Clinical and Experimental Reproductive Medicine-CERM最新文献

Objective: This study investigated potential relationships between the kinetics of nucleolar precursor bodies (NPBs) in the pronucleus and developmental morphokinetics and euploidy in human preimplantation genetic testing for aneuploidy (PGT-A) cycles.

Methods: The morphokinetic analysis of 200 blastocysts obtained from 53 PGT-A cycles was performed retrospectively in a time-lapse incubator. At the time of pronuclear breakdown (PNBD), we categorized the blastocysts into two groups based on the kinetic degree of clustering NPBs at the interface of the two pronuclei: clustered NPBs (CL) and non-clustered NPBs (NCL). We then compared morphokinetic parameters, abnormal behavioral events, and the rate of aneuploidy between the two groups.

Results: Pronuclear fading and the first cleavage occurred earlier in the NCL group than in the CL group. However, the initiation of blastocyst formation and blastocyst expansion was delayed in the NCL group relative to the CL group. No differences were found in the rate of abnormal cleavage events, such as multinucleation at the 2-cell stage, direct cleavage from one to three cells, and from two to five cells between the CL and NCL groups. However, the fragmentation rate at the 8-cell stage was higher in the NCL group than in the CL group (10.3% vs. 1.9%, p<0.05). Additionally, the euploid rate in the CL group was significantly higher than in the NCL group (37.9% vs. 12.4%, p<0.05).

Conclusion: These results demonstrate the effectiveness of combining NPB clustering at PNBD with morphokinetics as a parameter for selecting embryos with higher developmental potential in in vitro fertilization.

Objective: Ciprofloxacin (CPFX) is frequently prescribed by fertility specialists and urologists to manage infections in male reproductive organs. However, it is toxic to the testicles and can lead to infertility. Dietary antioxidants are known to protect the testis from damage. This study aimed to investigate the effects of coenzyme Q10 (CoQ10) on the adverse side effects of CPFX using stereological methods.

Methods: Sixty rats were divided into six groups: control (distilled water), CoQ10 (10 mg/kg/day), and low-dose (103 mg/kg/day) and high-dose (206 mg/kg/day) of CPFX (LD-CPFX, HD-CPFX) with or without CoQ10 consumption. The treatments lasted for 45 days. Sperm count, serum testosterone levels, and testicular parameters were evaluated.

Results: Significant decreases in sperm count, motility, normal morphology, viability, and testosterone levels were observed in the LD-CPFX (p<0.003) and HD-CPFX- treated rats (p=0.0001) compared to the control groups. A 10% to 36% reduction in the volume of seminiferous tubules, tubular epithelium, and tubule length was noted in LD-CPFX (p<0.01) and HD-CPFX-treated rats (p<0.006), while the volume of the interstitium increased by 25% to 28% in LD-CPFX (p=0.03) and HD-CPFX (p=0.008) groups. The number of cells, including spermatogonia, spermatocytes, spermatids, Sertoli cells, and Leydig cells, decreased by 36% to 75% in the testes exposed to LD-CPFX (p<0.04) and HD-CPFX (p<0.01), compared to the control groups. However, these changes normalized in rats that received CoQ10.

Conclusion: CPFX exposure for 45 days, regardless of the dose, has detrimental effects on testicular parameters. CoQ10 can prevent CPFX-induced testicular structural impairments.

Objective: The duration of progesterone exposure is critical for establishing and maintaining a pregnancy in hormone replacement treatment (HRT)-frozen embryo transfer (FET) cycles. This study compared the live birth rates (LBRs) of patients undergoing day-6 warmed blastocyst transfer on either the 6th or 7th day of progesterone administration in HRT-FET cycles.

Methods: A retrospective cohort study was conducted using data from the central registry of Indira IVF Hospital Private Limited. In total, 2,633 patients who underwent day-6 blastocyst transfer cycles with HRT-FET were identified. The cycles were categorized based on the timing of the day-6 blastocysts transfer: P+6 vs. P+7 (initiation date: P+1). Propensity scores were calculated. The primary outcome measure was the LBR.

Results: Following propensity score matching, a total of 1,401 patients were included in the final analysis (P+6: n=1,212; P+7: n=189). The number of previous attempts was significantly higher in the P+6 group, whereas the rate of preimplantation genetic testing for aneuploidy was significantly higher in the P+7 group. The LBRs were 59.2% and 54.5% in the P+6 and P+7 groups, respectively (p=0.21). Multivariate regression analysis revealed that the number of previous in vitro fertilization attempts (odds ratio [OR], 3.246; 95% confidence interval [CI], 2.429 to 4.337; p<0.001), the number of blastocysts transferred (OR, 2.011; 95% CI, 1.461 to 2.768; p<0.01), and endometrial thickness on the day of progesterone initiation (OR, 1.143; 95% CI, 1.022 to 1.28; p=0.02) were independent predictors of live birth.

Conclusions: The LBRs were comparable in patients who underwent day-6 warmed blastocyst transfer on day 6 or 7 post-progesterone initiation in HRT-FET cycles.

Objective: This study aimed to compare the thiol/disulfide balance, myeloperoxidase, and ischemia-modified albumin levels in the follicular fluid (FF) of poor ovarian response (POR) and normal ovarian response (NOR) women who received intracytoplasmic sperm injection (ICSI).

Methods: The study was performed between March 2021 and April 2022 at the Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Ankara City Hospital. The study included 27 POR and 35 NOR women who underwent ICSI. FF was obtained after the controlled ovarian stimulation cycle. The FF thiol/disulfide balance was detected using spectrophotometric methods. A correlation analysis was conducted to determine whether these oxidative stress markers could contribute to predicting oocyte quality.

Results: Disulfide levels were significantly higher in the NOR group than in the POR group (p=0.014). The number of fertilized egg (2PN) oocytes was positively correlated with the total thiol level (r=0.258, p=0.046). The disulfide level was positively correlated with the anti-Müllerian hormone level (r=0.262, p=0.039) and the total number of retrieved oocytes (r=0.335, p=0.008).

Conclusion: The disulfide levels differed significantly between the NOR and POR groups. The statistically significant differences of fewer metaphase II oocytes and lower percentage of good-quality embryos in the NOR group compared to the POR group might have resulted from the NOR group's elevated disulfide levels. The total thiol levels correlated with the total of 2PN oocytes. Future studies should examine the thiol/disulfide balance at assisted reproductive technology centers to predict which oocytes could be fertilized.

Objective: Several chemotherapeutic agents, including cyclophosphamide (CP) and busulfan, have been shown to interfere with spermatogenesis. Accordingly, the main objective of this study was to evaluate the potential therapeutic effects of curcumin nanoemulsion (CUR-NE) on spermatogenesis in mice with CP-induced testicular toxicity.

Methods: A total of 28 adult male mice were equally divided into four groups: control, CUR-NE (30 mg/kg, daily for 5 weeks), CP (200 mg/kg, single dose), and CP+CUR-NE. Each group was evaluated regarding sperm parameters, DNA fragmentation index, chromatin maturation, reactive oxygen species (ROS) levels, and histological parameters of the testes. Serum levels of follicle-stimulating hormone (FSH), luteinizing hormone, and testosterone were also assessed in all groups.

Results: In CP-induced mice, CUR-NE treatment significantly improved sperm parameters, including total sperm count, motility, morphology, and DNA integrity. CUR-NE administration was also associated with significantly higher serum levels of testosterone and FSH, as well as testis weight and volume, in the mice treated with CP. Furthermore, CUR-NE treatment significantly increased the number of spermatogonia, primary spermatocytes, round spermatids, and Leydig cells in the testicular tissue of these animals. A marked reduction in ROS levels in the testes tissue was observed following administration of CUR-NE to CP-induced mice.

Conclusion: CUR-NE appears to promote spermatogenesis in mice with CP-induced testicular toxicity by reducing ROS levels, improving testicular stereological parameters, and strengthening the reproductive hormone profile.

Modern drug discovery is driven by high demand in the pharmaceutical industry to test growing libraries of compounds against potential targets. High-throughput screening (HTS) is characterized by fully automated experimentation that leverages robotic liquid handling systems, analytical techniques, and advanced computing and statistics, including the recent integration of artificial intelligence. To align with this trend, it is crucial to develop and implement new HTS platforms that offer improved predictivity and physiological relevance. In recent years, microphysiological systems, commonly known as organ-on-chip (OoC) systems, have progressed from a theoretical concept to a powerful alternative to conventional in vitro and animal models. High-throughput OoC (HT-OoC) systems could represent the disruptive technology sought by pharmaceutical companies to address their enormous research and development (R&D) expenses. In this study, we provide a brief overview of commercial products utilizing modern HT-OoC systems in drug discovery and development. Additionally, we discuss recent trends in R&D aimed at industrialization.

Objective: In the application of assisted reproductive technologies (ART), selection of the optimal sperm presents a challenge. This study introduces an innovative microfluidic device that utilizes rheotaxis to efficiently sort sperm, offering superior selection of high-quality sperm compared to conventional methods.

Methods: We analyzed 30 normal samples from couples undergoing intracytoplasmic sperm injection cycles at the Infertility Center of Fatemieh Hospital in Hamadan, Iran. Each sample was divided into three groups: the initial sample, representing the control group; direct swim-up sperm selection; and sperm selection using rheotaxis. A syringe pump connected to the microfluidic device generated optimal flow conditions. Spermatozoa were evaluated regarding concentration, motility, morphology, mitochondrial membrane potential (MMP), and sperm DNA fragmentation index (DFI). Statistical significance was determined using one-way analysis of variance and the Student t-test.

Results: The concentration (7.46±2.84 million cells/mL vs. 56.67±18.27 million cells/mL, p<0.0001) and DFI (2.93±2.70 vs. 21.13±5.27, p<0.0001) were significantly lower in the sperm selected using the rheotaxis microfluidic device than in the control sperm. Progressive motility (98.10%±2.41% vs. 44.13%±7.06%, p<0.0001), normal morphology (8.36%±1.47% vs. 5.20%±1.15%, p<0.0001), and MMP (99.63%±0.71% vs. 81.13%±9.19%, p<0.0001) were significantly higher with the device than in the control group.

Conclusion: The use of a rheotaxis-based microfluidic device appeared effective in selecting high-quality sperm, demonstrating improvements in motility, morphology, and MMP and a reduction in DFI. This advancement has the potential to improve the outcomes of ART.

Objective: This study investigated the effects of pentoxifylline (PTX) and α-lipoic acid (ALA) on ovulation and pregnancy rates in women with clomiphene citrate (CC) resistant polycystic ovary syndrome (PCOS).

Methods: A prospective, randomized, controlled, open-label study was conducted on women with CC-resistant PCOS. In total, 120 PCOS patients were randomly assigned to four groups of 30 patients each, as follows: group 1 was the control group; group 2 received 400 mg of PTX twice daily; group 3 received 600 mg of ALA twice daily; and group 4 received a combination of PTX and ALA, following the same regimen as the previous groups. All groups were administered 150 mg of CC, the standard therapy for ovulation induction (ClinicalTrials.gov: NCT05231980).

Results: The cumulative ovulation rate was highest in the combined PTX-ALA group at 77% (23 cases), followed by the PTX group at 70% (n=21), the ALA group at 40% (n=12), and the control group at 30% (n=9) (p=0.0003). The cumulative pregnancy rates were 40% (n=12), 37% (n=11), 10% (n=3), and 3% (n=1) for the PTX-ALA, PTX, ALA, and control groups, respectively (p=0.0005). Endometrial thickness (ET) was significantly greater in the PTX group than in the control group.

Conclusion: Co-administration of PTX with CC significantly improved the ovulation rate, pregnancy rate, ET, and ovarian response to stimulation in patients with anovulatory PCOS. This combination may provide an effective, affordable, and safe treatment protocol for women with CC-resistant PCOS.

Objective: Researchers have long been captivated by the complex molecular interactions between vitamin D and the thyroid gland. Hypothyroidism affects 2% to 4% of women of reproductive age and can impact fertility through anovulatory cycles, luteal phase defects, hyperprolactinemia, and sex hormone imbalances. This study investigated the relationship between thyroid disease and the severity of vitamin D deficiency across different age groups.

Methods: A retrospective study was conducted of 286 patient samples from individuals aged 18 to 60 years who were processed in the clinical biochemistry laboratory of our hospital. Samples were tested for thyroid-stimulating hormone (TSH) and vitamin D (specifically, vitamin D3) levels. The study samples were categorized into four clinically relevant groups based on TSH levels and into three groups based on serum 25-hydroxyvitamin D (25(OH)D) levels.

Results: Most of the samples were from female patients (n=269), and the most common age group was 18 to 35 years (n=191, 66.78%). Subclinical hypothyroidism was identified in 120 patients, while vitamin D deficiency was present in 237 (82.87%) participants. A significant association was observed between vitamin D deficiency and the presence of thyroid disorders. Additionally, a significant negative correlation was found between TSH and vitamin D levels. Polycystic ovary syndrome was noted in 103 female patients (36.01%).

Conclusion: TSH and 25(OH)D levels should be screened in all women of reproductive age, not just those in high-risk groups, as subclinical and occult hypothyroidism may otherwise go undiagnosed. Furthermore, TSH should be considered the primary screening test.

Objective: This study aimed to explore the ambiguous link between dietary inflammatory indices and sperm parameters. Specifically, it investigated the associations between the dietary inflammatory index (DII) and the energy-adjusted dietary inflammatory index (E-DII) with sperm motility, morphology, and count in men undergoing routine semen analysis.

Methods: A cross-sectional study was conducted with 144 men enrolled, where semen samples were collected and evaluated according to the 2010 World Health Organization guidelines. Dietary data were gathered using a 147-item semi-quantitative food frequency questionnaire developed by the researchers. Pearson correlation analysis was employed to assess the relationships of the DII and E-DII with sperm parameters.

Results: The mean DII and E-DII scores were 1.23±1.1 and 0.49±0.43, respectively. The mean values for sperm motility, morphology, and count were 43.08%±19.30%, 78.03%±26.99%, and 48.12±44.41 million, respectively. Both motility (r=-0.353) and count (r=-0.348) were found to be inversely and significantly correlated with DII. Similarly, Pearson correlation tests revealed strong and significant inverse correlations of motility (r=-0.389) and count (r=-0.372) with E-DII.

Conclusion: The findings suggest that a diet with a higher anti-inflammatory potential may be associated with increased sperm count and motility, but not with changes in morphology. Further research is necessary to confirm these findings, elucidate the underlying mechanisms, and identify dietary modifications that could improve male fertility.