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The randomized clinical trial trustworthiness crisis 随机临床试验的可信度危机
IF 1.3 Q4 REPRODUCTIVE BIOLOGY Pub Date : 2024-01-02 DOI: 10.1186/s43043-023-00161-7
Furqan A. Butt, Mohammad Fawzy, Bassel H. Al Wattar, Aurora Bueno-Cavanillas, Khalid S. Khan, Yacoub Khalaf
The rising number of retracted randomised clinical trials (RCTs) is a concern over their trustworthiness. In today's digital landscape electronic observational data is easily accessible for research purposes. This emerging perspective, in tandem with the growing scrutiny of RCT credibility, may steer some researchers towards favouring non-randomized studies. It is crucial to emphasize the ongoing need for robust RCTs, shedding light on the areas within trial design that require enhancements and addressing existing gaps in trial execution. Evidence-based medicine pivots on the nexus between empirical medical research and the theoretical and applied facets of clinical care. Healthcare systems regularly amass patient data, creating a vast reservoir of information. This facilitates large-scale observational studies, which may appear as potential substitutes for RCTs. These large-scale studies inherently possess biases that place them a notch below randomized evidence. Honest errors, data manipulation, lapses in professionalism, and methodological shortcomings tarnish the integrity of RCTs, compromising trust in trials. Research institutions, funding agencies, journal editors and other stakeholders have the responsibility to establish robust frameworks to prevent both deliberate and inadvertent mishandling of RCT design, conduct and analysis. Systematic reviews that collate robust RCTs are invaluable. They amalgamate superior evidence instrumental in improving patient outcomes via informed health policy decisions. For systematic reviews to continue to retain trust, validated integrity assessment tools must be developed and routinely applied. This way it will be possible to prevent false or untrustworthy research from becoming part of the recommendations based on the evidence. High-quality RCTs and their systematic reviews play a crucial role in acquiring valid and reliable evidence that is instrumental in improving patient outcomes. They provide vital information on healthcare effectiveness, and their trustworthiness is key to evidence-based medicine.
被撤回的随机临床试验(RCT)数量不断增加,令人担忧其可信度。在当今的数字化时代,电子观察数据很容易被用于研究目的。这种新出现的观点,加上对随机临床试验可信度日益严格的审查,可能会引导一些研究人员倾向于非随机研究。我们必须强调目前对可靠的 RCT 的需求,揭示试验设计中需要改进的领域,并解决试验执行中的现有差距。循证医学的关键在于实证医学研究与临床护理的理论和应用之间的联系。医疗保健系统定期收集患者数据,形成了一个庞大的信息库。这为大规模观察性研究提供了便利,而观察性研究可能会成为研究性临床试验的潜在替代品。这些大规模研究本身存在偏差,比随机证据低一个等级。诚实错误、数据篡改、专业失误和方法缺陷玷污了 RCT 的诚信,损害了人们对试验的信任。研究机构、资助机构、期刊编辑和其他利益相关者有责任建立健全的框架,防止在 RCT 设计、实施和分析过程中出现有意或无意的不当处理。整理可靠的 RCT 的系统性综述非常宝贵。它们汇集了有助于通过明智的卫生政策决策改善患者治疗效果的优质证据。要想让系统性综述继续获得信任,就必须开发并常规应用经过验证的完整性评估工具。这样才能防止虚假或不可信的研究成为基于证据的建议的一部分。高质量的 RCT 及其系统性综述在获取有效、可靠的证据方面发挥着至关重要的作用,而这些证据对于改善患者的治疗效果至关重要。它们提供了有关医疗保健有效性的重要信息,其可信度是循证医学的关键。
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引用次数: 0
An insight into the associated factors with recurrent endometriomas after surgical excision 洞察手术切除后子宫内膜异位症复发的相关因素
IF 1.3 Q4 REPRODUCTIVE BIOLOGY Pub Date : 2024-01-02 DOI: 10.1186/s43043-023-00163-5
Faezeh Fashkhami, Ali Beykian
Atwa et al.’s study shed light on endometrioma management and factors affecting recurrence. However, the exclusion of open ovarian surgery patients and the potential impact of laparoscopic surgery on ovarian reserve and outcomes warrant consideration. Including both surgical approaches in future studies would enable a comprehensive assessment of their effectiveness and influence on endometrioma recurrence, enhancing our understanding of surgical excision outcomes.
Atwa 等人的研究揭示了子宫内膜异位症的治疗方法和影响复发的因素。然而,开腹卵巢手术患者被排除在外以及腹腔镜手术对卵巢储备和结果的潜在影响值得考虑。将这两种手术方法纳入今后的研究将能全面评估它们的效果和对子宫内膜瘤复发的影响,从而加深我们对手术切除结果的理解。
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引用次数: 0
Association between ambient particulate matter and semen quality parameters: a systematic review and meta-analysis 环境颗粒物与精液质量参数之间的关系:系统回顾与荟萃分析
IF 1.3 Q4 REPRODUCTIVE BIOLOGY Pub Date : 2024-01-02 DOI: 10.1186/s43043-023-00162-6
Seyed Sobhan Bahreiny, Mohammad-Navid Bastani, Mohammad Reza Dabbagh, Hamid Ghorbani, Mojtaba Aghaei, Mehdi Zahedian, Reza Mohammadpour Fard
The adverse consequences of ambient particulate matter (PM) on human health have been extensively studied. However, the association between PM2.5 and PM10 μm, two common sizes of particulate matter, and semen quality remains a subject of debate. This systematic review and meta-analysis aim to investigate the relationship between ambient PM2.5 and PM10 μm exposure and semen quality parameters. A systematic literature search was conducted using electronic databases to identify relevant studies investigating the association between (PM2.5 μm and PM10 μm) exposure and semen quality, covering the period from January 2000 to April 2023. Standard mean difference (SMD) was used to calculate pooled effect estimates with 95% confidence intervals (CIs). Furthermore, meta-regression and subgroup analyses provided additional insight into potential factors contributing to heterogeneity. The meta-analysis included a comprehensive review of nine studies with a total of 6264 participants. The findings demonstrated a significant negative correlation between ambient exposure to PM2.5 μm and PM10 μm and various parameters related to semen quality. The analysis revealed that PM2.5 exposure was linked to reduced semen volume (SMD = −0.028; 95% CI −0.055 to −0.01), total sperm count (SMD = −0.027; 95% CI −0.052 to -0.02), sperm motility (SMD = −0.156; 95% CI −0.26 to -0.04), and progressive motility (SMD = −0.194; 95% CI −0.38 to −0.01). Likewise, exposure to PM10 was associated with decreased sperm concentration (SMD = −0.036; 95% CI −0.06 to −0.01) and sperm motility (SMD = −0.93; 95% CI −0.15 to −0.02). This systematic review and meta-analysis demonstrate a consistent negative association between ambient PM10 and PM2.5 μm exposure and semen quality parameters. The findings suggest that increased levels of ambient particulate matter may have an adverse influence on sperm count and motility. The results highlight the importance of addressing environmental air pollution as a potential risk factor for male reproductive health.
环境颗粒物(PM)对人类健康的不利影响已被广泛研究。然而,PM2.5 和 PM10 μm 这两种常见大小的颗粒物与精液质量之间的关系仍存在争议。本系统综述和荟萃分析旨在研究环境中 PM2.5 和 PM10 μm 暴露与精液质量参数之间的关系。我们使用电子数据库进行了系统性文献检索,以确定调查(PM2.5 μm和PM10 μm)暴露与精液质量之间关系的相关研究,研究时间跨度为2000年1月至2023年4月。标准平均差(SMD)用于计算汇集效应估计值及95%置信区间(CI)。此外,荟萃回归和亚组分析还有助于深入了解导致异质性的潜在因素。荟萃分析全面回顾了九项研究,共有 6264 人参与。研究结果表明,环境中 PM2.5 μm 和 PM10 μm 的暴露量与精液质量的各种相关参数之间存在明显的负相关。分析表明,暴露于PM2.5与精液量减少(SMD = -0.028;95% CI -0.055至-0.01)、精子总数减少(SMD = -0.027;95% CI -0.052至-0.02)、精子活力减少(SMD = -0.156;95% CI -0.26至-0.04)和精子运动性减少(SMD = -0.194;95% CI -0.38至-0.01)有关。同样,暴露于PM10与精子浓度下降(SMD = -0.036;95% CI -0.06至-0.01)和精子活力下降(SMD = -0.93;95% CI -0.15至-0.02)有关。本系统综述和荟萃分析表明,环境 PM10 和 PM2.5 μm 暴露与精液质量参数之间存在一致的负相关。研究结果表明,环境颗粒物水平的增加可能会对精子数量和活力产生不利影响。研究结果凸显了解决环境空气污染这一男性生殖健康潜在风险因素的重要性。
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引用次数: 0
Inflammatory perspectives of polycystic ovary syndrome: role of specific mediators and markers 多囊卵巢综合征的炎症视角:特定介质和标记物的作用
IF 1.3 Q4 REPRODUCTIVE BIOLOGY Pub Date : 2023-12-12 DOI: 10.1186/s43043-023-00158-2
Rajen Dey, Koushik Bhattacharya, Asim Kumar Basak, Nimisha Paul, Raktima Bandyopadhyay, Gargi Ray Chaudhuri, Mahuya Patra Purkait, Aniruddha Bhattacharjee, Chaitali Bose, Nandini Shukla, Rama Bhaduri, Soumya Sinha Roy, Alak Kumar Syamal
Polycystic ovary syndrome (PCOS) is indeed one of the most common gynecological endocrine disorders, affecting a significant number of females in their reproductive age. While the exact cause of PCOS is not fully understood, several factors are believed to contribute to its onset. The relationship between polycystic ovary syndrome (PCOS) and low-grade chronic inflammation is complex and not fully understood. While there is evidence to suggest an association between PCOS and inflammation, the exact cause and causal nature of this relationship are still under investigation. Several inflammatory markers, including IL-6 (interleukin-6), TNF-α (tumor necrosis factor-alpha), IL-17 (interleukin-17), CRP (C-reactive protein), NLR (neutrophil-to-lymphocyte ratio), and PLR (platelet-to-lymphocyte ratio), have been studied about PCOS. These markers are substances produced by the immune system in response to inflammation. Increased levels of IL-17, IL-1, and IL-8 were correlated with PCO. CRP to albumin ratio can be employed as a precise bio-marker for PCOS. The neutrophil-to-lymphocyte ratio (NLR) indicates poor cardiovascular health and metabolic syndrome (MS) and can be considered a negative regulator for FSH which indirectly stimulates testosterone production. Platelet/lymphocyte ratio (PLR) and mean platelet volume (MPV) are also recently found to be associated with PCOS. The literature explaining the underlying mechanisms with specific inflammatory markers and how inflammation relates to PCOS will be highlighted in this review article. It will also discuss the roles of inflammation and the association of different inflammatory markers in the pathogenesis of PCOS, which may usher in a new era in the treatment approach for PCOS.
多囊卵巢综合征(PCOS)是最常见的妇科内分泌疾病之一,影响着大量育龄女性。虽然多囊卵巢综合症的确切病因尚不完全清楚,但有几个因素被认为是导致其发病的原因。多囊卵巢综合症(PCOS)与低度慢性炎症之间的关系十分复杂,尚未完全明了。虽然有证据表明多囊卵巢综合症与炎症有关,但这种关系的确切原因和因果性质仍在调查之中。关于多囊卵巢综合症,已经研究了几种炎症标志物,包括 IL-6(白细胞介素-6)、TNF-α(肿瘤坏死因子-α)、IL-17(白细胞介素-17)、CRP(C 反应蛋白)、NLR(中性粒细胞与淋巴细胞比值)和 PLR(血小板与淋巴细胞比值)。这些标志物是免疫系统在炎症反应时产生的物质。IL-17、IL-1 和 IL-8 水平的升高与多囊卵巢综合症有关。CRP 与白蛋白的比率可作为 PCOS 的精确生物标记。中性粒细胞与淋巴细胞比率(NLR)表明心血管健康状况不佳和代谢综合征(MS),可被视为 FSH 的负调节因子,间接刺激睾酮的产生。最近还发现血小板/淋巴细胞比率(PLR)和平均血小板体积(MPV)与多囊卵巢综合征有关。本综述文章将重点介绍解释特定炎症标志物潜在机制的文献,以及炎症与多囊卵巢综合症的关系。文章还将讨论炎症的作用以及不同炎症标志物在多囊卵巢综合症发病机制中的关联,这可能会开创多囊卵巢综合症治疗方法的新纪元。
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引用次数: 0
Worldwide sperm quality variations between 2000 and 2020: a scoping review 2000 年至 2020 年全球精子质量变化:范围审查
IF 1.3 Q4 REPRODUCTIVE BIOLOGY Pub Date : 2023-12-11 DOI: 10.1186/s43043-023-00159-1
Noor Mohammad Alqurna, Zina Mahdi Al-Alami
There is a scarcity of research on male infertility and semen quality worldwide, notably in the Middle East and North Africa (MENA) region. This lack includes temporal comparisons of seminal parameters over decades. The aim of this scoping review is to summarize the articles, published between January 1, 2000, and December 31, 2020, which discuss and describe human semen quality and/or sperm quality in different countries, and/or their alternating patterns through time. The search was done on PubMed, using the following keywords: (((semen[Title/Abstract]) OR (SFA[Title/Abstract])) OR (sperm[Title/Abstract])) AND (country name[Title/Abstract]) with 195 world countries put in the “country name” field one by one along with other filters. The abstracts that fulfilled the inclusion criteria were read thoroughly and summarized. In conclusion, although some semen parameters appear to be stable, semen quality has deteriorated over time. Therefore, various countries must conduct research to characterize their semen quality and its altering patterns throughout time to reach a thorough conclusion.
世界范围内,尤其是中东和北非地区,有关男性不育症和精液质量的研究十分匮乏。这种缺乏包括对几十年来精液参数的时间比较。本范围综述旨在总结 2000 年 1 月 1 日至 2020 年 12 月 31 日期间发表的、讨论和描述不同国家人类精液质量和/或精子质量和/或其时间交替模式的文章。检索在 PubMed 上进行,使用以下关键词:(((精液[标题/摘要])或(SFA[标题/摘要]))或(精子[标题/摘要])。或(精子[标题/摘要]))和(国名[标题/摘要]),在 "国名 "字段中逐一输入世界 195 个国家,并进行其他筛选。对符合纳入标准的摘要进行了全面阅读和总结。总之,虽然精液的某些参数看起来比较稳定,但随着时间的推移,精液质量却在下降。因此,各国必须对其精液质量特点及其随时间变化的模式进行研究,以得出全面的结论。
{"title":"Worldwide sperm quality variations between 2000 and 2020: a scoping review","authors":"Noor Mohammad Alqurna, Zina Mahdi Al-Alami","doi":"10.1186/s43043-023-00159-1","DOIUrl":"https://doi.org/10.1186/s43043-023-00159-1","url":null,"abstract":"There is a scarcity of research on male infertility and semen quality worldwide, notably in the Middle East and North Africa (MENA) region. This lack includes temporal comparisons of seminal parameters over decades. The aim of this scoping review is to summarize the articles, published between January 1, 2000, and December 31, 2020, which discuss and describe human semen quality and/or sperm quality in different countries, and/or their alternating patterns through time. The search was done on PubMed, using the following keywords: (((semen[Title/Abstract]) OR (SFA[Title/Abstract])) OR (sperm[Title/Abstract])) AND (country name[Title/Abstract]) with 195 world countries put in the “country name” field one by one along with other filters. The abstracts that fulfilled the inclusion criteria were read thoroughly and summarized. In conclusion, although some semen parameters appear to be stable, semen quality has deteriorated over time. Therefore, various countries must conduct research to characterize their semen quality and its altering patterns throughout time to reach a thorough conclusion.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"18 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138568067","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}
引用次数: 0
Enhancing endometrial pathology detection: chromohysteroscopy vs. conventional hysteroscopy in infertility evaluation 增强子宫内膜病理学检测:彩色宫腔镜与常规宫腔镜在不孕症评估中的比较
IF 1.3 Q4 REPRODUCTIVE BIOLOGY Pub Date : 2023-11-29 DOI: 10.1186/s43043-023-00157-3
Sangam Jha, Shalini Singh, Jafeesha B. Singh
Endometrial pathology is a recognized contributor to infertility and recurrent implantation failure, but its detection during hysteroscopy, particularly in the absence of visible lesions, is challenging. Chromohysteroscopy, involving the use of methylene blue dye, has shown promise in improving diagnostic accuracy. This interventional cross-sectional study compared the diagnostic accuracy of chromohysteroscopy and conventional hysteroscopy, using histopathology as the gold standard. A total of 100 consenting infertility patients were included, in a sequential step, hysteroscopy followed by chromohysteroscopy using methylene blue dye was performed to enhance the detection of subtle endometrial pathologies. Among the 100 women who underwent diagnostic hysteroscopy, 76 exhibited normal findings, while 24 had abnormal findings. During chromohysteroscopy, 62 cases displayed a light staining pattern, and 38 cases exhibited dark staining. Histopathological analysis of biopsy tissue from the dark-stained areas revealed endometrial pathology in 84.2% (32/38) and normal endometrium in 15.8% (6/38) cases. In contrast, biopsies from the light-stained areas indicated abnormal endometrium in only 3.23% (2/62) cases, with the remaining 96.77% having a normal histology. Chromohysteroscopy demonstrated a significantly higher diagnostic accuracy (92%) for endometrial pathology compared to conventional hysteroscopy (58%). Notably, chromohysteroscopy’s sensitivity was 94.12%, and its specificity was 90.9%. The staining patterns observed during chromohysteroscopy correlated well with histological findings, highlighting its effectiveness in identifying structurally damaged endometrium. Chromohysteroscopy emerges as a valuable diagnostic tool for assessing endometrial pathology, especially in infertility cases. This technique offers superior accuracy compared to conventional hysteroscopy, providing clinicians with a more precise means of diagnosis and potential targeted treatments.
子宫内膜病理是公认的不孕不育和反复植入失败的原因,但在宫腔镜检查中,特别是在没有可见病变的情况下,其检测是具有挑战性的。使用亚甲基蓝染料的彩色宫腔镜在提高诊断准确性方面显示出了希望。本介入横断面研究比较了彩色宫腔镜和常规宫腔镜的诊断准确性,以组织病理学为金标准。共纳入100例同意的不孕症患者,在连续的步骤中,宫腔镜检查和亚甲基蓝染色宫腔镜检查以加强对子宫内膜细微病变的检测。在100名接受诊断性宫腔镜检查的妇女中,76名表现正常,24名表现异常。色宫腔镜检查中,62例显示浅色染色,38例显示深色染色。深色染色区活检组织病理分析显示84.2%(32/38)的子宫内膜病理,15.8%(6/38)的子宫内膜正常。相比之下,仅3.23%(2/62)的病例在浅色染色区活检显示子宫内膜异常,其余96.77%的患者组织学正常。与传统宫腔镜(58%)相比,彩色宫腔镜对子宫内膜病理的诊断准确率(92%)明显更高。值得注意的是,色宫腔镜的敏感性为94.12%,特异性为90.9%。在染色宫腔镜中观察到的染色模式与组织学结果有很好的相关性,突出了其在识别结构性受损子宫内膜方面的有效性。彩色宫腔镜出现作为一个有价值的诊断工具评估子宫内膜病理,特别是在不孕症的情况下。与传统宫腔镜相比,该技术具有更高的准确性,为临床医生提供了更精确的诊断手段和潜在的靶向治疗。
{"title":"Enhancing endometrial pathology detection: chromohysteroscopy vs. conventional hysteroscopy in infertility evaluation","authors":"Sangam Jha, Shalini Singh, Jafeesha B. Singh","doi":"10.1186/s43043-023-00157-3","DOIUrl":"https://doi.org/10.1186/s43043-023-00157-3","url":null,"abstract":"Endometrial pathology is a recognized contributor to infertility and recurrent implantation failure, but its detection during hysteroscopy, particularly in the absence of visible lesions, is challenging. Chromohysteroscopy, involving the use of methylene blue dye, has shown promise in improving diagnostic accuracy. This interventional cross-sectional study compared the diagnostic accuracy of chromohysteroscopy and conventional hysteroscopy, using histopathology as the gold standard. A total of 100 consenting infertility patients were included, in a sequential step, hysteroscopy followed by chromohysteroscopy using methylene blue dye was performed to enhance the detection of subtle endometrial pathologies. Among the 100 women who underwent diagnostic hysteroscopy, 76 exhibited normal findings, while 24 had abnormal findings. During chromohysteroscopy, 62 cases displayed a light staining pattern, and 38 cases exhibited dark staining. Histopathological analysis of biopsy tissue from the dark-stained areas revealed endometrial pathology in 84.2% (32/38) and normal endometrium in 15.8% (6/38) cases. In contrast, biopsies from the light-stained areas indicated abnormal endometrium in only 3.23% (2/62) cases, with the remaining 96.77% having a normal histology. Chromohysteroscopy demonstrated a significantly higher diagnostic accuracy (92%) for endometrial pathology compared to conventional hysteroscopy (58%). Notably, chromohysteroscopy’s sensitivity was 94.12%, and its specificity was 90.9%. The staining patterns observed during chromohysteroscopy correlated well with histological findings, highlighting its effectiveness in identifying structurally damaged endometrium. Chromohysteroscopy emerges as a valuable diagnostic tool for assessing endometrial pathology, especially in infertility cases. This technique offers superior accuracy compared to conventional hysteroscopy, providing clinicians with a more precise means of diagnosis and potential targeted treatments.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"14 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138538002","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}
引用次数: 0
A narrative literature review of remaining male reproductive health concerns as an aspect of persistent/late-onset complications of COVID-19 关于男性生殖健康问题作为COVID-19持续性/晚发性并发症的一个方面的叙述文献综述
IF 1.3 Q4 REPRODUCTIVE BIOLOGY Pub Date : 2023-11-22 DOI: 10.1186/s43043-023-00156-4
Azra Allahveisi, Parivash Afradiasbagharani, Mahshid Bazrafkan, Raheleh Kafaeinezhad, Elham Hosseini
Although COVID-19 infection has dropped across the world and SARS-CoV-2 vaccines have been developed, global concerns remain about the disease’s long-term health consequences. The purpose of this research was to review the consequences of SARS-CoV-2 on male health, particularly the reproductive system and the pathogenic mechanisms affecting male infertility. Improving knowledge on these issues may help in considering to which extent some of the remaining concerns should be addressed. The primary target of this disease is the pulmonary system, but reproductive organs may be targeted by the virus. To enter host cells, the virus utilizes both ACE2 and TMPRSS2, which are differentially expressed in the spermatogonial stem, Leydig, and Sertoli cells, thereby providing possible testicular vulnerability. COVID-19-related stress and psychological distress may also affect aspects of male reproductive health. Since some pathological effects of COVID-19 infection and dysregulations are linked to infertility, more attention is needed to determine whether such dysregulations regress following infection decline.
尽管世界各地的COVID-19感染率已经下降,SARS-CoV-2疫苗也已经开发出来,但全球仍对该疾病的长期健康后果感到担忧。本研究的目的是回顾SARS-CoV-2对男性健康,特别是生殖系统的影响以及影响男性不育的致病机制。提高对这些问题的认识可能有助于考虑应在何种程度上解决一些遗留问题。这种疾病的主要目标是肺系统,但生殖器官也可能是病毒的目标。为了进入宿主细胞,病毒利用ACE2和TMPRSS2,这两种蛋白在精原干细胞、间质细胞和支持细胞中有差异表达,从而可能导致睾丸易感。与covid -19相关的压力和心理困扰也可能影响男性生殖健康的各个方面。由于COVID-19感染和失调的一些病理影响与不孕症有关,因此需要更多地关注这些失调是否会在感染下降后消退。
{"title":"A narrative literature review of remaining male reproductive health concerns as an aspect of persistent/late-onset complications of COVID-19","authors":"Azra Allahveisi, Parivash Afradiasbagharani, Mahshid Bazrafkan, Raheleh Kafaeinezhad, Elham Hosseini","doi":"10.1186/s43043-023-00156-4","DOIUrl":"https://doi.org/10.1186/s43043-023-00156-4","url":null,"abstract":"Although COVID-19 infection has dropped across the world and SARS-CoV-2 vaccines have been developed, global concerns remain about the disease’s long-term health consequences. The purpose of this research was to review the consequences of SARS-CoV-2 on male health, particularly the reproductive system and the pathogenic mechanisms affecting male infertility. Improving knowledge on these issues may help in considering to which extent some of the remaining concerns should be addressed. The primary target of this disease is the pulmonary system, but reproductive organs may be targeted by the virus. To enter host cells, the virus utilizes both ACE2 and TMPRSS2, which are differentially expressed in the spermatogonial stem, Leydig, and Sertoli cells, thereby providing possible testicular vulnerability. COVID-19-related stress and psychological distress may also affect aspects of male reproductive health. Since some pathological effects of COVID-19 infection and dysregulations are linked to infertility, more attention is needed to determine whether such dysregulations regress following infection decline.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"7 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138538017","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}
引用次数: 0
Evaluation of ovarian reserve in unexplained ınfertile cases: a case-controlled study 不明原因ınfertile病例评估卵巢储备:一项病例对照研究
Q4 REPRODUCTIVE BIOLOGY Pub Date : 2023-11-13 DOI: 10.1186/s43043-023-00154-6
Mustafa Sahin, Suleyman Guven, Hidayet Sal, Emine Seda Guvendag Guven
Abstract Background The aim of this study was to evaluate the effectiveness of current ovarian reserve tests in unexplained infertile cases. Material and methods This case–control study was conducted on 70 unexplained infertile women who were included in a tertiary university hospital. Both groups of basal FSH, estradiol, antimullerian hormone (AMH), inhibin B, ovarian volume, total antral follicle count (AFC), ovarian volume, and ovarian stromal blood flow (peak systolic velocity (PSV), S/D (systole and diastole ratio), resistance index (RI), and pulsatility index (PI)) values were compared. Results The mean AMH, inhibin B, PSV, and stromal blood flow values of the control group patients were higher than those in the unexplained infertility group. However, the values of the means of RI and PI of the cases in the control group were lower than those in the infertility group. When PI’s value was ≥ 2.00, its sensitivity was 65.7%, and its specificity was 64.3%. In the case of the RI, its value was ≥ 0.745, its sensitivity was 65.7%, and its specificity was 62.9%. In order to show ovarian reserve in unexplained infertile cases, the sensitivity values can be sorted from high to low as follows: PI > RI > estradiol > FSH > ovarian volume > AFC > inhibin B > stromal blood flow > PSV > S/D. Conclusion In the unexplained infertile patient group with normal ovarian reserve test results, basal estradiol, decreased PI, and RI values may be used as good ovarian reserve predictors.
摘要背景本研究的目的是评价目前卵巢储备检测在不明原因不孕症中的有效性。材料与方法本病例对照研究纳入某三级大学附属医院的70例不明原因不孕症妇女。比较两组患者基础FSH、雌二醇、抗苗勒管激素(AMH)、抑制素B、卵巢体积、总心房卵泡计数(AFC)、卵巢体积、卵巢间质血流(峰值收缩速度(PSV)、S/D(收缩舒张比)、阻力指数(RI)、搏动指数(PI))值。结果对照组患者AMH、抑制素B、PSV、间质血流量平均值均高于不明原因不孕组。而对照组患者的RI均值和PI均值均低于不孕症组。当PI值≥2.00时,其敏感性为65.7%,特异性为64.3%。RI的值≥0.745,敏感性为65.7%,特异性为62.9%。为显示不明原因不孕症患者卵巢储备情况,敏感性值可由高到低排序如下:PI >国际扶轮的在雌二醇在FSH在卵巢体积>亚足联祝辞抑制素B >基质血流量>埃因霍温祝辞S / D。结论在卵巢储备试验结果正常的不明原因不孕症患者组中,基础雌二醇、PI下降、RI值可作为卵巢储备的良好预测指标。
{"title":"Evaluation of ovarian reserve in unexplained ınfertile cases: a case-controlled study","authors":"Mustafa Sahin, Suleyman Guven, Hidayet Sal, Emine Seda Guvendag Guven","doi":"10.1186/s43043-023-00154-6","DOIUrl":"https://doi.org/10.1186/s43043-023-00154-6","url":null,"abstract":"Abstract Background The aim of this study was to evaluate the effectiveness of current ovarian reserve tests in unexplained infertile cases. Material and methods This case–control study was conducted on 70 unexplained infertile women who were included in a tertiary university hospital. Both groups of basal FSH, estradiol, antimullerian hormone (AMH), inhibin B, ovarian volume, total antral follicle count (AFC), ovarian volume, and ovarian stromal blood flow (peak systolic velocity (PSV), S/D (systole and diastole ratio), resistance index (RI), and pulsatility index (PI)) values were compared. Results The mean AMH, inhibin B, PSV, and stromal blood flow values of the control group patients were higher than those in the unexplained infertility group. However, the values of the means of RI and PI of the cases in the control group were lower than those in the infertility group. When PI’s value was ≥ 2.00, its sensitivity was 65.7%, and its specificity was 64.3%. In the case of the RI, its value was ≥ 0.745, its sensitivity was 65.7%, and its specificity was 62.9%. In order to show ovarian reserve in unexplained infertile cases, the sensitivity values can be sorted from high to low as follows: PI > RI > estradiol > FSH > ovarian volume > AFC > inhibin B > stromal blood flow > PSV > S/D. Conclusion In the unexplained infertile patient group with normal ovarian reserve test results, basal estradiol, decreased PI, and RI values may be used as good ovarian reserve predictors.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"13 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136346512","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}
引用次数: 0
Assessment of Cdx2 polymorphism in Iranian women with polycystic ovary syndrome 伊朗多囊卵巢综合征妇女Cdx2多态性的评估
Q4 REPRODUCTIVE BIOLOGY Pub Date : 2023-11-10 DOI: 10.1186/s43043-023-00155-5
Behdis Khansari, Hashem Nayeri, Maryam Ostadsharif
Abstract Background Women’s fertility is affected by polycystic ovarian syndrome (PCOS) as an endocrine disorder with characteristic symptoms such as insulin resistance, polycystic ovaries, menstrual irregularities, and obesity. In polycystic ovarian syndrome, the vitamin D endocrine system is regulated by the vitamin D receptor (VDR) associated with type II diabetes, endocrine dysfunctions, and insulin resistance. Therefore, the current paper deals with the investigation of the connection between Cdx2 VDR gene polymorphism and the biochemical factors in obese PCOS women. Material and methods In the current case–control study, 40 obese women without PCOS and 38 obese women with PCOS were enrolled in May–September 2016. Insulin, IGF1, FBS, and HOMA-IR were examined for the participants along with the allelic and genotypic frequency of Cdx2 polymorphism G/A (rs11568820) from Isfahan Fertility and Infertility Center, Iran. The ASM-PCR (multiplex allele-specific PCR) technique was utilized in this regard. Results The age of PCOS women was less ( P < 0.001) than the controls. In PCOS women, insulin, FBS, and HOMA-IR serum levels were higher than in the control women (all P values 0.05). For GG, AG, AA,A, and G Cdx2 (A/G) genotypic/allelic frequencies were 84.2%, 15.8%, 0%, 7.9%, and 92.1% in cases and 87.5%, 12.5%, 0%, 6.3%, and 93.8% in controls, respectively. HOMA-IR ( P = 0.047 and P = 0.033, respectively) and insulin than those with the AG genotype were in PCOS women with the GG Cdx2 genotype. The highest IGF-1 mean value ( P = 0.020) was found for the AG genotype in PCOS. In our study, a significant relation was found only between PCOS and FBS, in terms of a logistic regression analysis of Cdx2 and parameters. Conclusion In the present study, it was indicated that the GG genotype in PCOS subjects was associated with the IGF-1, HOMA-IR, and insulin. Similarly, no association was found between obese PCOS patients and Cdx 2 in the 1a promoter area of the VDR gene in our study.
摘要背景多囊卵巢综合征(PCOS)是一种内分泌紊乱,以胰岛素抵抗、多囊卵巢、月经不规律、肥胖等为特征,影响女性生育能力。在多囊卵巢综合征中,维生素D内分泌系统受维生素D受体(VDR)的调节,与II型糖尿病、内分泌功能障碍和胰岛素抵抗有关。因此,本文拟探讨肥胖型PCOS女性Cdx2 VDR基因多态性与生化因素的关系。材料与方法本病例对照研究于2016年5 - 9月招募40名未患多囊卵巢综合征的肥胖女性和38名患有多囊卵巢综合征的肥胖女性。检测受试者的胰岛素、IGF1、FBS和HOMA-IR以及来自伊朗Isfahan Fertility and Infertility Center的Cdx2多态性G/A (rs11568820)的等位基因和基因型频率。在这方面使用了ASM-PCR(多重等位基因特异性PCR)技术。结果PCOS患者年龄较小(P <0.001)。多囊卵巢综合征患者血清胰岛素、FBS和HOMA-IR水平均高于对照组(P值均为0.05)。GG、AG、AA、A和G Cdx2 (A/G)基因型/等位基因频率分别为84.2%、15.8%、0%、7.9%和92.1%,对照组为87.5%、12.5%、0%、6.3%和93.8%。GG - Cdx2基因型PCOS女性的HOMA-IR (P = 0.047)和胰岛素(P = 0.033)均高于AG基因型。IGF-1均值在AG基因型PCOS中最高(P = 0.020)。在我们的研究中,通过对Cdx2和参数的逻辑回归分析,发现PCOS和FBS之间存在显著关系。结论PCOS患者GG基因型与IGF-1、HOMA-IR、胰岛素水平相关。同样,在我们的研究中,肥胖PCOS患者与VDR基因1a启动子区域的cdx2没有关联。
{"title":"Assessment of Cdx2 polymorphism in Iranian women with polycystic ovary syndrome","authors":"Behdis Khansari, Hashem Nayeri, Maryam Ostadsharif","doi":"10.1186/s43043-023-00155-5","DOIUrl":"https://doi.org/10.1186/s43043-023-00155-5","url":null,"abstract":"Abstract Background Women’s fertility is affected by polycystic ovarian syndrome (PCOS) as an endocrine disorder with characteristic symptoms such as insulin resistance, polycystic ovaries, menstrual irregularities, and obesity. In polycystic ovarian syndrome, the vitamin D endocrine system is regulated by the vitamin D receptor (VDR) associated with type II diabetes, endocrine dysfunctions, and insulin resistance. Therefore, the current paper deals with the investigation of the connection between Cdx2 VDR gene polymorphism and the biochemical factors in obese PCOS women. Material and methods In the current case–control study, 40 obese women without PCOS and 38 obese women with PCOS were enrolled in May–September 2016. Insulin, IGF1, FBS, and HOMA-IR were examined for the participants along with the allelic and genotypic frequency of Cdx2 polymorphism G/A (rs11568820) from Isfahan Fertility and Infertility Center, Iran. The ASM-PCR (multiplex allele-specific PCR) technique was utilized in this regard. Results The age of PCOS women was less ( P < 0.001) than the controls. In PCOS women, insulin, FBS, and HOMA-IR serum levels were higher than in the control women (all P values 0.05). For GG, AG, AA,A, and G Cdx2 (A/G) genotypic/allelic frequencies were 84.2%, 15.8%, 0%, 7.9%, and 92.1% in cases and 87.5%, 12.5%, 0%, 6.3%, and 93.8% in controls, respectively. HOMA-IR ( P = 0.047 and P = 0.033, respectively) and insulin than those with the AG genotype were in PCOS women with the GG Cdx2 genotype. The highest IGF-1 mean value ( P = 0.020) was found for the AG genotype in PCOS. In our study, a significant relation was found only between PCOS and FBS, in terms of a logistic regression analysis of Cdx2 and parameters. Conclusion In the present study, it was indicated that the GG genotype in PCOS subjects was associated with the IGF-1, HOMA-IR, and insulin. Similarly, no association was found between obese PCOS patients and Cdx 2 in the 1a promoter area of the VDR gene in our study.","PeriodicalId":18532,"journal":{"name":"Middle East Fertility Society Journal","volume":"125 18","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135137401","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}
引用次数: 0
Letrozole plus misoprostol versus misoprostol alone in the induction of anembryonic missed abortion: a randomized controlled trial conducted in Upper Egypt 来曲唑加米索前列醇与米索前列醇单独诱导无胚胎性流产:在上埃及进行的一项随机对照试验
Q4 REPRODUCTIVE BIOLOGY Pub Date : 2023-11-03 DOI: 10.1186/s43043-023-00152-8
Ramy Heshmat Zekry Tadros, Usama Fouda, Sherif Sameh Zaki, Marwa Abdalla
Abstract Background A missed abortion is a spontaneous abortion in which the embryo or fetus has already died but has remained in the uterus for days or weeks with a closed cervical ostium. Termination of pregnancy could be achieved either by surgical evacuation or medical or expectant management. Letrozole is a third-generation aromatase inhibitor. According to many recent studies, letrozole given for three days before the administration of misoprostol was more effective than misoprostol alone at inducing abortion. Our study compared the efficacy of various letrozole regimens (10 mg/d for three days and a single dose of 20 mg) combined with misoprostol vs. misoprostol alone in inducing abortion. To find the most efficient regimen of letrozole administered before misoprostol to induce an abortion. Methodology This prospective, parallel, three-arm, single-blinded, allocation-concealed randomized controlled trial was conducted in Sohag Teaching Hospital in Upper Egypt. We randomly divided 105 patients with anembryonic missed abortion (up to 63 days gestation) with no history of medical disorders or a history of allergies to misoprostol or letrozole into three equal groups (a single-dose letrozole group, a multiple-dose letrozole group, and a misoprostol-only group). The complete abortion rate, incomplete abortion rate, failure to abort rate, and induction-to-abortion interval were all collected. All statistical calculations were performed using the computer program SPSS (Statistical Package for the Social Science, SPSS Inc., Chicago, IL, USA). Results The complete abortion rate was significantly higher in the single-dose letrozole and multiple-dose letrozole groups than in the misoprostol group ( p values = 0.0455 and 0.001, respectively). On the other hand, there was no significant difference in the complete abortion rate between the single-dose group and the multiple-dose letrozole group ( p -value = 0.1713). The time to complete abortion was significantly shorter in the single-dose and multiple-dose letrozole groups than in the misoprostol group ( p values = 0.0036 and 0.0049, respectively). On the other hand, there was no significant difference in the time to complete abortion between the single-dose letrozole group and the multiple-dose letrozole group ( P = 0.532). Conclusion Single- and multiple-dose letrozole regimens followed by misoprostol had a higher rate and a shorter time to complete abortion than misoprostol alone. Trial registration The trial is registered at gov with the name “letrozole and abortion” and the identifier “NCT05198050”. The date of registration was April 1, 2022, registered prospectively. URL: https://register.clinicaltrials.gov/prs/app/action/ViewOrUnrelease?uid=U0004GED&ts=25&sid=S000BPDQ&cx=43mobl .
摘要背景:漏报流产是指胚胎或胎儿已经死亡,但仍在子宫内数天或数周且宫颈口关闭的自然流产。终止妊娠可通过手术后送或医疗或预期管理来实现。来曲唑是第三代芳香酶抑制剂。根据最近的许多研究,在服用米索前列醇前三天服用来曲唑比单独服用米索前列醇更有效。我们的研究比较了不同来曲唑方案(10mg /d, 3天,单剂量20mg)联合米索前列醇与单独米索前列醇在人工流产中的效果。目的:寻找米索前列醇前应用来曲唑最有效的人工流产方案。方法本前瞻性、平行、三臂、单盲、分配隐蔽的随机对照试验在上埃及Sohag教学医院进行。我们将105例无疾病史或对米索前列醇或来曲唑过敏史的无胚胎性流产(妊娠63天以内)患者随机分为三组(单剂量来曲唑组、多剂量来曲唑组和单剂量米索前列醇组)。收集完全流产率、不完全流产率、流产失败率、引产至流产间隔时间。所有统计计算均使用SPSS (statistical Package for the Social Science, SPSS Inc., Chicago, IL, USA)计算机程序进行。结果单剂量来曲唑组和多剂量来曲唑组的完全流产率显著高于米索前列醇组(p值分别为0.0455和0.001)。另一方面,单剂量组与多剂量来曲唑组完全流产率差异无统计学意义(p值= 0.1713)。单剂量和多剂量来曲唑组完成流产时间明显短于米索前列醇组(p值分别为0.0036和0.0049)。单剂量来曲唑组与多剂量来曲唑组完成流产的时间差异无统计学意义(P = 0.532)。结论单剂量和多剂量来曲唑联合米索前列醇比单用米索前列醇流产率高,完成流产时间短。该试验在gov上注册,名称为“来曲唑与流产”,标识符为“NCT05198050”。注册日期为2022年4月1日,提前注册。网址:https://register.clinicaltrials.gov/prs/app/action/ViewOrUnrelease?uid=U0004GED&ts=25&sid=S000BPDQ&cx=43mobl。
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Middle East Fertility Society Journal
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