Pub Date : 2022-01-01DOI: 10.1016/j.xfnr.2021.12.001
Ettore Caroppo M.D. , Maurizio Dattilo M.D.
In spite of inconclusive or negative outcomes from clinical studies, oral antioxidants are still largely prescribed to infertile men to improve sperm motility and/or reduce sperm DNA damage, on the basis of the assumption that it is an oxidative damage and it will be corrected by antioxidants. We aimed to challenge this view by examining the available experimental evidence. The regulation of sperm motility may suffer several pathologic derangements, including alterations of the flagellum, impaired function of the activating phosphatases and kinases, impaired function of the extracellular vesicles of either epididymal or prostatic origin, deranged Ca2+ trafficking, and infection/inflammation of the male accessory glands. None of the aforementioned issues seem to be directly dependent on the redox balance and to indicate a direct role for oral antioxidants treatment. Indeed, antioxidants may generate reductive imbalances resulting in an increase in the nicotinamide adenine dinucleotide reduced/nicotinamide adenine dinucleotide oxidized ratio, which sustains reactive oxygen species generation in mitochondria, potentially leading to increased sperm DNA damage, whereas a shortage of nicotinamide adenine dinucleotide oxidized may jeopardize the pol(ADP-ribose) polymerase-based DNA repair mechanisms at the time of histone to protamine transition, resulting in unresolved double-strand breaks and defective protamination, which further increases DNA vulnerability. The occurrence of reactive oxygen species and oxidative damages does not necessarily imply a shortage of antioxidant defenses, and the possibility that a different problem is in place should be considered. On this base, the current attitude to prescribe oral antioxidants to infertile men without demonstration of antioxidant shortage or true oxidative imbalance should be reconsidered.
{"title":"Sperm redox biology challenges the role of antioxidants as a treatment for male factor infertility","authors":"Ettore Caroppo M.D. , Maurizio Dattilo M.D.","doi":"10.1016/j.xfnr.2021.12.001","DOIUrl":"10.1016/j.xfnr.2021.12.001","url":null,"abstract":"<div><p>In spite of inconclusive or negative outcomes from clinical studies, oral antioxidants are still largely prescribed to infertile men to improve sperm motility and/or reduce sperm DNA damage, on the basis of the assumption that it is an oxidative damage and it will be corrected by antioxidants. We aimed to challenge this view by examining the available experimental evidence. The regulation of sperm motility may suffer several pathologic derangements, including alterations of the flagellum, impaired function of the activating phosphatases and kinases, impaired function of the extracellular vesicles of either epididymal or prostatic origin, deranged Ca<sup>2+</sup> trafficking, and infection/inflammation of the male accessory glands. None of the aforementioned issues seem to be directly dependent on the redox balance and to indicate a direct role for oral antioxidants treatment. Indeed, antioxidants may generate reductive imbalances resulting in an increase in the nicotinamide adenine dinucleotide reduced/nicotinamide adenine dinucleotide oxidized ratio, which sustains reactive oxygen species generation in mitochondria, potentially leading to increased sperm DNA damage, whereas a shortage of nicotinamide adenine dinucleotide oxidized may jeopardize the pol(ADP-ribose) polymerase-based DNA repair mechanisms at the time of histone to protamine transition, resulting in unresolved double-strand breaks and defective protamination, which further increases DNA vulnerability. The occurrence of reactive oxygen species and oxidative damages does not necessarily imply a shortage of antioxidant defenses, and the possibility that a different problem is in place should be considered. On this base, the current attitude to prescribe oral antioxidants to infertile men without demonstration of antioxidant shortage or true oxidative imbalance should be reconsidered.</p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"3 1","pages":"Pages 90-104"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666571921000281/pdfft?md5=c3901d0e0e5090a2e9b55116ecd24f7a&pid=1-s2.0-S2666571921000281-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47301739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1016/j.xfnr.2021.11.004
Phoutdavone Phimphasone-Brady Ph.D. , Brooke Palmer Ph.D. , Alyssa Vela Ph.D. , Rachel L. Johnson M.S. , Ben Harnke M.L.I.S. , Lilian Hoffecker Ph.D. , Helen L. Coons Ph.D. , C. Neill Epperson M.D.
Objective
To synthesize the effects of psychosocial interventions to improve depression, anxiety, quality of life (QOL), and other psychological outcomes in adult women living with polycystic ovary syndrome (PCOS).
Evidence Review
On the basis of the guidelines for the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, we conducted a systematic review in the following databases: Ovid MEDLINE ALL; Embase; Cochrane Central Library; Cochrane Database of Systematic Reviews; American Psychological Association PsycInfo; and Elton B. Stephens CO (company) Cumulated Index to Nursing and Allied Health Literature. A study was included if it was a randomized controlled trial that examined the effect of psychosocial interventions to improve psychological outcomes (primary or secondary) in adult women (aged ≥18 years) diagnosed with PCOS. Study screening, data extraction, and assessment of methodological quality was conducted by 3 independent reviewers through a systematic process. The Cochrane risk-of-bias assessment for randomized controlled trials was used to assess the risk-of-bias and methodological quality. The results were combined and summarized in a narrative synthesis, and factors that may explain differences in the direction or effect sizes were considered and discussed.
Results
Of the 127 studies that met the initial inclusion criteria, we included 7 studies for full-text review, with an average sample size of 83 participants in the initial randomization. Across the 3 studies that reported race and ethnicity, an average of 57% of participants identified as White. There was significant heterogeneity across studies in terms of PCOS criteria followed, variation in outcome measures, variation in reporting of outcomes, and small sample sizes in each outcome, limiting our ability to estimate the magnitude of effects or standardized mean differences. Psychosocial interventions were cognitive behavioral therapy, acceptance and commitment therapy, mindfulness-based stress reduction, cognitive behavioral therapy combined with lifestyle modifications, or multicomponent behavioral modification program. Within the intervention groups, significant durations of effects from baseline to postintervention were observed for depression, anxiety, QOL, fatigue and sleep-related impairments, self-esteem, body image, perceived stress, and patient-reported outcomes for psychological distress and positive and negative affect. These findings demonstrate proof of concept that psychosocial interventions improve PCOS-related mental health issues. Significant results, however, between the intervention and control groups were inconsistent. Significant postintervention or 8-week outcomes were found in some, but not all, studies for depression, QOL, fatigue or sleep issues, self-esteem, body image, perceived stress, mindfulness, and negative affect. Further, on
目的综合心理社会干预对改善成年女性多囊卵巢综合征(PCOS)抑郁、焦虑、生活质量(QOL)等心理结局的影响。在系统评价和荟萃分析首选报告项目指南的基础上，我们对以下数据库进行了系统评价:Ovid MEDLINE ALL;Embase;科克伦中央图书馆;Cochrane系统评价数据库;美国心理学会;和Elton B. Stephens CO(公司)护理和相关健康文献累积索引。如果是一项随机对照试验，检查社会心理干预对改善诊断为多囊卵巢综合征的成年女性(年龄≥18岁)的心理结局(主要或次要)的影响，则纳入一项研究。研究筛选、数据提取和方法学质量评估由3名独立审稿人通过系统流程进行。随机对照试验的Cochrane偏倚风险评估用于评估偏倚风险和方法学质量。结果被合并和总结在一个叙事综合，并考虑和讨论可能解释的方向或效应大小的差异的因素。在符合初始纳入标准的127项研究中，我们纳入了7项研究进行全文综述，初始随机化的平均样本量为83名参与者。在3项关于种族和民族的研究中，平均有57%的参与者认为自己是白人。在PCOS标准、结果测量的差异、结果报告的差异以及每个结果的小样本量方面，研究之间存在显著的异质性，限制了我们估计影响程度或标准化平均差异的能力。心理社会干预包括认知行为疗法、接受和承诺疗法、以正念为基础的减压、认知行为疗法结合生活方式改变或多组分行为改变计划。在干预组中，从基线到干预后，观察到抑郁、焦虑、生活质量、疲劳和睡眠相关障碍、自尊、身体形象、感知压力和患者报告的心理困扰结果以及积极和消极影响的显著持续时间。这些发现证明了社会心理干预可以改善多囊卵巢综合征相关的心理健康问题。然而，干预组和对照组之间的显著结果并不一致。在一些(但不是全部)关于抑郁、生活质量、疲劳或睡眠问题、自尊、身体形象、感知压力、正念和负面影响的研究中，发现了显著的干预后或8周结果。此外，只有2项研究发现身体形象和感知压力有显著的长期或维持作用。没有研究发现干预后对焦虑的显著影响或对抑郁、焦虑和生活质量的长期影响。研究的异质性和较差的方法学质量可能解释了显著的干预后和长期结果的不一致，从而损害了结果的普遍性。结论PCOS在心理健康评估和治疗方面的研究亟待改进，这对将证据转化为临床实践具有重要意义。提出了今后的研究和建议，以提高对影响妇女健康和福祉的这一常见但未得到充分认识的疾病的研究和综合护理的方法质量。
{"title":"Psychosocial interventions for women with polycystic ovary syndrome: a systematic review of randomized controlled trials","authors":"Phoutdavone Phimphasone-Brady Ph.D. , Brooke Palmer Ph.D. , Alyssa Vela Ph.D. , Rachel L. Johnson M.S. , Ben Harnke M.L.I.S. , Lilian Hoffecker Ph.D. , Helen L. Coons Ph.D. , C. Neill Epperson M.D.","doi":"10.1016/j.xfnr.2021.11.004","DOIUrl":"10.1016/j.xfnr.2021.11.004","url":null,"abstract":"<div><h3>Objective</h3><p>To synthesize the effects of psychosocial interventions to improve depression, anxiety, quality of life<span> (QOL), and other psychological outcomes in adult women living with polycystic ovary syndrome (PCOS).</span></p></div><div><h3>Evidence Review</h3><p>On the basis of the guidelines for the Preferred Reporting Items for Systematic Reviews<span> and Meta-Analyses, we conducted a systematic review in the following databases: Ovid MEDLINE ALL; Embase; Cochrane Central Library; Cochrane Database of Systematic Reviews; American Psychological Association PsycInfo; and Elton B. Stephens CO (company) Cumulated Index to Nursing and Allied Health Literature. A study was included if it was a randomized controlled trial that examined the effect of psychosocial interventions to improve psychological outcomes (primary or secondary) in adult women (aged ≥18 years) diagnosed with PCOS. Study screening, data extraction, and assessment of methodological quality was conducted by 3 independent reviewers through a systematic process. The Cochrane risk-of-bias assessment for randomized controlled trials was used to assess the risk-of-bias and methodological quality. The results were combined and summarized in a narrative synthesis, and factors that may explain differences in the direction or effect sizes were considered and discussed.</span></p></div><div><h3>Results</h3><p><span>Of the 127 studies that met the initial inclusion criteria, we included 7 studies for full-text review, with an average sample size of 83 participants in the initial randomization. Across the 3 studies that reported race and ethnicity, an average of 57% of participants identified as White. There was significant heterogeneity across studies in terms of PCOS criteria followed, variation in outcome measures, variation in reporting of outcomes, and small sample sizes in each outcome, limiting our ability to estimate the magnitude of effects or standardized mean differences. Psychosocial interventions were cognitive behavioral therapy, </span>acceptance and commitment therapy, mindfulness-based stress reduction, cognitive behavioral therapy combined with lifestyle modifications, or multicomponent behavioral modification program. Within the intervention groups, significant durations of effects from baseline to postintervention were observed for depression, anxiety, QOL, fatigue and sleep-related impairments, self-esteem, body image, perceived stress, and patient-reported outcomes for psychological distress and positive and negative affect. These findings demonstrate proof of concept that psychosocial interventions improve PCOS-related mental health issues. Significant results, however, between the intervention and control groups were inconsistent. Significant postintervention or 8-week outcomes were found in some, but not all, studies for depression, QOL, fatigue or sleep issues, self-esteem, body image, perceived stress, mindfulness, and negative affect. Further, on","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"3 1","pages":"Pages 42-56"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44648835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1016/j.xfnr.2021.11.002
Geneviève Genest M.D. , Walaa Almasri M.D. , Shorooq Banjar M.D. , Coralie Beauchamp M.D. , William Buckett M.D. , Frederick Dzineku M.D. , Ezgi Demirtas M.D. , Phil Gold M.D., Ph.D. , Michael H. Dahan M.D. , Wael Jamal M.D. , Isaac Jacques Kadoch M.D. , Louise Lapensée M.D. , Neal Mahutte M.D. , Pierre Miron M.D., Ph.D. , Camille Sylvestre M.D. , Togas Tulandi M.D. , Ciriaco A. Piccirillo Ph.D. , Carl A. Laskin M.D.
Recurrent pregnancy loss (RPL) is frequently encountered in the outpatient setting. Despite extensive investigation, up to 50% of patients will be diagnosed with idiopathic RPL, for which no effective treatment exists. While the immune system is intricately involved in the initiation and maintenance of pregnancy, there are no validated diagnostic tests to confirm immune-mediated pregnancy loss. Therefore, drugs aiming to modulate or suppress the immune system are often used on speculation with limited scientific evidence. As the literature is heterogeneous and difficult to assimilate, we sought to provide the reader with an objective and comprehensive review of each type of treatment (progesterone, aspirin, low-molecular-weight heparin, granulocyte colony-stimulating factor, human chorionic gonadotropin, corticosteroids, Intralipids, and intravenous immunoglobulins), highlighting the possible mechanisms of action, potential efficacy or futility, and risks associated. This review aims to summarize current knowledge on the topic, provide a clinical guide for decision-making, and identify knowledge gaps required to harmonize practices and develop guidelines for suspected immune-mediated RPL management.
{"title":"Immunotherapy for recurrent pregnancy loss: a reappraisal","authors":"Geneviève Genest M.D. , Walaa Almasri M.D. , Shorooq Banjar M.D. , Coralie Beauchamp M.D. , William Buckett M.D. , Frederick Dzineku M.D. , Ezgi Demirtas M.D. , Phil Gold M.D., Ph.D. , Michael H. Dahan M.D. , Wael Jamal M.D. , Isaac Jacques Kadoch M.D. , Louise Lapensée M.D. , Neal Mahutte M.D. , Pierre Miron M.D., Ph.D. , Camille Sylvestre M.D. , Togas Tulandi M.D. , Ciriaco A. Piccirillo Ph.D. , Carl A. Laskin M.D.","doi":"10.1016/j.xfnr.2021.11.002","DOIUrl":"10.1016/j.xfnr.2021.11.002","url":null,"abstract":"<div><p><span>Recurrent pregnancy loss<span> (RPL) is frequently encountered in the outpatient setting. Despite extensive investigation, up to 50% of patients will be diagnosed with idiopathic RPL, for which no effective treatment exists. While the immune system is intricately involved in the initiation and maintenance of pregnancy, there are no validated diagnostic tests to confirm immune-mediated pregnancy loss. Therefore, </span></span>drugs<span><span> aiming to modulate or suppress the immune system are often used on speculation with limited scientific evidence. As the literature is heterogeneous and difficult to assimilate, we sought to provide the reader with an objective and comprehensive review of each type of treatment (progesterone, aspirin<span>, low-molecular-weight heparin, granulocyte colony-stimulating factor, human chorionic gonadotropin, corticosteroids, </span></span>Intralipids, and intravenous immunoglobulins), highlighting the possible mechanisms of action, potential efficacy or futility, and risks associated. This review aims to summarize current knowledge on the topic, provide a clinical guide for decision-making, and identify knowledge gaps required to harmonize practices and develop guidelines for suspected immune-mediated RPL management.</span></p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"3 1","pages":"Pages 24-41"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41411798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1016/j.xfnr.2021.11.001
Molly Quinn M.D. , Marcelle I. Cedars M.D. , Heather G. Huddleston M.D. , Nanette Santoro M.D.
Antimüllerian hormone (AMH) was originally discovered because of its role in suppressing the uterine and tubal structures during male sexual development. It has since become a valuable adjunct to the practice of reproductive endocrinology in several avenues. The ability of AMH to provide useful, albeit indirect, information regarding the size of the ovarian follicle pool has been used successfully for predicting ovarian reserve, forecasting the time to menopause, supporting the diagnosis of polycystic ovary syndrome and predicting the response to treatment, and assisting in dose selection for women undergoing assisted reproductive technology. However, the enthusiasm for AMH as a relatively new tool in the armamentarium of the reproductive endocrinologist must be tempered by its limitations. Although AMH is helpful in ascertaining the quantity of remaining ovarian follicles, it does not provide information about follicle quality. Therefore, using AMH to forecast fertility potential can be fraught with error and can drive unwarranted medical treatment. Certain conditions and medications can also result in falsely low AMH determinations, which can again lead to inappropriate treatment recommendations. The knowledge of the proven usefulness of AMH and its limitations is therefore critical for optimal clinical practice.
{"title":"Antimüllerian hormone use and misuse in current reproductive medicine practice: a clinically oriented review","authors":"Molly Quinn M.D. , Marcelle I. Cedars M.D. , Heather G. Huddleston M.D. , Nanette Santoro M.D.","doi":"10.1016/j.xfnr.2021.11.001","DOIUrl":"https://doi.org/10.1016/j.xfnr.2021.11.001","url":null,"abstract":"<div><p><span><span>Antimüllerian hormone<span> (AMH) was originally discovered because of its role in suppressing the uterine and tubal structures during male sexual development. It has since become a valuable adjunct to the practice of reproductive endocrinology in several avenues. The ability of AMH to provide useful, albeit indirect, information regarding the size of the </span></span>ovarian follicle pool has been used successfully for predicting </span>ovarian reserve<span><span>, forecasting the time to menopause, supporting the diagnosis of polycystic ovary syndrome<span> and predicting the response to treatment, and assisting in dose selection for women undergoing </span></span>assisted reproductive technology<span>. However, the enthusiasm for AMH as a relatively new tool in the armamentarium of the reproductive endocrinologist must be tempered by its limitations. Although AMH is helpful in ascertaining the quantity of remaining ovarian follicles, it does not provide information about follicle quality. Therefore, using AMH to forecast fertility potential can be fraught with error and can drive unwarranted medical treatment. Certain conditions and medications can also result in falsely low AMH determinations, which can again lead to inappropriate treatment recommendations. The knowledge of the proven usefulness of AMH and its limitations is therefore critical for optimal clinical practice.</span></span></p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"3 1","pages":"Pages 1-10"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91673311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To determine whether the use of intracytoplasmic sperm injection (ICSI), which was initially developed for sperm abnormalities but has progressively expanded beyond male factor infertility, improves live birth rate (LBR) compared with conventional in vitro fertilization (IVF) in non-male factor infertility cases.
Evidence Review
This prospectively registered systematic review and meta-analysis was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, and Cochrane Library were searched for relevant literature reported between January 01, 2004, and March 15, 2020. Only articles conducted in couples without obvious male factor infertility according to the investigators were included. Live birth rate (LBR) per cycle and/or per transfer was used as the main outcome. Fertilization rate, cycles with total fertilization failure, and clinical pregnancy rate were also recorded as the secondary outcomes. Study selection, bias assessment, and data extraction were performed by two independent reviewers. The methodological quality of the selected studies was assessed by two independent reviewers using the Cochrane Handbook methods and by the adapted Newcastle–Ottawa Quality Assessment Scale for cohort studies. The risks of bias were assessed using the ROBIN-1 tools. Risk ratio (RR) and 95% confidence interval (CI) were estimated using the random-effects model.
Results
Among the 1,760 potentially eligible studies, 61 were fully assessed, and 21 were included in the meta-analysis, corresponding to almost 1,000,000 assisted reproductive technology cycles. Among the selected studies, 17 reported LBR per cycle, 11 reported LBR per transfer, and 7 among them reported both outcomes. One was a prospective randomized controlled trial, whereas others were either retrospective cohort (n=17) or case–control studies (n=4). Individual studies’ sample size ranged from 60 to 569,605 cycles. Meta-analysis showed that IVF provided a significantly higher LBR per cycle when compared with ICSI (RR, 1.10; 95% CI, 1.02–1.18). LBR per transfer tended to be higher when IVF was used compared with ICSI, but this difference barely reached statistical significance (RR, 1.18; 95% CI, 1.00–1.38). Subgroup analysis performed in poor responders showed no significant difference between IVF and ICSI concerning LBR per cycle or LBR per transfer. The secondary analyses demonstrated a lower fertilization rate but comparable clinical pregnancy and fertilization failure rates with IVF compared with ICSI. Sensitivity analyses led to similar results and conclusions.
Conclusion
Despite its limitations, mainly related to the inclusion of most retrospective studies, this meta-analysis synthesizes and reinforces the existing literature and provides further evidence that ICSI does not impr
{"title":"Does intracytoplasmic sperm injection improve live birth rate when compared with conventional in vitro fertilization in non-male factor infertility? A systematic review and meta-analysis","authors":"Astrid de Bantel-Finet M.D. , Elisangela Arbo M.D., M.Sc. , Marina Colombani M.D. , Bernadette Darné M.D. , Vanessa Gallot M.D. , Veronika Grzegorczyk-Martin M.D. , Solène Languille Ph.D. , Thomas Fréour Pharm.D., Ph.D.","doi":"10.1016/j.xfnr.2021.09.004","DOIUrl":"https://doi.org/10.1016/j.xfnr.2021.09.004","url":null,"abstract":"<div><h3>Objective</h3><p>To determine whether the use of intracytoplasmic sperm injection<span><span> (ICSI), which was initially developed for sperm abnormalities but has progressively expanded beyond male factor infertility, improves live birth rate (LBR) compared with conventional </span>in vitro fertilization (IVF) in non-male factor infertility cases.</span></p></div><div><h3>Evidence Review</h3><p><span>This prospectively registered systematic review and meta-analysis was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, and Cochrane Library were searched for relevant literature reported between January 01, 2004, and March 15, 2020. Only articles conducted in couples without obvious male factor infertility according to the investigators were included. Live birth rate (LBR) per cycle and/or per transfer was used as the main outcome. </span>Fertilization<span> rate, cycles with total fertilization failure, and clinical pregnancy rate were also recorded as the secondary outcomes. Study selection, bias assessment, and data extraction were performed by two independent reviewers. The methodological quality of the selected studies was assessed by two independent reviewers using the Cochrane Handbook methods and by the adapted Newcastle–Ottawa Quality Assessment Scale for cohort studies. The risks of bias were assessed using the ROBIN-1 tools. Risk ratio (RR) and 95% confidence interval (CI) were estimated using the random-effects model.</span></p></div><div><h3>Results</h3><p><span>Among the 1,760 potentially eligible studies, 61 were fully assessed, and 21 were included in the meta-analysis, corresponding to almost 1,000,000 assisted reproductive technology cycles. Among the selected studies, 17 reported LBR per cycle, 11 reported LBR per transfer, and 7 among them reported both outcomes. One was a prospective </span>randomized controlled trial, whereas others were either retrospective cohort (n=17) or case–control studies (n=4). Individual studies’ sample size ranged from 60 to 569,605 cycles. Meta-analysis showed that IVF provided a significantly higher LBR per cycle when compared with ICSI (RR, 1.10; 95% CI, 1.02–1.18). LBR per transfer tended to be higher when IVF was used compared with ICSI, but this difference barely reached statistical significance (RR, 1.18; 95% CI, 1.00–1.38). Subgroup analysis performed in poor responders showed no significant difference between IVF and ICSI concerning LBR per cycle or LBR per transfer. The secondary analyses demonstrated a lower fertilization rate but comparable clinical pregnancy and fertilization failure rates with IVF compared with ICSI. Sensitivity analyses led to similar results and conclusions.</p></div><div><h3>Conclusion</h3><p>Despite its limitations, mainly related to the inclusion of most retrospective studies, this meta-analysis synthesizes and reinforces the existing literature and provides further evidence that ICSI does not impr","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"3 1","pages":"Pages 57-68"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91718306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Endometriosis and uterine fibroids are 2 common gynecological disorders. Their pathophysiology remains unclear, although several different risk factors have been identified, including genetic predisposition, hormones, and proinflammatory cytokines. The present review outlines the experimental evidence showing the role of autophagy in the physiology of the endometrium and myometrium and emerging evidence that autophagy may contribute to the onset of endometriosis and uterine fibroids. The full definition of the role of autophagy is likely to lead to effective new pharmacologic treatments for these disorders.
{"title":"Regulation of autophagy in the uterus: from physiological processes to endometriosis and uterine fibroids","authors":"Paola Marcolongo Ph.D. , Emilia Maellaro Ph.D. , Stefano Luisi M.D., Ph.D.","doi":"10.1016/j.xfnr.2021.11.003","DOIUrl":"10.1016/j.xfnr.2021.11.003","url":null,"abstract":"<div><p>Endometriosis<span><span><span><span> and uterine fibroids<span> are 2 common gynecological disorders. Their pathophysiology remains unclear, although several different risk factors have been identified, including </span></span>genetic predisposition, hormones, and proinflammatory cytokines. The present review outlines the experimental evidence showing the role of autophagy in the physiology of the </span>endometrium and </span>myometrium<span> and emerging evidence that autophagy may contribute to the onset of endometriosis and uterine fibroids. The full definition of the role of autophagy is likely to lead to effective new pharmacologic treatments for these disorders.</span></span></p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"3 1","pages":"Pages 69-75"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47036301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1016/j.xfnr.2021.11.005
Matthew Hamilton B.H.Sc. , Stewart Russell Ph.D. , Sergey Moskovtsev M.D., Ph.D. , Stephen A. Krawetz Ph.D. , Clifford Librach M.D.
The clinical challenge of diagnosing male factor infertility leaves several male patients with an unidentified cause of subfertility and increases time to pregnancy among couples undergoing fertility treatment. Traditionally assessed sperm characteristics inadequately predict male fertility status, reinforcing the concept that the male gamete harbors intrinsic factors that may determine its competency in fertilization and development. In addition to an intricate, epigenetically marked genome, spermatozoa carry a diverse collection of both small and large ribonucleic acids (RNAs). A growing body of literature suggests these coding and noncoding spermatozoal RNAs are functional in the early embryo, contributing to normal preimplantation development and progression. Furthermore, this dynamic population of sperm-borne RNAs is altered as maturing sperm traverse the male reproductive tract and is susceptible to various environmental influences, directing the paternal RNAs that are delivered to the oocyte. Research into such modifications has demonstrated that sperm-borne RNAs may act as mediators of epigenetic inheritance, with significant influences on offspring development and phenotype. Preliminary findings suggest that a variety of small and large RNAs are differentially expressed among the fertile and infertile groups of animals and humans and have value as diagnostic markers of male fertility status. Further investigation is necessary to better characterize the role of sperm-borne RNA elements in fertilization and development and evaluate their potential use as clinical markers for male factor infertility.
{"title":"The developmental significance of sperm-borne ribonucleic acids and their potential for use as diagnostic markers for male factor infertility","authors":"Matthew Hamilton B.H.Sc. , Stewart Russell Ph.D. , Sergey Moskovtsev M.D., Ph.D. , Stephen A. Krawetz Ph.D. , Clifford Librach M.D.","doi":"10.1016/j.xfnr.2021.11.005","DOIUrl":"https://doi.org/10.1016/j.xfnr.2021.11.005","url":null,"abstract":"<div><p><span><span>The clinical challenge of diagnosing male factor infertility leaves several male patients with an unidentified cause of subfertility and increases </span>time to pregnancy<span> among couples undergoing fertility treatment<span>. Traditionally assessed sperm characteristics inadequately predict male fertility<span> status, reinforcing the concept that the male gamete harbors intrinsic factors that may determine its competency in </span></span></span></span>fertilization<span><span> and development. In addition to an intricate, epigenetically marked genome, spermatozoa carry a diverse collection of both small and large ribonucleic acids (RNAs). A growing body of literature suggests these coding and noncoding spermatozoal RNAs are functional in the early embryo, contributing to normal preimplantation development and progression. Furthermore, this dynamic population of sperm-borne RNAs is altered as maturing sperm traverse the </span>male reproductive tract<span> and is susceptible to various environmental influences, directing the paternal RNAs that are delivered to the oocyte. Research into such modifications has demonstrated that sperm-borne RNAs may act as mediators of epigenetic inheritance, with significant influences on offspring development and phenotype. Preliminary findings suggest that a variety of small and large RNAs are differentially expressed among the fertile and infertile groups of animals and humans and have value as diagnostic markers of male fertility status. Further investigation is necessary to better characterize the role of sperm-borne RNA elements in fertilization and development and evaluate their potential use as clinical markers for male factor infertility.</span></span></p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"3 1","pages":"Pages 11-23"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91673286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-01DOI: 10.1016/j.xfnr.2021.11.005
M. Hamilton, S. Russell, S. Moskovtsev, S. Krawetz, C. Librach
{"title":"The Developmental Significance of Sperm-Borne RNAs and Their Potential for Use as Diagnostic Markers for Male Factor Infertility","authors":"M. Hamilton, S. Russell, S. Moskovtsev, S. Krawetz, C. Librach","doi":"10.1016/j.xfnr.2021.11.005","DOIUrl":"https://doi.org/10.1016/j.xfnr.2021.11.005","url":null,"abstract":"","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48988322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-01DOI: 10.1016/j.xfnr.2021.11.001
M. Quinn, M. Cedars, H. Huddleston, N. Santoro
{"title":"Anti-Mullerian Hormone: Use and Mis-use in Current Reproductive Medicine Practice: A Clinically Oriented Review","authors":"M. Quinn, M. Cedars, H. Huddleston, N. Santoro","doi":"10.1016/j.xfnr.2021.11.001","DOIUrl":"https://doi.org/10.1016/j.xfnr.2021.11.001","url":null,"abstract":"","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43783503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-01DOI: 10.1016/j.xfnr.2021.08.002
Sezcan Mumusoglu M.D. , Qingling Yang Ph.D. , Aaron J. Hsueh Ph.D.
Polycystic ovary syndrome (PCOS) is the most common endocrine and metabolic disorder affecting 6%–10% of reproductive-age women, and it is associated with defects in follicle functions. On the basis of advances in the evaluation of gene variants, together with family-based and genome-wide association studies, we discussed genes associated with PCOS. We used a gene-centric approach to sort out literature deposited in the Ovarian Kaleidoscope database (http://okdb.appliedbioinfo.net) by subcategorizing candidate genes as ligand-receptor signaling, meiosis and deoxyribonucleic acid repair, transcriptional factors, ribonucleic acid metabolism, enzymes, and others. Although multiple individual candidate genes with single nucleotide polymorphisms have been identified in patients with PCOS, only a limited number of findings have been verified and deal with genes with known ovarian functions. On the basis of genome-wide association studies, a limited group of PCOS candidate genes, including FSHB, FSHR, LHR, YAP1, AOPEP/C9orf3, RAB5/SUOX, THADA, and DENND1A, yielded consistent association in good-quality studies in both Caucasian and Chinese populations. Although some of these genes have known ovarian functions, the ovarian expression and function of others remain to be elucidated. Overall, PCOS candidate genes are likely associated with abnormal gene expression because of their recent evolutionary origins. Studying rare variants in complex diseases such as PCOS presents unique challenges. The identification of rare variants and functional gene networks by next-generation sequencing along with epigenetic studies may increase our understanding of the genetic bases of PCOS. A better definition of unique diseases underlying PCOS on the basis of ovarian expression patterns could provide new diagnosis and treatments.
{"title":"A kaleidoscopic view of ovarian genes associated with polycystic ovary syndrome","authors":"Sezcan Mumusoglu M.D. , Qingling Yang Ph.D. , Aaron J. Hsueh Ph.D.","doi":"10.1016/j.xfnr.2021.08.002","DOIUrl":"10.1016/j.xfnr.2021.08.002","url":null,"abstract":"<div><p><span>Polycystic ovary syndrome<span> (PCOS) is the most common endocrine and metabolic disorder affecting 6%–10% of reproductive-age women, and it is associated with defects in follicle functions. On the basis of advances in the evaluation of gene variants, together with family-based and genome-wide association studies, we discussed genes associated with PCOS. We used a gene-centric approach to sort out literature deposited in the Ovarian Kaleidoscope database (</span></span><span>http://okdb.appliedbioinfo.net</span><svg><path></path></svg><span><span>) by subcategorizing candidate genes as ligand-receptor signaling, meiosis and deoxyribonucleic acid repair, transcriptional factors, ribonucleic acid metabolism, enzymes, and others. Although multiple individual candidate genes with single nucleotide polymorphisms have been identified </span>in patients<span> with PCOS, only a limited number of findings have been verified and deal with genes with known ovarian functions. On the basis of genome-wide association studies, a limited group of PCOS candidate genes, including </span></span><em>FSHB</em>, <em>FSHR</em>, <em>LHR</em>, <em>YAP1</em>, <em>AOPEP</em>/<em>C9orf3</em>, <em>RAB5</em>/<em>SUOX</em>, <span><em>THADA</em></span>, and <em>DENND1A</em><span>, yielded consistent association in good-quality studies in both Caucasian and Chinese populations. Although some of these genes have known ovarian functions, the ovarian expression and function of others remain to be elucidated. Overall, PCOS candidate genes are likely associated with abnormal gene expression because of their recent evolutionary origins. Studying rare variants in complex diseases such as PCOS presents unique challenges. The identification of rare variants and functional gene networks by next-generation sequencing along with epigenetic<span> studies may increase our understanding of the genetic bases of PCOS. A better definition of unique diseases underlying PCOS on the basis of ovarian expression patterns could provide new diagnosis and treatments.</span></span></p></div>","PeriodicalId":73011,"journal":{"name":"F&S reviews","volume":"2 4","pages":"Pages 330-341"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.xfnr.2021.08.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42686316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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