, Saman H Abdullah, Hans Boehringer
<p><strong>Study question: </strong>What is the effect of oestrogen and progesterone at the beginning of the menstrual cycle in delaying entry into the fertile window?</p><p><strong>Summary answer: </strong>Both oestrogen and progesterone contribute to a delay in the onset of the fertile window.</p><p><strong>What is known already: </strong>Oestrogen enhances cervical mucus secretion while progesterone inhibits it.</p><p><strong>Study design, size, duration: </strong>Observational study. Daily observation of 220 menstrual cycles contributed by 88 women with no known menstrual cycle disorder.</p><p><strong>Participants/materials, setting, methods: </strong>Women recorded cervical mucus daily and collected first-morning urine samples for analysis of oestrone-3-glucuronide, pregnanediol-3-alpha-glucuronide (PDG), FHS, and LH. They underwent serial ovarian ultrasound examinations. The main outcome measure was the timing within the cycle of the onset of the fertile window, as identified by the appearance of mucus felt or seen at the vulva.</p><p><strong>Main results and the role of chance: </strong>Low oestrogen secretion and persistent progesterone secretion during the first week of the menstrual cycle both negatively affect mucus secretion. Doubling oestrogen approximately doubled the odds of entering the fertile window (OR: 1.82 95% CI=1.23; 2.69). Increasing PDG from below 1.5 to 4 µg/mg creatinine was associated with a 2-fold decrease in the odds of entering the fertile window (OR: 0.51 95% CI=0.31; 0.82). Prolonged progesterone secretion during the first week of the menstrual cycle was also statistically significantly associated with higher LH secretion. Finally, the later onset of the fertile window was associated with statistically significant persistently elevated LH secretion during the luteal phase of the previous menstrual cycle.</p><p><strong>Limitations, reasons for caution: </strong>This post hoc study was conducted to assess the potential impact of residual progesterone secretion at the beginning of the menstrual cycle. It was conducted on an existing data set because of the scarcity of data available to answer the question. Analysis with other datasets with similar hormone results would be useful to confirm these findings.</p><p><strong>Wider implications of the findings: </strong>This study provides evidence for residual progesterone secretion in the early latency phase of some menstrual cycles, which may delay the onset of the fertile window. This progesterone secretion may be supported by subtly increased LH secretion during the few days before and after the onset of menses, which may relate to follicular waves in the luteal phase. Persistent progesterone secretion should be considered in predicting the onset of the fertile window and in assessing ovulatory dysfunction.</p><p><strong>Study funding/competing interest(s): </strong>The authors declare no conflicts of interest. No funding was provided for this secondary data analysis.<
研究问题:月经周期开始时的雌激素和孕激素对推迟进入可孕窗口期有何影响?雌激素和孕酮都有助于推迟受孕窗口期的到来:研究设计、规模、持续时间:观察研究。对 88 名未发现月经周期紊乱的妇女所贡献的 220 个月经周期进行每日观察:妇女每天记录宫颈粘液并收集清晨尿液样本,用于分析雌酮-3-葡萄糖醛酸、孕二醇-3-α-葡萄糖醛酸(PDG)、FHS 和 LH。她们接受了连续的卵巢超声波检查。主要结果是通过外阴感觉到或看到粘液的出现来确定受孕窗开始的周期时间:主要结果和偶然性的作用:月经周期第一周雌激素分泌过少和孕酮分泌持续过多都会对粘液分泌产生负面影响。雌激素增加一倍,进入受孕窗口期的几率大约增加一倍(OR:1.82 95% CI=1.23;2.69)。将 PDG 从低于 1.5 微克/毫克肌酐提高到 4 微克/毫克肌酐与进入受孕窗的几率降低 2 倍相关(OR:0.51 95% CI=0.31; 0.82)。在统计学上,月经周期第一周孕酮分泌延长与 LH 分泌增加也有显著相关性。最后,可孕窗口期开始较晚与前一个月经周期黄体期 LH 分泌持续升高有明显的统计学关联:这项事后研究旨在评估月经周期开始时残余孕酮分泌的潜在影响。由于可用于回答该问题的数据较少,因此该研究是在现有数据集上进行的。与其他具有类似激素结果的数据集进行分析将有助于证实这些发现:这项研究为某些月经周期的早期潜伏期残留孕酮分泌提供了证据,这可能会推迟受孕窗口期的到来。在月经来潮前后的几天里,LH 的分泌量会有微妙的增加,这可能与黄体期的卵泡波有关。在预测受孕窗口期的开始和评估排卵功能障碍时,应考虑持续的孕酮分泌:作者声明无利益冲突。本次二次数据分析未获得任何资助:不适用。
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引用次数: 0
In vitro growth of secondary follicles from cryopreserved-thawed ovarian cortex. 低温解冻卵巢皮质中次级卵泡的体外生长。
IF 6 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-01 DOI: 10.1093/humrep/deae240
Hui Cheng, Fu Wei, Julieta S Del Valle, Tessa H R Stolk, Judith A Huirne, Joyce D Asseler, Gonneke S K Pilgram, Lucette A J Van Der Westerlaken, Norah M Van Mello, Susana M Chuva De Sousa Lopes
<p><strong>Study question: </strong>Can secondary follicles be obtained from cultured cryopreserved-thawed human ovarian cortical tissue?</p><p><strong>Summary answer: </strong>We obtained high-quality secondary follicles from cultured cryopreserved-thawed human ovarian cortical tissue from cis female donors (cOVA), but not from trans masculine donors (tOVA) in the same culture conditions.</p><p><strong>What is known already: </strong>The in vitro growth of oocytes present in unilaminar follicles into metaphase II stage (MII) oocytes has been previously achieved starting from freshly obtained ovarian cortical tissue from adult cis female donors. This involved a multi-step culture protocol and the first step included the transition from unilaminar follicles to multilayered secondary follicles. Given that the ovarian cortex (from both cis female and trans masculine donors) used for fertility preservation is cryopreserved, it is crucial to investigate the potential of unilaminar follicles from cryopreserved-thawed ovarian cortex to grow in culture.</p><p><strong>Study design, size, duration: </strong>Cryopreserved-thawed ovarian cortical tissue from adult trans masculine donors (n = 3) and adult cis female donors (n = 3) was used for in vitro culture following the first culture step described in two published culture protocols (7-8 days and 21 days) and compared to freshly isolated ovarian cortex from trans masculine donors (n = 3) and to ovarian cortex prior to culture.</p><p><strong>Participants/materials, setting, methods: </strong>Ovarian cortical tissue was obtained from adult trans masculine donors undergoing gender-affirming surgery while using testosterone, and from adult cis female donors undergoing oophorectomy for fertility preservation purposes before chemotherapy. The ovarian cortex was fixed either prior (day 0) or after the culture period. Follicular survival, growth, and morphology were assessed through histology and immunofluorescence.</p><p><strong>Main results and the role of chance: </strong>We quantified the different stages of follicular development (primordial, primary, secondary, and atretic) after culture and observed an increase in the percentage of secondary follicles as well as an increase in COLIV deposition in the stromal compartment regardless of the culture media used. The quality of the secondary follicles obtained from cOVA was comparable to those prior to culture. However, in the same culture conditions, the secondary follicles from tOVA (fresh and cryo) showed low-quality secondary follicles, containing oocytes with small diameter, granulosa cells that expressed abnormal levels of KRT19 and steroidogenic-marker STAR and lacked ACTA2+ theca cells, when compared to tOVA secondary follicles prior to culture.</p><p><strong>Limitations, reasons for caution: </strong>The number of different donors used was limited.</p><p><strong>Wider implications of the findings: </strong>Our study revealed that cryopreserved-thawed cO
研究问题:能否从培养低温解冻的人类卵巢皮质组织中获得次级卵泡?在相同的培养条件下,我们从顺式女性供体(cOVA)的低温解冻人卵巢皮质组织中获得了高质量的次级卵泡,但从反式男性供体(tOVA)中却没有获得:以前曾有人从成年顺式女性供体新鲜获得的卵巢皮质组织开始,将单层卵泡中的卵母细胞体外培养成分裂期 II 阶段(MII)的卵母细胞。这涉及到一个多步骤的培养方案,第一步包括从单层卵泡向多层次级卵泡的过渡。鉴于用于生育力保存的卵巢皮质(来自顺式女性和逆式男性供体)都是低温保存的,因此研究来自低温解冻卵巢皮质的单层卵泡在培养过程中的生长潜力至关重要:研究设计、规模、持续时间:将来自成年反式男性供体(n = 3)和成年顺式女性供体(n = 3)的低温保存-解冻卵巢皮质组织用于体外培养,按照两种已公布的培养方案中描述的第一个培养步骤(7-8天和21天)进行培养,并与来自反式男性供体(n = 3)的新鲜分离卵巢皮质和培养前的卵巢皮质进行比较:卵巢皮质组织取自正在接受性别确认手术并使用睾酮的成年男性变性捐献者,以及在化疗前为保留生育能力而接受输卵管切除术的成年顺式女性捐献者。卵巢皮质在培养期之前(第 0 天)或之后进行固定。通过组织学和免疫荧光评估卵泡的存活、生长和形态:我们对培养后卵泡发育的不同阶段(原始卵泡、初级卵泡、次级卵泡和闭锁卵泡)进行了量化,观察到无论使用哪种培养基,次级卵泡的比例都在增加,基质区的 COLIV 沉积也在增加。从 cOVA 中获得的次级卵泡的质量与培养前的质量相当。然而,与培养前的tOVA次级卵泡相比,在相同的培养条件下,tOVA(新鲜和冷冻)次级卵泡的质量较低,含有直径较小的卵母细胞、表达异常水平KRT19和类固醇生成标记物STAR的颗粒细胞,并且缺乏ACTA2+ theca细胞:研究结果的广泛意义:我们的研究表明,低温解冻的cOVA可用于在培养后生成高质量的次级卵泡,现在可以对这些卵泡进行进一步测试,以评估它们生成可用于临床的功能性MII卵母细胞的潜力。然而,对 tOVA(新鲜和低温)使用相同的培养方案并不能产生高质量的次级卵泡,这表明要么睾酮处理会影响卵泡质量,要么需要调整培养方案才能从 tOVA 中获得高质量的次级卵泡。重要的是,在使用tOVA优化体外卵泡生成时必须谨慎:本研究由欧洲研究理事会联合资助 OVOGROWTH(ERC-CoG-2016-725722,J.S.D.V.和 S.M.C.D.S.L.获得)、诺和诺德基金会(reNEW NF21CC0073729,H.C、F.W.、J.S.D.V.和 S.M.C.D.S.L.),以及国家留学基金委(CSC 202008320362 和 CSC 202008450034,分别给 H.C.和 F.W.)。作者没有利益冲突需要声明:不适用。
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引用次数: 0
Measuring non-events: infertility estimation using cross-sectional, population-based data from four countries in sub-Saharan Africa. 衡量非事件:利用撒哈拉以南非洲四个国家的横截面人口数据估算不孕症。
IF 6 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-01 DOI: 10.1093/humrep/deae218
Suzanne O Bell, Caroline Moreau, Dana Sarnak, Simon P S Kibira, Philip Anglewicz, Peter Gichangi, Alexander C McLain, Marie Thoma
<p><strong>Study question: </strong>Does the prevalence of 12-month infertility in Burkina Faso, Côte d'Ivoire, Kenya, and Uganda differ between women trying to conceive and the broader population of women exposed to unprotected sex, and how are prevalence estimates affected by model assumptions and adjustments?</p><p><strong>Summary answer: </strong>Estimates of 12-month infertility among tryers ranged from 8% in Burkina Faso to 30% in Côte d'Ivoire, increasing substantially among a larger population of women exposed to unprotected intercourse.</p><p><strong>What is known already: </strong>While having a child is a fundamental human experience, the extent to which women and couples experience infertility is a neglected area of research, particularly in sub-Saharan Africa. Existing estimates of infertility in this region vary widely from 2% to 32%, however, potential impacts of variability in study populations and model assumptions have not been well-examined.</p><p><strong>Study design, size, duration: </strong>We used cross-sectional nationally representative survey data from Burkina Faso, Côte d'Ivoire, Kenya, and Uganda. We employed a multi-stage cluster random sampling design with probability proportional to the size selection of clusters within each country to produce representative samples of women aged 15-49. Samples ranged from 3864 in Côte d'Ivoire to 9489 in Kenya.</p><p><strong>Participants/materials, setting, methods: </strong>We created two analytic samples in each country-tryers and a broader sample of women exposed to unprotected sex-exploring differences in population characteristics and estimating the period prevalence of 12-month infertility using the current duration (CD) approach. We also examined the impact of several model assumptions within each of the two analytic samples, including adjustments for recent injectable contraceptive use, unrecognized pregnancy, infertility treatment, underreported contraceptive use, and sexual activity.</p><p><strong>Main results and the role of chance: </strong>Employing the CD approach among tryers produced an overall 12-month infertility prevalence of 7.9% (95% CI 6.6-12.7) in Burkina Faso, 29.6% (95% CI 15.3-100.0) in Côte d'Ivoire, 24.5% (95% CI 16.5-34.6) in Kenya, and 14.7% (95% CI 8.1-22.4) in Uganda. Results among women exposed to unprotected intercourse indicated much higher levels of infertility, ranging from 22.4% (95% CI 18.6-30.8) in Uganda to 63.7% (95% CI 48.8-87.9) in Côte d'Ivoire. Sensitivity analyses suggest infertility estimates are particularly sensitive to adjustments around pregnancy recognition timing and sexual activity, with little impact of adjustments for recent injectable contraceptive use, infertility treatment, and underreporting of traditional and coital dependent contraceptive use.</p><p><strong>Limitations, reasons for caution: </strong>There was substantial digit preference in responses at 12 months, particularly among the tryers, which could introduce bia
研究问题在布基纳法索、科特迪瓦、肯尼亚和乌干达,试图怀孕的女性和更广泛的无保护性行为女性人群中 12 个月不孕症的流行率是否存在差异,流行率估计值如何受到模型假设和调整的影响?对试孕者 12 个月不孕率的估计从布基纳法索的 8%到科特迪瓦的 30%不等,在更广泛的无保护性交女性人群中,不孕率大幅上升:虽然生儿育女是人类的基本经历,但妇女和夫妇不孕不育的程度是一个被忽视的研究领域,尤其是在撒哈拉以南非洲地区。该地区不孕症的现有估计值差异很大,从 2% 到 32%,但是,研究人群和模型假设的变化可能产生的影响尚未得到很好的研究:我们使用了来自布基纳法索、科特迪瓦、肯尼亚和乌干达的具有全国代表性的横断面调查数据。我们采用了多阶段群组随机抽样设计,在每个国家内根据群组的规模选择概率成正比的样本,以产生具有代表性的 15-49 岁女性样本。样本从科特迪瓦的 3864 个到肯尼亚的 9489 个不等:我们在每个国家建立了两个分析样本--尝试者样本和更广泛的无保护性行为女性样本--探索人口特征的差异,并使用当前持续时间(CD)方法估算 12 个月不孕症的时期流行率。我们还在两个分析样本中分别考察了几个模型假设的影响,包括对最近使用注射避孕药、未被发现的怀孕、不孕症治疗、未报告的避孕药使用情况以及性活动的调整:在尝试避孕者中采用 CD 方法得出的 12 个月不孕症总发生率为:布基纳法索 7.9% (95% CI 6.6-12.7)、科特迪瓦 29.6% (95% CI 15.3-100.0)、肯尼亚 24.5% (95% CI 16.5-34.6)、乌干达 14.7% (95% CI 8.1-22.4)。无保护措施性交妇女的不孕率要高得多,乌干达为 22.4%(95% CI 18.6-30.8),科特迪瓦为 63.7%(95% CI 48.8-87.9)。敏感性分析表明,不孕不育的估计值对怀孕确认时间和性活动的调整特别敏感,而对近期注射避孕药、不孕不育治疗以及传统和依赖同房的避孕药使用的漏报进行调整则影响不大:在 12 个月的回答中存在大量的数字偏好,尤其是在尝试者中,这可能会造成偏差。生殖日历中的数据质量问题可能会影响 CD 方法在更广泛的无保护性行为女性样本中的准确性,尤其是在少报避孕药具使用情况、人工流产和自然流产以及未被发现的怀孕方面。最后,我们缺乏有关产后闭经或禁欲的信息:研究结果的更广泛意义:了解定义和分析方法的不一致及其对不孕不育估计的影响,对于可靠地监测人群不孕不育趋势、确定影响不孕不育的因素、改进预防计划以及确保获得高质量的治疗和服务非常重要:本研究得到了比尔及梅琳达-盖茨基金会(INV009639)和美国国家儿童健康与人类发展研究所(K01HD107172)的资助。资助方未参与研究设计、分析、手稿撰写或发表决定。作者无利益冲突需要声明:不适用。
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引用次数: 0
Time will tell: time-lapse technology and artificial intelligence to set time cut-offs indicating embryo incompetence. 时间会证明一切:通过延时摄影技术和人工智能设定时间分界线,显示胚胎发育不全。
IF 6 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-01 DOI: 10.1093/humrep/deae239
Giovanni Coticchio, Alessandro Bartolacci, Valentino Cimadomo, Samuele Trio, Federica Innocenti, Andrea Borini, Alberto Vaiarelli, Laura Rienzi, Aisling Ahlström, Danilo Cimadomo
<p><strong>Study question: </strong>Can more reliable time cut-offs of embryo developmental incompetence be generated by combining time-lapse technology (TLT), artificial intelligence, and preimplantation genetics screening for aneuploidy (PGT-A)?</p><p><strong>Summary answer: </strong>Embryo developmental incompetence can be better predicted by time cut-offs at multiple developmental stages and for different ranges of maternal age.</p><p><strong>What is known already: </strong>TLT is instrumental for the continual and undisturbed observation of embryo development. It has produced morphokinetic algorithms aimed at selecting embryos able to generate a viable pregnancy, however, such efforts have had limited success. Regardless, the potential of this technology for improving multiple aspects of the IVF process remains considerable. Specifically, TLT could be harnessed to discriminate developmentally incompetent embryos: i.e. those unable to develop to the blastocyst stage or affected by full-chromosome meiotic aneuploidies. If proven valuable, this application would prevent the non-productive use of such embryos, thereby improving laboratory and clinical efficiency and reducing patient stress and costs due to unnecessary embryo transfer and cryopreservation.</p><p><strong>Study design, size, duration: </strong>The training dataset involved embryos of PGT-A cycles cultured in Embryoscope with a single media (836 euploid and 1179 aneuploid blastocysts and 1874 arrested embryos; 2013-2020). Selection criteria were ejaculated sperm, own (not donated) fresh oocytes, trophectoderm biopsy and comprehensive-chromosome-testing to diagnose uniform aneuploidies. Out-of-sample (30% of training), internal (299 euploid and 490 aneuploid blastocysts and 680 arrested embryos; 2021-2022) and external (97 euploid, 110 aneuploid and 603 untested blastocysts and 514 arrested embryos, 2018 to early 2022) validations were conducted.</p><p><strong>Participants/materials, setting, methods: </strong>A training dataset (70%) was used to define thresholds. Several models were generated by fitting outcomes to each timing (tPNa-t8) and maternal age. ROC curves pinpointed in-sample classification values associated with 95%, 99% and 99.99% true-positive rate for predicting incompetence. These values were integrated with upper limits of maternal age ranges (<35, 35-37, 38-40, 41-42, and >42 years) in logit functions to identify time cut-offs, whose accuracy was tested on the validation datasets through confusion matrices.</p><p><strong>Main results and the role of chance: </strong>For developmental (in)competence, the best performing (i) tPNa cut-offs were 27.8 hpi (error-rate: 0/743), 32.6 hpi (error rate: 0/934), 26.8 hpi (error rate: 0/1178), 22.9 hpi (error-rate: 1/654, 0.1%) and 17.2 hpi (error rate: 4/423, 0.9%) in the <35, 35-37, 38-40, 41-42, and >42 years groups, respectively; (ii) tPNf cut-offs were 36.7 hpi (error rate: 0/738), 47.9 hpi (error rate: 0/921), 45.6 hpi (e
研究问题:结合延时技术(TLT)、人工智能和胚胎植入前非整倍体遗传学筛查(PGT-A),能否生成更可靠的胚胎发育不全时间临界值?在多个发育阶段和不同的母体年龄范围内,通过时间截断可以更好地预测胚胎发育不全:TLT有助于持续、不受干扰地观察胚胎发育。它已经产生了形态动力学算法,旨在选择能够产生可存活妊娠的胚胎,但这些努力取得的成功有限。无论如何,这项技术在改进试管婴儿过程的多个方面仍具有相当大的潜力。具体来说,TLT 可用于区分发育不全的胚胎:即无法发育到囊胚阶段或受全染色体减数分裂非整倍体影响的胚胎。如果这一应用被证明是有价值的,那么它将避免对这类胚胎的非生产性使用,从而提高实验室和临床效率,减少患者因不必要的胚胎移植和冷冻保存而产生的压力和费用:训练数据集涉及在 Embryoscope 中使用单一培养基培养的 PGT-A 周期胚胎(836 个优倍囊胚和 1179 个非优倍囊胚以及 1874 个停育胚胎;2013-2020 年)。选择标准为射精精子、自有(非捐赠)新鲜卵母细胞、滋养层活检和全面染色体检测,以诊断均匀非整倍体。进行了样本外(培训的30%)、内部(299个优倍体和490个非优倍体囊胚和680个着床胚胎;2021-2022年)和外部(97个优倍体、110个非优倍体和603个未经检测的囊胚和514个着床胚胎,2018年至2022年初)验证:使用训练数据集(70%)来定义阈值。通过将结果与每个时机(tPNa-t8)和母体年龄拟合,生成了多个模型。ROC 曲线确定了与预测无能力的 95%、99% 和 99.99% 真实阳性率相关的样本内分类值。这些值与对数函数中产妇年龄范围的上限(42 岁)相结合,以确定时间分界线,并通过混淆矩阵在验证数据集上测试其准确性:在发育(不)能力方面,42 岁组中表现最好的 (i) tPNa 临界值分别为 27.8 hpi(错误率:0/743)、32.6 hpi(错误率:0/934)、26.8 hpi(错误率:0/1178)、22.9 hpi(错误率:1/654,0.1%)和 17.2 hpi(错误率:4/423,0.9%);(ii) tPNf 临界值分别为 36.7 hpi(错误率:0/743)、26.8 hpi(错误率:0/1178)、22.9 hpi(错误率:1/654,0.1%)和 17.2 hpi(错误率:4/423,0.9%)。7 hpi(误差率:0/738)、47.9 hpi(误差率:0/921)、45.6 hpi(误差率:1/1156,0.1%)、44.1 hpi(误差率:0/647)和 41.8 hpi(误差率:0/417);(iii) t2 临界值分别为 50.9 hpi(误差率:0/724)、49 hpi(误差率:0/915)、47.1 hpi(错误率:0/1146)、45.8 hpi(错误率:0/636)和 43.9 hpi(错误率:0/416);(iv) t4 临界值分别为 66.9 hpi(错误率:0/683)、80.7 hpi(误差率:0/836)、77.1 hpi(误差率:0/1063)、74.7 hpi(误差率:0/590)和 71.2 hpi(误差率:0/389);以及 (v) t8 临界值为 118.1 hpi(误差率:0/619)、110.6 hpi(误差率:0/772)、140 hpi(误差率:0/969)、135 hpi(误差率:0/533)和 127.5 hpi(误差率:0/355)。然而,与囊胚发育临界值相比,相关临界值的表现较差,而且是多余的:研究的局限性在于其回顾性设计以及数据集在高龄产妇方面的不平衡。没有评估异常裂解模式的潜在影响。有必要扩大样本量,并在其他临床环境中进行外部验证:如果得到独立研究的证实,这种方法可大大提高 ART 的效率,因为它可减少与胚胎相关的工作量和对患者的影响(延长培养和分裂期冷冻保存或移植),而这些胚胎最终发育不良,不应考虑进行治疗。在验证之前,这些数据也可应用于静态胚胎观察环境:本研究得到了参与机构的支持。作者不存在利益冲突:不适用。
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引用次数: 0
Role, benefits, and risks of AMH testing for non-ART related indications. 针对非抗逆转录病毒药物相关适应症进行 AMH 检测的作用、益处和风险。
IF 6 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-12-01 DOI: 10.1093/humrep/deae234
Zoya Enakshi Ali, Claudia Massarotti, George Liperis, Mina Mincheva, Omar F Ammar, Julia Uraji, Antonio La Marca, Raj Mathur, Helen C O'Neill, Mariana Moura-Ramos, Juan J Fraire-Zamora
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引用次数: 0
The composition of commercially available human embryo culture media 市售人类胚胎培养基的成分
IF 6.1 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-11-25 DOI: 10.1093/humrep/deae248
M S Zagers, M Laverde, M Goddijn, J J de Groot, F A P Schrauwen, F M Vaz, S Mastenbroek
STUDY QUESTION What is the composition of currently available commercial human embryo culture media provided by seven suppliers, for each stage of human preimplantation embryo development? SUMMARY ANSWER While common trends existed across brands, distinct differences in composition underlined the absence of a clear standard for human embryo culture medium formulation. WHAT IS KNOWN ALREADY The reluctance of manufacturers to fully disclose the composition of their human embryo culture media generates uncertainty regarding the culture conditions that are used for human preimplantation embryo culture. The critical role of the embryo culture environment is well-recognized, with proven effects on IVF success rates and child outcomes, such as birth weight. The lack of comprehensive composition details restricts research efforts crucial for enhancing our understanding of its impacts on these outcomes. The ongoing demand for greater transparency remains unmet, highlighting a significant barrier in embryo culture medium optimization. STUDY DESIGN, SIZE, DURATION For this study, 47 different human embryo culture media and protein supplements were purchased between December 2019 and June 2020; they comprise complete media (n = 23), unsupplemented media (n = 14), and supplements (n = 10). Unsupplemented media were supplemented with each available supplement from the same brand (n = 33 combinations). All samples were directly frozen in liquid nitrogen and stored at −80°C until composition analysis. PARTICIPANTS/MATERIALS, SETTING, METHODS We determined the concentrations of 40 components in all samples collected (n = 80). Seven electrolytes (calcium, chloride, iron, magnesium, phosphate, potassium, sodium), glucose, immunoglobulins A, G, and M (IgA, IgG, IgM), uric acid, alanine aminotransferase (ALAT), aspartate aminotransferase (ASAT), and albumin, as well as the total protein concentration, were determined in each sample using a Cobas 8000 Analyser (Roche Diagnostics). Analysis of pyruvate, lactate, carnitine, and 21 amino acids was achieved with Ultra-High Performance Liquid Chromatography-Mass Spectrometry (UPLC-MS/MS). MAIN RESULTS AND THE ROLE OF CHANCE Our analysis showed that generally, the concentrations of components of ready-to-use human embryo culture media align with established assumptions about the changing needs of an embryo during early development. For instance, glucose concentrations displayed a high-low-high pattern in sequential media systems from all brands: 2.5–3 mM in most fertilization media, 0.5 mM or below in all cleavage stage media, and 2.5–3.3 mM in most blastocyst stage media. Continuous media generally resembled glucose concentrations of cleavage stage media. However, for other components, such as lactate, glycine, and potassium, we observed clear differences in medium composition across different brands. No two embryo culture media compositions were the same. Remarkably, even embryo culture media from brands that belong to th
研究问题 目前由七家供应商提供的商用人类胚胎培养基在人类植入前胚胎发育的各个阶段的成分是什么?简要解答 虽然不同品牌的人类胚胎培养基存在共同趋势,但其成分却有明显差异,这说明人类胚胎培养基配方缺乏明确的标准。已知信息 由于生产商不愿完全公开其人类胚胎培养基的成分,因此人类胚胎植入前培养所使用的培养条件存在不确定性。胚胎培养环境的关键作用已得到广泛认可,其对试管婴儿成功率和婴儿出生体重等结果的影响已得到证实。由于缺乏全面的组成细节,限制了研究工作的开展,而这些研究工作对于加深我们了解胚胎培养环境对这些结果的影响至关重要。对提高透明度的持续需求仍未得到满足,这凸显了胚胎培养基优化中的一个重大障碍。研究设计、规模、持续时间 本研究在 2019 年 12 月至 2020 年 6 月期间购买了 47 种不同的人类胚胎培养基和蛋白质补充剂;它们包括完整培养基(n = 23)、未添加补充剂的培养基(n = 14)和补充剂(n = 10)。未添加补充剂的培养基添加了同一品牌的每种可用补充剂(n = 33 种组合)。所有样本直接冷冻在液氮中,并保存在 -80°C 温度下,直至成分分析。我们测定了所有采集样本(n = 80)中 40 种成分的浓度。使用 Cobas 8000 分析仪(罗氏诊断公司)测定了每个样本中的七种电解质(钙、氯、铁、镁、磷酸盐、钾、钠)、葡萄糖、免疫球蛋白 A、G 和 M(IgA、IgG、IgM)、尿酸、丙氨酸氨基转移酶(ALAT)、天冬氨酸氨基转移酶(ASAT)、白蛋白以及总蛋白质浓度。丙酮酸、乳酸、肉碱和 21 种氨基酸的分析采用超高效液相色谱-质谱法(UPLC-MS/MS)进行。主要结果和偶然性的作用 我们的分析表明,一般来说,即用型人类胚胎培养基的成分浓度与胚胎在早期发育过程中需求变化的既定假设相一致。例如,在所有品牌的连续培养基系统中,葡萄糖浓度呈现出高-低-高的模式:大多数受精培养基为 2.5-3 mM,所有分裂期培养基为 0.5 mM 或以下,大多数囊胚期培养基为 2.5-3.3 mM。连续培养基的葡萄糖浓度一般与分裂期培养基相似。然而,对于其他成分,如乳酸盐、甘氨酸和钾,我们观察到不同品牌培养基成分的明显差异。没有两种胚胎培养基的成分是相同的。值得注意的是,即使是同一母公司旗下品牌的胚胎培养基,其成分也不尽相同。此外,所使用的特定浓度和连续培养基成分差异的科学依据非常有限,通常是基于样本量有限的最小体内研究或使用动物模型的研究。大规模数据不详。局限性、注意事项 我们采用了一种有针对性的方法,并进行了一些精选测试,从而将成分分析局限于这一组分析物。研究结果的广泛影响 有关人类胚胎培养基成分(包括每种成分的确切浓度)的全面披露和完全透明,对于以证据为基础改进人类胚胎植入前培养基至关重要。研究经费/合作利益 本研究得到了 ZonMw (https://www.zonmw.nl/en) 转化研究 2 计划(项目编号 446002003)的支持。M.G. 声明,Ferring 公司向 VU 医疗中心支付了一笔不受限制的研究基金,该基金与本研究无关。其余作者无利益冲突需要声明。试验注册号为 n/a。
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引用次数: 0
Upregulated let-7 expression in the follicular fluid of patients with endometriomas leads to dysfunction of granulosa cells through targeting of IGF1R 子宫内膜异位症患者卵泡液中let-7表达上调,通过靶向IGF1R导致颗粒细胞功能障碍
IF 6.1 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-11-10 DOI: 10.1093/humrep/deae247
Libing Shi, Hanqi Ying, Yongdong Dai, Yan Rong, Jianmin Chen, Feng Zhou, Shasha Wang, Shiqian Xu, Xiaomei Tong, Songying Zhang
STUDY QUESTION What molecular mechanisms underlie the decline in ovarian reserve as the number and quality of oocytes decrease in patients with ovarian endometriomas (OEM)? SUMMARY ANSWER Elevated expression of the let-7 micro(mi)RNAs in the follicular microenvironment of OEM-affected ovaries targets the expression of type 1 insulin-like growth factor receptor (IGF1R) in granulosa cell (GC) and disrupts their proliferation, steroid hormone secretion levels, adenosine triphosphate (ATP) energy metabolism, and reactive oxygen species (ROS) oxidative stress levels. WHAT IS KNOWN ALREADY Patients with OEM exhibit diminished ovarian reserve, characterized by reduced oocyte quantity and quality. Fibrotic changes in the ovarian tissue surrounding the OEM create a disruptive microenvironment for follicular growth and development. STUDY DESIGN, SIZE, DURATION This is a cross-sectional study aimed to elucidate the molecular mechanisms underlying the impact of OEM on follicular development. Initially, miRNA expression profiles in follicular fluid (FF) samples were sequenced from patients with infertility related to OEM (N = 3) and male factor (MF) infertility (N = 3), with the latter serving as the control group. Differentially expressed miRNAs were validated in additional samples from each group (N = 55 in OEM group and N = 45 in MF group) to confirm candidate miRNAs. The study also investigated indicators associated with GCs dysfunction in vitro on rat GCs. Subsequently, rat models of OEM were established through endometrial allogeneic transplantation, and fertility experiments were conducted to assess the let-7/IGF1R axis response to OEM in vivo. Patient samples were collected between May 2018 and April 2019, and the mechanistic study was conducted over the subsequent three years. PARTICIPANTS/MATERIALS, SETTING, METHODS FF and GC samples were obtained from infertile patients undergoing IVF treatment for OEM and MF related infertility. miRNA expression profiles in FF samples were analyzed using second-generation high-throughput sequencing technology, and candidate miRNAs were validated through quantitative PCR (qPCR). In the in vitro experiments conducted with rat GCs, cell proliferation was assessed using the CCK-8 assay, while steroid hormone concentrations were measured using chemiluminescence. ATP content was determined with an ATP assay kit, and levels of ROS were quantified using flow cytometry. A dual luciferase reporter gene assay was employed to identify the target gene of let-7 based on the construction of a IGF1R reporter gene plasmid using 293T cells. Western blotting was utilized to evaluate the expression of IGF1R in GCs, as well as its downstream proteins, and changes in signaling pathways following let-7 agomir/antagomir transfection and/or Igf1r silencing. In the in vivo OEM rat models, alterations in ovarian structure and cyst morphology were observed using hematoxylin and eosin staining. The expressions of let-7 and Igf1r in GCs were e
研究问题:卵巢子宫内膜异位症(OEM)患者的卵母细胞数量和质量下降,导致卵巢储备功能下降的分子机制是什么?概括解答 在受 OEM 影响的卵巢卵泡微环境中,let-7 微(mi)RNAs 的表达升高会抑制颗粒细胞(GC)中 1 型胰岛素样生长因子受体(IGF1R)的表达,并破坏它们的增殖、类固醇激素分泌水平、三磷酸腺苷(ATP)能量代谢和活性氧(ROS)氧化应激水平。已知情况 OEM 患者的卵巢储备功能减退,表现为卵母细胞数量和质量下降。OEM 周围卵巢组织的纤维化变化为卵泡的生长和发育创造了一个破坏性的微环境。研究设计、规模和持续时间 这是一项横断面研究,旨在阐明 OEM 对卵泡发育影响的分子机制。首先,对卵泡液(FF)样本中的 miRNA 表达谱进行测序,样本来自与 OEM 相关的不孕症患者(3 例)和男性因素(MF)不孕症患者(3 例),后者为对照组。对每组的其他样本(OEM 组 55 个,MF 组 45 个)中差异表达的 miRNA 进行了验证,以确认候选 miRNA。该研究还在大鼠 GCs 体外研究了与 GCs 功能障碍相关的指标。随后,通过子宫内膜异体移植建立了大鼠OEM模型,并进行了生育实验,以评估体内let-7/IGF1R轴对OEM的反应。患者样本于 2018 年 5 月至 2019 年 4 月期间采集,机理研究在随后的三年中进行。参与者/材料、设置、方法 FF 和 GC 样本取自因 OEM 和 MF 相关不孕症而接受 IVF 治疗的不孕症患者。采用第二代高通量测序技术分析了 FF 样本中的 miRNA 表达谱,并通过定量 PCR(qPCR)验证了候选 miRNA。在使用大鼠 GCs 进行的体外实验中,使用 CCK-8 检测法评估了细胞增殖情况,同时使用化学发光法测定了类固醇激素的浓度。ATP 含量用 ATP 检测试剂盒测定,ROS 水平用流式细胞仪量化。在利用 293T 细胞构建 IGF1R 报告基因质粒的基础上,采用了双荧光素酶报告基因检测法来确定 let-7 的靶基因。利用 Western 印迹法评估了 GC 中 IGF1R 及其下游蛋白的表达,以及 let-7 agomir/antagomir 转染和/或 Igf1r 沉默后信号通路的变化。在体内 OEM 大鼠模型中,使用苏木精和伊红染色法观察了卵巢结构和囊肿形态的改变。通过 qPCR 对 GC 中 let-7 和 Igf1r 的表达进行了评估,而 IGF1R 表达的变化则通过免疫组化进行了研究。主要结果与偶然性的作用 本研究中的卵巢OEM患者与MF对照组相比,前区卵泡数、卵母细胞取卵数和正常受精率均明显下降。在 OEM 患者的 FF 和 GC 中,let-7 miRNA 家族的表达明显上调。用let-7激动剂转染大鼠GC会降低GC的功能,包括破坏细胞增殖、线粒体氧化磷酸化和类固醇激素分泌,而用let-7拮抗剂转染大鼠GC则会产生相反的效果。荧光素酶报告基因实验证实,let-7与IGF1R的3′-非翻译区互补结合。刺激大鼠 GC 中 let-7 的表达会导致 IGF1R 的表达显著下降,而抑制 let-7 则会增加 IGF1R 的表达。与 MF 患者相比,OEM 患者 GC 中 IGF1R 的表达也明显减少。Igf1r 的沉默导致 GC 功能障碍,这与 let-7 激动的效果类似,表现为参与细胞增殖(CCND2 和 CCND3)和雌二醇合成的关键蛋白下调,以及孕酮合成(StAR)的增加,同时牵涉到 PI3K-Akt 和 MAPK 信号通路。当 Igf1r 被沉默时,let-7 对 GCs 的拮抗作用无效。相反,IGF1R 配体 IGF-1 的刺激可逆转 let-7 对 GCs 的激动作用。这些发现表明,let-7 是通过靶向 IGF1R 来调节 GC 的增殖、分化和 ATP 合成的。OEM 大鼠模型显示了卵巢形态和结构的改变,同时生育能力也降低了。
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引用次数: 0
Reproductive factors and biological aging: the association with all-cause and cause-specific premature mortality 生殖因素和生物老化:与全因和特定原因过早死亡的关系
IF 6.1 1区 医学 Q1 OBSTETRICS & GYNECOLOGY Pub Date : 2024-11-09 DOI: 10.1093/humrep/deae250
Gaojie Fan, Qing Liu, Jianing Bi, Qing Fang, Fei Luo, Xiaofeng Huang, Heng Li, Wenwen Guo, Binghai Liu, Lianyan Yan, Youjie Wang, Lulu Song
STUDY QUESTION Are reproductive factors associated with biological aging, and does biological aging mediate the associations of reproductive factors with premature mortality? SUMMARY ANSWER Multiple reproductive factors are related to phenotypic age acceleration (PhenoAge-Accel), while adherence to a healthy lifestyle mitigates these harmful effects; PhenoAge-Accel mediated the associations between reproductive factors and premature mortality. WHAT IS KNOWN ALREADY Accelerated aging is a key contributor to mortality, but knowledge about the effect of reproductive factors on aging is limited. STUDY DESIGN, SIZE, DURATION This prospective cohort study included 223 729 women aged 40–69 years from the UK biobank in 2006–2010 and followed up until 12 November 2021. PARTICIPANTS/MATERIALS, SETTING, METHODS Reproductive factors were collected through a touchscreen questionnaire. Biological aging was assessed through PhenoAge-Accel. Multiple linear regression models were used to examine the relationships of reproductive factors with PhenoAge-Accel and estimate the modified effect of a healthy lifestyle. Furthermore, we applied mediation analysis to explore the mediating role of PhenoAge-Accel in the associations between reproductive factors and premature mortality. MAIN RESULTS AND THE ROLE OF CHANCE Early menarche (&lt;12 years vs 13 years, β: 0.37, 95% CI: 0.30, 0.44), late menarche (≥15 years vs 13 years, β: 0.18, 95% CI: 0.11, 0.25), early menopause (&lt;45 years vs 50–51 years, β: 0.62, 95% CI: 0.51, 0.72), short reproductive lifespan (&lt;30 years vs 35–39 years, β: 0.81, 95% CI: 0.70, 0.92), nulliparity (vs two live births, β: 0.36, 95% CI: 0.30, 0.43), high parity (≥4 vs 2 live births, β: 0.49, 95% CI: 0.40, 0.59), early age at first live birth (&lt;20 years vs 25–29 years, β: 0.66, 95% CI: 0.56, 0.75), and stillbirth (β: 0.51, 95% CI: 0.36, 0.65) were associated with increased PhenoAge-Accel. Furthermore, PhenoAge-Accel mediated 6.0%–29.7% of the associations between reproductive factors and premature mortality. Women with an unfavorable lifestyle and reproductive risk factors had the highest PhenoAge-Accel compared to those with a favorable lifestyle and without reproductive risk factors. LIMITATIONS, REASONS FOR CAUTION The participants in the UK Biobank were predominantly of White ethnicity; thus, caution is warranted when generalizing these findings to other ethnic groups. WIDER IMPLICATIONS OF THE FINDINGS Our findings reveal the harmful effects of multiple reproductive factors on biological aging and the mediating role of biological aging in the associations between reproductive factors and premature mortality. They highlight the significance of adhering to a healthy lifestyle to slow biological aging as a potential way to reduce premature mortality among women with reproductive risk factors. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by the National Natural Science Foundation of China (82003479, 82073660, 72
研究问题 生殖因素是否与生物衰老有关,生物衰老是否会介导生殖因素与过早死亡之间的关系?简要解答 多种生殖因素与表型年龄加速(PhenoAge-Accel)有关,而坚持健康的生活方式可减轻这些有害影响;PhenoAge-Accel 可介导生殖因素与过早死亡率之间的关联。已知信息 加速衰老是导致死亡的一个关键因素,但有关生殖因素对衰老影响的知识却很有限。研究设计、规模、持续时间 这项前瞻性队列研究纳入了 2006-2010 年间英国生物库中 223 729 名 40-69 岁的女性,随访至 2021 年 11 月 12 日。通过触摸屏问卷收集生殖因素。生物衰老通过 PhenoAge-Accel 进行评估。我们使用多元线性回归模型来检验生殖因素与 PhenoAge-Accel 的关系,并估算健康生活方式的修正效应。此外,我们还运用中介分析法探讨了 PhenoAge-Accel 在生殖因素与过早死亡率之间的中介作用。主要结果和机会的作用 初潮早(&lt;12 岁 vs 13 岁,β:0.37,95% CI:0.30,0.44)、初潮晚(≥15 岁 vs 13 岁,β:0.18,95% CI:0.11,0.25)、绝经早(&lt;45 岁 vs 50-51 岁,β:0.62,95% CI:0.51,0.72)、生育期短(&lt;30 岁 vs 35-39 岁,β:0.81,95% CI:0.70,0.92)、无效生育(对 2 次活产,β:0.36,95% CI:0.30,0.43)、高奇偶数(≥4 对 2 次活产,β:0.49,95% CI:0.40,0.59)、首次活产年龄早(&lt;20 岁 vs 25-29 岁,β:0.66,95% CI:0.56,0.75)和死胎(β:0.51,95% CI:0.36,0.65)与 PhenoAge-Accel 增加有关。此外,PhenoAge-Accel 在生殖因素与过早死亡之间的关系中起着 6.0%-29.7% 的中介作用。与生活方式良好且无生殖风险因素的妇女相比,生活方式不良且有生殖风险因素的妇女的 PhenoAge-Accel 值最高。局限性和注意事项 英国生物数据库的参与者主要是白人,因此在将这些研究结果推广到其他种族群体时需要谨慎。研究结果的广泛意义 我们的研究结果揭示了多种生殖因素对生物衰老的有害影响,以及生物衰老在生殖因素与过早死亡之间的关联中的中介作用。这些发现强调了坚持健康的生活方式以延缓生物衰老的重要性,这是降低具有生殖风险因素的女性过早死亡率的一种潜在方法。研究经费/利益冲突 本研究得到了国家自然科学基金(82003479、82073660、72204215)、湖北省自然科学基金(2023AFB663)、浙江省公益技术应用研究项目(GF22H269155)和中国博士后科学基金(2019M662646、2020T130220)的资助。作者没有需要披露的利益冲突。试验注册号为 n/a。
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Human reproduction
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