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Prediction of polycystic ovary syndrome using machine learning with SFS and Boruta feature selection: an explainable AI approach. 使用SFS和Boruta特征选择的机器学习预测多囊卵巢综合征:一种可解释的人工智能方法。
IF 2.2 4区 医学 Q3 ANDROLOGY Pub Date : 2025-12-01 Epub Date: 2025-09-21 DOI: 10.1080/19396368.2025.2560839
Monali Ramteke, Shital Raut

Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder affecting numerous women of reproductive age, characterized by a variety of clinical and biochemical features. Accurate classification and diagnosis of PCOS remains challenging due to the heterogeneous nature of its manifestations. This study introduces a robust machine learning framework that combines a voting ensemble model with two distinct feature selection techniques, Sequential Forward Selection (SFS) and Boruta, to enhance the accuracy in classifying PCOS. We also utilized Explainable Artificial Intelligence (XAI) techniques, such as Shapley Additive Explanations (SHAP), Local Interpretable Model-agnostic Explanations (LIME), Partial Dependence Plot (PDP), AnchorTabular, and Permutation Importance, to interpret the ensemble model. These methods provide essential insights into the significance of key features for predicting PCOS patients. Results show that the proposed ensemble learning model achieved optimal performance with the feature selection technique used. Specifically, the proposed voting ensemble classifier and features picked by SFS had the highest accuracy among all models. This method can help in PCOS diagnosis and support early intervention.

多囊卵巢综合征(PCOS)是一种影响众多育龄妇女的复杂内分泌疾病,具有多种临床和生化特征。由于多囊卵巢综合征表现的异质性,其准确的分类和诊断仍然具有挑战性。本研究引入了一个鲁棒的机器学习框架,该框架将投票集成模型与两种不同的特征选择技术(顺序前向选择(SFS)和Boruta)相结合,以提高PCOS分类的准确性。我们还利用可解释人工智能(XAI)技术,如Shapley加性解释(SHAP)、局部可解释模型不可知解释(LIME)、部分依赖图(PDP)、锚表(AnchorTabular)和置换重要性(Permutation Importance)来解释集成模型。这些方法为预测PCOS患者的关键特征提供了重要的见解。结果表明,采用特征选择技术的集成学习模型取得了最优的学习性能。其中,提出的投票集成分类器和SFS选择的特征在所有模型中准确率最高。该方法有助于多囊卵巢综合征的诊断和早期干预。
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引用次数: 0
An intelligent decision-making system for embryo transfer in reproductive technology: a machine learning-based approach. 生殖技术中胚胎移植的智能决策系统:基于机器学习的方法。
IF 2.1 4区 医学 Q3 ANDROLOGY Pub Date : 2025-12-01 Epub Date: 2025-01-28 DOI: 10.1080/19396368.2024.2445831
Sanaa Badr, Meryem Tahri, Mohamed Maanan, Jan Kašpar, Noura Yousfi

Infertility has emerged as a significant public health concern, with assisted reproductive technology (ART) is a last-resort treatment option. However, ART's efficacy is limited by significant financial cost and physical discomfort. The aim of this study is to build Machine learning (ML) decision-support models to predict the optimal range of embryo numbers to transfer, using data from infertile couples identified through literature reviews. Binary classification models were developed to classify cases into two groups: those transferring two or fewer embryos and those transferring three or four. Four popular ML algorithms were used, including random forest (RF), logistic regression (LR), support vector machine (SVM), and artificial neural network (ANN), considering seven criteria: the woman's age, sperm origin, the developmental qualities of four potential embryos, infertility duration, assessment of the woman, morphological qualities of the four best embryos on the day of transfer, and number of oocytes extracted. The stratified 3-fold cross-validation results show that the SVM model obtained the highest average accuracy (95.83%) and demonstrated the best overall performance, closely followed by the ANN and LR models with an average accuracy equal to 91.67%. The RF model achieved a slightly lower average accuracy (88.89%), which demonstrated the lowest variability. Testing on a new dataset revealed all models performed well, with ANN and SVM models classified all test set instances correctly, while the RF and LR models achieved 91.68% accuracy. These results highlight the superior generalization and effectiveness of the ANN and SVM models in guiding ART decisions.

不孕不育已成为一个重大的公共卫生问题,辅助生殖技术(ART)是最后的治疗选择。然而,ART的疗效受到巨大的财务成本和身体不适的限制。本研究的目的是建立机器学习(ML)决策支持模型,使用通过文献综述确定的不育夫妇的数据来预测移植胚胎数量的最佳范围。建立了二元分类模型,将病例分为两组:移植两个或更少胚胎的病例和移植三个或四个胚胎的病例。采用随机森林(RF)、逻辑回归(LR)、支持向量机(SVM)和人工神经网络(ANN)等4种流行的ML算法,考虑7个标准:女性年龄、精子来源、4个潜在胚胎的发育质量、不孕持续时间、女性评估、移植当天4个最佳胚胎的形态质量和提取的卵母细胞数量。分层3重交叉验证结果表明,SVM模型平均准确率最高(95.83%),综合性能最佳,ANN和LR模型紧随其后,平均准确率为91.67%。RF模型的平均准确率略低(88.89%),这表明变异性最低。在新数据集上的测试表明,所有模型都表现良好,ANN和SVM模型对所有测试集实例的分类正确,而RF和LR模型的准确率达到91.68%。这些结果突出了ANN和SVM模型在指导ART决策方面的卓越泛化和有效性。
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引用次数: 0
Novel insights on cryostress, cryoinjury and cryotolerance in sperm - a review. 精子低温胁迫、低温损伤和低温耐受性研究进展综述。
IF 2.2 4区 医学 Q3 ANDROLOGY Pub Date : 2025-12-01 Epub Date: 2025-12-08 DOI: 10.1080/19396368.2025.2579555
Balaganur Krishnappa, Bala Krishnan Binsila, Arunachalam Arangasamy, Marappan Gopi, Natesan Ramachandran, Santhanahalli Siddalingappa Archana, Divakar Swathi, Anjilikal Tomy Tomcy, Laxman Ramya, Sellappan Selvaraju

Sperm cryopreservation is a critical component of assisted reproductive technologies employed for both livestock breeding and human fertility management. Sperm are the highly specialized motile cells prone to cryodamage during freezing. Moreover, buffalo, pig and sheep sperm are more susceptible to cryoinjury leading to increased semen rejection rates and substantial economic losses due to reduced fertility. Advances in freezing protocols and modulation in composition of semen diluents protect sperm from cryodamage; however, inconsistency and inter-individual variability in semen freezability exist due to multifactorial etiology. The use of molecular technologies, particularly genomics, transcriptomics, proteomics, and metabolomics led to identification of potential biomarkers associated with cryotolerance. These omics-driven insights have not only enlightened our understanding of the molecular basis of cryoinjury but also has the potential in selecting bulls with good semen freezability. A multidisciplinary approach toward the development of targeted strategies such as supplementing extenders with novel cryotolerant biomolecules to mitigate the sperm damage. This review consolidates current knowledge on the molecular and physiological underpinnings of sperm cryodamage offering a holistic perspective that may guide refinement of existing cryopreservation protocols and extenders for improving sperm cryo-survivability in breeding males.

精子冷冻保存是辅助生殖技术的重要组成部分,用于牲畜育种和人类生育管理。精子是高度特化的运动细胞,在冷冻过程中容易受到低温损伤。此外,水牛、猪和羊的精子更容易受到冷冻损伤,导致精液排异率增加,并因生育力降低而造成重大经济损失。冷冻方案的进展和精液稀释剂组成的调制保护精子免受冷冻损伤;然而,由于多因素的病因,精液冷冻性存在不一致和个体间差异。利用分子技术,特别是基因组学、转录组学、蛋白质组学和代谢组学,鉴定出与低温耐受性相关的潜在生物标志物。这些组学驱动的见解不仅启发了我们对冷冻损伤分子基础的理解,而且在选择具有良好精液冷冻性的公牛方面具有潜力。一种多学科的方法来发展有针对性的策略,如补充新的低温耐受性生物分子来减轻精子损伤。这篇综述整合了目前关于精子冷冻损伤的分子和生理基础的知识,提供了一个整体的视角,可以指导改进现有的冷冻保存方案和扩展物,以提高精子在繁殖雄性中的冷冻存活率。
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引用次数: 0
Animal models of polycystic ovary syndrome. 多囊卵巢综合征的动物模型。
IF 2.2 4区 医学 Q3 ANDROLOGY Pub Date : 2025-12-01 Epub Date: 2025-09-12 DOI: 10.1080/19396368.2025.2551005
Swanand Kulkarni, Dnyanesh Dahake, Khushi Gupta, Ketan Rathod, Urmila Aswar, Suresh Thareja

Polycystic ovary syndrome (PCOS) has an endocrine pathophysiology that needs immediate clinical attention for effective mitigation, as a significant portion of the reproductive population is affected globally. Current treatment options for PCOS are symptom-specific, and more extensive research is imperative to meet the therapeutic needs of the disease. Besides in vitro studies, the assessment of novel anti-PCOS drugs can be more effectively carried out through in vivo experimentation, for which the choice of appropriate animal models based on parameters and pathways to be evaluated is crucial. For a good preclinical evaluation, the animal model must ensure disease reproducibility and predictive validity. The present review provides insights into the animal models reported in the literature for PCOS studies and the aspects in which various therapeutics under study can be evaluated using these models. These animal models are also classified based on the mode of induction, duration essential for induction, and species. Besides, mammalian, non-mammalian and transgenic models are also included. This review will provide a detailed analysis to the researchers working in the domain of PCOS to facilitate an easy choice of appropriate animal model for their study and to identify the scope of developing newer animal models for PCOS study.

多囊卵巢综合征(PCOS)具有内分泌病理生理,需要立即引起临床关注以有效缓解,因为全球有很大一部分生殖人口受到影响。目前多囊卵巢综合征的治疗方案是症状特异性的,更广泛的研究是必要的,以满足疾病的治疗需求。除体外研究外,通过体内实验可以更有效地对新型抗多囊卵巢综合征药物进行评估,根据待评估的参数和途径选择合适的动物模型至关重要。为了进行良好的临床前评估,动物模型必须确保疾病的可重复性和预测有效性。本文综述了文献中报道的用于多囊卵巢综合征研究的动物模型,以及利用这些模型对各种治疗方法进行评估的方面。这些动物模型也根据诱导方式、诱导所需的持续时间和物种进行分类。此外,还包括哺乳动物、非哺乳动物和转基因模型。本文旨在为PCOS领域的研究人员提供详细的分析,以方便他们选择合适的动物模型进行研究,并确定开发新的PCOS动物模型的范围。
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引用次数: 0
Mitochondrial quality control disorder: a potential mechanism of male infertility. 线粒体质量控制障碍:男性不育的潜在机制。
IF 2.2 4区 医学 Q3 ANDROLOGY Pub Date : 2025-12-01 Epub Date: 2025-11-04 DOI: 10.1080/19396368.2025.2574003
Shanshan Qin, Ziming Zhu, Shenmin Lv, Zhipeng Guo, Linhui Xia, Xiaoyu Gong, Xiangyu Wang, Jinxiang Yuan, Kai Meng, Jianping Zhu

In recent years, the incidence of male infertility has increased to approximately 10%, with a continued upward trend. Therefore, understanding the mechanisms underlying male infertility and developing effective treatment strategies have become essential areas of focus. Mitochondria are regulated by a complex quality control system including mitochondrial dynamics, mitophagy and biogenesis, which not only maintains mitochondrial structural and functional integrity, but also supports the stability of testicular tissue and the intracellular environment necessary for male fertility. Several studies have demonstrated that dysfunction in mitochondrial dynamics and mitophagy is closely associated with a decline in male fertility. Disruptions caused by excessive external stimuli or gene mutations can impair these processes, resulting in oxidative damage, apoptosis, inflammation, and ferroptosis. These pathological changes ultimately damage testicular cells and tissues. Consequently, this review will focus on the two key mechanisms: mitochondrial dynamics and mitophagy. Furthermore, mitochondrial biogenesis-responsible for producing new mitochondria and regulating the number of mitochondria-also plays an important role in maintaining male fertility. Related studies have shown that mitochondrial biogenesis dysfunction can trigger a cascade of pathological events that lead to testicular tissue damage. In summary, this review systematically examines the roles of mitochondrial dynamics and mitophagy in regulating male fertility. It provides an in-depth analysis of the pathological mechanisms by which dysfunction in these processes leads to male infertility. Additionally, this review summarizes current therapeutic agents targeting mitochondrial dynamics and mitophagy, aiming to identify potential strategies for the clinical treatment of male infertility.

近年来,男性不育症的发病率已增加到约10%,并有持续上升的趋势。因此,了解男性不育症的机制和制定有效的治疗策略已成为重点关注的重要领域。线粒体受包括线粒体动力学、线粒体自噬和生物发生在内的复杂质量控制系统的调控,不仅维持线粒体结构和功能的完整性,而且支持睾丸组织的稳定性和男性生育所需的细胞内环境。一些研究表明,线粒体动力学和线粒体自噬功能障碍与男性生育能力下降密切相关。过度的外部刺激或基因突变引起的破坏可损害这些过程,导致氧化损伤、细胞凋亡、炎症和铁下垂。这些病理变化最终损害睾丸细胞和组织。因此,本文将重点讨论两个关键机制:线粒体动力学和线粒体自噬。此外,线粒体生物发生——负责产生新的线粒体和调节线粒体数量——在维持男性生育能力方面也起着重要作用。相关研究表明,线粒体生物发生功能障碍可引发一系列病理事件,导致睾丸组织损伤。综上所述,本文系统地探讨了线粒体动力学和线粒体自噬在调节男性生育能力中的作用。它提供了一个深入的病理机制,其中功能障碍在这些过程中导致男性不育的分析。此外,本文综述了目前针对线粒体动力学和线粒体自噬的治疗药物,旨在寻找临床治疗男性不育症的潜在策略。
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引用次数: 0
In vitro maturation of oocytes (IVM): historical landmarks, current status and future perspectives. 卵母细胞体外成熟(IVM):历史里程碑、现状和未来展望。
IF 2.1 4区 医学 Q3 ANDROLOGY Pub Date : 2025-12-01 Epub Date: 2025-03-12 DOI: 10.1080/19396368.2025.2469574
Katerina Chatzimeletiou, Konstantina Pappa, Nikos Petrogiannis, George Anifandis, Kalliopi Chatzovoulou, Elias Tsakos, Efstratios Kolibianakis, Grigoris Grimbizis, Antonia Sioga

One of the major advancements in in vitro fertilization (IVF) has been the development of culture media that enhance gamete maturation in vitro and sustain embryo development up to the blastocyst stage. The deep understanding of the mechanisms involved in gametogenesis and the complex sequence of events surrounding nuclear and cytoplasmic maturation has also enabled the development of efficient in vitro maturation (IVM) protocols. This review outlines the major landmarks in the history of in vitro maturation of oocytes, the advantages and importance of its clinical application in human, especially in patients with Polycystic Ovary Syndrome (PCOS), Resistant Ovary Syndrome, high antral follicle count or oncology patients, as well as the safety and efficacy of the technique. IVM has not been shown yet to be as effective as controlled ovarian stimulation in terms of maturation rates, fertilization rates, and clinical outcome, possibly owing to a dysfunctional or asynchronous nuclear/cytoplasmic maturation process. A confusing set of IVM clinical protocols may also have contributed to the slow incorporation of the technology into routine IVF practice. However, recent improvements have led to comparable live birth rates between IVM and IVF, in women with high antral follicle count. The current status of IVM in the Assisted Reproductive Technology (ART) laboratory and its future perspectives, aiming to provide maximum fertility care to patients will be discussed.

体外受精(IVF)的主要进展之一是培养基的发展,这种培养基可以促进配子在体外成熟,并将胚胎发育到囊胚阶段。对配子体发生机制的深入了解,以及围绕核和细胞质成熟的复杂事件序列,也使高效的体外成熟(IVM)方案得以发展。本文综述了卵母细胞体外成熟史上的主要里程碑,其在人类临床应用的优势和重要性,特别是在多囊卵巢综合征(PCOS)、抗性卵巢综合征、高窦卵泡计数或肿瘤患者中的应用,以及该技术的安全性和有效性。在成熟率、受精率和临床结果方面,IVM尚未显示出与受控卵巢刺激一样有效,这可能是由于核/细胞质成熟过程功能失调或不同步所致。一套令人困惑的体外受精临床方案也可能是将该技术缓慢纳入常规体外受精实践的原因。然而,最近的改进导致了IVM和IVF之间的活产率相当,在高腔卵泡计数的妇女中。本文将讨论体外受精技术在辅助生殖技术(ART)实验室中的应用现状及其未来前景,以期为患者提供最大限度的生育护理。
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引用次数: 0
Oocyte checkpoint response to the spindle poison depends on the cytoplasm volume. 卵母细胞对纺锤体毒素的检查点反应取决于细胞质体积。
IF 2.2 4区 医学 Q3 ANDROLOGY Pub Date : 2025-12-01 Epub Date: 2025-10-27 DOI: 10.1080/19396368.2025.2576084
Regina Daszkiewicz, Łukasz Gąsior, Katarzyna Kotarska, Zbigniew Polanski

The embryonic aneuploidy in mammals may arise from impaired Spindle Assembly Checkpoint (SAC) function, a mechanism which prevents errors in chromosome segregation by blocking anaphase in response to spindle anomalies. Mammalian oocytes are particularly susceptible to these errors, possibly because the large oocyte volume favors dilution of the checkpoint signal, preventing its efficient function. This study aimed to investigate hypothesis that oocyte cytoplasmic volume affects SAC functionality. Oocyte size was manipulated in prophase oocytes (before nuclear envelope breakdown, NEBD) or in M-phase oocytes (after NEBD) by either reducing or increasing cytoplasmic volume by half. These oocytes were then cultured in the presence of nocodazole which activated the SAC by arresting oocytes in metaphase I of the first meiotic division. The functionality of SAC was assessed by measuring the proportion of oocytes escaping SAC-induced metaphase I arrest and completing the first meiotic division i.e., extruding the first polar body and entering the metaphase II of the second meiotic division. Reduction of the cytoplasmic volume in the prophase stage resulted in stronger checkpoint function, with only 4% of oocytes escaping SAC arrest compared to 36% of control normal-sized oocytes. Conversely, enlarged oocytes showed diminished checkpoint efficiency, with 54% bypassing checkpoint-induced arrest compared to 20% of control normal-sized oocytes. Importantly, no such relationship was observed when cytoplasmic volume was altered in oocytes after NEBD. This may suggest that the SAC depends on some nucleus-associated factors that are released into the cytoplasm after NEBD, since such factors would be twice as concentrated in oocytes undergoing volume reduction before NEBD compared to those undergoing reduction after NEBD. These results prove that SAC efficiency in mouse oocytes is influenced by cytoplasmic volume, with larger volumes impairing its function.

哺乳动物的胚胎非整倍性可能是由于纺锤体组装检查点(SAC)功能受损引起的,这是一种通过阻断纺锤体异常的后期来防止染色体分离错误的机制。哺乳动物卵母细胞特别容易受到这些错误的影响,可能是因为大的卵母细胞体积有利于稀释检查点信号,从而阻碍其有效发挥作用。本研究旨在探讨卵母细胞细胞质体积影响SAC功能的假说。在前期卵母细胞(核膜破裂前,NEBD)或m期卵母细胞(NEBD后)中,通过减少或增加一半的细胞质体积来控制卵母细胞的大小。这些卵母细胞随后在nocodazole存在下培养,nocodazole通过在第一次减数分裂中期阻止卵母细胞激活SAC。通过测定卵母细胞脱离SAC诱导的中期I阻滞并完成第一次减数分裂即挤出第一个极体并进入第二次减数分裂中期II的比例来评估SAC的功能。前期细胞质体积的减少导致检查点功能更强,只有4%的卵母细胞逃脱了SAC阻滞,而正常大小的卵母细胞的这一比例为36%。相反,增大的卵母细胞显示检查点效率降低,54%的卵母细胞绕过检查点诱导的阻滞,而正常大小的卵母细胞为20%。重要的是,当NEBD后卵母细胞的细胞质体积改变时,没有观察到这种关系。这可能表明SAC依赖于NEBD后释放到细胞质中的一些核相关因子,因为这些因子在NEBD前体积减小的卵母细胞中的浓度是NEBD后体积减小的卵母细胞的两倍。这些结果证明,小鼠卵母细胞的SAC效率受到细胞质体积的影响,细胞质体积越大,其功能就越弱。
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引用次数: 0
The genetic basis of male and female infertility. 男性和女性不育的遗传基础。
IF 2.1 4区 医学 Q3 ANDROLOGY Pub Date : 2025-12-01 Epub Date: 2025-04-28 DOI: 10.1080/19396368.2025.2493621
Dimitrios Ioannou, Helen G Tempest

This review provides a comprehensive overview of the genetic factors underlying male and female infertility. Infertility affects an estimated one in six couples worldwide, with both male and female factors contributing equally to its prevalence. Approximately, 50% of infertility cases are attributed to genetic causes. We explore three main categories of genetic causes: chromosomal abnormalities, monogenic disorders, and syndromic conditions. Chromosomal causes, including numerical and structural aberrations, are discussed with a focus on their impact on gametogenesis and reproductive outcomes. We review key monogenic causes of infertility, highlighting recent discoveries in genes critical for gonadal development, gametogenesis, and hormonal regulation. Syndromic conditions affecting fertility are examined, highlighting their impact on reproductive function. Throughout the review, we address the challenges in identifying genetic mechanisms of infertility, particularly focusing on the intricate processes involved in oogenesis and spermatogenesis. We also discuss how advancements in genetic testing, such as next-generation sequencing (NGS) and genome-wide association studies (GWAS), have significantly enhanced our understanding of idiopathic infertility and promise further insights in the future. We also discuss the clinical implications of genetic diagnoses, including the role of preimplantation genetic testing (PGT) and genetic counseling in reproductive medicine. This review synthesizes current knowledge on the genetic basis of infertility, providing a comprehensive overview of chromosomal, monogenic, and syndromic causes. It aims to offer readers a solid foundation for understanding the complex genetic factors underlying reproductive disorders.

本文综述了男性和女性不育症的遗传因素。据估计,全世界有六分之一的夫妇受到不孕症的影响,男性和女性因素对其发病率的影响是相同的。大约50%的不孕症病例归因于遗传原因。我们探讨三个主要类别的遗传原因:染色体异常,单基因疾病和综合征条件。染色体原因,包括数字和结构畸变,重点讨论了它们对配子发生和生殖结果的影响。我们回顾了不育的主要单基因原因,重点介绍了对性腺发育、配子发生和激素调节至关重要的基因的最新发现。检查影响生育的综合症,突出其对生殖功能的影响。在整个综述中,我们解决了在确定不孕症的遗传机制方面的挑战,特别是关注涉及卵子发生和精子发生的复杂过程。我们还讨论了基因检测的进步,如下一代测序(NGS)和全基因组关联研究(GWAS),如何显著提高我们对特发性不孕症的理解,并承诺在未来进一步深入了解。我们还讨论了遗传诊断的临床意义,包括胚胎植入前基因检测(PGT)和遗传咨询在生殖医学中的作用。这篇综述综合了目前关于不孕症的遗传基础知识,提供了染色体、单基因和综合征原因的全面概述。它的目的是为读者提供一个坚实的基础,了解复杂的遗传因素潜在的生殖障碍。
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引用次数: 0
Whole exome sequencing uncovers rare variants associated with PCOS susceptibility in Indian women. 全外显子组测序揭示了与印度妇女多囊卵巢综合征易感性相关的罕见变异。
IF 2.1 4区 医学 Q3 ANDROLOGY Pub Date : 2025-12-01 Epub Date: 2025-03-14 DOI: 10.1080/19396368.2025.2471418
Medini Samant, Mahalakshmi Bhat, Roshan Dadachanji, Digumarthi V S Sudhakar, Anushree Patil, Srabani Mukherjee

Polycystic ovary syndrome (PCOS) is a complex polygenic endocrinopathy affecting 5-20% of reproductive-age women. Familial studies, candidate gene studies, and GWAS have identified multiple PCOS-associated genetic loci. This study aims to identify the functional variants associated with PCOS. We applied whole exome sequencing (WES) to identify functional variants among eighty-five well-characterized women with PCOS. The annotated variants were filtered based on minor allele frequency and in-silico pathogenicity prediction. We found a significant association of 234 rare pathogenic nonsynonymous variants in 201 genes with PCOS in our study group. These genes are linked to steroid hormone biosynthesis, ovarian steroidogenesis, insulin resistance, and PI3K-Akt signaling pathway which are influential in PCOS pathophysiology. Further, several rare variants were found to be unique to women with and without insulin resistance, and enrichment analysis revealed that carbohydrate and lipid metabolism was especially deranged in insulin-resistant PCOS women. Variants of the steroidogenesis pathway were validated by Sanger sequencing including rs368902124 (CYP19A1), rs143286842 (IGF1R), and rs555458296 (BMP-6). In-silico analysis by DUET showed that these variants destabilized the folding of their corresponding protein. Women carrying these rare variants presented with altered hormonal profiles and clinical signs of hyperandrogenism and hyperinsulinemia, emphasizing their impact on PCOS pathophysiology. Several functional rare variants have been revealed to be associated with increased PCOS risk in the present study thus, expanding the genetic susceptibility landscape of Indian women to PCOS.

多囊卵巢综合征(PCOS)是一种复杂的多基因内分泌病,影响5-20%的育龄妇女。家族性研究、候选基因研究和GWAS已经确定了多个pcos相关的遗传位点。本研究旨在鉴定与PCOS相关的功能变异。我们应用全外显子组测序(WES)来鉴定85名特征明确的PCOS女性的功能变异。根据小等位基因频率和计算机预测的致病性对加注释的变异进行筛选。在我们的研究组中,我们发现201个基因中的234个罕见致病性非同义变异体与PCOS有显著关联。这些基因与类固醇激素生物合成、卵巢类固醇生成、胰岛素抵抗和PI3K-Akt信号通路相关,对PCOS的病理生理有影响。此外,我们还发现了一些罕见的变异是有胰岛素抵抗和没有胰岛素抵抗的女性所特有的,富集分析显示,在胰岛素抵抗的PCOS女性中,碳水化合物和脂质代谢尤其紊乱。Sanger测序验证了甾体生成途径的变体,包括rs368902124 (CYP19A1)、rs143286842 (IGF1R)和rs555458296 (BMP-6)。DUET的计算机分析表明,这些变异破坏了相应蛋白质的折叠。携带这些罕见变异的女性表现出激素谱改变和高雄激素症和高胰岛素血症的临床症状,强调了它们对多囊卵巢综合征病理生理的影响。在本研究中发现了几种功能性罕见变异与多囊卵巢综合征风险增加有关,从而扩大了印度妇女对多囊卵巢综合征的遗传易感性。
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引用次数: 0
Navigating the practical challenges and ethical dilemmas of surplus cryopreserved human embryos. 超低温保存人类胚胎的实践挑战和伦理困境。
IF 2.1 4区 医学 Q3 ANDROLOGY Pub Date : 2025-12-01 Epub Date: 2025-01-28 DOI: 10.1080/19396368.2025.2449901
George Anifandis, Dimitrios Ioannou, Georgia Kokkali, Katerina Chatzimeletiou, Christina Messini, Sevastiani Antonouli, Helen G Tempest

Cryopreservation, the use of very low temperatures to preserve structurally intact living cells and tissues, has seen exponential growth in the field of in vitro fertilization (IVF). In the last decade, cryopreservation of embryos and freeze-all protocols have become an essential aspect and a prerequisite for a successful IVF outcome. Moreover, vitrification, which is a fast and safe cryopreservation method, has proved to be an effective choice for cryopreserving gametes and embryos. The increasing number of cryopreserved embryos worldwide in cryobanks and IVF clinics is an undisputable fact that raises important physiological, ethical, and moral considerations that merit careful examination and discussion. Many couples utilizing assisted reproduction will have a surplus of cryopreserved embryos, in other words they already have completed their family without exhausting all the embryos that were created and cryopreserved during the process. Additionally, the global IVF market has also experienced significant growth due to various factors, including advancements in technology, increased awareness about infertility treatments, and changing societal norms towards delayed parenthood. Thus, for the foreseeable future the number of cryopreserved embryos, and the phenomenon of surplus embryos will likely remain unresolved. In the present review, following a description of the cryopreservation method and the physiological changes during the cryopreservation of embryos, the bioethical issues raised by the surplus cryopreserved embryos will be discussed alongside possible solutions for resolving this phenomenon.

低温保存,利用极低的温度来保存结构完整的活细胞和组织,在体外受精(IVF)领域得到了指数级的增长。在过去的十年里,胚胎冷冻保存和冷冻技术已经成为试管婴儿成功的一个重要方面和先决条件。此外,玻璃化冷冻作为一种快速、安全的冷冻保存方法,已被证明是冷冻保存配子和胚胎的有效选择。在世界范围内,冷冻银行和体外受精诊所中冷冻保存的胚胎数量不断增加,这是一个无可争议的事实,它引起了重要的生理、伦理和道德方面的考虑,值得仔细检查和讨论。许多使用辅助生殖技术的夫妇将有多余的冷冻胚胎,换句话说,他们已经完成了他们的家庭,而没有耗尽在这个过程中创造和冷冻保存的所有胚胎。此外,由于各种因素,包括技术进步,对不孕症治疗认识的提高以及对延迟生育的社会规范的改变,全球试管婴儿市场也经历了显着增长。因此,在可预见的未来,冷冻胚胎的数量和多余胚胎的现象可能仍未得到解决。在本文中,本文将介绍冷冻保存的方法和胚胎在冷冻保存过程中的生理变化,并讨论剩余冷冻胚胎引起的生物伦理问题以及解决这一现象的可能解决方案。
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Systems Biology in Reproductive Medicine
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