Journal of Reproduction and Infertility最新文献

Background: Testicular torsion is a critical urological emergency that can lead to testicular ischemia and significant tissue damage. Citrulline, a supplement known for enhancing cellular metabolism and mitigating oxidative stress and inflammation, has been explored for its protective effects against testicular injury resulting from torsion and detorsion in rat models.

Methods: This study involved 42 Wistar rats, divided into six groups: Sham, torsion/detorsion (T/D), and four groups receiving varying doses of Citrulline (300, 600, 900 mg/kg) and vitamin E (20 mg/kg). A surgical procedure was performed to induce torsion by rotating the left testicle for 4 hr, followed by reperfusion. Daily oral administration of the supplements continued for one week post-surgery. Assessments included oxidative stress markers, apoptosis, inflammation, pathology, and sperm parameters. Statistical analysis was conducted using GraphPad Prism.

Results: Citrulline administration at doses of 600 and 900 mg/kg significantly reduced malondialdehyde (MDA) and reactive oxygen species (ROS) levels. Additionally, it increased glutathione (GSH) levels and decreased protein carbonyl levels at the 900 mg/kg dose. The expression of interleukin-6 (IL-6) decreased at 900 mg/kg, tumor necrosis factor-alpha (TNF-α) levels dropped at 600 and 900 mg/kg, and the pro-apoptotic factor Bax was reduced at all doses. Sperm analysis showed improved sperm count and motility at the 900 mg/kg dose. Histological examination revealed significant positive effects of Citrulline on testicular tissue.

Conclusion: Citrulline effectively lowers oxidative stress, inflammation, while enhancing sperm quality and pathological outcomes. These results indicate that Citrulline has potential as a therapeutic agent for testicular torsion.

Background: The purpose of the present study was to investigate the assisted reproductive technology (ART) outcomes after ethanol sclerotherapy (EST) in poor responder patients with endometriomas.

Methods: In this before-after clinical trial, the outcomes of ART of 31 poor responders with endometriomas were evaluated after EST between July 2023 to March 2024. These patients had undergone ART at least in one cycle before and did not respond well. Recurrence rate, antral follicle count (AFC), anti-Müllerian hormone (AMH), and relief of symptoms including dysmenorrhea and abnormal uterine bleeding (AUB) were evaluated before the procedure. Follow-up assessments were conducted two and six weeks after the procedure for evaluating the complications. Fisher's exact test, chi-square test, and paired sample t-test were used for statistical analysis using SPSS 24.

Results: In this study, the levels of AFC and AMH increased significantly after endometrioma stripping therapy (p<0.05). Additionally, the number of embryos obtained increased significantly, indicating potential improvement in oocyte quality. There was a significant reduction in pelvic pain scores (p=0.001), as well as a notable decrease in dysmenorrhea (p=0.02) and dyspareunia (p=0.001). Moreover, 16.12% of patients reported recovery from intermenstrual bleeding. However, no significant difference was observed in the amount of gonadotropin used (p=0.56).

Conclusion: EST is an appropriate and safe procedure before ART for poor responders who have endometriomas and can be a replacement for surgery among selected patients.

The impact of artificial light exposure on human health has garnered significant attention in recent years. In particular, its effects on reproductive health have raised concerns. Given that the onset of menarche serves as a crucial indicator of reproductive maturity, understanding the implications of artificial light exposure becomes paramount. Age of menarche onset occurs relatively earlier in urban females than females raised in rural areas. Besides the decline in age of menarche onset, exposure to artificial light may contribute to impairment in reproductive hormones, particularly gonadotropins, by disrupting rhythms of reproductive hormones, modulating stress hormones and kisspeptin productions, and causing body weight changes. This drastic environmentally induced change may increase the proportion of teenage pregnancies, unfulfilled childhood dreams, depression, and ill-prepared marriages, thus creating a potential need for public health intervention. Due to limited studies and often lack of longitudinal data, a significant knowledge gap exists in unraveling the potential mechanism involved in alteration of these physiologic processes. The purpose of the current review was to elucidate the intricate interplay between environmental factors, cultural practices, and biological processes within indigenous communities. By meticulously examining the multifaceted influences of artificial light, including its prevalence and varying intensity based on geographical locations and light pollution levels, this study aimed to provide scholarly insights in-to the pathophysiologic mechanisms underlying the observed changes. The findings of this inquiry will also inform evidence-based strategies and interventions aimed at safeguarding the reproductive well-being of indigenous populations amidst the escalating challenges posed by artificial light exposure.

Background: COVID-19 infection during pregnancy could be associated with placental histopathological changes such as vascular diseases and malperfusion. There are studies showing that mRNA vaccines are not associated with significant placental pathological changes. Our objective was to evaluate the placental histopathology in pregnant women who received Sinopharm, an inactivated virus vaccine, during pregnancy.

Case presentation: The study included placental samples collected from mothers who gave birth of living singletons through elective cesarean sections performed between March 2022 and May 2022 at Imam Khomeini Hospital Complex. The study included women who had no history of positive reverse transcription polymerase chain reaction (RT-PCR) testing for COVID-19 during pregnancy, and had received at least one dose of COVID-19 vaccine during their pregnancy. Humoral levels of anti-SARS-CoV-2 spike IgG were measured in both the mothers and neonates.

Results: The study included 20 mother-neonate pairs. The mean maternal age was 34±3.6 years, and all mothers received Sinopharm vaccine as their first and second doses. The last vaccine dose was administered during pregnancy, with 3 mothers receiving it in the first trimester, 9 in the second trimester, and 8 in the third trimester. The histopathological findings in the placental samples included decidual vasculopathy, subchorionic thrombosis, and chronic histiocytic intervillositis. All mothers and neonates, except one pair, were positive for anti-spike antibody.

Conclusion: Multiple abnormal histopathological findings were reported in placenta of vaccinated mothers. However, similar to previous studies, these placental findings are considered mild lesions and have been observed in both vaccinated and unvaccinated mothers.

Background: The purpose of the current study was to compare the color Doppler findings of uterine arteries and perinatal outcomes in pregnant women with and without previous cesarean section (C/S).

Methods: This cohort study enrolled 308 pregnant women aged 20-35 without underlying diseases, with at least one previous pregnancy and childbirth. The participants were divided into two groups: 154 women without C/S and 154 women with C/S. Baseline data were collected, followed by uterine artery Doppler scans. Then, the perinatal outcomes, including pre-eclampsia, intrauterine growth restriction (IUGR), premature delivery, and birth weight were evaluated.

Results: The average age of patients in the C/S group was 30.46±3.81, which was significantly higher than the non-C/S group (28.86±4.64). It was found that uterine artery resistance was higher in women with C/S history (1.11±0.44, p<0.001) compared to those without (1.00±0.37, p<0.001). Pre-eclampsia incidence was also higher in C/S group (16.1%, p=0.042) compared to non-C/S group (9.1%, p=0.042). The incidence of preterm birth in the C/S group (p=0.209), the incidence of IUGR (p=0.791), and the average birth weight (p=0.291) in the two groups did not differ significantly. The average gestational age in the C/S group was 37.54±1.4, and in the non-C/S group was 38.01±1.99 weeks. The results were not affected by potential confounders such as age, the time interval between pregnancies, and also body mass index.

Conclusion: Previous cesarean section can significantly increase the uterine artery resistance in subsequent pregnancy.

Background: Progesterone (P4) activates sperm calcium channels (CatSper), allowing calcium to enter the cell, which activates NADPH Oxidase-5 (NOX5) and produces reactive oxygen species (ROS). While calcium and ROS are essential for sperm capacitation, the role of NOX5 in capacitated sperm is unclear. This study investigated NOX5 activity in capacitated human sperm.

Methods: Forty semen samples from fertile men were processed, with motile sperm separated and divided into nine groups: control (Ham's F-10), solvent (DMSO), progesterone, diphenyleneiodonium chloride (DPI, NOX5 inhibitor), phorbol-12-myristate 13-acetate (PMA, NOX5 activator), P4+DPI, P4+PMA, Trolox, and P4+ Trolox. Sperm kinematics, membrane integrity, survival rate, and ROS production was evaluated. Data were analyzed using ANOVA and Kruskal-Wallis tests, p≤ 0.05 considered statistically significant.

Results: Progressive motility significantly decreased with DPI (56.2±2.1%) and PMA (56.5±2.1%), both alone and combined with progesterone (58.0±2.0% and 57.4±2.2%), compared to the progesterone group (66.0±1.9%). No significant change was observed in the Trolox groups. Progesterone, alone or combined with DPI, PMA, and Trolox, significantly reduced sperm linearity from 0.6±0.01 to 0.5±0.01%. Straight-line velocity decreased in P4+PMA and P4+Trolox groups (88.2±4.4 and 89.7±3.9 μm/s) compared to the control group (105.0±5.5 μm/s). Trolox reduced ROS content, while other treatments had no effect on ROS levels.

Conclusion: NOX5 does not play a prominent role in capacitated sperm. The negative effects of PMA and DPI on sperm motility appear independent of their actions on NOX5 and ROS production. Trolox did not affect sperm motility and survival, indicating that capacitated sperm require little or no ROS.

Background: Endometriosis is a gynecologic disorder which causes dysmenorrhea and infertility. Early diagnosis of endometriosis can help prevent the necessity for invasive diagnostic procedures. Medical imaging has been widely utilized to diagnose various diseases without the need for invasive procedures. The purpose of this study was to investigate the cervical length in women with endometriosis.

Methods: In this case-control study, the case group consisted of nulliparous women with endometriosis, while the control group comprised nulliparous women without endometriosis. A total of 42 individuals were included in each group. Cervical length was measured using transvaginal ultrasound from the external os to the internal os. The patients in the case group underwent laparoscopy to confirm the diagnosis. Pearson chi-square test and Fisher's exact test were employed to compare categorical variables with a p<0.05 considered statistically significant.

Results: In both groups, there were no notable variations in any of the demographic characteristics. However, the severity of dysmenorrhea was significantly different between the two groups (p=0.01). The average diameter of the mediolateral cervix (29.48±6.2 and 27.14±3.8) was statistically significant between the patient group and control group, respectively (p=0.04). The mediolateral width may have a positive predictive effect on the presence of endometriosis, while cervical length appears to have a protective effect against endometriosis.

Conclusion: Demographic data do not predict endometriosis. This study suggests that mediolateral width in transvaginal sonography can serve as a minimally invasive diagnostic tool for endometriosis, showing correlation with endometriosis symptoms like dysmenorrhea and dyspareunia.

Background: Several approaches have been proposed to optimize the construction of an artificial intelligence-based model for assessing ploidy status. These encompass the investigation of algorithms, refining image segmentation techniques, and discerning essential patterns throughout embryonic development. The purpose of the current study was to evaluate the effectiveness of using U-NET architecture for embryo segmentation and time-lapse embryo image sequence extraction, three and ten hr before biopsy to improve model accuracy for prediction of embryonic ploidy status.

Methods: A total of 1.020 time-lapse videos of blastocysts with known ploidy status were used to construct a convolutional neural network (CNN)-based model for ploidy detection. Sequential images of each blastocyst were extracted from the time-lapse videos over a period of three and ten hr prior to the biopsy, generating 31.642 and 99.324 blastocyst images, respectively. U-NET architecture was applied for blastocyst image segmentation before its implementation in CNN-based model development.

Results: The accuracy of ploidy prediction model without applying the U-NET segmented sequential embryo images was 0.59 and 0.63 over a period of three and ten hr before biopsy, respectively. Improved model accuracy of 0.61 and 0.66 was achieved, respectively with the implementation of U-NET architecture for embryo segmentation on the current model. Extracting blastocyst images over a 10 hr period yields higher accuracy compared to a three-hr extraction period prior to biopsy.

Conclusion: Combined implementation of U-NET architecture for blastocyst image segmentation and the sequential compilation of ten hr of time-lapse blastocyst images could yield a CNN-based model with improved accuracy in predicting ploidy status.

Background: Oxidative stress is known to play a key role in the occurrence of polycystic ovary syndrome (PCOS) as the most common cause of anovulatory infertility. The purpose of the current study was to investigate whether diminished activity of ovarian enzymes responsible for hydrogen sulfide (H₂S) production, cystathionine β-synthase (CBS), and cystathionine γ-lyase (CSE) contributes to oxidative stress in PCOS. The study also explored whether administration of sodium hydrosulfide (NaSH), an H₂S donor, could ameliorate PCOS symptoms by reducing oxidative stress.

Methods: The total eighteen rats were randomly assigned into three groups (n=6): control, PCOS, and PCOS+NaSH. PCOS was induced by intramuscular injection of estradiol valerate to induce PCOS in the PCOS and PCOS+NaSH groups. The PCOS+NaSH group received 30 μmol/L of NaSH in drinking water for 27 days after PCOS induction. Ovarian tissue samples were analyzed for oxidative stress indices including malondialdehyde (MDA) levels and superoxide dismutase (SOD) activity. Additional analyses measured H₂S levels, CBS, and CSE activity.

Results: PCOS induction led to a significant decrease in SOD activity, H₂S levels, and CBS and CSE activity, accompanied by a significant increase in MDA levels (p<0.0001). Furthermore, PCOS caused severe histological alterations in the ovaries. However, administration of NaSH effectively restored all measured parameters to pre-PCOS induction levels (p<0.0001).

Conclusion: This study showed that the decrease in the activity of H₂S-producing enzymes and H₂S levels may contribute to oxidative stress in PCOS. Therefore, administration of NaSH as a H₂S donor can be considered as a potential therapeutic strategy for PCOS patients.