Pub Date : 2024-05-10DOI: 10.1186/s43043-024-00179-5
Nining Handayani, Ayu Mulia Sundari, Tri Aprilliana, Arief Boediono, Arie A. Polim, Budi Wiweko, Batara Sirait, Ivan Sini
This study aimed to evaluate the effects of immature oocyte proportion in a cohort on both IVF laboratory and clinical outcomes. This retrospective cohort study took place at Morula IVF Jakarta Clinic from January 2016 to July 2020. A total of 1.826 couples undergoing IVF-ICSI/IMSI were included and classified into four groups according to the proportion of immature oocytes retrieved during OPU as follows: (1) immature ≤ 15% (n = 1.064), (2) immature 16–25% (n = 369), (3) immature 26–50% (n = 331), and (4) immature > 50% (n = 62). Primary outcomes were clinical pregnancy and miscarriage. Embryology laboratory results were assessed as the secondary outcomes. Statistical analyses were carried out utilizing Kruskal–Wallis or chi-square tests. p-value < 0.05 was considered statistically significant. Increased proportion of immature oocytes in a cohort was significantly associated with body mass index, tubal factors, and estradiol level on trigger day (p < 0.05). Neither clinical pregnancy nor miscarriage was associated with the immature oocyte proportion (adjusted p-value = 0.872 and p = 0.345, respectively). However, a higher proportion of immature oocytes significantly reduced the total number of fertilized oocytes, number of top-quality cleavages, and blastocysts (p < 0.001). Furthermore, embryo transfer cancelation rates due to poor embryo quality were elevated significantly. Despite overall poor embryo development in the laboratory, our study seems to suggest that the proportion of immature oocytes in a cohort has no impact on clinical pregnancy and miscarriage rate in IVF program.
{"title":"Immature oocyte proportion in a cohort led to poor embryo development but did not reduce clinical pregnancy rate","authors":"Nining Handayani, Ayu Mulia Sundari, Tri Aprilliana, Arief Boediono, Arie A. Polim, Budi Wiweko, Batara Sirait, Ivan Sini","doi":"10.1186/s43043-024-00179-5","DOIUrl":"https://doi.org/10.1186/s43043-024-00179-5","url":null,"abstract":"This study aimed to evaluate the effects of immature oocyte proportion in a cohort on both IVF laboratory and clinical outcomes. This retrospective cohort study took place at Morula IVF Jakarta Clinic from January 2016 to July 2020. A total of 1.826 couples undergoing IVF-ICSI/IMSI were included and classified into four groups according to the proportion of immature oocytes retrieved during OPU as follows: (1) immature ≤ 15% (n = 1.064), (2) immature 16–25% (n = 369), (3) immature 26–50% (n = 331), and (4) immature > 50% (n = 62). Primary outcomes were clinical pregnancy and miscarriage. Embryology laboratory results were assessed as the secondary outcomes. Statistical analyses were carried out utilizing Kruskal–Wallis or chi-square tests. p-value < 0.05 was considered statistically significant. Increased proportion of immature oocytes in a cohort was significantly associated with body mass index, tubal factors, and estradiol level on trigger day (p < 0.05). Neither clinical pregnancy nor miscarriage was associated with the immature oocyte proportion (adjusted p-value = 0.872 and p = 0.345, respectively). However, a higher proportion of immature oocytes significantly reduced the total number of fertilized oocytes, number of top-quality cleavages, and blastocysts (p < 0.001). Furthermore, embryo transfer cancelation rates due to poor embryo quality were elevated significantly. Despite overall poor embryo development in the laboratory, our study seems to suggest that the proportion of immature oocytes in a cohort has no impact on clinical pregnancy and miscarriage rate in IVF program.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"31 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140936244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To characterize the seminal microbiome associated with normal and abnormal semen parameters, towards the prediction of reproductive health and sperm quality. Despite the association between bacteria and infertility, few studies have looked at the beneficial effects of the seminal microbiome on infertility. The study comprised semen samples from 69 men with normal spermiograms and 166 men with at least 1 abnormal spermiogram parameter from the Institutional IVF Center between October 2019 and October 2022. We hypothesized that the composition of the microbiota may affect semen parameters. To determine the composition of uncultured bacteria, the 16S ribosomal RNA (rRNA) gene was amplified using Oxford Nanopore Technology. Different groups of bacteria were present in the semen samples of patients with normal semen parameters, such as female factor infertility and abnormal sperm parameters. Bacterial communities differed between samples. However, the relative distribution of Lactobacillus and Prevotella in the normal and abnormal semen groups differed (p = 0.05) and was statistically significant. In the abnormal semen group, the incidence of Lactobacillus probiotics was lower and the frequency of Prevotella was higher. Additionally, principal component analysis (PCA) revealed differences in the microbial composition of normal and abnormal semen. In our study, NGS analysis revealed the increased presence of harmful bacteria Prevotella in groups with abnormal semen raises the possibility that certain microbiota may be associated with semen quality and male infertility.
{"title":"Characterization of seminal microbiome associated with semen parameters using next-generation sequencing","authors":"Manisha Vajpeyee, Shivam Tiwari, Lokendra Bahadur Yadav","doi":"10.1186/s43043-024-00181-x","DOIUrl":"https://doi.org/10.1186/s43043-024-00181-x","url":null,"abstract":"To characterize the seminal microbiome associated with normal and abnormal semen parameters, towards the prediction of reproductive health and sperm quality. Despite the association between bacteria and infertility, few studies have looked at the beneficial effects of the seminal microbiome on infertility. The study comprised semen samples from 69 men with normal spermiograms and 166 men with at least 1 abnormal spermiogram parameter from the Institutional IVF Center between October 2019 and October 2022. We hypothesized that the composition of the microbiota may affect semen parameters. To determine the composition of uncultured bacteria, the 16S ribosomal RNA (rRNA) gene was amplified using Oxford Nanopore Technology. Different groups of bacteria were present in the semen samples of patients with normal semen parameters, such as female factor infertility and abnormal sperm parameters. Bacterial communities differed between samples. However, the relative distribution of Lactobacillus and Prevotella in the normal and abnormal semen groups differed (p = 0.05) and was statistically significant. In the abnormal semen group, the incidence of Lactobacillus probiotics was lower and the frequency of Prevotella was higher. Additionally, principal component analysis (PCA) revealed differences in the microbial composition of normal and abnormal semen. In our study, NGS analysis revealed the increased presence of harmful bacteria Prevotella in groups with abnormal semen raises the possibility that certain microbiota may be associated with semen quality and male infertility.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"26 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140936345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-07DOI: 10.1186/s43043-024-00182-w
Manal Alquobaili, Shahd Hamsho, Marwan Alhalabi
Infertility is an important health problem, affecting couples worldwide. Non-obstructive azoospermia is the most severe form of azoospermia, which is mostly idiopathic or caused by different causes such as chemotherapy and genetic disorders. Testicular fine needle aspiration (or testicular sperm aspiration (TESA)) is simple, cost-effective and less invasive than testicular sperm extraction. Three hundred twenty Middle Eastern patients with NOA were recruited in this study. The patients underwent routine infertility assessment including medical, surgical, and reproductive history, physical examination, semen analysis, and hormonal profile including FSH, Testosterone, and inhibin B in addition to Genetic assessment including karyotype and Y-chromosome micro-deletion. Testicular sperm aspiration was positive in 70 patients (22.18%). Serum FSH levels were clearly elevated in the patients with negative sperm retrieval (mean = 21.39 U/L), while they were reduced in the patients with positive sperm retrieval (mean = 14.61 U/L). Testosterone value did not clearly correlate with the results of testicular sperm aspiration in the two groups of patients, and testicular volume was normal for most of the patients in the two groups. Patients with Y-chromosome micro-deletion were 11.22% of the total patients studied and they had negative TESA results, while 13.12% of patients had Klinefelter Syndrome and their TESA results were negative. We confirmed that there are many factors that negatively affect Testicular sperm aspiration results: high FSH and low inhibin B levels, smoking, and genetic disorders. Despite the absence of sperm in the semen, some NOA patients have a chance to have children by using this technique.
{"title":"Testicular sperm aspiration (TESA) outcome in Middle Eastern patients with non-obstructive azoospermia: a retrospective cohort study","authors":"Manal Alquobaili, Shahd Hamsho, Marwan Alhalabi","doi":"10.1186/s43043-024-00182-w","DOIUrl":"https://doi.org/10.1186/s43043-024-00182-w","url":null,"abstract":"Infertility is an important health problem, affecting couples worldwide. Non-obstructive azoospermia is the most severe form of azoospermia, which is mostly idiopathic or caused by different causes such as chemotherapy and genetic disorders. Testicular fine needle aspiration (or testicular sperm aspiration (TESA)) is simple, cost-effective and less invasive than testicular sperm extraction. Three hundred twenty Middle Eastern patients with NOA were recruited in this study. The patients underwent routine infertility assessment including medical, surgical, and reproductive history, physical examination, semen analysis, and hormonal profile including FSH, Testosterone, and inhibin B in addition to Genetic assessment including karyotype and Y-chromosome micro-deletion. Testicular sperm aspiration was positive in 70 patients (22.18%). Serum FSH levels were clearly elevated in the patients with negative sperm retrieval (mean = 21.39 U/L), while they were reduced in the patients with positive sperm retrieval (mean = 14.61 U/L). Testosterone value did not clearly correlate with the results of testicular sperm aspiration in the two groups of patients, and testicular volume was normal for most of the patients in the two groups. Patients with Y-chromosome micro-deletion were 11.22% of the total patients studied and they had negative TESA results, while 13.12% of patients had Klinefelter Syndrome and their TESA results were negative. We confirmed that there are many factors that negatively affect Testicular sperm aspiration results: high FSH and low inhibin B levels, smoking, and genetic disorders. Despite the absence of sperm in the semen, some NOA patients have a chance to have children by using this technique.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"17 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140884179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-05DOI: 10.1186/s43043-024-00171-z
Khalid Saeed Khan
To prepare a set of statements for randomised clinical trials (RCT) integrity through an international multi-stakeholder consensus. The consensus was developed via multi-country multidisciplinary stakeholder group composition and engagement; evidence synthesis of 55 systematic reviews concerning RCT integrity; anonymized two-round modified Delphi survey with consensus threshold based on the average percentage of majority opinions; and a final consensus development meeting. Prospective registrations: ( https://osf.io/bhncy , https://osf.io/3ursn ). There were 30 stakeholders representing 15 countries from five continents including trialists, ethicists, methodologists, statisticians, consumer representatives, industry representatives, systematic reviewers, funding body panel members, regulatory experts, authors, journal editors, peer reviewers and advisors for resolving integrity concerns. Delphi survey response rate was 86.7% (26/30 stakeholders). There were 111 statements (73 stakeholder-provided, 46 systematic review-generated, 8 supported by both) in the initial long list, with eight additional statements provided during the consensus rounds. Through consensus the final set consolidated 81 statements (49 stakeholder-provided, 41 systematic review-generated, 9 supported by both). The entire RCT life cycle was covered by the set of statements including general aspects (n = 6), design and approval (n = 11), conduct and monitoring (n = 19), reporting of protocols and findings (n = 20), post-publication concerns (n = 12) and future research and development (n = 13). Implementation of this multi-stakeholder consensus statement is expected to enhance RCT integrity.
{"title":"International multi-stakeholder consensus statement on clinical trial integrity","authors":"Khalid Saeed Khan","doi":"10.1186/s43043-024-00171-z","DOIUrl":"https://doi.org/10.1186/s43043-024-00171-z","url":null,"abstract":"To prepare a set of statements for randomised clinical trials (RCT) integrity through an international multi-stakeholder consensus. The consensus was developed via multi-country multidisciplinary stakeholder group composition and engagement; evidence synthesis of 55 systematic reviews concerning RCT integrity; anonymized two-round modified Delphi survey with consensus threshold based on the average percentage of majority opinions; and a final consensus development meeting. Prospective registrations: ( https://osf.io/bhncy , https://osf.io/3ursn ). There were 30 stakeholders representing 15 countries from five continents including trialists, ethicists, methodologists, statisticians, consumer representatives, industry representatives, systematic reviewers, funding body panel members, regulatory experts, authors, journal editors, peer reviewers and advisors for resolving integrity concerns. Delphi survey response rate was 86.7% (26/30 stakeholders). There were 111 statements (73 stakeholder-provided, 46 systematic review-generated, 8 supported by both) in the initial long list, with eight additional statements provided during the consensus rounds. Through consensus the final set consolidated 81 statements (49 stakeholder-provided, 41 systematic review-generated, 9 supported by both). The entire RCT life cycle was covered by the set of statements including general aspects (n = 6), design and approval (n = 11), conduct and monitoring (n = 19), reporting of protocols and findings (n = 20), post-publication concerns (n = 12) and future research and development (n = 13). Implementation of this multi-stakeholder consensus statement is expected to enhance RCT integrity.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"202 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140568869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-04DOI: 10.1186/s43043-024-00178-6
Deniswari Rahayu, Alfa Putri Meutia, Tyas Priyatini, Ni Made Desy Suratih, Mila Maidarti, Achmad Kemal Harzif, R. Muharam, Gita Pratama
Hyperandrogenism is frequently found in polycystic ovary syndrome (PCOS) and contributes to physical manifestations like hirsutism and obesity, along with infertility. This condition can result in anxiety, depression, and body image disorders, potentially leading to sexual dysfunction. The objective of this investigation was to assess the correlation among hirsutism, anthropometric characteristics, sexual dysfunction, and anxiety levels among infertile Indonesian women diagnosed with PCOS. From December 2021 to December 2022, a cross-sectional study was undertaken involving 71 infertile women diagnosed with PCOS at Yasmin Clinic, Dr. Cipto Mangunkusumo General Hospital in Jakarta, Indonesia. Hirsutism was assessed using the modified Ferriman-Gallwey (mFG) score; the anthropometric profile was assessed using BMI and waist-to-hip ratio. The assessment of sexual dysfunction was conducted using the Female Sexual Function Index (FSFI) questionnaire, while the evaluation of anxiety levels utilized the HAM-A questionnaires. In this study, it was discovered that 53.3% of subjects experienced sexual dysfunction. However, there was no statistically significant relationship between hirsutism, anthropometric profile, and sexual dysfunction score in infertile women with PCOS (p > 0.05). Analysis of the overall FSFI domain score revealed that lubrication and satisfaction were lower in obese patients (p = 0.02 and p = 0.03), but this did not contribute to an overall sexual dysfunction score. Also, we found that subjects who experienced sexual dysfunction had a higher anxiety score (p < 0.005), with correlation analysis showing that Ferriman-Gallwey (FG) scores have a significant positive correlation with anxiety. There is no correlation between hirsutism, anthropometric profile, and sexual dysfunction in infertile Indonesian women diagnosed with PCOS. However, hirsutism could play a role in causing anxiety in Indonesian PCOS women. Additional investigation is required, as female sexual function is an intricate subject.
{"title":"Association of hirsutism and anthropometric profiles with sexual dysfunction and anxiety levels in infertile Indonesian women with polycystic ovarian syndrome","authors":"Deniswari Rahayu, Alfa Putri Meutia, Tyas Priyatini, Ni Made Desy Suratih, Mila Maidarti, Achmad Kemal Harzif, R. Muharam, Gita Pratama","doi":"10.1186/s43043-024-00178-6","DOIUrl":"https://doi.org/10.1186/s43043-024-00178-6","url":null,"abstract":"Hyperandrogenism is frequently found in polycystic ovary syndrome (PCOS) and contributes to physical manifestations like hirsutism and obesity, along with infertility. This condition can result in anxiety, depression, and body image disorders, potentially leading to sexual dysfunction. The objective of this investigation was to assess the correlation among hirsutism, anthropometric characteristics, sexual dysfunction, and anxiety levels among infertile Indonesian women diagnosed with PCOS. From December 2021 to December 2022, a cross-sectional study was undertaken involving 71 infertile women diagnosed with PCOS at Yasmin Clinic, Dr. Cipto Mangunkusumo General Hospital in Jakarta, Indonesia. Hirsutism was assessed using the modified Ferriman-Gallwey (mFG) score; the anthropometric profile was assessed using BMI and waist-to-hip ratio. The assessment of sexual dysfunction was conducted using the Female Sexual Function Index (FSFI) questionnaire, while the evaluation of anxiety levels utilized the HAM-A questionnaires. In this study, it was discovered that 53.3% of subjects experienced sexual dysfunction. However, there was no statistically significant relationship between hirsutism, anthropometric profile, and sexual dysfunction score in infertile women with PCOS (p > 0.05). Analysis of the overall FSFI domain score revealed that lubrication and satisfaction were lower in obese patients (p = 0.02 and p = 0.03), but this did not contribute to an overall sexual dysfunction score. Also, we found that subjects who experienced sexual dysfunction had a higher anxiety score (p < 0.005), with correlation analysis showing that Ferriman-Gallwey (FG) scores have a significant positive correlation with anxiety. There is no correlation between hirsutism, anthropometric profile, and sexual dysfunction in infertile Indonesian women diagnosed with PCOS. However, hirsutism could play a role in causing anxiety in Indonesian PCOS women. Additional investigation is required, as female sexual function is an intricate subject.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"50 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140568874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-28DOI: 10.1186/s43043-023-00150-w
Maged M. Yassin, Mohammed M. Laqqan, Saleh N. Mwafy, Sana I. EL-Qreenawy
Women with type 1 diabetes depend on insulin injections throughout their life. However, the recommendation for strict metabolic control of diabetes requires the administration of supra-physiological doses of insulin, which might result in insulin-mediated stimulation of androgen synthesis. Hyperandrogenism in women with type 1 diabetes may be associated with polycystic ovary syndrome (PCOS). This study was performed to investigate PCOS and its associated clinical symptoms and biochemical alterations in women with type 1 diabetes in the Palestinian Territories. This retrospective cohort study consists of 50 women with type 1 diabetes and 50 apparently healthy non-diabetic controls. Questionnaire interviews were conducted. The diagnosis of PCOS was based on chronic anovulation and biochemical evidence of hyperandrogenism. Serum total testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and insulin were measured by ELISA. The mean waist-to-hip ratio and age at menarche were significantly higher in diabetic women than in non-diabetic controls (81.9 ± 7.9 and 13.9 ± 1.6 years vs. 78.8 ± 5.7 and 13.2 ± 1.2 years, and P = 0.045, P = 0.020, respectively). Oligomenorrhea, acanthosis nigricans, seborrhea, and hirsutism were more frequent in diabetics. The levels of total testosterone and insulin were significantly higher in diabetics (0.58 ± 0.11 ng/ml and 15.8 ± 12.4 mlU/ml vs. 0.44 ± 0.11 ng/ml and 10.8 ± 4.5 mlU/ml, P < 0.001 and P = 0.010, respectively). PCOS was present in 11 (22.0%) of diabetic women compared to 3 (6.0%) in non-diabetics (P = 0.044). Diabetic women with PCOS received higher doses of insulin than non-PCOS women (72.7 ± 23.9 vs. 55.0 ± 19.8 UI.cc/ml/day, P = 0.023). PCOS women showed more frequent oligomenorrhea (100% vs. 15.4%, P < 0.001) and higher levels of total testosterone and insulin (0.64 ± 0.09 and 23.1 ± 13.0 vs. 0.53 ± 0.11 and 14.1 ± 11.8, P = 0.023 and P = 0.041, respectively). PCOS cases were significantly more frequent in diabetic women receiving intensive insulin therapy than their counterparts with non-intensive insulin therapy (40.9% vs. 7.1%, P = 0.012). Intensive insulin treatment in type 1 diabetes potentiates the development of PCOS and its related clinical and biochemical features particularly oligomenorrhea, hyperinsulinemia, and hyperandrogenemia.
{"title":"Comparative analysis of clinical symptoms and biochemical alterations in women with polycystic ovary syndrome: assessing the impact of type 1 diabetes versus non-diabetic controls","authors":"Maged M. Yassin, Mohammed M. Laqqan, Saleh N. Mwafy, Sana I. EL-Qreenawy","doi":"10.1186/s43043-023-00150-w","DOIUrl":"https://doi.org/10.1186/s43043-023-00150-w","url":null,"abstract":"Women with type 1 diabetes depend on insulin injections throughout their life. However, the recommendation for strict metabolic control of diabetes requires the administration of supra-physiological doses of insulin, which might result in insulin-mediated stimulation of androgen synthesis. Hyperandrogenism in women with type 1 diabetes may be associated with polycystic ovary syndrome (PCOS). This study was performed to investigate PCOS and its associated clinical symptoms and biochemical alterations in women with type 1 diabetes in the Palestinian Territories. This retrospective cohort study consists of 50 women with type 1 diabetes and 50 apparently healthy non-diabetic controls. Questionnaire interviews were conducted. The diagnosis of PCOS was based on chronic anovulation and biochemical evidence of hyperandrogenism. Serum total testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and insulin were measured by ELISA. The mean waist-to-hip ratio and age at menarche were significantly higher in diabetic women than in non-diabetic controls (81.9 ± 7.9 and 13.9 ± 1.6 years vs. 78.8 ± 5.7 and 13.2 ± 1.2 years, and P = 0.045, P = 0.020, respectively). Oligomenorrhea, acanthosis nigricans, seborrhea, and hirsutism were more frequent in diabetics. The levels of total testosterone and insulin were significantly higher in diabetics (0.58 ± 0.11 ng/ml and 15.8 ± 12.4 mlU/ml vs. 0.44 ± 0.11 ng/ml and 10.8 ± 4.5 mlU/ml, P < 0.001 and P = 0.010, respectively). PCOS was present in 11 (22.0%) of diabetic women compared to 3 (6.0%) in non-diabetics (P = 0.044). Diabetic women with PCOS received higher doses of insulin than non-PCOS women (72.7 ± 23.9 vs. 55.0 ± 19.8 UI.cc/ml/day, P = 0.023). PCOS women showed more frequent oligomenorrhea (100% vs. 15.4%, P < 0.001) and higher levels of total testosterone and insulin (0.64 ± 0.09 and 23.1 ± 13.0 vs. 0.53 ± 0.11 and 14.1 ± 11.8, P = 0.023 and P = 0.041, respectively). PCOS cases were significantly more frequent in diabetic women receiving intensive insulin therapy than their counterparts with non-intensive insulin therapy (40.9% vs. 7.1%, P = 0.012). Intensive insulin treatment in type 1 diabetes potentiates the development of PCOS and its related clinical and biochemical features particularly oligomenorrhea, hyperinsulinemia, and hyperandrogenemia.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"72 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140316725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-22DOI: 10.1186/s43043-024-00177-7
Yun-Hsuen Lim, Poo Keen Sim, Prashant Nadkarni
This retrospective study aimed to compare the outcomes of day 3 double embryo transfer (DET) with single blastocyst transfer (SBT) during frozen embryo transfer (FET) cycles. A total of 999 women below the age of 38 years who underwent FET at Malaysia’s KL Fertility and Gynaecology Centre from January 2019 to December 2021 were analyzed. Patients with autologous eggs were recruited in the study. All the eggs were inseminated by intracytoplasmic sperm injection. The embryos were vitrified on day 3 cleavage-stage or blastocyst stage with Cryotop® method. The FET was performed following natural cycle (NC), modified natural cycle (m-NC), or hormone replacement therapy (HRT) cycles. The NC and m-NC groups received oral dydrogesterone for luteal phase support. There were no statistical differences in the rates of positive pregnancy, clinical pregnancy, and ongoing pregnancy between the two groups. However, implantation rates were significantly higher in the SBT group (50.1% versus 37.6%, p < 0.05). The day 3 DET group had significantly higher multiple pregnancy rates (28.7% versus 1.1%, p < 0.05). Subgroup analysis of embryo transfers performed following NC, m-NC, or HRT cycles showed similar results. This study suggests that SBT is the better choice for embryo transfers as it had higher implantation rates and its pregnancy rates were similar to day 3 DET. The SBT also significantly reduced the incidence of multiple pregnancies without compromising pregnancy rates.
{"title":"A retrospective comparative study of double cleavage-stage embryo transfer versus single blastocyst in frozen-thawed cycles","authors":"Yun-Hsuen Lim, Poo Keen Sim, Prashant Nadkarni","doi":"10.1186/s43043-024-00177-7","DOIUrl":"https://doi.org/10.1186/s43043-024-00177-7","url":null,"abstract":"This retrospective study aimed to compare the outcomes of day 3 double embryo transfer (DET) with single blastocyst transfer (SBT) during frozen embryo transfer (FET) cycles. A total of 999 women below the age of 38 years who underwent FET at Malaysia’s KL Fertility and Gynaecology Centre from January 2019 to December 2021 were analyzed. Patients with autologous eggs were recruited in the study. All the eggs were inseminated by intracytoplasmic sperm injection. The embryos were vitrified on day 3 cleavage-stage or blastocyst stage with Cryotop® method. The FET was performed following natural cycle (NC), modified natural cycle (m-NC), or hormone replacement therapy (HRT) cycles. The NC and m-NC groups received oral dydrogesterone for luteal phase support. There were no statistical differences in the rates of positive pregnancy, clinical pregnancy, and ongoing pregnancy between the two groups. However, implantation rates were significantly higher in the SBT group (50.1% versus 37.6%, p < 0.05). The day 3 DET group had significantly higher multiple pregnancy rates (28.7% versus 1.1%, p < 0.05). Subgroup analysis of embryo transfers performed following NC, m-NC, or HRT cycles showed similar results. This study suggests that SBT is the better choice for embryo transfers as it had higher implantation rates and its pregnancy rates were similar to day 3 DET. The SBT also significantly reduced the incidence of multiple pregnancies without compromising pregnancy rates.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"153 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140199961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Meiotic and mitotic errors often lead to aneuploidy and mosaicism. In this context, the self-correction mechanism enables the embryo to preferentially retain and preserve euploid cells through processes such as apoptosis, necrosis, or marginalization. This mechanism is thought to minimize the chance of genetic abnormalities during cell development. A literature search for articles written in English from January 2013 to October 2023 was conducted on PubMed, EBSCO, and Scopus, using the keywords “self-correction,” “self-repair,” “aneuploidy,” “mosaicism,” and “embryo.” A total of 308 articles were collected, out of which 5 retrospective and 1 prospective study were selected based on inclusion criteria. Investigations showed that embryos remove chromosomally abnormal cells, supporting the self-correction mechanism. aCGH has been used in 4 studies to demonstrate the presence of self-correction in mosaic embryos. Furthermore, a higher relative viability of polyploidies than complex aneuploidies was observed, suggesting early discrimination against complex aneuploidy, particularly those arising from mitotic origins. However, there are doubts about the reliability of preimplantation genetic testing for aneuploidy at the blastocyst stage, as it may lead to a high rate of false positives and the discarding of "good" embryos. Studies showed a self-correction mechanism in human embryos through the ability to expel abnormal cells. Further investigation is needed to elucidate the underlying mechanisms and determine optimal strategies for preimplantation genetic testing to fully understand and optimize the use of self-correction mechanisms in embryo assessment and selection.
{"title":"Embryo response to aneuploidy through self-correction mechanism: a literature review","authors":"Achmad Kemal Harzif, Azizah Fitriayu Andyra, Atikah Sayogo, Nafi’atul Ummah, Aisyah Retno Puspawardani, Putri Nurbaeti, Budi Wiweko","doi":"10.1186/s43043-024-00176-8","DOIUrl":"https://doi.org/10.1186/s43043-024-00176-8","url":null,"abstract":"Meiotic and mitotic errors often lead to aneuploidy and mosaicism. In this context, the self-correction mechanism enables the embryo to preferentially retain and preserve euploid cells through processes such as apoptosis, necrosis, or marginalization. This mechanism is thought to minimize the chance of genetic abnormalities during cell development. A literature search for articles written in English from January 2013 to October 2023 was conducted on PubMed, EBSCO, and Scopus, using the keywords “self-correction,” “self-repair,” “aneuploidy,” “mosaicism,” and “embryo.” A total of 308 articles were collected, out of which 5 retrospective and 1 prospective study were selected based on inclusion criteria. Investigations showed that embryos remove chromosomally abnormal cells, supporting the self-correction mechanism. aCGH has been used in 4 studies to demonstrate the presence of self-correction in mosaic embryos. Furthermore, a higher relative viability of polyploidies than complex aneuploidies was observed, suggesting early discrimination against complex aneuploidy, particularly those arising from mitotic origins. However, there are doubts about the reliability of preimplantation genetic testing for aneuploidy at the blastocyst stage, as it may lead to a high rate of false positives and the discarding of \"good\" embryos. Studies showed a self-correction mechanism in human embryos through the ability to expel abnormal cells. Further investigation is needed to elucidate the underlying mechanisms and determine optimal strategies for preimplantation genetic testing to fully understand and optimize the use of self-correction mechanisms in embryo assessment and selection.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"102 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140166927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-07DOI: 10.1186/s43043-024-00174-w
Mohmed Fathy Abohashim, Waleed M. Etman, Mohamed A. Wasfy, Amany M. Abdallah, Enas Mahmoud Hamed, Mona Mahmoud Eladl, Sherif Yehia Mohammed, Ola A. Harb, Fawaz E. Edris, Ahmed Baker A. Alshaikh, Mohamed Elbakry Lashin
Surgery is the main line of treatment of endometriosis. Patients with stage IV endometriosis have more extensive adhesions, which make the surgery difficult. There are no accurate non-invasive predictive preoperative parameters of stage IV endometriosis and no consensus has been reached. Therefore, the aim of the present study was to evaluate and detect preoperative non-invasive parameters for the detection of stage IV endometriosis. In the present study, we included 150 females admitted for surgical removal of endometriosis. We scored and classified endometriosis into four stages according to the revised ASRM classification. We compared between baseline characteristics of patients with different stages of endometriosis, and then we selected the best combination of diagnostic and predictive parameters of stage IV endometriosis. Predictors of stage IV endometriosis and indicators for safety surgery were as follows: VAS ≥ 4 (p < 0.001), fixed uterus (p = 0.005), fixed ovarian cysts (p < 0.001), tender uterosacral ligament nodule (p < 0.001), tender rectovaginal septum nodule (p = 0.003), bilateral endometriosis (p < 0.001), and sum of sizes of endometriotic nodules (p < 0.001). Fixed uterus, fixed ovarian cysts, tender uterosacral ligament nodule, tender rectovaginal septum nodule, bilateral endometriosis, and indications for surgery were significantly considered adequate predictive markers for stage IV endometriosis.
手术是治疗子宫内膜异位症的主要方法。IV 期子宫内膜异位症患者的粘连范围更广，给手术带来困难。对于 IV 期子宫内膜异位症，目前尚无准确的非侵入性术前预测参数，也未达成共识。因此，本研究旨在评估和检测用于检测 IV 期子宫内膜异位症的术前无创参数。在本研究中，我们纳入了 150 名接受子宫内膜异位症手术切除的女性。我们根据修订后的 ASRM 分类法对子宫内膜异位症进行了评分和四期分类。我们比较了不同阶段子宫内膜异位症患者的基线特征，然后选出了诊断和预测 IV 期子宫内膜异位症参数的最佳组合。IV 期子宫内膜异位症的预测指标和手术安全性指标如下：VAS≥4（P＜0.001）、固定子宫（P＝0.005）、固定卵巢囊肿（P＜0.001）、子宫骶骨韧带触痛结节（P＜0.001）、直肠阴道隔触痛结节（P＝0.003）、双侧子宫内膜异位症（P＜0.001）、子宫内膜异位结节大小之和（P＜0.001）。固定子宫、固定卵巢囊肿、子宫骶韧带触痛性结节、直肠阴道隔触痛性结节、双侧子宫内膜异位症和手术指征被认为是子宫内膜异位症 IV 期的充分预测指标。
{"title":"Preoperative predictive parameters for accurate detection of stage IV endometriosis","authors":"Mohmed Fathy Abohashim, Waleed M. Etman, Mohamed A. Wasfy, Amany M. Abdallah, Enas Mahmoud Hamed, Mona Mahmoud Eladl, Sherif Yehia Mohammed, Ola A. Harb, Fawaz E. Edris, Ahmed Baker A. Alshaikh, Mohamed Elbakry Lashin","doi":"10.1186/s43043-024-00174-w","DOIUrl":"https://doi.org/10.1186/s43043-024-00174-w","url":null,"abstract":"Surgery is the main line of treatment of endometriosis. Patients with stage IV endometriosis have more extensive adhesions, which make the surgery difficult. There are no accurate non-invasive predictive preoperative parameters of stage IV endometriosis and no consensus has been reached. Therefore, the aim of the present study was to evaluate and detect preoperative non-invasive parameters for the detection of stage IV endometriosis. In the present study, we included 150 females admitted for surgical removal of endometriosis. We scored and classified endometriosis into four stages according to the revised ASRM classification. We compared between baseline characteristics of patients with different stages of endometriosis, and then we selected the best combination of diagnostic and predictive parameters of stage IV endometriosis. Predictors of stage IV endometriosis and indicators for safety surgery were as follows: VAS ≥ 4 (p < 0.001), fixed uterus (p = 0.005), fixed ovarian cysts (p < 0.001), tender uterosacral ligament nodule (p < 0.001), tender rectovaginal septum nodule (p = 0.003), bilateral endometriosis (p < 0.001), and sum of sizes of endometriotic nodules (p < 0.001). Fixed uterus, fixed ovarian cysts, tender uterosacral ligament nodule, tender rectovaginal septum nodule, bilateral endometriosis, and indications for surgery were significantly considered adequate predictive markers for stage IV endometriosis.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"167 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140057315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Considering the close link between polycystic ovary syndrome (PCOS) and metabolic syndrome considerable research has been devoted to studying the pattern of fat distribution in PCOS. The study aims to assess the usefulness of dual-energy X-ray absorptiometry (DEXA) based regional fat distribution indices as a predictor of the development of PCOS. This case–control study recruited diagnosed cases of PCOS using Rotterdam Criteria (cases n = 86) and healthy age-matched controls (n = 90). DEXA was performed in both groups for assessment of total and regional body fat distribution after undergoing ultrasonography (USG) and baseline/biochemical evaluation. The study revealed a significant difference between cases and controls in trunk fat percentage (40.2% ± 9.1% vs 26.5% ± 9.1%; p < 0.001), android fat percentage (42.4% ± 41%vs 27.8% ± 1.51%; p < 0.001), total fat percentage (43.8% ± 8% vs28.5% ± 1.6%; p < 0.001), fat mass/ht2 (fat mass index) (8.82 ± 3% vs 4.8 ± 1.7%; p < 0.001), android/gynoid ratio (1.05 ± 0.1 vs 0.7 ± 0.2; p < 0.001), and trunk/limb fat mass ratio (1.06 ± 0.3 vs 0.69 ± 0.3; p 0.001). Multivariate analysis revealed a significant relation of trunk fat mass with android % fat, gynoid fat mass, and android-gynoid ratio. The study demonstrates that there is a central pattern of fat distribution in patients with PCOS while the overall fat might not be increased which is well analyzed by DEXA. Hence, we suggest its use in the initial diagnostic workup and follow-up of PCOS patients for their body fat distribution and content.
考虑到多囊卵巢综合症（PCOS）与代谢综合症之间的密切联系，大量研究致力于研究多囊卵巢综合症的脂肪分布模式。本研究旨在评估基于双能 X 射线吸收测定法（DEXA）的区域脂肪分布指数作为多囊卵巢综合征发病预测指标的实用性。这项病例对照研究招募了根据鹿特丹标准确诊的多囊卵巢综合症病例（病例 n = 86）和年龄匹配的健康对照组（n = 90）。两组患者在接受超声波检查（USG）和基础/生化评估后，均进行了 DEXA 检查，以评估身体总脂肪和区域脂肪分布。研究显示，病例和对照组在躯干脂肪百分比（40.2% ± 9.1% vs 26.5% ± 9.1%；P < 0.001）、甲状腺脂肪百分比（42.4% ± 41% vs 27.8% ± 1.51%；P < 0.001）、总脂肪百分比（43.8% ± 8% vs28.5%±1.6%；P＜0.001）、脂肪质量/ht2（脂肪质量指数）（8.82±3% vs 4.8±1.7%；P＜0.001）、android/gynoid比率（1.05±0.1 vs 0.7±0.2；P＜0.001）和躯干/肢体脂肪质量比率（1.06±0.3 vs 0.69±0.3；P 0.001）。多变量分析表明，躯干脂肪量与睾丸脂肪率、雌蕊脂肪量和睾丸-雌蕊比率有显著关系。这项研究表明，多囊卵巢综合症患者的脂肪分布呈中心模式，而整体脂肪可能不会增加，这一点在 DEXA 中得到了很好的分析。因此，我们建议在对多囊卵巢综合症患者进行初步诊断和随访时，使用 DEXA 检查其体内脂肪的分布和含量。
{"title":"Pattern of body fat distribution in patients of PCOS using DEXA-based indices","authors":"Sanna Birjees, Majid Jehangir, Mirza Vamiq Rasool, Fiza Amin, Seema Qayoom","doi":"10.1186/s43043-024-00175-9","DOIUrl":"https://doi.org/10.1186/s43043-024-00175-9","url":null,"abstract":"Considering the close link between polycystic ovary syndrome (PCOS) and metabolic syndrome considerable research has been devoted to studying the pattern of fat distribution in PCOS. The study aims to assess the usefulness of dual-energy X-ray absorptiometry (DEXA) based regional fat distribution indices as a predictor of the development of PCOS. This case–control study recruited diagnosed cases of PCOS using Rotterdam Criteria (cases n = 86) and healthy age-matched controls (n = 90). DEXA was performed in both groups for assessment of total and regional body fat distribution after undergoing ultrasonography (USG) and baseline/biochemical evaluation. The study revealed a significant difference between cases and controls in trunk fat percentage (40.2% ± 9.1% vs 26.5% ± 9.1%; p < 0.001), android fat percentage (42.4% ± 41%vs 27.8% ± 1.51%; p < 0.001), total fat percentage (43.8% ± 8% vs28.5% ± 1.6%; p < 0.001), fat mass/ht2 (fat mass index) (8.82 ± 3% vs 4.8 ± 1.7%; p < 0.001), android/gynoid ratio (1.05 ± 0.1 vs 0.7 ± 0.2; p < 0.001), and trunk/limb fat mass ratio (1.06 ± 0.3 vs 0.69 ± 0.3; p 0.001). Multivariate analysis revealed a significant relation of trunk fat mass with android % fat, gynoid fat mass, and android-gynoid ratio. The study demonstrates that there is a central pattern of fat distribution in patients with PCOS while the overall fat might not be increased which is well analyzed by DEXA. Hence, we suggest its use in the initial diagnostic workup and follow-up of PCOS patients for their body fat distribution and content.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"2 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140057571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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