Jornal Brasileiro de Reproducao Assistida最新文献

Objective: This study aimed to explore the correlation between ambient particulate matter 2.5 (PM2.5) concentration and sperm quality among northern Thai men exposed to the seasonal air pollution from the agricultural burning process.

Methods: The demographic data and semen analysis of Thai men living in Chiang Mai, Thailand, who visited the infertile clinic were collected. The correlation test between the monthly amount of PM2.5 and sperm quality was carried out.

Results: From 2017 to 2021, 1,109 Thai men visited the Infertile Clinic. The correlation test between PM2.5 and sperm quality in years with a better climate revealed a weak positive correlation between the mean PM2.5 and percentage of progressive motile sperm and normal morphology (r=0.08, p=0.05 and r=0.1, p=0.02). However, there was a negative correlation between the mean PM2.5 and sperm concentration, progressive motility and normal sperm morphology during the years with a higher amount of ambient PM2.5, and especially PM2.5 exposure 3 months before semen collection (r=-0.12, p=0.01, r=-0.11, p=0.003, r=-0.15, p=0.004).

Conclusions: Exposure to a high amount of PM2.5 air pollution negatively affects sperm quality.

Objective: The relevance of the study is determined by the deepening understanding of the global consequences of the coronavirus pandemic, which affect not only lung health but also a wide range of other body systems. In light of new data on the long-term effects of coronavirus infection, this study is highly significant. The purpose of this study is to investigate the impact of coronavirus infection on the male reproductive system and assess its potential influence on male fertility to refine the mechanisms of damage and provide recommendations for medical care.

Methods: The study utilised a combination of methods, including a meta-analysis of medical organisation databases, analysis of clinical cases, representative sample method, and quantitative survey method. These approaches allowed for a comprehensive and multifaceted view of the problem.

Results: The samples of sperm showed a noticeable decrease in progressive motility, sperm concentration, and volume, especially in patients with moderate and severe symptoms of COVID-19, whereas patients with mild symptoms only experienced a decrease in progressive motility and overall sperm motility. The survey identified symptoms of male reproductive system dysfunction after recovering from COVID-19. Predominant symptoms included decreased libido (15%), impotence (13%), and infections of the genital organs (12%). Most surveyed men lacked sufficient awareness of other aspects of male reproductive health, including infections, genetic defects, chronic diseases, and available medical services.

Conclusions: As a result of the study, it was concluded that coronavirus infection can have a negative impact on the male reproductive system. The practical value of this study lies in improving approaches to medical care for men who have recovered from COVID-19 and creating preventive programmes.

Objective: The deleterious effects of caffeine consumption on reproductive functions of female Wistar rats were investigated in this study.

Methods: In this experimental study, 35 female Wistar rats (180-200g) were divided into 7 groups: Control, II-IV received oral caffeine (10, 20, and 40mg/kg/day respectively) for 21 days. V-VII received similar caffeine doses for 21 days, followed by a 21-day withdrawal period. The ovaries, fallopian tubes, and uteri were assessed for levels of malondialdehyde (MDA), nitric oxide (NO), reduced glutathione (GSH), superoxide dismutase (SOD), and catalase activity using spectrophotometry. Serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estradiol levels were measured by ELISA. Organ histology was performed using microscopy. Statistical analysis employed ANOVA with significance at p<0.05.

Results: Caffeine caused dose-dependent increases in MDA, NO, and catalase activity in the ovaries, fallopian tubes, and uteri which decreased upon withdrawal. GSH levels in the ovary and fallopian tubes decreased with caffeine intake but recovered during withdrawal. Caffeine reduced estradiol levels in a dose-dependent manner, its withdrawal led to reductions in serum LH at 20 and 40mg/kg/day and FSH at 40mg/kg/day. Histology revealed dose-dependent alterations in ovarian architecture with congested connective tissues. Caffeine caused sloughing of plicae in the muscularis of the fallopian tubes, degenerated epithelial layer in the uterus, and severe inflammation of the myometrial stroma cells that persisted during caffeine withdrawal.

Conclusions: Caffeine consumption adversely impacted the female reproductive functions of rats, altering hormonal balance and organ structure which persisted even after caffeine withdrawal.

Objective: This study aimed to assess the impact of β-caryophyllene (BC) supplementation in the extender on the post-cryopreservation quality of semen from Dorper rams.

Methods: Six Dorper rams were utilized for semen collection over 16 weeks, with BC concentrations determined via the MTT test. Animals were divided into a control group and three treatment groups receiving BC at concentrations of 1.0mM, 2.0mM, and 3.0mM in the Trisegg yolk diluent. Semen was cryopreserved and stored in liquid nitrogen for at least 15 days. After thawing, in vitro assessments including CASA, acrosomal integrity, plasma membrane integrity, mitochondrial membrane potential, and thermo-resistance tests were conducted. Additionally, the TBARS assay was performed to evaluate oxidative stress.

Results: While BC supplementation did not significantly affect sperm motility, it notably improved mitochondrial potential and mitigated oxidative stress in cryopreserved ram semen.

Conclusions: Incorporating β-caryophyllene into the extender exhibited beneficial effects on the quality of Dorper ram semen post-cryopreservation, enhancing mitochondrial functionality and reducing oxidative stress.

Objective: The rapid development of Artificial Intelligence (AI) has raised questions about its potential uses in different sectors of everyday life. Specifically in medicine, the question arose whether chatbots could be used as tools for clinical decision-making or patients' and physicians' education. To answer this question in the context of fertility, we conducted a test to determine whether current AI platforms can provide evidence-based responses regarding methods that can improve the outcomes of embryo transfers.

Methods: We asked nine popular chatbots to write a 300-word scientific essay, outlining scientific methods that improve embryo transfer outcomes. We then gathered the responses and extracted the methods suggested by each chatbot.

Results: Out of a total of 43 recommendations, which could be grouped into 19 similar categories, only 3/19 (15.8%) were evidence-based practices, those being "ultrasound-guided embryo transfer" in 7/9 (77.8%) chatbots, "single embryo transfer" in 4/9 (44.4%) and "use of a soft catheter" in 2/9 (22.2%), whereas some controversial responses like "preimplantation genetic testing" appeared frequently (6/9 chatbots; 66.7%), along with other debatable recommendations like "endometrial receptivity assay", "assisted hatching" and "time-lapse incubator".

Conclusions: Our results suggest that AI is not yet in a position to give evidence-based recommendations in the field of fertility, particularly concerning embryo transfer, since the vast majority of responses consisted of scientifically unsupported recommendations. As such, both patients and physicians should be wary of guiding care based on chatbot recommendations in infertility. Chatbot results might improve with time especially if trained from validated medical databases; however, this will have to be scientifically checked.

Objective: To evaluate the impact of prior use of combined oral contraceptives in assisted reproduction techniques with ovulation blockade by oral progestin.

Methods: Retrospective cohort study with a single-center convenience sample of patients treated between 2018 and 2021. Two groups were compared: with and without a history of combined oral contraceptives (comparator). The clinical variables were age, body mass index, type of infertility and smoking. Regarding treatment, antral follicle count; follicles >14 mm; oocytes in metaphase I and II; number of embryos; days of treatment; total dose of medication, chemical and clinical pregnancy rate and delivery after 1st embryo transfer. Absolute and relative frequencies were used for the qualitative variables; means, medians and t-test for the quantitative ones. Association between qualitative variables used the Chi-square test and, for quantitative variables, the Mann-Whitney test (p<0.05). The statistical program used was Stata 16.0.

Results: Among 407 medical records, 351 were included (combined oral contraceptive=243 and comparator=108). The combined oral contraceptive and the comparator groups had, respectively, mean (SD±) age 38.2 (4.5) and 38.2 (4.5) years; chemical pregnancy rates of 30.5% and 29.6% (p=0.281); clinical pregnancy rates of 24.8% and 24.1% (p=0.313) and abortion, 5% and 4.6% (p=0.544). The median time on combined oral contraceptives was 6 years.

Conclusions: Previous use of combined oral contraceptives did not impact reproductive results in relation to the comparator group in patients undergoing assisted reproduction techniques in protocols with oral progestin.

Objective: A new approach to evaluate whether Progestin-Primed Ovarian Stimulation with micronized vaginal progesterone was as effective as using dydrogesterone in suppress LH pulse surge in young women under stimulation in an oocyte donor programme.

Methods: This prospective study included 21 patients aged 19 to 32 years-old stimulated with Elonva® 150, associated or not with Menopur® or Merional® (75 or 150IU) since the beginning of the cycle, plus HMG 150-225IU after the 8th day or just HMG 150-300IU per day. Patients were placed in a PPOS protocol with micronized vaginal progesterone (MVP) 200 mg (Gynpro® Exeltis or Junno Farmoquimica) every 12 hours or dydrogesterone (Duphaston® Abbott) 10 mg every 8 hours from the start of stimulation until the day after the GnRH trigger with Triptorelin 0.2 mg (Gonapeptyl daily®). The primary endpoint was the prevention of untimely LH surge, and secondarily the number of 16 mm follicles, retrieved oocytes and metafase II.

Results: Fourteen oocyte donor patients were prescribed MVP while seven others received dydrogesterone (DYG).The gonadotropin protocols included 04 with Corifollitropin alfa 150 plus HMG since the beginning and complemented after the 7th day, and 17 times of just HMG. There was no diferences in the number of follicles >10≤15mm, ≥16mm or number of metafase II oocytes. There was no untimely LH surge on both groups and no OHSS was developed after the agonist trigger.

Conclusions: Progestin-Primed Ovarian Stimulation with micronized vaginal progesterone seems to be a compelling choice for preventing premature ovulation without compromising oocyte quality in women undergoing ovarian stimulation.

Objective: Human reproduction presents a challenge for our species, as evidenced by the escalating rates of infertility. This trend has prompted inquiries into diverse strategies aimed at mitigating infertility and enhancing conception rates. Despite the extensive research on advanced maternal age as a risk factor for reproductive outcomes, paternal age has historically garnered comparatively less attention. The aim of this study was to assess the impact of paternal age on embryos and its subsequent repercussions on fertilization rate, biochemical pregnancy, clinical pregnancy, and live birth rate in individuals undergoing assisted reproductive treatment in a public reproductive center located in Brazil.

Methods: This investigation adopted a retrospective cohort, cross-sectional, analytical design, utilizing the analysis of secondary data, covering the period from July 2015 to July 2021.

Results: A total of 350 couples grappling with infertility and undergoing intrauterine insemination (IUI), in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI) were included in the analysis. Examination of age groups revealed a notable correlation between the ages of women and men (correlation coefficient R=0.12, p<0.0001). In the analysis of IVF techniques, a discernible trend towards a negative correlation with paternal age was observed, signifying that higher paternal age was linked to lower fertilization rates (p=0.004).

Conclusions: Advanced paternal age significantly impacts full-term birth rates in IVF procedures, emphasizing the need for preconception public health advisories that underscore the risks associated with delaying parenthood for both men and women, particularly among those necessitating assisted reproductive techniques.

Objective: To investigate the effect of astaxanthin supplementation in cryopreservation media on post-thawed sperm motility, viability, morphology, reactive oxygen species (ROS), and DNA fragmentation in two cryopreservation techniques using vitrification and liquid nitrogen vapor freezing.

Methods: Thirty normozoospermic semen samples were used in the study. Post-prepared semen samples were divided into 1) non-cryopreserved control, 2) and 3) vitrified without (V) and with astaxanthin 0.5 µM (V+ATX), 4) and 5) frozen in liquid nitrogen vapor without (L) and with astaxanthin 0.5 µM (L+ATX).

Results: Cryopreservation using vitrification and liquid nitrogen vapor freezing significantly decreased sperm motility and viability and increased ROS levels. However, no changes were seen in sperm morphology or DNA fragmentation. The addition of astaxanthin in cryopreservation media significantly increased post-thawed motility in both vitrification (77.6±8.9% vs. 69.0±9.5% in V+ATX and V) and vapor freezing (57.0±13.3% vs. 47.7±14.6% in L+ATX and L); it significantly increased sperm viability in vitrification (75.0±11.9% vs. 65.9±11.1% in V+ATX and V), and significantly decreased ROS level in both vitrification (4.7 (2.6-8.3) RLU/sec/106 vs. 10.6 (9.4-16.0) RLU/sec/106 in V+ATX and V) and vapor freezing (4.6 (3.3-10.5) RLU/sec/106 vs. 10.3 (7.9-18.6) RLU/ sec/106 in L+ATX and L). Astaxanthin supplementation in cryopreservation media did not affect sperm morphology or DNA fragmentation.

Conclusions: Astaxanthin supplementation improved post-cryopreserved sperm motility, decreased ROS levels in both vitrification and liquid nitrogen vapor freezing and improved sperm viability only in the vitrification technique.