International Journal of Fertility & Sterility最新文献

Background: Despite the remarkable advancements in the use of embryo donation, concerns have arisen regarding its potential effects on the psychological well-being of children conceived through this assisted reproductive technology and their parent-child relationships. The aim of the study is to evaluate children's psychological adjustment and parenting style in families with donor-conceived children and compare them with the normal population.

Materials and methods: A historical cohort study was conducted to assess the psychological adjustment of 31 children aged 3 to 7 years born via embryo donation and to compare the results with those of 30 age-matched children from families who conceived naturally using the Strengths and Difficulties Questionnaire. The sample size was determined using G power, and the samples were selected using a convenient sampling method. Parenting styles within these families were also evaluated using the Baumrind Parenting Styles Inventory through clinical interviews.

Results: Although 8 out of 31 children born through embryo donation (25.8%) and 3 out of 30 children from families with natural conception exhibited psychological maladjustment, this difference was not statistically significant (P=0.249). Furthermore, there were no significant differences in parenting styles between the two groups (P values for permissive, authoritarian, and authoritative parenting styles were 0.424, 0.656, and 0.219, respectively).

Conclusion: The lack of genetic parent-child relationships does not seem to be a dominant factor affecting the psychological adjustment of children or parenting styles.

Background: Diabetes mellitus (DM), one of the most pervasive and enduring metabolic diseases, has been demonstrated to adversely impact male fertility. Conversely, both exercise training and Chrysin have been identified as potential interventions capable of mitigating the deleterious effects of diabetes on spermatogenesis. Thus, the current study aims to explore the individual and combined influences of Chrysin supplementation and running exercise on oxidative stress and germ cell apoptosis in the testicular tissue of diabetic adult rats.

Materials and methods: In this experimental study, the DM was induced by streptozotocin (STZ,50 mg/kg). Rats were divided into control (received STZ solvent), DM-sole, Chrysin-sole (50 mg/kg, daily), moderate-intensity running exercise training (MIRET-sole, warm-up, 5 minutes at 30% of Smax1 (Maximum speed); Moderate intensity exercise, 60 minutes at 60% of Smax1, and recovery, 5 minutes to 30% of Smax1), DM+Chrysin, DM+MIRET, and DM+MIRET+Chrysin. Following 8 weeks, the histopathological changes (Johnson's score, epithelial height, and tubular diameter), testicular malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GPX), and the mRNA levels of anti-apoptotic gene Bcl-2 and pro-apoptotic gene Bax was analyzed.

Results: Chrysin solely and simultaneous with MIRET could remarkably (P=0.001) improve the DM-induced histopathological damages, increase the testicular SOD and GPx levels, and decline the DM-increased MDA content. Moreover, our results showed that Chrysin solely and more simultaneously with MIRET could significantly (P=0.001) decrease the mRNA expression of Bax and improve the Bcl-2 expression and rebalance the Bax/Bcl-2 balance.

Conclusion: Our findings showed that co-administration of Chrysin along with MIRET can significantly ameliorate the DM-induced histopathological, and biochemical impairments and reduce the pro-apoptotic impact of DM on testicular tissue.

Background: The effectiveness of changing the type of luteal phase support in patients with poor ovarian response (POR) remains unclear based on the available evidence. This study aimed to compare the effectiveness of various luteal phase support (LPS) methods, including progesterone alone, human chorionic gonadotropin (hCG) alone, and the combination of progesterone with hCG, in these patients.

Materials and methods: In this randomized clinical trial, 375 patients diagnosed with POR based on the Bologna criteria underwent intracytoplasmic sperm injection-embryo transfer (ET) cycles at the Royan Institute between November 2015 and June 2019. The patients were allocated randomly into three different LPS groups on the day of oocyte pickup. In the first group, 1500 IU of hCG on the ET day, as well as 4 days after that were administrated intramuscularly. In the second group, the patients received 1500 IU of hCG IM on the ET day, as well as 3 and 6 days after the ET along with vaginal progesterone suppositories of 400 mg twice daily. For the third group, only vaginal suppositories twice daily were administrated from the day of oocyte pick up until the pregnancy test day. The clinical pregnancy, miscarriage and live birth rates were compared among groups using appropriate statistical tests.

Results: The data analysis indicated that the three groups were comparable, and there were no significant differences among the groups in terms of implantation, clinical pregnancy, miscarriage, and live birth rates. The twin pregnancy rate in the hCG-only group was higher than in the other two groups, although this difference did not reach statistical significance (P=0.060).

Conclusion: Similar pregnancy and live birth rates were observed among different LPS regimens. Interestingly, the use of two boluses of low-dose hCG (1500) was associated with a slight increase in multiple pregnancies. We suggest this effective method, which is easier and more patient-friendly (registration number: NCT02798653).

Background: Pregnant mothers frequently have vitamin D deficiency, which has potential consequences for the health of their unborn children. Prenatal vitamin D administration raises maternal and foetal 25(OH)D levels. This study aims to assess the effects of 25(OH)D supplementation on clinical pregnancy and miscarriage rates in women diagnosed with hyperandrogenic polycystic ovarian syndrome (PCOS).

Materials and methods: This prospective study was conducted on 200 patients with hyperandrogenic PCOS who attended an outpatient infertility clinic at Menoufia University Hospital from March 2021 until March 2022. Participants were divided into two groups-(A) women who received a therapeutic dose of 25(OH)D supplements (n=100) and (B) women who did not receive 25(OH)D supplements (n=100).

Results: The duration needed to reach follicles that were ≥18 mm was significantly higher in group B (16.74 ± 2.57) compared with group A (13.40 ± 2.12). Midluteal progesterone was significantly higher in group A (19.63 ± 2.12) compared with group B (17.74 ± 2.36, P<0.001). Our results indicate that women with adequate 25(OH)D levels are far more likely to experience clinical pregnancies than those with 25(OH)D deficiency.

Conclusion: More research is necessary to determine whether vitamin D supplementation can be a simple and economical solution to increase pregnancy rates. Our study population had a significant 25(OH)D deficit or insufficiency prevalence. Determining 25(OH)D levels as part of a routine infertility assessment may be advantageous.

Background: Unexplained recurrent miscarriage (RM) is still an unsolved reproductive health problem. Inherited thrombophilias have been one of the causes. Mutation in genes encoding coagulation proteins, including prothrombin (PT G20210A) and methylenetetrahydrofolate reductase (MTHFR) genes, increase tendency for venous thromboembolism. This study aimed to evaluate association between polymorphisms in prothrombine and MTHFR genes with RM. We also evaluated association between protein C (PC), protein S (PS), antithrombin III (ATIII), and homocystiene with RM.

Materials and methods: We conducted a case-control study on women with history of miscarriages and healthy controls. Genetic analysis was done using (TaqMan) polymerase chain reaction (PCR) technique and the other tests were performed to check general health indications and thrombophilia markers.

Results: In this study, 195 RM group (group I) participants and 90 healthy controls (group II), PC, PS, ATIII deficiency and Hyperhomocysteinemia were in 7.2, 65.6, 9.2, 10.8% of group I respectively, but was 1.1, 7.8, 2.2, 2.2% of group II. PT G20210A showed two in group I were A/G, no A/G in group II, and no AA carrier in the either group. G allele was observed in 99.5% of the group I and 100% of the group II, while A allele was detected in 0.5% of group I. MTHFR C677T gene showed C/T mutation in 33.3% of group I and 32.2% of group II, while T/T mutation was detected in 12.8% of group I and 8.9% of the group II. C allele was found in 70.5% of group I and 75% of group II, while T allele was found in 29.5% of group I and 25% of group II (P=0.269).

Conclusion: PT G20210A and MTHFR C677T gene mutations are not correlated with RM in the Egyptian population. However, Egyptian women with RM are strongly associated with hyperhomocysteinemia, PC, PS, and ATIII deficiencies (registration number: NCT03209063).

Background: Chromosomal mosaicism, a phenomenon observed in a minority of embryos, showcases its prevalence and inherent unpredictability, leading to variations in embryo mosaic rates across different centers. This research endeavors to assess the prevalence of mosaicism and its characteristics within the scope of our preimplantation genetic testing-A (PGT-A) services in Indonesia. Specifically focusing on our center's experience since 2020, this study aims to elucidate mosaic rates among embryos in our care.

Materials and methods: In a retrospective approach, we collected secondary data sourced from our PGT-A outcomes dating back to 2020. A total of 196 embryos underwent analysis, their characteristics were documented and presented descriptively. Notably, the incidence of specific chromosome abnormalities was outlined. We assess a comparative analysis to investigate the relationship between mosaicism and its corresponding clinical characteristics.

Results: In the analysis of 196 embryos, 106 (54.1%) displayed chromosomal anomalies spanning from low-level mosaicism to whole chromosome aneuploidy. Low mosaicism was observed in 25 (12.8%) of the embryos, while high mosaicism was identified in 8 (4.1%) embryos. Notably, low-level mosaicism predominated in chromosome 9 (n=10, 5.1%), whereas abnormality prevalence was highest in chromosome 21 (n=20, 10.2%). Statistical analysis revealed no significant disparity in mean maternal age among embryos with low-level mosaicism, high mosaicism, and normal chromosomes (33.88 vs. 35 vs. 33.26 years old, respectively). However, a statistically significant difference in mean maternal age (35.84 vs. 33.26 years) was observed between embryos with aneuploidy (monosomy or trisomy) and those with normal chromosomes. Furthermore, a significant difference in high mosaicism rates was detected in patients with unexplained infertility (P<0.05).

Conclusion: In contrast to the study conducted elsewhere, our center had a higher mosaicism rate. Chromosomes 9, 8, and 6 were the most frequently affected. There was a significant difference in the high mosaicism rate for PGT-Arelated unexplained infertility causes.

Background: Reproductive dysfunctions of polycystic ovary syndrome (PCOS) and blood anti-mullerian hormone (AMH) concentration are significantly influenced by the dietary advanced glycation end products (AGEs). The interplay between AGEs and their soluble form of receptor, might exert a protective role on the follicular environment and affect AMH concentration. This study investigated the relationship between soluble receptor for advanced glycation end-products (sRAGE) levels in follicular fluid (FF) and serum AMH levels in PCOS and non-PCOS women.

Materials and methods: Among 43 women of reproductive age who participated in this case-control study 26 non- PCOS women were assigned to the control group, while 17 participants were diagnosed with PCOS and allocated to the case group. Prior to the in vitro fertilization (IVF) procedure, fluid samples were collected and levels of FF sRAGEs and serum AMH were recorded through the use of commercially available ELISA kits.

Results: Correlation analysis, without age adjusting, revealed a statistically considerable and positive association between FF sRAGE and serum AMH concentration in PCOS women (P=0.012, r=0.596). Moreover, after age stratification, the same pattern was observed in some age groups; in PCOS women aged 40 years or older (r=1, P<0.001), as well as those younger than 30 years (r=0.922, P=0.003), correlation analysis demonstrated a significant and positive relationship between FF sRAGE and serum AMH levels.

Conclusion: The association between sRAGE and AMH in women with PCOS is primarily affected by their age, whereas non-PCOS women showed no relationship. The results show that the levels of these receptors (sRAGE) show their specific effects in young women and women over 40 years old and not in middle age and target the ovarian reserve. It seems to act as a defensive shield in older women and increase fertility in young women.

Background: T-shaped uterus is a subclass of dysmorphic uteri according to the European Society of Human Reproduction and Embryology (ESHRE) classification. A T-shaped uterus might be related to poor reproductive outcomes or pregnancy complications. We aim to compare the success rates of in vitro fertilization (IVF) between individuals with a normal uterus and those with a T-shaped uterus identified through Hysterosalpingography.

Materials and methods: A retrospective cohort study was done in Royan Institute, Iran, in April 2020-April 2021. In line with the criteria for inclusion and exclusion, 468 cases were selected. Inclusion criteria were as follow: women of 20-45 years old, primary infertility, no repeated implantation failure (RIF), embryo quality "grade A" or "grade B" (freeze), and no consumption of smoking or alcohol. Patients with uterine fibroid, polyp, metabolic disorders, previous uterine surgery were excluded. Based on the hysterosalpingography (HSG) images, the patients were categorized as: "T-shaped uterus" or "normal uterus". IVF outcomes including positive or negative chemical pregnancy were entered into SPSS software. Using the Chi-square test, the success rate of IVF in those groups was compared.

Results: Of 468 cases, 91 cases had T-shaped uterus and 377 cases had normal uterus. The mean age of patients was 34 ± 3. The frequency of positive chemical pregnancy in the T-shaped uterus group was 42.9%, but 48% in the normal uterus group. The distribution of positive clinical pregnancy was 34.06% in the T-shaped uterus group and 46.1% in the normal uterus group. The distribution of failed pregnancies was 20.5% in women with T-shaped uteri and 19.8% in the normal uterus group (P=0.867). There was no significant difference observed between the two groups.

Conclusion: The success rate of IVF and pregnancy outcomes of patients in the T-shape and normal groups were not found to be statistically significantly different.

Background: The immunologic factors are the chief reason for recurrent pregnancy loss (RPL) and induction of maternal-fetal tolerance is the main treatment for this cause of RPL, but the effect of this method is uncertainly and needs multiple doses and/or interventions. The aim of this study was to investigate whether a single administration of transforming growth factor-β1 (TGF-β1) can improve the pregnancy outcomes of RPL mice and whether the improvement is cause by TGF-β1 driving the expression of immune tolerance molecule indoleamine 2,3-dioxygenase (IDO).

Materials and methods: In this experimental study, 40 RPL model mice were equally divided into a control group, that received 0.01 M phosphate-buffered saline (PBS), and a treatment group, that received PBS containing 2, 20, and 200 ng/ml TGF-β1 via tail vein injection. The mice were sacrificed at 13.5 days of pregnancy and the embryo resorption rate was determined. The expression of IDO, TGF-β1, and TGF-β3 were detected in the placenta using western blotting and immunohistochemistry techniques.

Results: The expression of IDO was positively correlated with TGF-β1 in the placental tissue of RPL mice (r=0.591, P<0.001). In all treatment groups, the embryo resorption rates were significantly lower than the control group and the expression of IDO in the placental tissue of all treatment groups was significantly higher than the control group. The expression of TGF-β1 increased gradually from, 2, 20 to 200 ng/ml in treatment groups, and the concentration of exogenous TGF-β1 positively correlated with the expression of TGF-β1, in placental tissues in treatment groups (r=0.372, P=0.018).

Conclusion: Exogenous TGF-β1 improves pregnancy outcomes in RPL mice, and the possible therapeutic mechanism is that exogenous TGF-β1 induces the persistent expression of endogenous TGF-β1 and IDO due to mutually induced expression of the other. This experiment may provide a new direction and idea for the future treatment of RPL patients.

Background: Oxidative aggression is a hallmark of varicocele and may depend on decreased reactive ability of the endogenous antioxidant system following heat stress. We aimed to investigate the underlying mechanisms. Therefore, the expression of the main enzyme proteins involved in the generation of endogenous antioxidant power, cystathionine beta-synthase (CBS), cystathionine gamma-lyase (CSE), heme oxygenase (HO-1), and also, some of the metabolites (methionine, homocysteine, taurine and vitamin B6) reporting on their activity was investigated using a surgical varicocele model in rats.

Materials and methods: In this experimental study, thirty male Wistar rats (7-8 weeks old, weighing 180-220 g) were divided into three groups: control, sham, and varicocele. We evaluated sperm parameters and functional tests, as well as the expression of CBS, CSE, and HO-1 proteins using Western blot analysis. Serum levels of methionine, homocysteine, and taurine were analyzed through high-performance liquid chromatography, while vitamin B6 concentrations were measured using enzyme-linked immunosorbent assay. For group comparisons, we employed ANOVA and the Tukey test, considering a P<0.05 as significant.

Results: We observed a significant reduction in both sperm quality and functional parameters. Additionally, there was a notable decrease in the expression of CBS, CSE, and HO-1 proteins, as well as circulating vitamin B6 levels, in the varicocele group compared to the control and sham groups (P<0.001).

Conclusion: The results of this study suggest that one possible cause of increased oxidative stress in varicocele may be the reduced expression of testicular enzymes involved in the production of endogenous antioxidants, which are associated with the transsulfuration pathway. However, further studies are needed to confirm these findings.