Jornal Brasileiro de Reproducao Assistida最新文献

Objective: To compare recombinant FSH (rFSH) with highly purified-human menopausal gonadotrophin (hp-hMG) on ovarian response in women undergoing elective fertility preservation (FP).

Methods: This retrospective study included 456 women who underwent elective FP with gonadotropin-releasing hormone (GnRH) antagonist or progestin-primed ovarian stimulation (PPOS) protocols between 01/2017-12/2021. Only the first treatment cycle of each woman was included. 341 women were stimulated with rFSH and 115 with hp-hMG, and the ovarian stimulation outcomes were compared. A multivariate linear regression assessed the impact of age, basal FSH, antral follicle count (AFC) and protocol and gonadotropin types on the outcomes.

Results: Women in the rFSH group were significantly younger, and their AFC was significantly higher than those in the hp-hMG group (35.50±2.12 vs. 35.99±2.13years, p=0.034 and 13.76±6.08 vs. 11.84±6.06, p=0.002). There were no significant group differences in the amount (p=0.645) and duration (p=0.265) of FSH stimulation. The estradiol level was significantly lower for the rFSH group compared to the hp-hMG group (2547.18±1648.21pg/mL vs. 3468.02±2497.69pg/mL, p<0.001), while the progesterone level was significantly higher (1.33±0.75 ng/mL vs. 1.01±0.52ng/mL, p=0.001). The numbers of retrieved and MII oocytes were significantly higher for the rFSH group compared with the hp-hMG group (16.82±10.95 vs. 13.25±9.66, p=0.02, and 13.22±9.13 vs. 9.76±7.11, p=0.005), while the maturity rates were comparable (p=0.103).

Conclusions: Patients in the rFSH group had higher numbers of both retrieved and MII oocytes when undergoing elective FP.

Objective: To identify whether the LGBT community desires to start a family and the major challenges they experience, especially in regards to assisted reproductive technology (ART) procedures in Brazil.

Methods: This cross-sectional study invited individuals Brazilian, identified themselves as cisgender, and homosexual (male and female); aged 18-60, the study used an online questionnaire distributed through various platforms.

Results: Of the 698 respondents, mostly educated and Caucasian, 86.7% were female. While 69% expressed same-sex orientation, many were in long-term relationships. Family acceptance varied, with financial barriers (69.3%) and societal prejudices (73.1%) being significant concerns. Despite a desire for children (92% were childless), only 10% consulted infertility specialists, and 66.5% were unaware of ART legislation. Emotionally, 51.1% felt unprepared for parenthood. While societal acceptance of non-heteronormative families is perceived to be increasing (53%), unequal healthcare treatment (73.1%) and societal pressures (20% felt pressured towards adoption) remain prevalent.

Conclusions: Over 90% of LGBT individuals contemplate having biological or adoptive children. There's notable ignorance about legislation and ART. Financial hurdles in ART are significant but manageable with proper planning. Prejudice also strongly influences their lives.

Objective: The study focused the contraceptive efficacy of hydro-ethanolic (60:40) extract (HEE) of Caesalpinia pulcherrima leaves in human and rat sperm samples by in vitro study.

Methods: Six young fertile adult males were selected for semen collection. Sperm samples were collected from six adult rat also by chopping the epididymis along with the collection of testicles, epididymis, and liver. The semen, sperm, and tissue samples were grouped into control, 1, 2, and 4 mg HEE exposed categories. Sensitive spermiological sensors, androgenic key enzymes, oxidative stress, and metabolic toxicity markers were assessed according to standard protocols. Human semen samples, rat sperm samples and metabolic tissue samples were divided into 16 test tubes in all of the above groups to find out the direct effect of the extract on such sensors in concentration and duration dependent manner.

Results: Spermiological sensors both in human and rat were decreased significantly (p<0.05) in concentration and duration dependent manner after in vitro exposure of HEE against the control group. Testicular ∆5,3β-hydroxysteroid dehydrogenase, 17β-hydroxysteroid dehydrogenase, superoxide dismutase, and catalase activities were significantly (p<0.05) decreased, and level of the end product of lipid oxidation-peroxidation was elevated (p<0.05) in rat after extract charging. No general toxicity imposition of the said extract indicated by the activities of hepatic transaminases. Phytochemical screening was done by qualitative and liquid chromatography-mass spectrometry analysis.

Conclusion: Extract focused the promising male contraceptive potentiality at 2 mg/ml concentration. Mode of action will be unfolded from running in vivo study very shortly.

Objective: Many cancer survivors may experience irreversible infertility due to chemotherapy treatment for childhood cancer. In this study, spermatogenesis development was evaluated following the grafting of fresh and frozen-thawed testicular tissue from neonatal mice to the epididymal fat of adult mice.

Methods: After bilateral castration of recipient mice, fresh or frozen-thawed neonatal testis tissues were grafted into the epididymal fat of the mice. Grafted testicular tissue was evaluated eight weeks after implantation using H&E staining, real-time PCR, immunofluorescence staining, and TUNEL assay. Blood was drawn from recipient mice to determine testosterone, FSH, and LH levels.

Results: A gradient of different types of germ cells, from spermatogonia to elongated spermatids was observed. The upregulation of meiotic and post-meiotic genes and proteins in fresh and frozen grafted groups confirmed the progression of meiosis and post-meiosis in grafted tissues. There were no significant differences in the expression of apoptosis and necrosis genes between the grafted and non-grafted control groups. Additionally, no significant differences were observed between the control and experimental groups in hormonal assessments.

Conclusions: The optimal hormonal and temperature conditions of the epididymal fat could support spermatogenesis in grafted immature testicular tissue. This grafting technique could pave the way for fertility preservation.

Objective: To investigate the perspectives of infertile couples regarding embryo cryopreservation throughout assisted reproduction treatment.

Methods: The convenience sample included infertile couples undergoing assisted reproduction treatment. They responded to a questionnaire specifically designed to gauge views and opinions on cryopreservation of surplus embryos. Statistical analysis was conducted using SPSS, employing the Mann-Whitney U and Fisher's exact tests (p<0.05).

Results: The study included 187 couples, with average ages of 35 years for women and 38 years for men. A total of 182 couples (97.3%) agreed with the practice of freezing surplus embryos and, the desire to increase the odds of pregnancy within the same ovarian stimulation cycle was the main motivation (89%). Almost 40% of participants said they might consider embryo donation to other couples for assisted reproductive treatment. However, less than 20% of volunteers (15.38% of women and 12.08% of men) expressed the desire to donate for research purposes. Women with higher levels of education were significantly (p<0.05) more likely to support the donation of surplus embryos for research. Gender, religion, and education did not influence (p>0.05) the respondents' perspectives regarding the beginning of life and posthumous conception.

Conclusions: Embryo cryopreservation provides infertile couples with hope however, the fate of surplus embryos remains controversial. A careful approach with appropriate regulation is necessary to ensure safe and ethical practices.

Objective: To evaluate the impact of infertility and Medically Assisted Procreation (MAP) on female sexuality. Human sexuality presents a multifaceted complexity, shaped by diverse factors and individual intricacies. Infertility and assisted reproductive treatments entail a prolonged and arduous journey, amplifying pre-existing sexual dysfunctions and serving as a rigorous trial of the affected women's sexuality and the resilience of couples.

Methods: This is a prospective descriptive comparative study with an analytical section, involving 140 female participants: 70 with infertility undergoing assisted reproductive technology (ART) treatment, and 70 who are fertile and had no prior history of conceiving problems. The evaluation of the sexual function of the two groups was conducted using the Female Sexual Function Index (FSFI) score.

Results: The infertile group exhibited a higher level of marital adjustment compared to the fertile cohort. A majority of participants within the infertile cohort (51.4%) presented with primary infertility and (48.6%) experiencing secondary infertility. A marginal elevation in the frequency of sexual intercourse among infertile participants was observed. The mean global score of female sexual function was (21.57±3.36) in the infertile group, which was significantly lower compared to (24.46±1.97) in the fertile group. Notably, both scores fell within the criteria for high risk of sexual dysfunction. The difference between the two groups was significant for all dimensions of FSFI.

Conclusions: Infertility and its treatments pose challenges to female sexuality, often leading to sexual dysfunction. Thus, counseling and sexological support are crucial during treatment.

Induction of in vitro spermatogenesis may be helpful in the treatment of infertility in azoospermic individuals and those undergoing chemotherapy. Different cultivation systems have been implemented to achieve this aim. This review study aimed to investigate the application of three-dimensional culture in the induction of in vitro spermatogenesis. Relevant studies published in English were identified using PubMed using a range of search terms related to the core focus on tissue engineering of male reproductive systems, in vitro spermatogenesis, germ cell preservation, 3D culture systems for in vitro spermatogenesis, a 3D culture of testis tissue with were last updated in end of 2023. Searches were not restricted to a particular time frame or species, although the emphasis within the review is on regenerative medicine in mammalian male fertility preservation and in vitro spermatogenesis. Spermatogenesis is one of the most complicated cellular differentiation processes in the body. Significant attempts have been made to control spermatogenesis to drive differentiation of male germ stem cells toward mature sperm. Current research efforts focus on providing appropriate microenvironmental conditions to support the process of in vitro spermatogenesis by applying the principles of cell transplantation, material science, and bioengineering. Regenerative medicine may open a new avenue to patients for restoration and maintenance of normal function in spermatogenesis. The techniques reviewed are still in development, and this paper can become the primary reference for a large body of scientists developing advanced tissue engineering for male germ cells or developing the next generation of reproductive medicine.

Objective: To assess the prevalence of self-reported symptoms of endometriosis and adenomyosis among university students and identify potential predictors of these diseases among these symptoms.

Methods: This cross-sectional study was conducted at a private university in northeastern Brazil. The students were asked to complete an electronic questionnaire using a Google Form link. Participants were asked about general information, the menstrual cycle, and bleeding symptoms. The electronic questionnaire results were compared between two groups: students who self-reported endometriosis/adenomyosis (ENDO/ADENO) and students who self-reported no endometriosis/adenomyosis (NO ENDO/ADENO).

Results: Four (2.9%) students self-reported adenomyosis alone, 26 (18.6%) students self-reported endometriosis alone, and two (1.4%) students self-reported an associated diagnosis of endometriosis and adenomyosis. Participants were divided into two groups: ENDO/ADENO (n=32) and NO ENDO/ADENO (n=108). Participants in the ENDO/ADENO group reported more severe dysmenorrhea, worsening dysmenorrhea in the last 12 months, frequent absence from class, dyspareunia, and dysuria. Worsening dysmenorrhea was a predictor of endometriosis/adenomyosis in university female students (odds ratio = 5.73; 95% confidence interval, 1.91-17.22, p=0.002).

Conclusions: The assessment of menstrual cycle symptoms can be used as a screening tool for patients at risk of endometriosis/adenomyosis. The progressive worsening of dysmenorrhea in the last 12 months was a predictor of endometriosis/adenomyosis diagnosis.

Objective: Premature ovarian failure (POF) leads to infertility. Numerous researchers have endeavored to enhance ovarian function through antioxidant interventions. Extract from Vitex agnus-castus (VAC) has demonstrated a protective effect. Therefore, the objective of this study was to investigate the amelioration of ovarian function following VAC treatment in a POF mouse model.

Methods: In this investigation, 30 female NMRI mice were categorized into control, POF model (cyclophosphamide 120 mg/kg I.P), and experimental groups (100, 300, and 500 of VAC extract). Parameters such as body weight, vaginal smears, and follicular evaluation were examined. FSH, estradiol levels, free radicals, and the expression of the FMR1 gene were assessed.

Results: The microscopic assessment revealed that POF induced morphological alterations in ovarian tissue, whereas VAC treatment significantly ameliorated ovarian tissue conditions. The follicles number exhibited a significant reduction in the POF group; however, VAC led to an increase in follicular count and elevated estradiol levels in the treatment groups. Serum FSH levels displayed an elevation in the POF group, whereas the treatment groups exhibited a substantial reduction in FSH levels compared to the POF group. The expression of the FMR1 gene demonstrated upregulation in the POF group compared to the control group (p<0.05). Moreover, this expression significantly decreased in the 500-dose VAC group compared to the POF group (p<0.001). ROS generation exhibited a significant increase in the POF group, which was conversely mitigated in all experimental groups.

Conclusions: Our findings underscore the potential of this extract to ameliorate POF symptoms, however, further investigations are needed.

Objective: To determine the frequency of pregnancy in patients submitted to uterine artery embolization (UAE) for the treatment of uterine leiomyomas who undergo medical follow-up at a clinic in Belo Horizonte.

Methods: This study consists of a retrospective cohort study. It is based on data analysis of electronic medical records of patients who underwent the embolization procedure for uterine leiomyomas between March 2003 and March 2018.

Results: Out of a total of 587 patients who underwent the UAE procedure to treat leiomyomas, 150 expressed an interested in becoming pregnant. Among these patients, 88 successfully achieved pregnancy, representing a frequency of 58.7%. Among the symptoms and signs analyzed prior to the procedure, menorrhagia (97%) and dyspareunia (71%) were the most commonly observed in the analyzed patients. According to race/ethnicity, the majority (n=39) of the patients identified themselves as brown, and the intramural location (96%) was the most frequent.

Conclusions: The study showed that 58.7% of the women who underwent UAE and expressed an interest in becoming pregnant were able to achieve pregnancy, with a 13.6% loss rate. However, further studies are needed to elucidate the key variables that contribute to the increased likelihood of pregnancy after leiomyoma embolization procedure, as well as the effectiveness of symptoms reduction and the actual improvement in pregnancy rates.