[Luteal insufficiency and sterility]

Luteal insufficiency is badly defined, and shows up with difficulty as a definite syndrome, and, although regarded by some as a frequent cause of hypofertility, is found by others in 3% of cases only. The author attempts to establish objective criteria for luteal insufficiency and to evaluate the proposed therapy, emphasising that the apparent good results are difficult to authenticate in the absence of a control series.

Pseudocorpus luteum insufficiency: a study of cytosol progesterone receptors in human endometrium

This prospective, controlled study of 38 women was designed to compare the number of endometrial cytosol progesterone receptor (PRc) binding sites in infertile women with documented luteal phase defect with those of similar women without luteal phase defect. A 25% reduction in PRc binding sites was observed in women with luteal phase defect (P less than .05). Considerable overlap was noted between luteal phase defect and control groups; thus, no definite range of binding site numbers was predictive of luteal phase defect. The results of this study, therefore, suggest that an end-organ receptor defect may exist in some women with luteal phase abnormalities.

[Cytosol estrogen, progestin receptors and secretory endometrium in infertile women]

The serum levels of estradiol (E2), progesterone (P), FSH, PRL and cytosol estrogen and progestin receptors (EcR, PcR) contents in the endometrial tissues were analyzed in patients with inadequate secretory endometrium. The result shows that EcR and PcR are significantly lower (EcR: P less than 0.01; PcR: P less than 0.05) in these patients than those of control group. The inadequate secretory changes of endometrium correlated with insufficient EcR and PcR contents rather than with decreased levels of serum E2, P, FSH and PRL. The authors suggest that during treatment of such patients both the hormonal levels in the peripheral blood and the EcR, PcR contents in the tissue should be considered at the same time.

[Monitoring hormones during the menstrual cycle among sterile women. I]

This paper attempts to estimate the endocrinological function of the following glands: pituitary, thyroid, adrenal, pancreas, and ovary. An examination only once of their hormones was made between the 8th and 10th day of the follicular phase of the menstrual cycle. This examination was performed on 22 sterile women with monophasic menstrual cycle, 119 sterile women with biphasic menstrual cycle and 17 women who delivered at least one child without previous treatment (control group). Radioimmunoassays (RIA) of 11 hormones: LH, FSH, PRL, estradiol, progesterone, cortisol, aldosterone, insulin, T3, T4, and testosterone were made. It was confirmed that the marked differences showed only the examinations of LH and estradiol among sterile women with monophasic menstrual cycle in comparison to the group of sterile women with biphasic cycle and the control group. RIA of the concentrations of the thyroid, pancreas and adrenal hormones among women without endocrinopathy have not a mark diagnostical value. RIA of the level of the testosterone is not appropriate in clinical cases which do not carry symptoms a hyperandrogenism.

Endometrial receptivity: expression of alpha3beta1, alpha4beta1 and alphaVbeta1 endometrial integrins in women with impaired fertility

Advances in immunohistochemical methods with the specificity of poly- and monoclonal antibodies allow the description of the endometrial receptivity, which is characterized by the ability of secretion of phase specific proteins and glikoproteins by epithelial and stromal cells. We studied the differences in the expression of alpha3beta1, alpha4beta1 and alphaVbeta1 integrins in endometrium of women with recurrent miscarriages and women with unexplained infertility. The endometrial tissue was collected during hysteroscopy performed between 7th and 9th day after ovulation. The immunohistochemical evaluation of alpha3beta1, alpha4beta1 and alphaVbeta1 integrin expression was determined in all endometrial biopsies. Staining intensity of alpha3beta1 in glandular epithelium and endometrial stroma was similar in both groups. In women with recurrent miscarriages we noted a lower concentrations of the alpha4beta1 and alphaVbeta1 integrins during the midluteal phase than in women with unexplained infertility. Moreover, integrins alpha4beta1 and alphaVbeta1 were expressed more frequently in glandular epithelium and endometrial stroma of women with unexplained infertility than those of women with recurrent miscarriages. However, alphaV(2)1 staining in endometrial stroma was stronger than that of alpha4beta1. It can be concluded, that these integrins may play an important role in the implantation process.

Histopathological study of endometrium in infertility

A study of 200 cases of primary and secondary infertility was carried out in the department of pathology, Dr. V.M. Medical College, Solapur. Endometrial specimens were evaluated in the light of menstrual history to find out the incidence of various endometrial changes in cases of infertility. All cases underwent endometrial biopsy premenstrually. Haematoxylin and eosin staining was done for dating of endometrium and diagnosis of corpus luteal defect and anovalutory cycles. PAS stain was done in 50 cases of infertility with control of 25 cases to detect the amount of glycogen. Menstrual problems were seen in 38.2% of patients. Anovulatory infertility was present in 28.2% cases. Luteal phase defect was seen in 20% cases. Cystoglandular hyperplasia was seen in 1.7% cases & tuberculous endometritis was present in 2.6% cases. Glycogen deficiency was seen in 30% cases of luteal phase defect.

[Homocysteine level in ovarian follicular fluid or serum as a predictor of successful fertilization]

OBJECTIVES

There are some data concerning homocysteine influence on fertilization and early embryogenesis, especially in women experiencing recurrent pregnancy loss (RSA). However, limited data support hypothesis that the ovum might be exposed to high homocysteine concentration what may be important in egg-sperm interactions, for example during in vitro-fertilization (IVF) cycle.

DESIGN

Therefore, the aim of our study was to determine fasting total homocysteine concentration in follicular fluid or serum of women experiencing reproductive failure after spontaneous or in-vitro fertilization.

MATERIALS AND METHODS

Eight nonpregnant RSA women, 8 normal healthy women with previous successful pregnancy outcome and 15 women undergoing IVF (6 with unexplained infertility-UI, 6 with male factor-MF, 3 with tubal obstruction-TO). Total fasting homocysteine level concentrations were established by ELISA method (Axis Homocysteine EIA, Axis-Shield AS) in serum of RSA and normal healthy women or ovarian follicular fluid of women undergoing IVF.

RESULTS

Mean fasting total homocysteine concentration in study group were as follows: RSA-18.63 mumol/L +/- 6.67, Normal-13.98 mumol/L +/- 6.62, UI-20.62 mumol/L +/- 8.19, MF-22.60 mumol/L +/- 7.87, TO-36.75 mumol/L +/- 13.26. We found that RSA women have had significantly higher serum homocysteine concentration when compared to normal healthy women (P < 0.05). Among women undergoing IVF, those with following IVF success had not significantly lower homocysteine level when compared to those with IVF failure (22.81 mumol/L +/- 11.27 vs. 24.54 mumol/L +/- 9.50, P > 0.05).

CONCLUSIONS

Our preliminary data suggest that high homocysteine level may negatively influence pregnancy outcome following natural or in-vitro fertilization. It cannot be excluded that elevated homocysteine concentrations contribute to defective chorionic villous vascularization during early stages of gestation.

The assessment of LIF in uterine flushing--a possible new diagnostic tool in states of impaired fertility

The objective of this study was to assess the LIF (leukemia inhibitory factor) concentration in uterine flushing and serum (ELISA) of women with proven fertility, infertile women and women with recurrent miscarriage. In addition, progesterone level was determined in serum. A decreased production of LIF in the uterine microenvironment was found in states of impaired fertility. With a cut-off point of 8.23 pg/ml for LIF level in uterine flushings we have achieved 86.7% sensitivity and 100% specificity in detection of women with idiopathic infertility compared to fertile controls. No correlation between LIF in serum and uterine flushing was demonstrated, rendering LIF measurements in serum useless for diagnosis of impaired infertility. We conclude that LIF measurement in uterine flushing could be a useful diagnostic tool to predict unsuccessful implantation.

Alkali and alkaline earth elements in follicular fluid and the likelihood of diminished ovarian reserve in reproductive-aged women: a case‒control study

BACKGROUND

Imbalances in alkali elements (AEs) and alkaline earth elements (AEEs) cause reproductive disorders. However, it remains unclear whether AEs/AEEs in follicular fluid have a relationship with the serious reproductive disorder known as diminished ovarian reserve (DOR).

METHODS

A nested case‒control study was carried out in China. Follicular fluid samples from 154 DOR patients and 154 controls were collected and assessed for nine AEs/AEE levels. Both the mixed and single effects of the elements on DOR were estimated with a Bayesian kernel machine (BKMR) and logistic regressions.

RESULTS

The DOR group had higher median concentrations of Li, Na, and K in follicular fluid (all P values < 0.05). The logistic regression showed that compared with their lowest tertile, the high tertiles of K [OR:2.45 (1.67-4.43)], Li [OR: 1.89 (1.06-3.42)], and Cs [OR: 1.97 (1.10-3.54)] were significantly associated with the odds of DOR. The BKMR model reported that the DOR likelihood increased linearly across the 25th through 75th percentiles of the nine-AE/AEE mixture, while the AE group contributed more to the overall effect.

CONCLUSION

This study revealed an association in which the likelihood of DOR increased with higher overall concentrations of AE/AEEs in follicular fluid. Among the nine detected elements, K, Li, and Cs exhibited significant individual associations with DOR. We provide new clues for the environmental factors on female fertility decline.

TRIAL REGISTRATION

Retrospectively registered.

Activation of HAND2-FGFR signaling pathway by lncRNA HAND2-AS1 in adenomyosis†

Heart and neural crest derivatives expressed transcript 2 (HAND2) is a critical mediator of progesterone action in endometrial stromal cells. Silencing of Hand2 expression in mouse uterus leads to an unopposed FGFR-mediated action that causes female mice infertility. To investigate the involvement of HAND2-FGFR signaling in pathogenesis of adenomyosis, immunohistochemistry, in situ hybridization, and quantitative real-time PCR were employed to assess gene expression in the normal endometrium, the paired eutopic endometrium and ectopic lesions obtained from women with adenomyosis. DNA methylation in the regions of HAND2 promoter and the first exon was also monitored in these samples. Our results revealed that HAND2 expression were dramatically reduced, but FGF9 expression and FGFR-ERK1/2-mediated MAPK signaling pathway were enhanced in the eutopic endometrium and ectopic lesions of patients with adenomyosis compared to the normal controls. Interestingly, expression of HAND2-AS1, a long noncoding RNA that resides adjacent to HAND2 in genome, was also reduced in adenomyosis. DNA methylation analysis revealed that the bidirectional promoter between HAND2 and HAND2-AS1, and the first exon of HAND2 gene was heavily methylated in the eutopic endometrium and the ectopic lesions of adenomyosis. To investigate the regulation of gene expression by HAND2-AS1, HAND2-AS1 expression was silenced in human endometrial stromal cells. In contrast to the downregulation of HAND2 in response to HAND2-AS1 silencing, FGF9 expression was augmented significantly. Endometrial stromal cells lacking HAND2-AS1 exhibited enhanced proliferation and migration potentials. Collectively, our studies revealed a new molecular mechanism by which HAND2-AS1 is involved in the pathogenesis of adenomyosis via modulating HAND2-FGFR-mediated signaling.

Metabolic landscape and pathogenic insights: a comprehensive analysis of high ovarian response in infertile women undergoing in vitro fertilization

BACKGROUND

In the realm of assisted reproduction, a subset of infertile patients demonstrates high ovarian response following controlled ovarian stimulation (COS), with approximately 29.7% facing the risk of Ovarian Hyperstimulation Syndrome (OHSS). Management of OHSS risk often necessitates embryo transfer cancellation, leading to delayed prospects of successful pregnancy and significant psychological distress. Regrettably, these patients have received limited research attention, particularly regarding their metabolic profile. In this study, we aim to utilize gas chromatography-mass spectrometry (GC-MS) to reveal these patients' unique serum metabolic profiles and provide insights into the disease's pathogenesis.

METHODS

We categorized 145 infertile women into two main groups: the CON infertility group from tubal infertility patients and the Polycystic Ovary Syndrome (PCOS) infertility group. Within these groups, we further subdivided them into four categories: patients with normal ovarian response (CON-NOR group), patients with high ovarian response and at risk for OHSS (CON-HOR group) within the CON group, as well as patients with normal ovarian response (PCOS-NOR group) and patients with high ovarian response and at risk for OHSS (PCOS-HOR group) within the PCOS group. Serum metabolic profiles were analyzed using GC-MS. The risk criteria for OHSS were: the number of developing follicles > 20, peak Estradiol (E2) > 4000pg/mL, and Anti-Müllerian Hormone (AMH) levels > 4.5ng/mL.

RESULTS

The serum metabolomics analysis revealed four different metabolites within the CON group and 14 within the PCOS group. Remarkably, 10-pentadecenoic acid emerged as a discernible risk metabolite for the CON-HOR, also found to be a differential metabolite between CON-NOR and PCOS groups. cysteine and 5-methoxytryptamine were also identified as risk metabolites for the PCOS-HOR. Furthermore, KEGG analysis unveiled significant enrichment of the aminoacyl-tRNA biosynthesis pathway among the metabolites differing between PCOS-NOR and PCOS-HOR.

CONCLUSION

Our study highlights significant metabolite differences between patients with normal ovarian response and those with high ovarian response and at risk for OHSS within both the tubal infertility control group and PCOS infertility group. Importantly, we observe metabolic similarities between patients with PCOS and those with a high ovarian response but without PCOS, suggesting potential parallels in their underlying causes.

Follicular fluid concentration of soluble Human-G Leukocytic Antigen (sHLA-G) in in vitro fertilization cycles of women with and without peritoneal endometriosis

OBJECTIVE

The objective of this research is to investigate the association between the concentrations of soluble human leukocyte G antigen (sHLA-G) in the follicular fluid (FF) in infertile patients with peritoneal endometriosis submitted to in vitro fertilization.

METHODS

We performed a cross-sectional study, including ninety-six women undergoing in vitro fertilization (IVF) ageing ≤ 40 years. Infertile patients were classified into two groups: with endometriosis diagnosed by laparoscopy and without endometriosis due to tubal factor. ELISA measured soluble HLA-G in the FF of a pool of punctured (more than 17mm) follicles from women with endometriosis and without endometriosis who were subjected to ovulation induction for IVF. Embryos obtained after fertilization were classified according to the graduated embryo score (GES).

RESULTS

Groups were comparables in terms of age, the number of follicles, AMH, FSH and all included reproductive outcomes. There was no association between sHLA-G concentrations and the average score of the generated embryos (p>0.05). Measurement of sHLA-G in the follicle fluid in women with endometriosis and without endometriosis (tubal factor) showed no significant difference (p>0.05). We also compared sHLA-G per follicle and per embryo, which were not different between both groups (p>0.05).

CONCLUSIONS

Patients with peritoneal endometriosis submitted to IVF did not demonstrate an altered sHLA-G in the follicular fluid compared to the follicular fluid sHLA-G concentration in tubal factor patients. Also, this molecule was not linked to any other reproductive outcome.

Association of oxidative stress with female infertility - A case control study

OBJECTIVE

To compare stress markers and reproductive hormones in fertile and infertile females, and to relate the markers with age, duration and cause of infertility, and body mass index..

METHODS

The case-control study was conducted at Aga Khan University Hospital, Karachi, from March 2017 to February 2018. Females aged 16-50 years regardless of ethnic background were recruited from the Australian Concept Infertility Medical Centre, Karachi, and were equally divided into infertile cases group A, and fertile controls group B. Serum follicular stimulating hormone, luteinizing hormone, estradiol, glutathione reductase and cortisol were measured using enzyme-linked innmunosorbent assay. SPSS 19 was used for statistical analysis..

RESULTS

There were 328 female subjects divided into two equal groups of 164(50%). Serum luteinizing hormone and cortisol was higher in the group A than in group B (p<0.001). Serum glutathione reductase was low in group A compared to group B (p<0.001). Duration of infertility, serum levels of glutathione reductase and cortisol were also significantly different among infertile females when distributed on the basis of cause of infertility (p<0.05). Serum cortisol had negative correlation with glutathione reductase (p<0.001). Age and body mass index had a positive correlation with serum cortisol (p=0.035; p=0.63), while there was a negative correlation with glutathione reductase (p = -0.732)..

CONCLUSIONS

Prolonged duration of infertility, age of females and body mass index enhanced the production of stress hormones and decreased antioxidant activity which augmented the risk of infertility.

Metabolomic Analysis Of Human Follicular Fluid: Potential Follicular Fluid Markers Of Reproductive Aging

OBJECTIVE

To assess the difference in the metabolomics profiles of follicular fluid between older and younger reproductive-aged women.

METHODS

The retrospective study was conducted at the Centre of Reproduction and Genetics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China and comprised patient data related to the period between July and October 2015. Follicular fluid was obtained from male-factor infertility women aged 28-35 years as the younger group A, and those aged 35-42 years as the older group B. The subjects were undergoing in vitro fertilization / intracytoplasmic sperm injection and were retrospectively analysed by ultra-performance liquid chromatography-high-resolution mass spectrometry. The fragments were structurally identified using debris' information obtained from fragmented ion scans to identify the different compounds.

RESULTS

Of the 55 cases studied, 28(51%) were in group A with a mean age of 29.57 ± 2.92 years, and 27(49%) were in group B with a mean age of 39.19±2.95 years. Compared with the group A, four types of compounds, hormones, licithin, lysophospholipids, and protein degradation fragments, were expressed significantly differentially in group B (p<0.05 each). Nicotine glucuronide and phosphatidylcholine were found only in Group B follicular fluid.

CONCLUSIONS

The components of follicular fluid and relative contents were found changed with ageing.

Expression of extracellular matrix metalloproteinase inducer (EMMPRIN) in the endometrium of patients with repeated implantation failure after in vitro fertilization

AIM

To compare the immunohistochemical expression of extracellular matrix metalloproteinase inducer (EMMPRIN) in repeated implantation failure (RIF) patients with normal fertile controls.

PATIENTS AND METHODS

The study group consisted of primary infertile patients with RIF and normal fertile controls between January 2011 and February 2013. Endometrial samples received at the luteal phase were exposed to immunohistochemical staining for EMMPRIN antibodies. EMMPRIN expression of endometrial glandular epithelial cells, stromal cells and vascular endothelial cells were evaluated. The main outcome measure was defined as immunohistochemical score with regard to the severity and extent of staining.

RESULTS

The study group consisted of 26 primary infertile patients, whereas the control group consisted of 40 normal fertile controls. The fertile group was found to have stronger expression of EMMPRIN than the study group when endometrial glandular epithelial cells, stromal cells and vascular endothelial cells were evaluated with regards to the severity of staining (p < 0.001), the extent of staining (p < 0.001) and total staining score (p < 0.001).

CONCLUSIONS

This is the first study showing low expression of EMMPRIN in the endometrial cells of the patients with RIF compared with fertile healthy controls. We suggest that reduced EMMPRIN expression in the human endometrium may lead to poor endometrial receptivity.

NLRP14 deficiency causes female infertility with oocyte maturation defects and early embryonic arrest by impairing cytoplasmic UHRF1 abundance

Oocyte maturation is vital to attain full competence required for fertilization and embryogenesis. NLRP14 is preferentially expressed in mammalian oocytes and early embryos. Yet, the role and molecular mechanism of NLRP14 in oocyte maturation and early embryogenesis are poorly understood, and whether NLRP14 deficiency accounts for human infertility is unknown. Here, we found that maternal loss of Nlrp14 resulted in sterility with oocyte maturation defects and early embryonic arrest (EEA). Nlrp14 ablation compromised oocyte competence due to impaired cytoplasmic and nuclear maturation. Importantly, we revealed that NLRP14 maintained cytoplasmic UHRF1 abundance by protecting it from proteasome-dependent degradation and anchoring it from nuclear translocation in the oocyte. Furthermore, we identified compound heterozygous NLRP14 variants in women affected by infertility with EEA, which interrupted the NLRP14-UHRF1 interaction and decreased UHRF1 levels. Our data demonstrate NLRP14 as a cytoplasm-specific regulator of UHRF1 during oocyte maturation, providing insights into genetic diagnosis for female infertility.

Dysregulated miR-124-3p in endometrial epithelial cells reduces endometrial receptivity by altering polarity and adhesion

The endometrium undergoes substantial remodeling in each menstrual cycle to become receptive to an implanting embryo. Abnormal endometrial receptivity is one of the major causes of embryo implantation failure and infertility. MicroRNA-124-3p is elevated in both the serum and endometrial tissue of women with chronic endometritis, a condition associated with infertility. MicroRNA-124-3p also has a role in cell adhesion, a key function during receptivity to allow blastocysts to adhere and implant. In this study, we aimed to determine the function of microRNA-124-3p on endometrial epithelial adhesive capacity during receptivity and effect on embryo implantation. Using a unique inducible, uterine epithelial-specific microRNA overexpression mouse model, we demonstrated that elevated uterine epithelial microRNA-124-3p impaired endometrial receptivity by altering genes associated with cell adhesion and polarity. This resulted in embryo implantation failure. Similarly in a second mouse model, increasing microRNA-124-3p expression only in mouse uterine surface (luminal) epithelium impaired receptivity and led to implantation failure. In humans, we demonstrated that microRNA-124-3p was abnormally increased in the endometrial epithelium of women with unexplained infertility during the receptive window. MicroRNA-124-3p overexpression in primary human endometrial epithelial cells (HEECs) impaired primary human embryo trophectoderm attachment in a 3-dimensional culture model of endometrium. Reduction of microRNA-124-3p in HEECs from infertile women normalized HEEC adhesive capacity. Overexpression of microRNA-124-3p or knockdown of its direct target IQGAP1 reduced fertile HEEC adhesion and its ability to lose polarity. Collectively, our data highlight that microRNA-124-3p and its protein targets contribute to endometrial receptivity by altering cell polarity and adhesion.

Bioconcentration of polycyclic aromatic hydrocarbons in the adipose tissue of women with pelvic endometriosis and idiopathic infertility: A case-control study

PURPOSE

Polycyclic aromatic hydrocarbons (PAHs), present in air and food, generated during energy production and waste incineration, are known for health toxicity. PAHs may activate the aryl hydrocarbon receptor, which could in turn modify estrogen-dependent inflammatory pathways in endometriosis. The possible role of PAHs in the pathogenesis of endometriosis remains unclear. The study aimed to evaluate the potential link between exposure to PAHs and the occurrence of peritoneal and ovarian endometriosis.

METHODS

A prospective case-control tertiary-center study included 46 women aged 22-45 undergoing laparoscopy due to pelvic endometriosis (n ​= ​32; arm 1) and idiopathic infertility (n ​= ​14; arm 2). A sample of the greater omentum was collected intraoperatively for detection of 16 standard PAHs by gas chromatography-isotope dilution mass spectrometry method. PAHs concentrations were compared in both study arms. The associations between PAHs concentrations and selected variables were investigated.

RESULTS

There were no significant differences between both arms in terms of reference PAHs concentrations, nor correlations between PAHs concentrations and the stage of endometriosis. However, notable differences were observed in specific PAHs concentrations related to certain conditions. The concentrations of acenaphthene (p ​= ​0.016) and fluorene (p ​= ​0.013) were significantly lower in women with peritoneal adhesions, while the concentrations of benz[a]anthracene, benzo[k]fluoranthene and indeno[1,2,3-cd]pyrene [ng/g] were higher in cigarette smokers.

CONCLUSIONS

The study showed no differences in exposure to PAHs between women with and without pelvic endometriosis. Determining the toxicity of PAHs in endometriosis requires further research.

Correlation of Glycolysis-immune-related Genes in the Follicular Microenvironment of Endometriosis Patients with ART Outcomes

Endometriosis (EMT) -related infertility has been a challenge for clinical research. Many studies have confirmed that abnormal alterations in the immune microenvironment and glycolysis are instrumental in causing EMT-related infertility. Recently, our research team identified several key glycolysis-immune-related genes in the endometrial cells of EMT patients. This study aimed to further investigate the expression patterns of pyruvate dehydrogenase kinase 3 (PDK3), glypican-3 (GPC3), and alcohol dehydrogenase 6 (ADH6), which are related to glycolysis and immunity, in the follicular microenvironment of infertile patients with EMT using enzyme-linked immunosorbent assay (ELISA) and quantitative real-time polymerase chain reaction (qRT-PCR) assays. According to the results, compared to the patients with tubal factor infertility, the concentrations of PDK3 and GPC3 were considerably increased in the follicular environment of EMT patients, while ADH6 expression was significantly reduced. The number of oocytes retrieved, the transferable embryo rate, and the cumulative clinical pregnancy rate of EMT patients were significantly reduced, and there was a correlation with the level of PDK3, GPC3, and ADH6 in Follicular Fluid (FF). The area under the receiver operating characteristic (ROC) curve for predicting clinical pregnancy in infertile patients with EMT for PDK3, GPC3, ADH6, and their combination was 0.732, 0.705, 0.855, and 0.879, respectively (P < 0.05). In conclusion, our research indicates that glycolysis-immune-related genes may contribute to infertility in EMT patients through immune infiltration, and disruption of mitochondrial and oocyte functions. The combined detection of PDK3, GPC3, and ADH6 in FF helps to predict clinical pregnancy outcomes in infertile patients with EMT.

Melatonin levels and embryo quality in IVF patients with diminished ovarian reserve: a comparative study

BACKGROUND

Melatonin, a hormone found in various bodily fluids and cells, is known for its potent antioxidative, anti-apoptotic, and endocrine regulatory properties. This study aimed to analyze melatonin levels in patients with diminished ovarian reserve (DOR) and its impact on embryo quality.

METHODS

We enrolled 85 women who were undergoing in vitro fertilization or intracytoplasmic sperm injection procedures, including normal ovarian reserve (NOR, n = 27), pathological DOR (DOR-Path, n = 25), and physiological DOR (DOR-Phy, n = 33). Melatonin levels in patient serum and follicular fluid were assessed using ELISA, and correlations between melatonin levels and indicators of embryo quality were examined.

RESULTS

Our findings indicate that melatonin levels in the follicular fluid and basal serum of the DOR-Path and DOR-Phy groups were lower compared to the NOR group (P < 0.05). However, no significant differences in melatonin levels were found between the DOR-Path and DOR-Phy groups (P > 0.05). Additionally, the concentration of melatonin in the follicular fluid of the NOR group was significantly higher than in their serum (P < 0.001). Lastly, a significant correlation was discovered between melatonin levels in serum and follicular fluid and parameters of ovarian reserve and embryonic development (P < 0.05).

CONCLUSIONS

Melatonin levels in DOR patients may impact embryo quality, offering insights into potential DOR pathogenesis and opportunities to enhance treatment outcomes in these patients.

[Effect of tiangui recipe on hypothalamic proopiomelanocortin mRNA levels in androgen sterilized rats]

OBJECTIVE

To explore the effect of Tiangui recipe (TGR) in androgen sterilized rats (ASR).

METHODS

New-born female SD rats were randomly divided into 3 groups. ASR model was established by means of testosterone injection subcutaneously at the age of 9 days, ASR were administered with TGR for 14 days. Around the age of 106 days (proestrus day), all rats were sacrificed, serum total testosterone (TT) and free testosterone (FT) were measured by radioimmunoassay (RIA), and levels of hypothalamic proopiomelanocortin (POMC) mRNA expression in hypothalamus were determined.

RESULTS

None of the ASR ovulated and all rats in control group ovulated. The rate of ovulation in TGR group was 58%, the mean-serum concentration of TT and FT in ASR were significantly higher than those in the control group and TGR group (P < 0.01). The hypothalamic POMC mRNA level in ASR model group was significantly higher than that in the control group (P < 0.01), and became normal after TGR treatment.

CONCLUSION

The elevated serum androgen levels in ASR could challenge hypothalamic POMC mRNA overexpression via androgen receptor (AR). TGR might reduce serum androgen and lower the expression of POMC mRNA.

Integrin cell adhesion molecules in endometrium of fertile and infertile women throughout menstrual cycle

Integrins (ITGs) are ubiquitous cell adhesion molecules that undergo dynamic alterations during the normal menstrual cycle in human endometrium. The distribution of four different subunits, viz. alpha 4, alpha 6, beta 3 and beta 4 in human endometrial tissue at different stages of the menstrual cycle was studied using immunohistochemical, enzyme immunoassay and SDS-PAGE/Western blot techniques. The specificity of each mAb to their respective ligands viz., laminin (Ln), fibronectin (Fn) and vitronectin (Vn) was done by cell adhesion assays. Both alpha 6 and beta 4 subunits (Ln receptors) expressed primarily on the glandular epithelium, while glandular, stromal and luminal cells expressed predominantly alpha 4 (Fn receptor) and beta 3 (Vn receptor). The appearance of alpha 4 and beta 3 ITG subunits was found to be cell and cycle specific. The levels of both alpha 6 and beta 4 increased throughout the menstrual cycle, while beta 3 subunit appeared abruptly on cycle day 19/20. The immunostaining for alpha 4 and beta 3 was absent in 90% of infertile women. The timing of expression of alpha 4 and beta 3, the two cycle--dependent ITGs framed the putative window of implantation and suggests a role in the diagnosis of infertility. In conclusion, the absence of alpha 4 and beta 3 ITG expression in the endometrium of infertility subjects during mid luteal phase may be associated with defects in uterine function. The defective uterine receptivity may be an unrecognised cause of infertility in these group of women.

[Semiquantitative measurement of progesterone receptors in luteal-phase-defect endometrial cells during secretory phase]

To investigate the changes of endometrial progesterone receptor (PR) of luteal-phase-defect (LPD) patients during the secretory phase, thirteen patients with complaints of infertility or habitual abortion were studied. During the early-mid secretory phase, endometrial tissue was obtained by dilatation and curettage (D & C) for histological and receptor study: meanwhile serum E2, P, FSH, LH and PRL were measured. Based on histologic diagnosis, the patients were divided into two groups: the LPD group (n = 7) and the normal control group(n = 6). PR content was determined by immunohisto-chemical (IHC) assay. The results showed that during the early-mid luteal phase a significantly low PR content on endometrial glandular nucleus was observed in LPD group, compared with normal control(6.75 +/- 2.57 vs 9.50 +/- 1.64 P < 0.05), but no difference in serum progesterone was noted between the two groups. These findings suggest that during early-mid secretory phase, PR content on endometrial glandular nucleus decreases in LPD cases, which results in deficient response of endometrium to proper stimulus of progesterone. This change may cause endometrial secretory deficiency and blockade of embreyo implantation. That is why infertility or habitual abortion happened.