Considering the growing therapeutic use of cannabidiol as well as the presence of cannabinoid receptors in sperm and its possible genotoxic activity, the effect of cannabidiol on sperm quality and function was examined. Thirty male NMRI mice were randomly divided into three groups: control (no injection), sham (intraperitoneal (IP) injection of DMSO daily for 34 days), and cannabidiol (IP injection of cannabidiol 30 mg/ml daily for 34 days). Following 35 days after the last injection, sperm parameters, chromatin integrity (CMA3 staining), acrosome reaction (FITC-PNA method), fertility-related genes (IZUMO1, PLCζ), and blastulation rate of the embryos obtained from the oocytes fertilized with the mentioned sperms was investigated. Count, motility, and morphology of sperm were not significantly affected by cannabidiol. CMA3+ sperms (protamine deficiency) were significantly higher in the cannabidiol group compared to the control group (P = 0.03). The acrosomal reaction and fertility-related genes (IZUMO1, PLCζ) in the cannabidiol group did not differ significantly compared to the control group. Also, there was no significant difference between the cannabidiol group and the control group in the two-cell and the eight-cell stages but the rate of blastocyst formation was significantly lower in the cannabidiol group compared to other groups (P < 0.0001). Our results showed that cannabidiol leads to negative effects on the male reproductive system through an effect on sperm chromatin and the rate of reaching the blastocyst stage of the embryo.
{"title":"Cannabidiol impairs sperm quality and function in adult mice","authors":"Azam Govahi, Sahar Eghbali, Marziyeh Ajdary, Fatemehsadat Amjadi, Mahsa Nazari, Farzaneh Mohammadzadeh Kazorgah, Mehdi Mehdizadeh","doi":"10.1186/s43043-024-00184-8","DOIUrl":"https://doi.org/10.1186/s43043-024-00184-8","url":null,"abstract":"Considering the growing therapeutic use of cannabidiol as well as the presence of cannabinoid receptors in sperm and its possible genotoxic activity, the effect of cannabidiol on sperm quality and function was examined. Thirty male NMRI mice were randomly divided into three groups: control (no injection), sham (intraperitoneal (IP) injection of DMSO daily for 34 days), and cannabidiol (IP injection of cannabidiol 30 mg/ml daily for 34 days). Following 35 days after the last injection, sperm parameters, chromatin integrity (CMA3 staining), acrosome reaction (FITC-PNA method), fertility-related genes (IZUMO1, PLCζ), and blastulation rate of the embryos obtained from the oocytes fertilized with the mentioned sperms was investigated. Count, motility, and morphology of sperm were not significantly affected by cannabidiol. CMA3+ sperms (protamine deficiency) were significantly higher in the cannabidiol group compared to the control group (P = 0.03). The acrosomal reaction and fertility-related genes (IZUMO1, PLCζ) in the cannabidiol group did not differ significantly compared to the control group. Also, there was no significant difference between the cannabidiol group and the control group in the two-cell and the eight-cell stages but the rate of blastocyst formation was significantly lower in the cannabidiol group compared to other groups (P < 0.0001). Our results showed that cannabidiol leads to negative effects on the male reproductive system through an effect on sperm chromatin and the rate of reaching the blastocyst stage of the embryo. ","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141172228","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 : 2024-05-18DOI: 10.1186/s43043-024-00183-9
Rahana Harjee, Jalila Devji, Ella Katelyn Barrett-Chan, Jas Khinda, Mohamed A. Bedaiwy
Caesarean scar disorders (CSDi) are an increasingly recognized consequence of caesarean sections, which can present with secondary infertility. Currently, there is limited data on the management of CSDi, and the subsequent fertility and pregnancy outcomes. Our aim was to examine different treatment methods and outcomes in a cohort of women with secondary infertility. This study involved a retrospective case series for patients (n = 26) diagnosed with and treated for a CSDi between 2008 and 2019 at a tertiary care centre in British Columbia, Canada, by one of three gynecologists with expertise in CSDi repair. Surgical repair was performed via laparoscopy for residual myometrial thickness (RMT) < 3.0 mm, and via hysteroscopy otherwise. Postoperative pregnancy rates and reproductive outcomes are reported. This study also included a search of the literature to gain an overview of the indications, outcomes, advantages, disadvantages, and risks associated with four surgical approaches (hysteroscopic, laparoscopic, vaginal, abdominal) used in the management of CSDi. A Medline and manual searches of referenced articles were conducted for this purpose. Twenty-six patients with CSDi were diagnosed with secondary infertility (mean age = 36.4 years) during the study period. Twenty of these patients underwent surgical management, with 12 receiving hysteroscopic resection or ablation, and 8 receiving laparoscopic repair. Six patients had no treatment or are still awaiting management at this time. Postoperatively, 11/20 patients (55%) were able to successfully conceive at least once. 8/11 patients were from the hysteroscopy group (66% pregnancy rate) and 10/11 pregnancies resulted in live births at term. In the laparoscopy group, there were 3 pregnancies (37.5% pregnancy rate), including 2 term live births, and 1 preterm live birth at 26 weeks. With respect to our review of the literature, a total of 49 articles were included in our final review of surgical techniques used in the management of CSDi. This study suggests that surgical repair can improve pregnancy rates in patients with secondary infertility in the context of a confirmed CSDi.
{"title":"Surgical management of caesarean scar disorder using different techniques: a scoping review and case series","authors":"Rahana Harjee, Jalila Devji, Ella Katelyn Barrett-Chan, Jas Khinda, Mohamed A. Bedaiwy","doi":"10.1186/s43043-024-00183-9","DOIUrl":"https://doi.org/10.1186/s43043-024-00183-9","url":null,"abstract":"Caesarean scar disorders (CSDi) are an increasingly recognized consequence of caesarean sections, which can present with secondary infertility. Currently, there is limited data on the management of CSDi, and the subsequent fertility and pregnancy outcomes. Our aim was to examine different treatment methods and outcomes in a cohort of women with secondary infertility. This study involved a retrospective case series for patients (n = 26) diagnosed with and treated for a CSDi between 2008 and 2019 at a tertiary care centre in British Columbia, Canada, by one of three gynecologists with expertise in CSDi repair. Surgical repair was performed via laparoscopy for residual myometrial thickness (RMT) < 3.0 mm, and via hysteroscopy otherwise. Postoperative pregnancy rates and reproductive outcomes are reported. This study also included a search of the literature to gain an overview of the indications, outcomes, advantages, disadvantages, and risks associated with four surgical approaches (hysteroscopic, laparoscopic, vaginal, abdominal) used in the management of CSDi. A Medline and manual searches of referenced articles were conducted for this purpose. Twenty-six patients with CSDi were diagnosed with secondary infertility (mean age = 36.4 years) during the study period. Twenty of these patients underwent surgical management, with 12 receiving hysteroscopic resection or ablation, and 8 receiving laparoscopic repair. Six patients had no treatment or are still awaiting management at this time. Postoperatively, 11/20 patients (55%) were able to successfully conceive at least once. 8/11 patients were from the hysteroscopy group (66% pregnancy rate) and 10/11 pregnancies resulted in live births at term. In the laparoscopy group, there were 3 pregnancies (37.5% pregnancy rate), including 2 term live births, and 1 preterm live birth at 26 weeks. With respect to our review of the literature, a total of 49 articles were included in our final review of surgical techniques used in the management of CSDi. This study suggests that surgical repair can improve pregnancy rates in patients with secondary infertility in the context of a confirmed CSDi.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141061474","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 : 2024-05-11DOI: 10.1186/s43043-024-00180-y
Prashanth K. Adiga, Nicola Marconi, Ravishankar N, Srisailesh Vitthala
POR or POI poses a significant challenge to fertility treatment with different ovarian stimulation strategies. Intra-ovarian injection of platelet-rich plasma (PRP) has been hypothesised to improve ovarian reserve and pregnancies in POI or POR. However, its effectiveness on pregnancy, embryology and ovarian reserve outcomes need to be established. Therefore, we systematically searched databases based on PRISMA guidelines that reported on the effects of intra-ovarian autologous PRP injections in sub-fertile women with POI and POR. The following outcome effects were analysed by random model and included in the meta-analysis in pre- and post-PRP injection groups of POI & POR: (a) pregnancy rates, rate of oocyte & embryo formation (b) ovarian reserve markers (Antral follicular count, Anti-Mullerian Hormone, Follicle Stimulating Hormone). A separate analysis of pregnancies, AFC and AMH was done in POI and POR groups and in age groups < 35 years and > 35 years. A total of 12 studies were included. The estimated overall effects size of the log odds ratio (log OR = 2.03; 95% CI = 0.13 to 3.92; P = 0.04; I2 = 0.42) favoured post-PRP with a moderate level of evidence. There are no significant differences in POI/POR and those with < 35 years or > 35 years. The pooled standard difference of means favoured the post-PRP injection group significantly with regards to rates of embryo formation (1.39; 95% CI = 0.56 to 2.21; P = 0.02; I2 = 46%.), Oocyte (0.84; 95% CI = -1.3 to 3.0; P = 0.24; I 2 93%), Antral follicle count (1.78; 95% CI = 0.73 to 2.84; P = 0.01. I2 = 97%) with a low level of evidence and Anti-Mullerian Hormone (1.11; 95% CI = 0.16 to 2.05; P = 0.03; I2 = 96%) with low level of evidence. Our study shows that intraovarian PRP injection was associated with no significant increase in the rates of pregnancy, in the rates of pregnancy, oocyte, embryo formation, Anti-Mullerian Hormone and antral follicle count. Live birth rates were not calculated. There was no statistical difference between POR/POI and those with < 35 years or > 35 years. Further randomized studies are warranted to confirm our findings.
POR或POI对采用不同卵巢刺激策略的生育治疗构成了巨大挑战。卵巢内注射富血小板血浆（PRP）被认为可改善 POI 或 POR 的卵巢储备和妊娠。然而，其对妊娠、胚胎学和卵巢储备结果的有效性还有待证实。因此，我们根据 PRISMA 指南，系统地检索了对患有 POI 和 POR 的亚健康女性进行卵巢内自体 PRP 注射的效果进行报道的数据库。荟萃分析采用随机模型对 POI 和 POR 注射前后两组的下列结果效应进行了分析：（a）妊娠率、卵母细胞和胚胎形成率（b）卵巢储备指标（前卵泡计数、抗穆勒氏管激素、卵泡刺激素）。对 POI 组和 POR 组以及 35 岁年龄组的妊娠、AFC 和 AMH 进行了单独分析。共纳入了 12 项研究。估计的总效应对数比（log OR = 2.03; 95% CI = 0.13 to 3.92; P = 0.04; I2 = 0.42）倾向于后PRP，证据等级为中等。POI/POR与35岁以上者无明显差异。在胚胎形成率（1.39；95% CI = 0.56 至 2.21；P = 0.02；I2 = 46%）、卵母细胞（0.84；95% CI = -1.3 至 3.0；P = 0.24; I 2 93%）、前卵泡计数（1.78; 95% CI = 0.73 to 2.84; P = 0.01. I2 = 97%）证据水平较低，抗苗勒氏管激素（1.11; 95% CI = 0.16 to 2.05; P = 0.03; I2 = 96%）证据水平较低。我们的研究表明，卵巢内注射 PRP 与妊娠率、妊娠率、卵母细胞率、胚胎形成率、抗穆勒氏激素和前卵泡数无显著相关性。活产率没有计算在内。POR/POI与 35 岁者之间没有统计学差异。需要进一步的随机研究来证实我们的发现。
{"title":"Effect of intra-ovarian injection of platelet-rich plasma on the patients with a poor ovarian response (POR) or premature ovarian insufficiency (POI): a systematic review and meta-analysis","authors":"Prashanth K. Adiga, Nicola Marconi, Ravishankar N, Srisailesh Vitthala","doi":"10.1186/s43043-024-00180-y","DOIUrl":"https://doi.org/10.1186/s43043-024-00180-y","url":null,"abstract":"POR or POI poses a significant challenge to fertility treatment with different ovarian stimulation strategies. Intra-ovarian injection of platelet-rich plasma (PRP) has been hypothesised to improve ovarian reserve and pregnancies in POI or POR. However, its effectiveness on pregnancy, embryology and ovarian reserve outcomes need to be established. Therefore, we systematically searched databases based on PRISMA guidelines that reported on the effects of intra-ovarian autologous PRP injections in sub-fertile women with POI and POR. The following outcome effects were analysed by random model and included in the meta-analysis in pre- and post-PRP injection groups of POI & POR: (a) pregnancy rates, rate of oocyte & embryo formation (b) ovarian reserve markers (Antral follicular count, Anti-Mullerian Hormone, Follicle Stimulating Hormone). A separate analysis of pregnancies, AFC and AMH was done in POI and POR groups and in age groups < 35 years and > 35 years. A total of 12 studies were included. The estimated overall effects size of the log odds ratio (log OR = 2.03; 95% CI = 0.13 to 3.92; P = 0.04; I2 = 0.42) favoured post-PRP with a moderate level of evidence. There are no significant differences in POI/POR and those with < 35 years or > 35 years. The pooled standard difference of means favoured the post-PRP injection group significantly with regards to rates of embryo formation (1.39; 95% CI = 0.56 to 2.21; P = 0.02; I2 = 46%.), Oocyte (0.84; 95% CI = -1.3 to 3.0; P = 0.24; I 2 93%), Antral follicle count (1.78; 95% CI = 0.73 to 2.84; P = 0.01. I2 = 97%) with a low level of evidence and Anti-Mullerian Hormone (1.11; 95% CI = 0.16 to 2.05; P = 0.03; I2 = 96%) with low level of evidence. Our study shows that intraovarian PRP injection was associated with no significant increase in the rates of pregnancy, in the rates of pregnancy, oocyte, embryo formation, Anti-Mullerian Hormone and antral follicle count. Live birth rates were not calculated. There was no statistical difference between POR/POI and those with < 35 years or > 35 years. Further randomized studies are warranted to confirm our findings.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140941938","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 : 2024-05-10DOI: 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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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}
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