Journal of reproductive health and medicine最新文献

A significant proportion of pregnancy related complications like preterm birth, preeclampsia, intra-uterine growth restriction (IUGR) and spontaneous abortion may be due to defects at various stages of embryo implantation process, in particular, placentation. One of these defects is impaired syncytialization. This may also be responsible for low success rate of embryo implantation during Assisted Reproductive Technology (ART). As it is an early differentiation event of the trophectoderm, unveiling its elementary molecular network might help in understanding the cause behind such complications and even ameliorate the success rate of pregnancies. Therefore, the current review highlights the available information with respect to effector molecules such as syncytins, syndecan-1, CD98, connexin-43, proteases and protease convertase in trophoblast syncytialization. Promotion of syncytialization by EGF, hCG, IGFs, LIF etc. and its inhibition by TGF-β1 and TNF-α is also discussed. The signaling pathways, such as PKA-CREB, MAPK, STAT, Wnt/β-catenin etc. through which various factors modulate the process of syncytialization have also been presented. Post-transcriptional regulation via microRNAs has also been discussed. The information provided in this review will help in our understanding of the molecular mechanisms associated with syncytialization and their implications in pregnancy related complications.

Microbes are intimately associated with human existence and health. Gut, oral cavity, skin, respiratory and urinogenical tracts are the major body sites inhabited by large consortia of microorganisms; each with specific composition. Application of high throughput genomic technologies has paved ways to gain an improved knowledge about the composition of the resident microbes and the ecosystem homeostasis and underscores the concept that dysbiosis of the flora may lead to predisposition to infection and diseases. Successful human reproduction owes an immense debt to this microbial community. Microbial communities exist throughout the entire length of the female reproductive tract at variable composition and density and play a role in gametogenesis, reproductive cyclicity, pregnancy and successful delivery of newborns. This review focuses on the recent studies from all over the globe on the composition of microflora in the female reproductive tract, their spatio-temporal diversity across the age of women and how the host–microbe collaboration is pursued to maintain reproductive efficiency. A special emphasis has been placed on the disruption of the stable flora and its association with the microbial imbalance and infections in bacterial vaginosis, endometriosis and pre-term birth. Finally, this article highlights that the restoration of normal microbial flora might provide a long-term therapeutic measure for the reproductive failures and endow with solutions to the global problem of reproductive failure, preterm birth and neonatal deaths.

Sperm membranes undergo progressive structural and functional modifications during epididymal maturation, capacitation and acrosome reaction. Though sperm membranes have raft microdomains, our understanding on the reorganization of membrane rafts during these events is limited. Using caveolin1 (CAV1) and ganglioside GM-1 as markers of membrane rafts, we studied the organization of sperm membrane rafts during epididymal maturation, in vitro capacitation and progesterone-induced acrosome reaction. We also evaluated the effect of raft disruption by methyl beta cyclodextrin on sperm hyperactivation, progesterone induced acrosome reaction and sperm-zona pellucida binding in vitro. CAV1 and ganglioside GM-1 showed transient non-overlapping localization pattern on sperm head during the intermediate phase of epididymal maturation and ended with co-localization on the acrosomal region toward the advanced stages of epididymal maturation and subsequent capacitation. CAV1 was excluded from sperm membrane rafts during capacitation and acrosome reaction. Progesterone receptor (PR) was present in the caveolar rafts of spermatozoa from testis, caput epididymidis and corpus epididymidis, but was not detected in that from cauda epididymidis. Further, capacitation was associated with the appearance of PR in non-caveolar rafts. Estrogen receptors ERα and ERβ, which were located in the caveolar rafts of spermatozoa from testis and epididymides, appeared in the non-caveolar rafts during capacitation and acrosome reaction. It appears that PR, ERα and ERβ were sequestered in the caveolar rafts of spermatozoa during epididymal maturation, and the exit of CAV1 from the membrane rafts overlying the acrosome during capacitation might free them from the sequestration that might trigger PR into action.

In this paper we discuss some of the features of the New Surrogacy (Regulation) Bill 2016 in India and ask whether the extreme step of a complete ban on commercial surrogacy is an appropriate response to the underlying issue of exploitation of surrogate mothers and children. The paper asserts that the negative externality associated with commercial surrogacy is low. Appropriate regulations can ensure that the rights of surrogate mothers are protected and both the parties to the process are equipped to understand the consequences of their choices. The non-availability of even altruistic surrogacy for certain groups of people has been criticized.

Objectives

Bacterial infections of the female reproductive tract have long been recognized as having an association with infertility. Microorganisms in the female genital tract might themselves or by producing some extracellular metabolites inhibit sperm motility leading to infertility. So, microbiological screening of female genital tract is needed before in vitro fertilization (IVF) procedures. The aim of the present study was to look for the microbiological profile of cervical samples of females attending IVF clinic for infertility.

Materials and methods

The study was conducted in the Department of Microbiology, Bacteriology Division, Maulana Azad Medical College, New Delhi. Cervical swabs from the females attending the IVF clinics for infertility from January 2015 to June 2015 were screened for the bacterial isolates. The isolates were identified by standard microbiological procedures.

Results

Total 296 samples were analyzed. Majority was from females belonging to 31–40 years age group (56.4%) followed by 21–30 years (37.1%). Most of the samples (54.3%) were sterile, while normal vaginal flora and environmental contaminants were obtained from 34.7% of the samples. Various isolates obtained were, Micrococcus spp. (12.5%), diphtheroids (9%), Non enterococcal group D streptococcus (6.7%), Staphylococcus aureus (0.3%), Coagulase negative staphylococcus (2%), Enterococcus spp. (1%), Bacillus spp. (3%), Escherichia coli (5.7%), Klebsiella spp. (2%), Acinetobacter spp. (1.3%) and Candida spp. (2.3%).

Conclusion

Gram negative organisms in the female reproductive tract might be a cause of female infertility. There is still a need for practising proper procedure while collecting endocervical samples from females attending infertility clinic.

Background/objectives/introduction

Perceived stress and stress reduction interventions have a mixed relationship with fecundity. The objective of this study is to attempt and disentangle these relationships by looking at practicing stress reduction techniques and fecundity and examining their relationship to a behavioral and a neuroendocrine measure of stress.

Materials and methods

Fifty nulliparous-infertile women participated in a randomized prospective pilot study with repeated measures to examine the efficacy of cognitive behavioral interventions (CBI) in reducing perceived stress and improving pregnancy rates. Stress measures were taken at T0 (before CBI), T2 (ovum pick up) and T3 (time of pregnancy test).

Results

We found that women who reported low perceived stress at the beginning of treatment (T0) had a twofold increased chance of becoming pregnant (βhCG >7 mIU/mL) compared to those who reported high-perceived stress, regardless of CBI. Women who received CBI reported reduced perceived stress at the time of the pregnancy test (T3). Women who engaged in daily practice of CBI had significantly higher pregnancy rates compared to those who did not practice.

Conclusions

It may be beneficial for women who have high perceived stress levels to learn and practice stress reduction techniques before beginning IVF treatment, and continue to practice daily during IVF treatment.