Clinical and Experimental Reproductive Medicine-CERM最新文献

Objective: This study was conducted to assess hypothalamic-pituitary-adrenal axis activity, perceived stress, and metabolic markers across menstrual status categories in women with polycystic ovary syndrome (PCOS), and to test whether perceived stress is independently associated with menstrual irregularity.

Methods: In this retrospective cross-sectional study, 296 women with PCOS (2023-2024) were classified as having regular menses, oligomenorrhea, or amenorrhea. Hormonal, metabolic, and biochemical parameters were recorded, and perceived stress was measured using the 10-item Perceived Stress Scale (PSS-10). Correlations, multivariable logistic regression (amenorrhea vs. other categories), and receiver operating characteristic analyses were performed.

Results: PSS score was correlated with homeostatic model assessment of insulin resistance (HOMA-IR) (r=0.619, p<0.001), as well as cortisol (r=0.81, p<0.001), adrenocorticotropic hormone (r=0.72, p<0.001), and high-sensitivity C-reactive protein (hs-CRP) (r=0.609, p<0.001) levels. As menstrual irregularity worsened, HOMA-IR, hs-CRP level, and PSS score increased. HOMA-IR independently predicted amenorrhea (odds ratio, 1.86; p=0.025; area under the curve [AUC], 0.554; cut-off, 4.02; sensitivity, 14%; specificity, 98%). However, after adjustment for age, body mass index, medications, luteinizing hormone/follicle-stimulating hormone level, and testosterone level, the PSS score was not independently associated with menstrual irregularity and showed low discrimination (AUC, 0.57). These findings suggest that the observed association between perceived stress and menstrual irregularity may operate indirectly via metabolic and inflammatory pathways.

Conclusion: In PCOS, menstrual irregularity aligns more closely with metabolic and inflammatory markers than with perceived stress itself; after adjustment, PSS-10 score is not an independent predictor.

Kallmann syndrome is characterized by the combination of hypogonadotropic hypogonadism and anosmia. It is a clinically and genetically heterogeneous disorder. We report the case of ovarian stimulation in a woman with Kallmann-De Morsier syndrome, resulting in a pregnancy achieved through insemination, which progressed to term. The patient underwent cesarean section for a contracted pelvis and delivered a live female infant. Drawing upon a review of the literature on Kallmann-De Morsier syndrome, we discuss the role of follicle-stimulating hormone during the follicular phase, as well as criteria for monitoring ovarian stimulation.

Objective: We evaluated the effects of growth hormone (GH) pretreatment on oocyte retrieval and embryo quality in patients undergoing assisted reproductive technology (ART) for diminished ovarian reserve (DOR).

Methods: In this prospective cohort study, conducted at Shahida Islam Medical Complex from October 2023 to June 2025, 2,000 women aged ≤40 years with DOR were recruited before starting ART. DOR diagnosis was based on the 2017 criteria and the 2011 Bologna criteria. Participants were nonrandomly allocated to four equal groups: G1 (1 month of GH before ovulation induction+standard ART), G2 (2 months of GH pretreatment+ART), G3 (GH supplementation during the ovulation induction phase+ART), and G4 (control; standard ART). Hormonal and metabolic profiling was performed before, during, and after GH treatment. Accordingly, secondary stratification was applied to enable personalized treatment. Based on early response to GH pretreatment, participants underwent dynamic regrouping into good and poor responders. Key outcomes included oocyte retrieval, embryo quality, and maternal-fetal outcomes.

Results: GH pretreatment improved ART results, with the G2 group achieving the best estradiol levels, follicular growth, and oocyte retrieval, albeit with increased insulin resistance (homeostatic model assessment of insulin resistance [HOMA-IR]). The G1 and G3 groups also outperformed controls (G4). GH dose and anti-Müllerian hormone (AMH) level strongly predicted successful oocyte retrieval. Testosterone was negatively associated with retrieval; interleukin 6 and dehydroepiandrosterone sulfate (DHEA-S) had weaker effects. G2 embryos exhibited the best development and blastocyst formation outcomes, with the most advanced development by day 5. A nomogram was developed to predict oocyte retrieval outcomes from GH dose, AMH, HOMA-IR, and testosterone.

Conclusion: In patients with DOR, GH pretreatment improves treatment outcomes. Over 1 month of pretreatment can increase the oocytes retrieved but confers higher insulin resistance. Thus, when using GH for more than 4 weeks, clinicians should closely monitor HOMA-IR and perform continuous glucose monitoring; otherwise, 1-month GH pretreatment is preferred when initiating ART.

Objective: This study investigated whether the average oocyte quality index (AOQI), used as a dysmorphic oocyte scoring system, is higher in women with ovarian endometrioma than in those with unexplained infertility or diminished ovarian reserve (DOR).

Methods: We included 92 intracytoplasmic sperm injection cycles in which one to five metaphase II oocytes were obtained, and the AOQI was calculated in each cycle. Cycles were grouped according to the indication for in vitro fertilization: current or recurrent endometrioma (34 cycles), unexplained infertility (26 cycles), and DOR (32 cycles). DOR was defined by a serum anti-Müllerian hormone (AMH) level <1.0 ng/mL. The AOQI was compared among the three groups, and the relationship between serum AMH levels and AOQI was also analyzed.

Results: The median AOQI value was significantly higher in the endometrioma group (1.50) compared to the unexplained infertility group (1.00) (p=0.037), but not compared to the DOR group (1.42). Overall, serum AMH level showed an inverse correlation with the AOQI (r=-0.242, p=0.02). Serum AMH level was also inversely correlated with the AOQI in the endometrioma group (r=-0.429, p=0.011), but not in the unexplained infertility and DOR groups. Multiple linear regression analysis demonstrated that serum AMH levels remained inversely correlated with the AOQI (B=-0.176; 95% confidence interval, -0.327 to -0.024; p=0.024), whereas the presence of endometrioma was not a significant factor.

Conclusion: The AOQI in the ovarian endometrioma group was higher compared to the unexplained infertility group, and this difference appeared to arise primarily from reduced ovarian reserve rather than the direct impact of endometrioma itself. Serum AMH levels showed an inverse correlation with AOQI, emphasizing the central role of ovarian reserve in determining oocyte quality.

Objective: Organic compounds present in environmental pollution are currently regarded as major health threats. Phenanthrene (Phe), a polycyclic aromatic hydrocarbon, impairs testicular function through oxidative stress, leading to the failure of spermatogenesis. This study aimed to explore the potential beneficial effects of photobiomodulation (PBM) on testicular tissue and sperm parameters following Phe exposure in mice.

Methods: Twenty-four adult male mice, aged 8 weeks, were randomly divided into three groups: control, Phe, and Phe+PBM. In the Phe and Phe+PBM groups, mice received Phe (500 ng/kg) via gavage every 48 hours for 5 weeks. Following Phe exposure, the testes of the Phe+PBM mice were irradiated with laser photons every other day for 35 days. After euthanasia, epididymal tails and testes were collected for molecular and histological analyses.

Results: PBM significantly improved sperm count, motility, and viability (p<0.0001). Moreover, reactive oxygen species production, lipid peroxidation, and apoptosis were markedly reduced in the testicular tissue of the laser-treated mice (p<0.0001). Improvements were also observed in seminiferous epithelium thickness and cell distribution following PBM (p<0.0001).

Conclusion: Laser therapy significantly mitigates testicular damage from Phe exposure by reducing oxidative stress and apoptosis biomarkers, thereby improving testicular tissue and sperm parameters.

Objective: The aims of this study were to assess embryonic development using a time-lapse monitoring system based on cleavage timing and the use of vitrification and to investigate the correlation between miRNA-429 expression and embryonic development in both fresh and vitrified-thawed embryos.

Methods: Mouse embryos at the 1-cell stage were collected and randomly divided into fresh and vitrified-thawed groups. The embryos were monitored and further subdivided into early and delayed cleavage based on the timing of the third cleavage event at 55 hours after human chorionic gonadotropin injection. miRNA-429 extracted from spent media or embryos cultured in vitro was analyzed by quantitative reverse transcription-polymerase chain reaction.

Results: Early cleavage was associated with a significantly higher blastulation rate, regardless of cryopreservation status. Notably, among vitrified- thawed embryos, outgrowth was greater in those exhibiting early cleavage compared to those with delayed cleavage. Furthermore, miRNA-429 expression was elevated in embryos exhibiting delayed cleavage, but only within the cryopreserved group.

Conclusion: Based on these findings, we suggest that the timing of the third cleavage event may be more critical than the vitrification process itself, and evaluating miRNA-429 expression could serve as an alternative non-invasive selection tool for vitrified surplus embryos.

Objective: Previous studies have reported a higher rate of small for gestational age (SGA) newborns from fresh embryo transfers compared with frozen-thawed embryo transfers (FET), potentially due to the supraphysiologic serum estradiol levels observed during controlled ovarian stimulation. This study aimed to evaluate whether different regimens of exogenous estradiol administration influence live birth rates and neonatal outcomes in hormone replacement therapy (HRT)-FET cycles.

Methods: We conducted a retrospective analysis of patients undergoing their first FET with HRT-based endometrial preparation between January 2015 and December 2018 at our center, comparing those who received estradiol both orally and vaginally (OVE group) with those who received estradiol orally only (OE group).

Results: Patients in the OVE group achieved higher serum estradiol levels and underwent longer durations of estradiol treatment. No significant differences were found in live birth rate (adjusted odds ratio [OR], 1.327; 95% confidence interval [CI], 0.982 to 1.794; p=0.066) or clinical pregnancy rate (adjusted OR, 1.278; 95% CI, 0.937 to 1.743; p=0.121). The estradiol regimen did not affect singleton birth weight (β=-30.962; standard error=68.723; p=0.653), the odds of large for gestational age (adjusted OR, 1.165; 95% CI, 0.545 to 2.490; p=0.694), the odds of SGA (adjusted OR, 0.569; 95% CI, 0.096 to 3.369; p=0.535), or preterm delivery (adjusted OR, 0.969; 95% CI, 0.292 to 3.214; p=0.959).

Conclusion: Combined oral and In subsequent cycles, patients received estrogen administration did not alter live birth rates or singleton neonatal outcomes, but was associated with higher serum estradiol levels and potential maternal risks.

Objective: Cyclophosphamide (CP), a chemotherapeutic agent, has been shown to inhibit spermatogenesis. Accordingly, the primary objective of this study was to evaluate the potential therapeutic benefits of quercetin‑loaded nanoselenium (quercetin‑loaded selenium nanoparticles [SeNPs]) in mice treated with CP.

Methods: Thirty‑five adult male mice were randomly assigned to five groups (n=7 per group): control, quercetin‑loaded SeNPs (20 mg/kg, daily for 5 weeks), CP (200 mg/kg, single dose), treatment A (CP+quercetin‑loaded SeNPs), and treatment B (CP+quercetin, 20 mg/kg daily for 5 weeks). Sperm parameters, DNA fragmentation index, catalase activity, levels of glutathione (GSH), glutathione disulfide (GSSG), malondialdehyde (MDA), and reactive oxygen species (ROS) were evaluated in all groups, along with histological assessments of testicular tissue.

Results: In CP‑treated mice, administration of quercetin‑loaded SeNPs (treatment A) significantly improved sperm parameters, including total count, motility, morphology, and DNA integrity. Treatment also markedly increased the numbers of spermatogonia, primary spermatocytes, spermatids, Sertoli cells, and Leydig cells in testicular tissue. Furthermore, treatment with quercetin‑loaded SeNPs resulted in a significant increase in catalase activity and GSH levels while significantly reducing GSSG, MDA, and ROS levels in CP‑induced testicular damage.

Conclusion: These findings suggest that quercetin‑loaded SeNPs enhance spermatogenesis in a CP‑induced mouse model by improving the antioxidant profile and testicular stereological parameters.

Objective: Nicotine, a principal constituent of tobacco smoke, disrupts female reproductive physiology. Quercetin, a flavonoid with both phytoestrogenic and antioxidant properties, may counteract this toxicity. This study aimed to evaluate the histological, biochemical, and molecular effects of quercetin co-administration with nicotine on ovarian and uterine tissues in rats.

Methods: Thirty-two female Wistar rats were assigned to four groups: control, nicotine-treated (1 mg/kg), quercetin-treated (15 mg/kg), and a combined nicotine (1 mg/kg)-quercetin (15 mg/kg) group. Histopathological assessments were performed alongside biochemical analyses of oxidative stress markers-malondialdehyde (MDA), superoxide dismutase (SOD), and total antioxidant capacity (TAC)-and enzyme- linked immunosorbent assay (ELISA)-based hormonal profiling. Immunohistochemistry was employed to quantify estrogen receptor- alpha (ERα) and Ki-67 expression.

Results: Co-administration of nicotine and quercetin increased uterine wall thickness and was associated with elevated estradiol levels, reduced MDA activity, and increased SOD and TAC in both uterine and ovarian tissues compared with the nicotine group. The nicotine-quercetin group also showed a lower Ki-67 index in ovarian follicles and stroma, along with a marked reduction in atretic follicles. Conversely, there were significant increases in antral follicles, corpus luteum formation, and ERα expression in the uterine endometrium and epithelium, as well as in the ovarian stroma and corpus luteum, versus the nicotine-only group.

Conclusion: Quercetin (15 mg/kg) appears to protect against nicotine-induced reproductive impairments (1 mg/kg), likely through its antioxidant properties, its capacity to stabilize hormone levels, and its modulation of ERα and Ki-67 expression. These findings support quercetin's therapeutic potential for preventing or alleviating smoking-related reproductive damage.

Objective: Polycystic ovary syndrome (PCOS) is a metabolic and endocrine disorder that frequently results in infertility due to ovulatory dysfunction. Granulosa cells (GCs), which are essential for oocyte maturation, are highly vulnerable to oxidative stress (OS)-induced damage. The nuclear factor erythroid-2-related factor 2 (NRF2)-antioxidant responsive element (ARE) pathway, a major antioxidant mechanism, may help protect GCs from OS. This study investigated NRF2-ARE pathway activity in GCs of PCOS patients compared to healthy fertile controls.

Methods: In total, 46 follicular fluid and GC samples were collected from 28 patients diagnosed with PCOS and 18 fertile women aged 20-40 years. After RNA extraction, expression levels of antioxidant genes- heme oxygenase 1 (HO1), peroxiredoxin 1 (PRDX1), superoxide dismutase 1 (SOD1), thioredoxin (TXN), NRF2, and kelch like ECH associated protein 1 (KEAP1)-were measured using quantitative reverse transcription polymerase chain reaction. In addition, total antioxidant capacity (TAC) and nitric oxide (NO) levels were analyzed in follicular fluid, with statistical comparisons performed using the t-test.

Results: In GCs of PCOS patients, HO1 expression was downregulated, while PRDX1, SOD1, NRF2, TXN, and KEAP1 were upregulated. NO activity was elevated, and TAC levels were significantly decreased in the follicular fluid of PCOS patients.

Conclusion: These findings demonstrate a significant association between antioxidant gene expression in GCs and PCOS. The results suggest that OS plays a critical role in the development and progression of PCOS.