International Journal of Fertility & Sterility最新文献

Background: The utilization of decellularized extracellular matrix (dECM) derived from animal testis tissue has demonstrated potential as a component of tissue-specific scaffolds. Current research is mostly centered around dECM as a natural resource for culturing testicular cells. This study aimed to assess firstly the comparison of Voytik-Harbin (VH) and Frytes protocol in creating Ram's dECM testis hydrogel and secondly the evaluation of the best protocol effect on in vitro spermatogenesis.

Materials and methods: In this experimental study, the six testes of mature rams were decellularized and the hydrogel production was performed by i. The Frytes protocol utilized a concentration of 1 mg/mL of pepsin, dissolved in either 0.1 or 0.01 M HCl, and ii. The VH protocol was involved 10 mg of pepsin per 100 mg of ECM in 0.5 M of acetic acid. Subsequently, mouse testicular cells were cultivated on collagen hydrogel as the control and the more effective testicular-derived hydrogel (TDH) to evaluate the early stages of in vitro spermatogenesis.

Results: While the Freytes protocol produced a homogeneous pre-gel solution with both HCl concentrations; elevating the pH to 7.4 loosened the hydrogel and made gelation problematic. In contrast, the VH protocol solidified the hydrogel and produced a strong hydrogel due to its gelation consistency. Furthermore, the prepared hydrogel by VH with 25 mg of dECM had a significantly higher priority in terms of rheology and structure (P<0.05). Following mouse testicular cell culture, TDH and collagen hydrogel did not differ significantly in terms of cell survival rates and the mRNA expression of early spermatogenesis genes.

Conclusion: Using the VH protocol for producing ram TDH resulted in a firm hydrogel with a high frequency of repeat, which may be suited for testicular cell growth.

Background: Over the past decade, numerous studies have been conducted to determine the role of homocysteine and methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms in the pathogenesis of polycystic ovary syndrome (PCOS), yet the results are inconsistent. The aim of the current study was to determine the association between homocysteine levels (Hcy), MTHFR) C677T and A1298C polymorphisms, and pregnancy outcomes in Georgian women with PCOS.

Materials and methods: This case-control study included 177 female participants, of which 96 women were diagnosed with PCOS, and 81 age-matched women were without PCOS. Participants were divided into four groups; group I: 59 PCOS patients with history of recurrent pregnancy loss (RPL), group II: 37 PCOS patients with live birth in history and without RPL, group III: 39 women with RPL, without PCOS, group IV: controls, 42 women with live birth in history, without RPL and PCOS. These groups were compared based on their serum Hcy and the presence of two common single nucleotide polymorphisms (SNPs) in the MTHFR) gene: C677T and A1298C.

Results: The mean Hcy, frequency of hyperhomocysteinemia (Hhcy) and the prevalence of C677T and A1298C polymorphisms in MTHFR) gene in PCOS patients were significantly higher than those without PCOS (P<0.05). Group I (PCOS with RPL) showed significantly elevated Hcy (13.7 ± 2.7) compared to group II (10.3 ± 2.6), group III (11.5 ± 2.3), and group IV (7.3 ± 2.2), P<0.001. In group I, the frequencies of the C677T-CT, A1298CAC genotypes, and the compound heterozygous of C677T-CT/A1298C-AC were significantly higher than in the other groups (P<0.05). The prevalence of MTHFR) A1298C (CC) was significantly higher in group II (PCOS patients with live birth) than in other comparison groups (P<0.05).

Conclusion: The study reveals a significant correlation between hyperhomocysteinemia, MTHFR) polymorphisms (C677T and A1298C), and PCOS, impacting pregnancy outcomes.

Background: Polycystic ovary syndrome (PCOS) is one of the most prevalent endocrine conditions that significantly impact the life quality of reproductive-aged women. In the Indian population, its prevalence varies from 3.7 to 22.5% depending on ethnicity and diagnostic criteria. Chronic inflammation plays a pivotal role in PCOS pathogenesis. The monocyte chemoattractant protein-1 (MCP-1) is an important chemotactic factor for inflammatory response of monocytes. Genetic variations in the MCP-1) gene may modulate MCP-1 expression. Although the association of the MCP-1 promoter polymorphism (-2518A/G) was extensively studied in different inflammatory conditions, there is only one report in PCOS conditions. Since no study was reported from the Indian population, we aimed to explore the association of the MCP-1 -2518A/G polymorphism (rs1024611) with PCOS.

Materials and methods: In this case-control study, to analyse the distribution and association of rs1024611 with PCOS, polymerase chain reaction-fragment length polymorphism (PCR-RFLP) analysis was carried out in 202 patients who exhibited PCOS from menarche onwards or with higher severity of symptoms and 122 age-matched controls.

Results: In our study, no significant correlation was observed in rs1024611 polymorphism with PCOS patients in comparison with control. In addition to this, we found no significant difference in the genotype and allele frequencies between obese and non-obese PCOS patients.

Conclusion: Our finding suggests that the MCP-1 -2518 A/G polymorphism has not been associated with PCOS predisposition.

The fertility preservation (FP) is a paramount concern for oncology patients and should be regarded as an essential component of their overall cancer management strategy. The magnitude of this issue has been recognized in FP guidelines. The formulation and execution of harmonized guidelines and policies concerning the provision of FP services, inclusive of therapeutic strategies and standardization of procedures, are crucial to surmount disagreements regarding the delivery of these therapeutic services and avert delays in cancer treatment. The matter of FP and the methodology for managing the treatment and follow-up of cancer patients should be documented as a component of their management guideline, thereby providing patients with clear recommendations on fertility preservation. In this manuscript, we provide a succinct overview of existing international guidelines history and reference comprehensive networks of FP services for oncology patients. Furthermore, we present the Royan Institute's guideline specifically designed for preserving the fertility of female oncology patients.

Background: Testicular torsion is a surgical emergency leads to severe acute ischemia injuries, and may eventually cause male infertility. The nucleotide-binding oligomerization domain (NOD)-like receptor family pyrin domaincontaining 3 (NLRP3) inflammasome is involved in testicular torsion pathophysiology. The aim of this study was to evaluate the effects of nanocurcumin (nCur) on testicular tissue and the NLRP3 inflammasome components.

Materials and methods: In this experimental study, male Wistar rats (n=36) were randomly divided into six equal groups: controls, ischemia-reperfusion (I/R), I/R+nCur (50 or 100 mg/kg thirty minutes before reperfusion), and I/ R+nCur (50 or 100 mg/kg thirty minutes before reperfusion and continued for seven days). The left testis was rotated 720 (2×360) degrees counterclockwise to induce testicular torsion. After two hours of ischemia, detorsion was performed. At the end of treatment, an orchiectomy was carried out. The testis histopathology and the mRNA levels of NLRP3, apoptosis-associated speck-like protein (ASC), and Caspase-1 were evaluated.

Results: Our results revealed that, testicular I/R had a detrimental effect on testis histology such as the number of spermatogonia (14.5 ± 0.57, P<0.001) and the seminiferous tubules epithelium thickness (28.5 ± 11.7, P=0.007). It also significantly increased the expression of the NLRP3 inflammasome components (P<0.001). Treatment with nCur (in both doses) improved testicular damage and significantly reduced the expression of NLRP3 (P=0.007), ASC (P=0.003), and Caspase-1 (P<0.001).

Conclusion: These results imply that nCur might be a useful therapeutic strategy in the field of reproductive medicine to diminish the side effects of testicular I/R via its anti-inflammatory properties and may be employed as adjuvant therapy to lessen testicular torsion complications.

Background: The role of laparoscopy and hysteroscopy in managing unexplained infertility (UI) is debatable because of the improved success rate of assisted reproductive technologies (ART). This study aims to assess the findings of laparoscopy and hysteroscopy in selected women diagnosed with UI to determine the frequency of such pathological conditions in order to manage them properly.

Materials and methods: The current cross-sectional study was conducted on 96 women who attended an infertility clinic at the educational hospitals of Isfahan University of Medical Sciences from March 2018 to February 2020. The participants had one or more of the following conditions: had failed to conceive after 2-3 cycles of ovulation induction with clomiphene citrate and intrauterine insemination (IUI), had a history of pelvic infection, pelvic surgery, or ectopic pregnancy (EP). Laparoscopy and hysteroscopic findings were recorded for all participants.

Results: Fifty-nine (61.4%) women had primary infertility, while 37 (38.6%) suffered from secondary infertility. In patients with primary and secondary infertility, 42.3 and 43.2% had laparoscopic abnormalities, respectively. Additionally, 33.8 and 21.6% of the participants had hysteroscopic abnormalities in the primary and secondary groups, respectively. The most common findings in the two groups of infertility who had done laparoscopy were endometriosis (21.8%, P=0.201) followed by tubal pathology (13.5%, P=0.952). Also, the most common intrauterine pathology found in both groups were uterine septum (7.2%, P=0.753) and endometritis (6.2%, P=0.241).

Conclusion: Based on the findings of this study, laparoscopy is recommended in UI after three failed IUI and ovarian stimulation, a history of pelvic pain, pelvic surgery, or pelvic infection; however, it seems that further investigation is required to recommend universal hysteroscopy to all women with UI. Nonetheless, it is still emphasized that regional practice in one's local settings may also be effective concerning the prevalence of these pathologies.

Semen quality is considered as an alternative measure for men's fertility. Several studies have examined the association between the hepatitis B virus (HBV) infection and semen quality, but the findings have been inconclusive. This study investigated the effects of HBV on semen quality. This systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020, as well as Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guideline. In this study, international electronic databases including PubMed (National Library of Medicine), Web of Science, Scopus and Cochrane Library and also Persian databases including Scientific Information Database (SID) and Magiran were searched without a time limit until June 2023. All cohort and case-control studies examining the effects of HBV infection on the semen parameters of infertile men were included in the study. Animal studies, letters to the editor and case reports were excluded. The Newcastle-Ottawa scale was used to evaluate the quality of the included articles. Data analysis was done with Stata software. Of the 913 studies, 13 observational studies comprised a total of 10156 patients were included in this review, nine of which were included in the meta-analysis. The results showed that HBV infection has a negative effect on semen volume (95% confidence interval (CI): [-0.33, -0.09], P<0.001), sperm concentration (95% CI: [-8.53, -2.66], Pv<0.001), sperm motility (95% CI: [-10.06, -3.39], P<0.001), sperm normal morphology (95% CI: [-6.42, -1.06], P<0.001) and sperm viability (95% CI: [-11.64, -0.31], P<0.001). These results suggest that the HBV infection has a negative effect on the semen quality in infertile men. Nonetheless, further research with more robust design is recommended.

Background: Circulating microRNAs (miRNAs or miRs) are key regulators of a wide array of biological processes that aberrantly express under physiological as well as pathological conditions. This study aims to determine whether altered expression of circulating miR-223-3p in plasma is associated with an increased risk of idiopathic recurrent pregnancy loss (iRPL), and if it could be a novel non-invasive biomarker for diagnosis of iRPL.

Materials and methods: In this case and control study, Plasma samples were obtained from 60 women with a history of ≥ 2 consecutive miscarriages and 60 women with at least one full-term pregnancy and no history of miscarriage. The samples were used to assess the expression of circulating miR-223-3p by quantitative real-time polymerase chain reaction (qPCR) and determine the correlation between patient clinico-demographic parameters and miR-223-3p expression levels. We used receiver operating characteristic (ROC) curve analysis to evaluate the diagnostic accuracy of miR-223-3p for the diagnosis of iRPL.

Results: There was significant up-regulation in miR-223-3p expression in patients with iRPL compared with healthy controls (P=0.002). No significant correlation was found between the expression level of miR-223-3p and the number of miscarriages in iRPL patients (P=0.344). ROC curve analysis revealed that the area under the curve (AUC) value for miR-223-3p was 0.658 [95% confidence interval (95% CI): 0.5590.757, P=0.002).

Conclusion: These results suggest that a higher expression level of circulating miR-223-3p may be closely related with the increased risk of iRPL and possibly serve as a promising non-invasive diagnostic biomarker for iRPL.

Background: Frozen embryo transfer (FET) has been increasingly used due to advancements in cryopreservation techniques and the safety advantages. This study aims to determine various factors influencing the successful FET.

Materials and methods: Retrospective cohort analysis included 1112 women who underwent programmed FET between January 2012 and October 2022, at King Chulalongkorn Memorial Hospital, Thailand. Patient characteristics, embryo characteristics, endometrial preparation protocol, endometrial characteristics (thickness, pattern), embryo transfer procedure (tip and flow during transfer, embryo placement location, the difficulty of the procedure, presence of blood and mucous at catheter), and operator factor were analyzed. Multiple logistic regression analysis was used to assess the relationship between collected variables and successful embryo transfer which is defined by clinical pregnancy.

Results: The overall clinical pregnancy rate was 34.2%. Women aged 35-40 years and >40 years were less likely to have a clinical pregnancy compared to those aged <35 years [adjusted odds ratio (aOR): 0.523; 95% confidence intervals (CI): 0.360-0.757, P<0.001 and aOR: 0.260; 95% CI: 0.152-0.434, P<0.001, respectively]. Obese women with body mass index (BMI) ≥25 kg/m2 were significantly associated with decreased clinical pregnancy (aOR: 0.632; 95% CI: 0.403-0.978, P=0.042) compared to those with normal BMI. Day-3 and day-4 embryo transfer showed a significant decrease in clinical pregnancy compared to blastocyst transfer (aOR: 0.294; 95% CI: 0.173-0.485, P<0.001 and aOR: 0.497; 95% CI: 0.265-0.900, P=0.024). Double embryo transfer (DET) was 1.78 times more likely to have a clinical pregnancy than women with single embryo transfer (SET) (aOR: 1.779; 95% CI: 1.293-2.458, P<0.001). The cycles with endometrial thickness <8 mm were associated with a decrease in clinical pregnancy compared with those with a thickness ≥8 mm (aOR: 0.443; 95% CI: 0.225-0.823, P=0.013).

Conclusion: Older age, obesity, non-blastocyst transfer, single embryo transfer, and endometrial thickness of <8 mm were significantly associated with a decreased clinical pregnancy in programmed FET.

Preeclampsia (PE) remains a significant cause of maternal and neonatal morbidity and mortality, particularly in high-risk pregnancies. The present study aims to assess the efficacy of L-arginine supplementation in preventing PE and improving maternal and neonatal outcomes in high-risk pregnancies. We searched international databases (ISI, PubMed, Scopus, and Embase) and extracted studies that evaluated the efficacy of L-arginine for preventing PE and improving maternal and neonatal outcomes in high-risk pregnancies. The data collected were analysed utilising the random-effects model in Stata (version 15). Out of the collected studies, 10 met the eligibility criteria, comprising a total sample size of 1165 subjects (586 cases and 584 controls). The mean age of the cases was 28 ± 5.05 years, while that of the controls was 27.32 ± 4.58 years. The results revealed that L-arginine was more effective in reducing the incidence of PE than placebo [odds ratio (OR)=0.36, 95% confidence interval (CI): 0.17, 0.77]. Also, the results showed no statistically significant difference between the two groups in systolic blood pressure (SBP; standard mean difference (SMD): -0.35, 95% CI: -91, 21) and diastolic blood pressure (DBP; SMD: -0.50, 95% CI: -1.08, 0.07). There was a statistically significant difference in neonatal birth weight between the two groups (SMD: -0.16, 95% CI: -31, -0.01). No statistically significant difference existed between the two groups in terms of gestational age (SMD: 0.6, 95% CI: -0.06, 0.18). Furthermore, there was no significant difference between the two groups in the APGAR score at one minute (SMD: 0.40, 95% CI: -0.02, 0.82). Our findings revealed that L-arginine supplementation during pregnancy reduced the incidence of PE in high-risk pregnancies. However, it does not significantly improve maternal and neonatal outcomes.