International Journal of Fertility & Sterility最新文献

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: 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: 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.

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.