51
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Li C, Lin L, Tsai H, Wen Z, Tsui K. Phosphoglycerate mutase family member 5 maintains oocyte quality via mitochondrial dynamic rearrangement during aging. Aging Cell 2022; 21:e13546. [PMID: 34995407 PMCID: PMC8844125 DOI: 10.1111/acel.13546] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 11/28/2021] [Accepted: 12/19/2021] [Indexed: 12/12/2022] Open
Abstract
Decline in ovarian reserve with aging is associated with reduced fertility and the development of metabolic abnormalities. Once mitochondrial homeostasis is imbalanced, it may lead to poor reproductive cell quality and aging. However, Phosphoglycerate translocase 5 (PGAM5), located in the mitochondrial membrane, is associated with necroptosis, apoptosis, and mitophagy, although the underlying mechanisms associated with ovarian aging remain unknown. Therefore, we attempted to uncover whether the high phosphoglycerate mutant enzyme family member 5 (PGAM5) expression is associated with female infertility in cumulus cells, and aims to find out the underlying mechanism of action of PGAM5. We found that PGAM5 is highly expressed and positively associated with aging, and has the potential to help maintain and regulate mitochondrial dynamics and metabolic reprogramming in aging granulosa cells, ovaries of aged female mice, and elderly patients. PGAM5 undergoes activation in the aging group and translocated to the outer membrane of mitochondria, co‐regulating DRP1; thereby increasing mitochondrial fission. A significant reduction in the quality of mitochondria in the aging group, a serious imbalance, and a significant reduction in energy, causing metabolism shift toward glycolysis, were also reported. Since PGAM5 is eliminated, the mitochondrial function and metabolism of aging cells are partially reversed. A total of 70 patients undergoing in vitro fertilization (IVF) treatment were recruited in this clinical study. The high expression of PGAM5 in the cumulus cells is negatively correlated with the pregnancy rate of infertile patients. Hence, PGAM5 has immense potential to be used as a diagnostic marker.
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Affiliation(s)
- Chia‐Jung Li
- Department of Obstetrics and Gynaecology Kaohsiung Veterans General Hospital Kaohsiung Taiwan
- Institute of Biopharmaceutical Sciences National Sun Yat‐sen University Kaohsiung Taiwan
| | - Li‐Te Lin
- Department of Obstetrics and Gynaecology Kaohsiung Veterans General Hospital Kaohsiung Taiwan
- Institute of Biopharmaceutical Sciences National Sun Yat‐sen University Kaohsiung Taiwan
- Department of Obstetrics and Gynaecology National Yang‐Ming University School of Medicine Taipei Taiwan
| | - Hsiao‐Wen Tsai
- Department of Obstetrics and Gynaecology Kaohsiung Veterans General Hospital Kaohsiung Taiwan
- Institute of Biopharmaceutical Sciences National Sun Yat‐sen University Kaohsiung Taiwan
- Department of Obstetrics and Gynaecology National Yang‐Ming University School of Medicine Taipei Taiwan
| | - Zhi‐Hong Wen
- Department of Marine Biotechnology and Resources National Sun Yat‐sen University Kaohsiung Taiwan
| | - Kuan‐Hao Tsui
- Department of Obstetrics and Gynaecology Kaohsiung Veterans General Hospital Kaohsiung Taiwan
- Institute of Biopharmaceutical Sciences National Sun Yat‐sen University Kaohsiung Taiwan
- Department of Obstetrics and Gynaecology National Yang‐Ming University School of Medicine Taipei Taiwan
- Department of Obstetrics and Gynecology Taipei Veterans General Hospital Taipei Taiwan
- Department of Pharmacy and Master Program College of Pharmacy and Health Care Tajen University Pingtung County Taiwan
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FAM111A Is a Novel Molecular Marker for Oocyte Aging. Biomedicines 2022; 10:biomedicines10020257. [PMID: 35203468 PMCID: PMC8869572 DOI: 10.3390/biomedicines10020257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/12/2022] [Accepted: 01/17/2022] [Indexed: 11/17/2022] Open
Abstract
Aging is the main cause of decline in oocyte quality, which can further trigger the failure of assisted reproductive technology (ART). Exploring age-related genes in oocytes is an important way to investigate the molecular mechanisms involved in oocyte aging. To provide novel insight into this field, we performed a pooled analysis of publicly available datasets, using the overlapping results of two statistical methods on two Gene Expression Omnibus (GEO) datasets. The methods utilized in the current study mainly include Spearman rank correlation, the Wilcoxon signed-rank test, t-tests, Venn diagrams, Gene Ontology (GO), Protein–Protein Interaction (PPI), Gene Set Enrichment Analysis (GSEA), Gene Set Variation Analysis (GSVA), and receiver operating characteristic (ROC) curve analysis. We identified hundreds of age-related genes across different gene expression datasets of in vitro maturation-metaphase II (IVM-MII) oocytes. Age-related genes in IVM-MII oocytes were involved in the biological processes of cellular metabolism, DNA replication, and histone modifications. Among these age-related genes, FAM111A expression presented a robust correlation with age, seen in the results of different statistical methods and different datasets. FAM111A is associated with the processes of chromosome segregation and cell cycle regulation. Thus, this enzyme is potentially an interesting novel marker for the aging of oocytes, and warrants further mechanistic study.
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53
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Moghadam ARE, Moghadam MT, Hemadi M, Saki G. Oocyte quality and aging. JBRA Assist Reprod 2022; 26:105-122. [PMID: 34338482 PMCID: PMC8769179 DOI: 10.5935/1518-0557.20210026] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 04/15/2021] [Indexed: 11/20/2022] Open
Abstract
It is well known that female reproduction ability decreases during the forth decade of life due to age-related changes in oocyte quality and quantity; although the number of women trying to conceive has today increased remarkably between the ages of 36 to 44. The causes of reproductive aging and physiological aspects of this phenomenon are still elusive. With increase in the women's age, during Assisted Reproductive Technologies (ART) we have perceived a significant decline in the number and quality of retrieved oocytes, as well as in ovarian follicle reserves. This is because of increased aneuploidy due to factors such as spindle apparatus disruption; oxidative stress and mitochondrial damage. The aim of this review paper is to study data on the potential role of the aging process impacting oocyte quality and female reproductive ability. We present the current evidence that show the decreased oocyte quality with age, related to reductions in female reproductive outcome. The aging process is complicated and it is caused by many factors that control cellular and organism life span. Although the factors responsible for reduced oocyte quality remain unknown, the present review focuses on the potential role of ovarian follicle environment, oocyte structure and its organelles. To find a way to optimize oocyte quality and ameliorate clinical outcomes for women with aging-related causes of infertility.
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Affiliation(s)
- Ali Reza Eftekhari Moghadam
- Cellular & Molecular Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Anatomical Science, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahin Taheri Moghadam
- Department of Anatomical Science, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Masoud Hemadi
- Department of Anatomical Science, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ghasem Saki
- Department of Anatomical Science, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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54
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Essentiality of Trace Elements in Pregnancy, Fertility, and Gynecologic Cancers-A State-of-the-Art Review. Nutrients 2021; 14:nu14010185. [PMID: 35011060 PMCID: PMC8746721 DOI: 10.3390/nu14010185] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/23/2021] [Accepted: 12/28/2021] [Indexed: 12/18/2022] Open
Abstract
Gynecological neoplasms pose a serious threat to women's health. It is estimated that in 2020, there were nearly 1.3 million new cases worldwide, from which almost 50% ended in death. The most commonly diagnosed are cervical and endometrial cancers; when it comes to infertility, it affects ~48.5 million couples worldwide and the number is continually rising. Ageing of the population, environmental factors such as dietary habits, environmental pollutants and increasing prevalence of risk factors may affect the reproductive potential in women. Therefore, in order to identify potential risk factors for these issues, attention has been drawn to trace elements. Trace mineral imbalances can be caused by a variety of causes, starting with hereditary diseases, finishing with an incorrect diet or exposure to polluted air or water. In this review, we aimed to summarize the current knowledge regarding trace elements imbalances in the case of gynecologic cancers as well as female fertility and during pregnancy.
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55
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Yakin K, Urman B, Balaban B. Dynamic view of assisted reproduction in Turkey from 1996 to 2020. Reprod Biomed Online 2021; 44:747-754. [DOI: 10.1016/j.rbmo.2021.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 10/28/2021] [Accepted: 12/10/2021] [Indexed: 10/19/2022]
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56
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Chiaratti MR. Uncovering the important role of mitochondrial dynamics in oogenesis: impact on fertility and metabolic disorder transmission. Biophys Rev 2021; 13:967-981. [PMID: 35059021 PMCID: PMC8724343 DOI: 10.1007/s12551-021-00891-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 11/01/2021] [Indexed: 12/12/2022] Open
Abstract
Oocyte health is tightly tied to mitochondria given their role in energy production, metabolite supply, calcium (Ca2+) buffering, and cell death regulation, among others. In turn, mitochondrial function strongly relies on these organelle dynamics once cyclic events of fusion and fission (division) are required for mitochondrial turnover, positioning, content homogenization, metabolic flexibility, interaction with subcellular compartments, etc. Importantly, during oogenesis, mitochondria change their architecture from an "orthodox" elongated shape characterized by the presence of numerous transversely oriented cristae to a round-to-oval morphology containing arched and concentrically arranged cristae. This, along with evidence showing that mitochondrial function is kept quiescent during most part of oocyte development, suggests an important role of mitochondrial dynamics in oogenesis. To investigate this, recent works have downregulated/upregulated in oocytes the expression of key effectors of mitochondrial dynamics, including mitofusins 1 (MFN1) and 2 (MFN2) and the dynamin-related protein 1 (DRP1). As a result, both MFN1 and DRP1 were found to be essential to oogenesis and fertility, while MFN2 deletion led to offspring with increased weight gain and glucose intolerance. Curiously, neither MFN1/MFN2 deficiency nor DRP1 overexpression enhanced mitochondrial fragmentation, indicating that mitochondrial size is strictly regulated in oocytes. Therefore, the present work seeks to discuss the role of mitochondria in supporting oogenesis as well as recent findings connecting defective mitochondrial dynamics in oocytes with infertility and transmission of metabolic disorders.
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Affiliation(s)
- Marcos Roberto Chiaratti
- Departamento de Genética e Evolução, Centro de Ciências Biológicas e da Saúde, Universidade Federal de São Carlos, São Carlos, 13565-905 Brazil
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57
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Osaikhuwuomwan JA, Aziken ME. Pregnancy in Older Women: Analysis of Outcomes in Pregnancies from Donor oocyte In- vitro Fertilization. J Hum Reprod Sci 2021; 14:300-306. [PMID: 34759621 PMCID: PMC8527082 DOI: 10.4103/jhrs.jhrs_209_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 07/04/2021] [Accepted: 07/10/2021] [Indexed: 11/24/2022] Open
Abstract
Background: As the number of older women attempting to conceive through donor oocyte-in vitro fertilization (DO-IVF) rises, their safety in pregnancy needs to be judiciously considered. Aims: This study aims to review the obstetric and perinatal outcomes of pregnancies achieved by DO-IVF. Study Setting and Design: A retrospective study design conducted at a private health facility with services for assisted reproduction and gynecologic endoscopy. Methods: A retrospective comparative study of all pregnancies achieved using DO-IVF and that using Self oocyte In-vitro fertilization (SO-IVF) treatment over a 3 years' period was performed. Statistical Analysis: Comparative analysis of demographic variables, major obstetric, and perinatal complications was done with Chi-square test and Student's t-test as appropriate. Regression analysis was done to determine a significant predictor variable for pregnancy and delivery outcome. The significance level was set at P < 0.05. Results: A total of 343 completed IVF treatment cycles was reviewed; there were 238 DO-IVF and 105 SO-IVF cycles, with clinical pregnancy rate of 41.6% and 37.1%, respectively. The DO-IVF group was significantly older than the SO-IVF group (46.1 years vs. 34.1 years, P < 0.001). Major obstetric complications identified, were hypertensive disorders in pregnancy (23.9%), preterm labor (16.7%), antepartum hemorrhage (11.6%). There was no statistically significant difference between the two groups in terms of obstetric complications and adverse maternal or perinatal outcomes. There were 97 (77.6%) singleton and 28 (22.4%) multiple pregnancies. Pregnancy complications were significantly associated with fetal plurality, P < 0.001. Multiple pregnancy had higher odds of experiencing adverse perinatal 4.96 (1.95–12.58) and maternal 7.16 (2.05–25.03) outcomes compared to singleton pregnancies, P < 0.001. Conclusion: Key obstetric outcomes did not differ between DO or SO IVF achieved pregnancy. Even for older women, satisfactory outcomes can be expected for pregnancies achieved by DO-IVF. It is, however, instructive that for multiple pregnancies, obstetricians should institute appropriate surveillance strategies during pregnancy and delivery period and also to develop institutional capacity for quality neonatal care.
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Affiliation(s)
- James A Osaikhuwuomwan
- Department of Obstetrics and Gynaecology, College of Medical Sciences, University of Benin, Benin-City, Nigeria
| | - Michael E Aziken
- Department of Obstetrics and Gynaecology, College of Medical Sciences, University of Benin, Benin-City, Nigeria.,Assisted Reproduction and Endoscopy Unit, Graceland Medical Centre, Benin-City, Nigeria
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58
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The contribution of assisted reproductive technology to fertility rates and parity transition: An analysis of Australian data. DEMOGRAPHIC RESEARCH 2021. [DOI: 10.4054/demres.2021.45.35] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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59
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Heyward Q, Walter JR, Alur-Gupta S, Lal A, Berger DS, Koelper N, Butts SF, Gracia CR. Racial disparities in frozen embryo transfer success. J Assist Reprod Genet 2021; 38:3069-3075. [PMID: 34739643 DOI: 10.1007/s10815-021-02348-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/25/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To compare pregnancy and birth outcomes after frozen embryo transfers (FETs) among White, Black, and Asian women and evaluate the effect of patient, protocol, and cycle characteristics on success. METHODS A retrospective chart review identified women who underwent an autologous FET at an academic fertility center between January 2013 and March 2020. RESULTS White, Black, and Asian women completed 1,181 (71.7%), 230 (14.0%), and 235 (14.3%) cycles, respectively. Black women were significantly less likely to achieve a positive hCG level (AOR 0.66, 95% CI 0.49-0.90), clinical pregnancy (AOR 0.71, 95% CI 0.53-0.97), and live birth (AOR 0.65, 95% CI 0.47-0.89) compared to White women after adjusting for possible confounders. There were no differences in the aforementioned outcomes when looking at cycles completed by Asian versus White women. When comparing outcomes by endometrial preparation protocol, significant differences were seen amongst the three groups for live birth rates following natural cycle FETs (52.36%, 25.81%, and 44.19% for White, Black, and Asian women, respectively, p = 0.02), a difference not appreciated after programmed FETs. CONCLUSION Black race is associated with significantly worse pregnancy and live birth rates following FET when compared to White race. Additionally, significant differences in live birth rates among White, Black, and Asian women exist following natural cycle FET versus programmed FET. These disparities in success are not only important for patient counseling, but also when determining management strategies to improve fertility rates among minority women.
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Affiliation(s)
- Quetrell Heyward
- Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, 3400 Spruce Street, 1 West Gates, Philadelphia, PA, 19104, USA.
| | - Jessica R Walter
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, PA, Philadelphia, USA
| | | | - Arnav Lal
- University of Pennsylvania, Philadelphia, PA, USA
| | - Dara S Berger
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, PA, Philadelphia, USA
| | - Nathanael Koelper
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, PA, Philadelphia, USA
| | - Samantha F Butts
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Pennsylvania State Hershey Medical Center, Hershey, PA, USA
| | - Clarisa R Gracia
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, PA, Philadelphia, USA
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60
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Jwa SC, Ishihara O, Kuwahara A, Saito K, Saito H, Terada Y, Kobayashi Y, Maeda E. Cumulative live birth rate according to the number of receiving governmental subsidies for assisted reproductive technology in Saitama Prefecture, Japan: A retrospective study using individual data for governmental subsidies. Reprod Med Biol 2021; 20:451-459. [PMID: 34646073 PMCID: PMC8499586 DOI: 10.1002/rmb2.12397] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/20/2021] [Accepted: 06/01/2021] [Indexed: 01/31/2023] Open
Abstract
PURPOSE We investigated the cumulative live birth rate (CLBR) in women receiving governmental subsidies for assisted reproductive technology (ART) in Saitama Prefecture, Japan. METHODS Women who applied for subsidies from Saitama Prefectural Government for the first time in 2016 were enrolled and followed up until the end of 2017. Treatment information, including live birth, was obtained from the Japanese ART registry by linking it with unique identification numbers for treatment. Patients' factors associated with having a live birth were investigated. RESULTS Of 1,072 women (2,513 applications), 495 (46.2%) had a live birth with 8 (1.6%) twin pregnancies. The CLBR over six subsidized cycles was 53.7% for women aged <40 years, and 17.2% over three subsidized cycles for women 40-42 years; highest among women <35 years (58.4%), followed by those aged 35-39 years (49.3%). Multivariate analysis revealed patient age as the only independent factor for having a live birth. CONCLUSIONS The CLBR of women receiving subsidies for ART was greatest in women aged <35 years. Effective policies for promoting ART among younger couples who seek infertility treatment are essential.
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Affiliation(s)
- Seung Chik Jwa
- Department of Obstetrics and GynecologySaitama Medical UniversitySaitamaJapan
| | - Osamu Ishihara
- Department of Obstetrics and GynecologySaitama Medical UniversitySaitamaJapan
| | - Akira Kuwahara
- Department of Obstetrics and GynecologyGraduate School of Biomedical SciencesTokushima UniversityTokushimaJapan
| | - Kazuki Saito
- Department of Comprehensive Reproductive MedicineGraduate SchoolTokyo Medical and Dental UniversityTokyoJapan
| | | | - Yukihiro Terada
- Department of Obstetrics and GynecologyGraduate School of MedicineAkita UniversityAkitaJapan
| | - Yasuki Kobayashi
- Department of Public HealthGraduate School of MedicineThe University of TokyoTokyoJapan
| | - Eri Maeda
- Department of Environmental Health Science and Public HealthAkita University Graduate School of MedicineAkitaJapan
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61
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Canha-Gouveia A, Prieto-Sánchez MT, Sánchez-Ferrer ML, Mollá M, Martínez-Soto JC, París-Oller E, Soriano-Úbeda C, Landeras J, Coy P. Physicochemical and Functional Characterization of Female Reproductive Fluids: A Report of the First Two Infants Born Following Addition of Their Mother's Fluids to the Embryo Culture Media. Front Physiol 2021; 12:710887. [PMID: 34552502 PMCID: PMC8451538 DOI: 10.3389/fphys.2021.710887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/05/2021] [Indexed: 12/31/2022] Open
Abstract
Culture media supplemented with reproductive fluids (RF) have been used in livestock species, improving the efficiency and quality of in vitro produced embryos. However, usefulness in humans is still unknown. In this study, we collected human reproductive fluids (HRFs) ex vivo (from 25 patients undergoing abdominal hysterectomy plus bilateral salpingectomy) and in vivo (from 31 oocyte donors). Afterward, protocols to evaluate their osmolality, pH, total protein concentration, endotoxin level, and sterility were optimized, establishing security ranges for their use as natural additives. In addition, a functional assay was developed with bovine embryos grown in vitro in a medium supplemented with 1% of collected HRFs. Finally, a proof of concept was performed with six patients on post ovulation day 2 to evaluate the full-term viability of embryos grown in media supplemented with autologous uterine fluid, collected under in vivo conditions. Two of the embryos resulted in successful pregnancy and delivery of healthy babies. In conclusion, this study establishes a complete quality control sheet of HRFs as additives for embryo culture media and shows first preliminary data on obtaining healthy offspring derived from embryos grown in media supplemented with HRFs.
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Affiliation(s)
- Analuce Canha-Gouveia
- Department of Physiology, Faculty of Veterinary, University of Murcia, Murcia, Spain.,Institute for Biomedical Research of Murcia IMIB-Arrixaca, Murcia, Spain
| | - Maria Teresa Prieto-Sánchez
- Institute for Biomedical Research of Murcia IMIB-Arrixaca, Murcia, Spain.,Department of Obstetrics and Gynecology, "Virgen de la Arrixaca" University Clinical Hospital, Murcia, Spain
| | - Maria Luisa Sánchez-Ferrer
- Institute for Biomedical Research of Murcia IMIB-Arrixaca, Murcia, Spain.,Department of Obstetrics and Gynecology, "Virgen de la Arrixaca" University Clinical Hospital, Murcia, Spain
| | - Marta Mollá
- Institute for Biomedical Research of Murcia IMIB-Arrixaca, Murcia, Spain.,IVI Murcia, Murcia, Spain
| | | | - Evelyne París-Oller
- Department of Physiology, Faculty of Veterinary, University of Murcia, Murcia, Spain.,Institute for Biomedical Research of Murcia IMIB-Arrixaca, Murcia, Spain
| | - Cristina Soriano-Úbeda
- Department of Physiology, Faculty of Veterinary, University of Murcia, Murcia, Spain.,Institute for Biomedical Research of Murcia IMIB-Arrixaca, Murcia, Spain
| | - José Landeras
- Institute for Biomedical Research of Murcia IMIB-Arrixaca, Murcia, Spain.,IVI Murcia, Murcia, Spain
| | - Pilar Coy
- Department of Physiology, Faculty of Veterinary, University of Murcia, Murcia, Spain.,Institute for Biomedical Research of Murcia IMIB-Arrixaca, Murcia, Spain
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62
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The Use of Androgen Priming in Women with Reduced Ovarian Reserve Undergoing Assisted Reproductive Technology. Semin Reprod Med 2021; 39:207-219. [PMID: 34500477 DOI: 10.1055/s-0041-1735646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Androgen priming with either dehydroepiandrosterone (DHEA) or testosterone has been suggested as an adjunct to improve in vitro fertilization (IVF) outcomes in women with diminished ovarian reserve (DOR). Numerous studies have investigated the effects of both DHEA and testosterone on IVF outcome. The results were inconsistent, and the quality of most studies is substandard. Meta-analyses have consistently reported that DHEA does appear to significantly improve IVF outcome in women with predicted or proven poor ovarian response (POR), but these have included some normal responders and/or nonrandomized studies. Our meta-analyses including randomized controlled trials (RCTs) incorporating only women with DOR or POR suggest that DHEA confers no benefit. While meta-analyses of RCTs on the use of testosterone in women with DOR or POR showed an improved IVF outcome, most studies included are of low quality with high risk of bias. When analysis of data from studies of only low-risk bias was performed, such a benefit with testosterone was not observed. Although recruitment may well be a challenge, a large, well-designed RCT is, however, still warranted to investigate whether or not androgen priming with either DHEA or testosterone should be recommended as an adjuvant treatment for women with DOR or POR undergoing IVF.
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63
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Tomari H, Kawamura T, Asanoma K, Egashira K, Kawamura K, Honjo K, Nagata Y, Kato K. Contribution of senescence in human endometrial stromal cells during proliferative phase to embryo receptivity†. Biol Reprod 2021; 103:104-113. [PMID: 32285109 PMCID: PMC7313258 DOI: 10.1093/biolre/ioaa044] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 02/25/2020] [Accepted: 04/10/2020] [Indexed: 12/15/2022] Open
Abstract
Successful assisted reproductive technology pregnancy depends on the viability of embryos and endometrial receptivity. However, the literature has neglected effects of the endometrial environment during the proliferative phase on implantation success or failure. Human endometrial stromal cells (hESCs) were isolated from endometrial tissues sampled at oocyte retrieval during the proliferative phase from women undergoing infertility treatment. Primary hESC cultures were used to investigate the relationship between stemness and senescence induction in this population and embryo receptivity. Patients were classified as receptive or non-receptive based on their pregnancy diagnosis after embryo transfer. Biomarkers of cellular senescence and somatic stem cells were compared between each sample. hESCs from non-receptive patients exhibited significantly higher (P < 0.01) proportions of senescent cells, mRNA expressions of CDKN2A and CDKN1A transcripts (P < 0.01), and expressions of genes encoding the senescence-associated secretory phenotype (P < 0.05). hESCs from receptive patients had significantly higher (P < 0.01) mRNA expressions of ABCG2 and ALDH1A1 transcripts. Our findings suggest that stemness is inversely associated with senescence induction in hESCs and, by extension, that implantation failure in infertility treatment may be attributable to a combination of senescence promotion and disruption of this maintenance function in this population during the proliferative phase of the menstrual cycle. This is a promising step towards potentially improving the embryo receptivity of endometrium. The specific mechanism by which implantation failure is prefigured by a loss of stemness among endometrial stem cells, and cellular senescence induction among hESCs, should be elucidated in detail in the future.
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Affiliation(s)
- Hiroyuki Tomari
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Center for Reproductive Medicine, IVF Nagata Clinic, Fukuoka, Japan
| | - Teruhiko Kawamura
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kazuo Asanoma
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Katsuko Egashira
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Keiko Kawamura
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ko Honjo
- Center for Reproductive Medicine, IVF Nagata Clinic, Fukuoka, Japan
| | - Yumi Nagata
- Center for Reproductive Medicine, IVF Nagata Clinic, Fukuoka, Japan
| | - Kiyoko Kato
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Linehan L, Hennessy M, O'Donoghue K. Infertility and subsequent recurrent miscarriage: Current state of the literature and future considerations for practice and research. HRB Open Res 2021. [DOI: 10.12688/hrbopenres.13397.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Recurrent miscarriage (RM) and infertility are independently associated with adverse pregnancy outcomes, in addition to psychological sequelae. Experiencing pregnancy loss alongside infertility is particularly difficult. International guidance regarding RM is conflicting, and applicability to women with infertility is undetermined. The aim of this study was to: (i) establish if women/couples with a history of infertility are recognised in the literature on the investigation and management of RM, and (ii) determine if the specific needs of women/couples experiencing RM and infertility are ascertained and incorporated into clinical management strategies. Methods: We examined the wide-ranging literature to ascertain what gaps existed. Studies were retrieved through searches of PubMed and Google Scholar up to 21 January 2021 using appropriate controlled vocabulary and combinations of key words. No language or study design restrictions were applied. Results: While women/couples experiencing RM after infertility appear in studies evaluating investigations and proposed treatments, high-quality studies are lacking. Furthermore, they are largely excluded from international clinical guidance and qualitative research. Conclusions: The experiences of women/couples with RM and infertility and their specific care needs within maternity and fertility services are underexplored. It is unclear from current RM guidelines how best to manage and support this complex cohort. Women/couples with infertility and RM are underserved in the literature and in clinical guidance. Further robust studies are warranted to examine pregnancy outcomes, investigations and treatments currently used. Qualitative research is also required to identify their medical and psychological needs to better support this vulnerable group.
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Faiza H, Khan M, Rafiq M, Khan AA, Rind NA, Naqvi SHA. Two novel mutations in exon 2 of bone morphogenetic protein (BMP) 15 gene in Pakistani infertile females. Saudi J Biol Sci 2021; 28:5364-5370. [PMID: 34466116 PMCID: PMC8381042 DOI: 10.1016/j.sjbs.2021.05.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/23/2021] [Accepted: 05/24/2021] [Indexed: 12/01/2022] Open
Abstract
Objective To determine the proportion of fertility in Pakistani infertile females and discover if there are considerable connection among BMP15 gene polymorphism, follicle maturation and hormonal regulation in Pakistani infertile females. Methods All selected participants were initially examined through follicle-stimulating hormones (FSH), luteinizing hormone (LH), thyroid-stimulating hormone (TSH), Prolactin, and Trans-vaginal scan (TVS). BMP15 gene polymorphism among infertile and fertile females was done by extracted Genomic DNA from whole blood. Sanger sequencing was performed for the identification of mutation in exons-intron boundaries of the BMP15 gene. Bioinformatics tools were used to assess the protein structure. Results The total five mutations including two novel missense variants of BMP15 in exon 2, whereas three previously reported i.e. two cosmic mutations (c.615delC), (c.584InsG) and one frame shift mutations (c.635delA) were also observed. The first novel mutation was found at (c.1038InsGG) (p.346Gln < Gly) in which the insertion of GG at DNA position 1038 of exon 2 resulting in a substitution of glutamine into glycine at 346th amino acid of BMP15 protein. The second novel variant (c.1049delT) (p. Ser334Pro) was also observed in exon 2 of the BMP15 gene, which substituted serine into proline at 334th amino acid of the BMP15 protein. Conclusion It is concluded that there are various missense mutations present in exon 2 of the BMP15 gene of Pakistani infertile females, consequently expected function of protein changes due to change in codons of amino acids. Provean and SIFT suggest the two novel variants as potentially deleterious. Although three other variants were also found in Pakistani infertile females which were previously reported. These mutations may result in early blockage of folliculogenesis and ovaries become streaky. Further research is required to resolve the actual allusion of these variations in the BMP15 gene.
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Affiliation(s)
- Hafiza Faiza
- Institute of Biotechnology and Genetic Engineering, University of Sindh, Jamshoro, Pakistan
| | - Majida Khan
- Department of Gynecology, Liaquat University of Medical Science, Jamshoro, Pakistan
| | - Muhammad Rafiq
- Institute of Biotechnology and Genetic Engineering, University of Sindh, Jamshoro, Pakistan
| | - Anoshiya Ali Khan
- Institute of Biotechnology and Genetic Engineering, University of Sindh, Jamshoro, Pakistan
| | - Nadir Ali Rind
- Institute of Biotechnology and Genetic Engineering, University of Sindh, Jamshoro, Pakistan.,Department of Genetics & Molecular Biology, SBBU, Shaheed Benazirabad, Pakistan
| | - Syed Habib Ahmed Naqvi
- Institute of Biotechnology and Genetic Engineering, University of Sindh, Jamshoro, Pakistan
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Wang X, Jin L, Mao YD, Shi JZ, Huang R, Jiang YN, Zhang CL, Liang XY. Evaluation of Ovarian Reserve Tests and Age in the Prediction of Poor Ovarian Response to Controlled Ovarian Stimulation-A Real-World Data Analysis of 89,002 Patients. Front Endocrinol (Lausanne) 2021; 12:702061. [PMID: 34526967 PMCID: PMC8435745 DOI: 10.3389/fendo.2021.702061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 08/06/2021] [Indexed: 11/18/2022] Open
Abstract
Aims This study aimed to explore the value of ovarian reserve tests (ORTs) for predicting poor ovary response (POR) and whether an age cutoff could improve this forecasting, so as to facilitate clinical decision-making for women undergoing in vitro fertilization (IVF). Methods A retrospective cohort study was conducted on poor ovary response (POR) patients using real-world data from five reproductive centers of university-affiliated hospitals or large academic hospitals in China. A total of 89,002 women with infertility undergoing their first traditional ovarian stimulation cycle for in vitro fertilization from January 2013 to December 2019 were included. The receiver operating characteristic (ROC) curve was performed to estimate the prediction value of POR by the following ORTs: anti-Mullerian hormone (AMH), antral follicle count (AFC), basal FSH (bFSH), as well as patient age. Results In this retrospective cohort, the frequency of POR in the first IVF cycle was 14.8%. Age, AFC, AMH, and bFSH were used as predicting factors for POR, of which AMH and AFC were the best indicators when using a single factor for prediction (AUC 0.862 and 0.842, respectively). The predictive values of the multivariate model included age and AMH (AUC 0.865), age and AFC (AUC 0.850), age and all three ORTs (AUC 0.873). Compared with using a single factor alone, the combinations of ORTs and female age can increase the predictive value of POR. Adding age to single AMH model improved the prediction accuracy compared with AMH alone (AUC 0.865 vs. 0.862), but the improvement was not significant. The AFC with age model significantly improved the prediction accuracy of the single AFC model (AUC 0.846 vs. 0.837). To reach 90% specificity for POR prediction, the cutoff point for age was 38 years old with a sensitivity of 40.7%, 5 for AFC with a sensitivity of 55.9%, and 1.18 ng/ml for AMH with a sensitivity of 63.3%. Conclusion AFC and AMH demonstrated a high accuracy when using ROC regression to predict POR. When testing is reliable, AMH can be used alone to forecast POR. When AFC is used as a prediction parameter, age is suggested to be considered as well. Based on the results of the cutoff threshold analysis, AFC ≤ 5 and AMH ≤ 1.18 ng/ml should be recommended to predict POR more accurately in IVF/ICSI patients.
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Affiliation(s)
- Xue Wang
- Reproductive Medicine Center, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Lei Jin
- Reproductive Medicine Center, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Yun-dong Mao
- State Key Laboratory of Reproductive Medicine, Clinical Center for Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China
| | - Juan-zi Shi
- Reproductive Medicine Center, Northwest Women’s and Children’s Hospital, Xi’an, China
| | - Rui Huang
- Reproductive Medicine Center, Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yue-ning Jiang
- Reproductive Medicine Center, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Cui-lian Zhang
- Reproductive Medicine Center, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiao-yan Liang
- Reproductive Medicine Center, Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Morales-Martínez FA, Salas-Castro C, García-Garza MR, Valdés-Martínez O, García-Luna SM, Garza-Elizondo M, Vidal-Gutiérrez O, Saldívar-Rodríguez D, Sordia-Hernández LH. Evaluation of the Ovarian Reserve in Women With Systemic Lupus Erythematosus. J Family Reprod Health 2021; 15:38-44. [PMID: 34429735 PMCID: PMC8346742 DOI: 10.18502/jfrh.v15i1.6076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objective: Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disorder where the disease activity itself and the medications used for its treatment, may have adverse effects on ovarian function. This study aimed to assess the ovarian reserve (OR) in SLE patients. Materials and methods: The anti-müllerian hormone (AMH) and the antral follicle count (AFC), two markers to evaluate the OR was assessed in 64 SLE patients and compared to normal individuals. Additionally, we assessed whether the disease per se or the pharmacological treatments affect the OR. Results: Patients with SLE displayed alterations in the OR regardless of the presence of alterations of the menstrual cycle. The AFC and AMH were significantly lower in SLE patients with and without menstrual alterations when compared to control individuals (p<0.0001). However, the AFC and AMH levels were significantly correlated (p=0.006) in the SLE patients with menstrual alterations. Except for hydroxychloroquine that was statistically higher in SLE patients with menstrual alterations (p=0.04), the cumulative dose for cyclophosphamide, corticosteroid, and methotrexate was similar in SLE patients regardless of the occurrence of menstrual alterations. Conclusion: The monitoring of AMH and AFC in SLE patients should be used to detect the rapid and irreversible decline of the OR to provide a possibility of pregnancy to the SLE patients.
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Affiliation(s)
- Felipe Arturo Morales-Martínez
- University Center of Reproductive Medicine, Dr. José Eleuterio González Hospital, Free University of New León, Monterrey, Mexic
| | - Celina Salas-Castro
- University Center of Reproductive Medicine, Dr. José Eleuterio González Hospital, Free University of New León, Monterrey, Mexic
| | - Manuel Rolando García-Garza
- University Center of Reproductive Medicine, Dr. José Eleuterio González Hospital, Free University of New León, Monterrey, Mexic
| | - Otto Valdés-Martínez
- University Center of Reproductive Medicine, Dr. José Eleuterio González Hospital, Free University of New León, Monterrey, Mexic
| | - Selene Marysol García-Luna
- University Center of Reproductive Medicine, Dr. José Eleuterio González Hospital, Free University of New León, Monterrey, Mexic
| | - Mario Garza-Elizondo
- Reumatology ward, Dr. José Eleuterio González Hospital, Free University of New León, Monterrey, Mexic
| | - Oscar Vidal-Gutiérrez
- Departament of Gynecology and Obstetrics, Dr. José Eleuterio González Hospital, Free University of New León, Monterrey, Mexic
| | - Donato Saldívar-Rodríguez
- Departament of Gynecology and Obstetrics, Dr. José Eleuterio González Hospital, Free University of New León, Monterrey, Mexic
| | - Luis Humberto Sordia-Hernández
- University Center of Reproductive Medicine, Dr. José Eleuterio González Hospital, Free University of New León, Monterrey, Mexic
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Iba A, Maeda E, Jwa SC, Yanagisawa-Sugita A, Saito K, Kuwahara A, Saito H, Terada Y, Ishihara O, Kobayashi Y. Household income and medical help-seeking for fertility problems among a representative population in Japan. Reprod Health 2021; 18:165. [PMID: 34344417 PMCID: PMC8336394 DOI: 10.1186/s12978-021-01212-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 07/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fertility treatments help many infertile couples to have children. However, disparities exist in access to fertility tests and treatments. We investigated the association between household income and medical help-seeking for fertility in Japan. METHODS We conducted a cross-sectional study using nationally representative data from the National Fertility Survey 2015. Respondents were 6598 married women younger than 50 years old. The primary outcome was medical help-seeking for fertility among those who experienced fertility problems. Multiple logistic regression models were used to assess the association between household income and medical help-seeking, adjusting for age, length of marriage, educational level, employment status, number of children, childbearing desires, living with parents, and region of residence. RESULTS Among 2253 (34%) women who experienced fertility problems, 1154 (51%) sought medical help. The proportion of help-seekers increased linearly from 43% in the low-income group (< 4 million Japanese yen [JPY]) to 59% in the high-income group (≥ 8 million JPY) (P for trend < 0.001). Respondents with upper-middle (6-8 million JPY) or high household income were more likely to seek medical help, compared to those with low household income: adjusted odds ratio [aOR] 1.37 (95% confidence interval [CI]: 1.00-1.86) and aOR 1.78 (95% CI: 1.29-2.47), respectively. CONCLUSIONS We found that higher household income was associated with a higher probability of seeking medical help among Japanese women who experienced fertility problem. Along with policy discussion about additional financial support, further studies from societal, cultural, or psychological views are required.
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Affiliation(s)
- Arisa Iba
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Eri Maeda
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan
| | - Seung Chik Jwa
- Department of Obstetrics and Gynecology, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma, Saitama, 350-0495, Japan
| | - Ayako Yanagisawa-Sugita
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Kazuki Saito
- Department of Pediatrics, Perinatal, and Maternal Medicine (Ibaraki), Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Akira Kuwahara
- Department of Obstetrics and Gynecology, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima, Tokushima, 770-8503, Japan
| | - Hidekazu Saito
- Umegaoka Women's Clinic, 1-33-3 Umegaoka, Setagaya-ku, Tokyo, 154-0022, Japan
| | - Yukihiro Terada
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, Akita, 010-8543, Japan
| | - Osamu Ishihara
- Department of Obstetrics and Gynecology, Saitama Medical University, 38 Morohongo, Moroyama-machi, Iruma, Saitama, 350-0495, Japan
| | - Yasuki Kobayashi
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
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Chen J, Cheng Y, Fu W, Peng X, Sun X, Chen H, Chen X, Yu M. PPOS Protocol Effectively Improves the IVF Outcome Without Increasing the Recurrence Rate in Early Endometrioid Endometrial Cancer and Atypical Endometrial Hyperplasia Patients After Fertility Preserving Treatment. Front Med (Lausanne) 2021; 8:581927. [PMID: 34386503 PMCID: PMC8354380 DOI: 10.3389/fmed.2021.581927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 06/28/2021] [Indexed: 01/21/2023] Open
Abstract
Objective: To investigate the effectiveness and recurrence risk of different ovulation stimulation protocols in early-stage endometrioid endometrial cancer (EEC) and atypical endometrial hyperplasia (AEH) patients after successful fertility preserving treatment. Design: A retrospective review of clinical files between June 2012 and July 2018. Setting: University hospital. Patients: Ninety seven women (74 AEH and 23 early-stage EEC patients) underwent in vitro fertilization (IVF) and frozen-thawed embryo transfer (FET) after successful fertility preserving treatment. All patients received megestrol acetate which was initiated immediately after AEH or EEC diagnosis by hysteroscopy. Fertility treatment was initiated after confirmation of complete response by two consecutive hysteroscopic evaluations and endometrium biopsy in a 3-month interval. Women with tubal factors underwent IVF treatment directly. Women who failed to conceive spontaneously within 12 months or after other infertility treatments like ovulation induction for 6 consecutive months or 2 consecutive artificial insemination failures were also offered IVF treatment. Main Outcome Measure (s): The clinical and laboratory embryo data, clinical pregnancy outcomes and endometrial disease recurrence rates. Results: Compared with the standard regimen group, the good-quality embryo rate was higher in progestin primed ovarian stimulation (PPOS) regimen group (P = 0.034). Univariate analysis showed significant differences in age (P = 0.033), treatment time of endometrial lesions (P < 0.001), and duration of Gn treatment (P = 0.018) between the recurrent and non-recurrent groups. In the adjusted model of multivariate logistic regression analysis, the age (P = 0.014) at ovulation induction and treatment time of endometrial lesions (P < 0.001) were significantly correlated with the recurrence of endometrial disease. Conclusions: The PPOS protocol is a feasible and safe strategy to stimulate ovulation during IVF after fertility preservation therapy, and the age at ovulation induction and treatment time of endometrial lesions are two stable predictors of recurrence in endometrial diseases.
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Affiliation(s)
- Jiazhou Chen
- Shanghai JIAI Genetics and IVF Institute, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Yali Cheng
- Shanghai Key Laboratory of Female Reproductive and Endocrine-Related Diseases, Shanghai, China
| | - Wei Fu
- Shanghai JIAI Genetics and IVF Institute, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xiandong Peng
- Shanghai JIAI Genetics and IVF Institute, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xiaoxi Sun
- Shanghai JIAI Genetics and IVF Institute, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Female Reproductive and Endocrine-Related Diseases, Shanghai, China
| | - Hua Chen
- Shanghai JIAI Genetics and IVF Institute, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Xiaojun Chen
- Shanghai Key Laboratory of Female Reproductive and Endocrine-Related Diseases, Shanghai, China.,Department of Gynecologic Oncology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Min Yu
- Shanghai JIAI Genetics and IVF Institute, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
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Oni TO, Ilesanmi BB, Yinusa RA, Oyeleye OJ, Oluwatope OB, Solanke BL. Individual and community factors associated with unintended pregnancies among women of advanced reproductive age in Nigeria. Women Health 2021; 61:700-712. [PMID: 34304727 DOI: 10.1080/03630242.2021.1957746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Studies have examined individual and community level factors associated with unintended pregnancies. However, existing studies tends to focus the general population of reproductive age women without isolating women of advanced reproductive age (women at the age range of 35-49 years) for specific research attention. There is need for specific attention on this group of women because pregnancies among them whether intended or unintended elevate obstetric risks for both mother and child. This study examines associated individual and community factors of unintended pregnancies among women of advanced reproductive age in Nigeria. Data were extracted from the 2018 Nigeria Demographic and Health Survey. A weighted sample of 12,509 women was analyzed. Three multilevel logistic regression models were estimated. The study revealed a 10.3% prevalence of unintended pregnancies. Individual characteristics such as maternal age, number of living children, delayed marriage, and community characteristics such as high community poverty and high community unmet contraceptive need were significantly associated with unintended pregnancies. Variations in unintended pregnancies across the communities were more attributable to individual factors. Interventions should develop specific strategies tailored toward women of advanced reproductive age.
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Affiliation(s)
- Tosin Olajide Oni
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Benjamin Bukky Ilesanmi
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Rasheed Adebayo Yinusa
- Department of Demography and Social Statistics, Federal University, Birnin-Kebbi, Nigeria
| | - Olaoye James Oyeleye
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria.,Action Against Hunger, ACF-International, Damaturu, Yobe
| | - Omolayo Bukola Oluwatope
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria.,National Centre for Technology Management, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Bola Lukman Solanke
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria
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Predictive value of cytoplasmic granulation patterns during in vitro fertilization in metaphase II oocytes: part II, donor oocyte cycles. Fertil Steril 2021; 116:1330-1340. [PMID: 34294452 DOI: 10.1016/j.fertnstert.2021.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/21/2021] [Accepted: 06/10/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To determine whether the ooplasm granulation patterns of donor oocytes, like those of oocytes from poor-prognosis patients, are predictive of in vitro fertilization (IVF) outcomes. DESIGN Retrospective cohort study. SETTING Academically affiliated private clinical infertility and research center. PATIENT(S) 770 fresh and 381 vitrified-thawed metaphase II oocytes from young donors (aged 21.0-34.6 years) used for IVF during 2017-2020. INTERVENTION(S) Determination of granulation patterns in every oocyte during intracytoplasmic sperm injection as fine, central, uneven, dispersed, and peripheral (thawed only). MAIN OUTCOME MEASURE(S) Fertilization, pregnancy, and live birth rates in fresh and thawed donor oocytes. Both overall and known-outcome analyses were performed for pregnancy and live birth. RESULT(S) In fresh donor oocytes, 2 pronuclei rates trended down from 96.1% to 90.2%, 88.9%, and 69.7% from fine to central, uneven, and dispersed granulations; overall pregnancy rates trended down from 50.4% to 29.0%, 17.7%, and 6.9%, as well as live birth rates (43.4%, 21.6%, 12.5%, and 6.4%), from fine to uneven, central, and dispersed granulations. Known pregnancy and known-live birth analyses showed similar findings. Thawed donor oocytes demonstrated similar trends in differences in fertilization, pregnancy, and live birth analyses with relatively worse outcomes. Peripheral granulation, unique to vitrification and thawing, always demonstrated the worst IVF outcomes. Moreover, granulation patterns were relatively disassociated from embryo morphological grades in fresh and largely disassociated in thawed donor oocytes. CONCLUSION(S) Predictive values of oocyte granulation patterns for fertilization, pregnancy, and live birth in IVF cycles are even more pronounced in young donors than results in older poor-prognosis patients, further supporting integration of oocyte granulation patterns into embryo selection.
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Conforti A, Esteves SC, Humaidan P, Longobardi S, D'Hooghe T, Orvieto R, Vaiarelli A, Cimadomo D, Rienzi L, Ubaldi FM, Zullo F, Alviggi C. Recombinant human luteinizing hormone co-treatment in ovarian stimulation for assisted reproductive technology in women of advanced reproductive age: a systematic review and meta-analysis of randomized controlled trials. Reprod Biol Endocrinol 2021; 19:91. [PMID: 34154604 PMCID: PMC8215738 DOI: 10.1186/s12958-021-00759-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 05/10/2021] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Several studies suggest that luteinizing hormone (LH) could improve IVF outcome in women of advanced reproductive age by optimizing androgen production. In this review, we assessed the role of recombinant-human LH (r-hLH) and recombinant human follicle stimulating hormone (r-hFSH) co-treatment in ovarian stimulation for assisted reproductive technology in women of advanced reproductive age candidates for assisted reproduction. MATERIAL AND METHODS Using a preregistered protocol we systematically searched Medline/PubMed, Scopus and the ISI Web of Science databases to identify randomized controlled trials in which r-hFSH monotherapy protocols were compared with r-hFSH/r-hLH co-treatment in women ≥35 years undergoing fresh IVF cycles. We calculated the pooled odds ratio (OR) for dichotomous data and the weight mean difference (WMD) for continuous data with an associated 95% confidence interval (CI). The meta-analyses were conducted using the random-effect model. P values < 0.05 were considered statistically significant. Subgroup analyses of all primary and secondary outcomes were performed only in women aged 35-40 years. RESULTS Twelve studies were identified. In women aged between 35 and 40 years, r-hFSH/r-hLH co-treatment was associated with higher clinical pregnancy rates (OR 1.45, CI 95% 1.05-2.00, I2 = 0%, P = 0.03) and implantation rates (OR 1.49, CI 95% 1.10-2.01, I2 = 13%, P = 0.01) versus r-hFSH monotherapy. Fewer oocytes were retrieved in r-hFSH/r-hLH-treated patients than in r-hFSH-treated patients both in women aged ≥35 years (WMD -0.82 CI 95% -1.40 to - 0.24, I2 = 88%, P = 0.005) and in those aged between 35 and 40 years (WMD -1.03, CI - 1.89 to - 0.17, I2 = 0%, P = 0.02). The number of metaphase II oocytes, miscarriage rates and live birth rates did not differ between the two groups of women overall or in subgroup analysis. CONCLUSION Although more oocytes were retrieved in patients who underwent r-hFSH monotherapy, this meta-analysis suggests that r-hFSH/r-hLH co-treatment improves clinical pregnancy and implantation rates in women between 35 and 40 years of age undergoing ovarian stimulation for assisted reproduction technology. However, more RCTs using narrower age ranges in advanced age women are warranted to corroborate these findings.
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Affiliation(s)
- Alessandro Conforti
- University of Naples Federico II, Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Naples, Italy.
| | - Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Campinas, Brazil
- Department of Surgery, University of Campinas, Campinas, Brazil
- Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Peter Humaidan
- Faculty of Health, Aarhus University, Aarhus, Denmark
- Fertility Clinic, Skive Regional Hospital, Skive, Denmark
| | | | - Thomas D'Hooghe
- Department of Development and Regeneration, Biomedical Sciences Group, KU Leuven (University of Leuven), Merck, Leuven, Belgium
- KGaA, Darmstadt, Germany
| | - Raoul Orvieto
- Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Ramat Gan, Israel
- The Tarnesby-Tarnowski Chair for Family Planning and Fertility Regulation, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Alberto Vaiarelli
- Clinica Valle Giulia, G.EN.E.R.A. Centers for Reproductive Medicine, Rome, Italy
| | - Danilo Cimadomo
- Clinica Valle Giulia, G.EN.E.R.A. Centers for Reproductive Medicine, Rome, Italy
| | - Laura Rienzi
- Clinica Valle Giulia, G.EN.E.R.A. Centers for Reproductive Medicine, Rome, Italy
| | - Filippo Maria Ubaldi
- Clinica Valle Giulia, G.EN.E.R.A. Centers for Reproductive Medicine, Rome, Italy
| | - Fulvio Zullo
- University of Naples Federico II, Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Carlo Alviggi
- University of Naples Federico II, Department of Neuroscience, Reproductive Science and Odontostomatology, University of Naples Federico II, Naples, Italy
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73
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Cecchino GN, Pacheco A, García-Velasco JA. Reproductive senescence and energetic metabolism of human luteinized granulosa cells: is it all about ATP? A prospective cohort and critical view. Gynecol Endocrinol 2021; 37:523-527. [PMID: 32820962 DOI: 10.1080/09513590.2020.1810656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Mitochondria are known to play a key role in the regulation of reproductive capacity. Senescence is known to impair mitochondrial function and, ultimately, cellular energetic metabolism. Therefore, as women age, a deficient energy supply is likely to affect oocyte quality. The analysis of granulosa cells is considered a valuable noninvasive strategy to assess factors implicated in oocyte competence. Thus, we conducted an observational prospective cohort to evaluate the impact of aging on energy production by luteinized granulosa cells (LGCs). The control group comprised 13 young oocyte donors, whereas the comparison group included 13 infertile women over 38 years of age undergoing in vitro fertilization. Women with diseases that could potentially impact mitochondrial function were excluded. No differences were detected in the ATP levels in LGCs from young donors and infertile patients of advanced reproductive age (1.9 ± 0.99 picomoles in the control group vs. 2.1 ± 0.59 picomoles; p-value = .139). Likewise, the ATP levels in our series did not correlate with either oocyte number or maturity. Despite the similar ATP levels in LGCs, an age effect on the bioenergetic status cannot be excluded. Energy metabolism is very complex, and ATP does not seem to be the most important and reliable parameter.
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Affiliation(s)
- Gustavo N Cecchino
- Department of Gynecology, Federal University of São Paulo, São Paulo, SP, Brazil
- Department of Gynecology and Obstetrics, Rey Juan Carlos University, Madrid, Spain
- Department of Reproductive Endocrinology and Infertility, IVIRMA Global Madrid, Madrid, Spain
| | - Alberto Pacheco
- Department of Reproductive Endocrinology and Infertility, IVIRMA Global Madrid, Madrid, Spain
| | - Juan A García-Velasco
- Department of Gynecology and Obstetrics, Rey Juan Carlos University, Madrid, Spain
- Department of Reproductive Endocrinology and Infertility, IVIRMA Global Madrid, Madrid, Spain
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74
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Al-Zubaidi U, Adhikari D, Cinar O, Zhang QH, Yuen WS, Murphy MP, Rombauts L, Robker RL, Carroll J. Mitochondria-targeted therapeutics, MitoQ and BGP-15, reverse aging-associated meiotic spindle defects in mouse and human oocytes. Hum Reprod 2021; 36:771-784. [PMID: 33367783 DOI: 10.1093/humrep/deaa300] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/28/2020] [Indexed: 12/22/2022] Open
Abstract
STUDY QUESTION Do mitochondria-targeted therapies reverse ageing- and oxidative stress-induced spindle defects in oocytes from mice and humans? SUMMARY ANSWER Exposure to MitoQ or BGP-15 during IVM protected against spindle and chromosomal defects in mouse oocytes exposed to oxidative stress or derived from reproductively aged mice whilst MitoQ promoted nuclear maturation and protected against chromosomal misalignments in human oocytes. WHAT IS KNOWN ALREADY Spindle and chromosomal abnormalities in oocytes are more prevalent with maternal aging, increasing the risk of aneuploidy, miscarriage and genetic disorders such as Down's syndrome. The origin of compromised oocyte function may be founded in mitochondrial dysfunction and increased reactive oxygen species (ROS). STUDY DESIGN, SIZE, DURATION Oocytes from young and old mice were treated with MitoQ and/or BGP-15 during IVM. To directly induce mitochondrial dysfunction, oocytes were treated with H2O2, and then treated the MitoQ and/or BGP-15. Immature human oocytes were cultured with or without MitoQ. Each experiment was repeated at least three times, and data were analyzed by unpaired-sample t-test or chi-square test. PARTICIPANTS/MATERIALS, SETTING, METHODS Immature germinal vesicle (GV) stage oocytes from 1-, 12- and 18-month-old mice were obtained from preovulatory ovarian follicles. Oocytes were treated with MitoQ and/or BGP-15 during IVM. GV-stage human oocytes were cultured with or without MitoQ. Mitochondrial membrane potential and mitochondrial ROS were measured by live-cell imaging. Meiotic spindle and chromosome alignments were visualized by immunofluorescent labeling of fixed oocytes and the 3-dimensional images were analyzed by Imaris. MAIN RESULTS AND THE ROLE OF CHANCE MitoQ or BGP-15 during IVM protects against spindle and chromosomal defects in oocytes exposed to oxidative stress and in oocytes from aged mice (P < 0.001). In human oocytes, the presence of MitoQ during IVM promoted nuclear maturation and had a similar positive effect in protecting against chromosomal misalignments (P < 0.001). LIMITATIONS, REASONS FOR CAUTION Our study identifies two excellent candidates that may help to improve fertility in older women. However, these potential therapies must be tested for efficacy in clinical IVM systems, and undergo thorough examination of resultant offspring in preclinical models before utilization. WIDER IMPLICATIONS OF THE FINDINGS Our results using in-vitro systems for oocyte maturation in both mouse and human provide proof of principle that mitochondrially targeted molecules such as MitoQ and BGP-15 may represent a novel therapeutic approach against maternal aging-related spindle and chromosomal abnormalities. STUDY FUNDING/COMPETING INTEREST(S) The project was financially supported by the National Health and Medical Research Council and Australian Research Council, Australia. U.A.-Z. was supported by the Iraqi Higher Education and Scientific Research Ministry PhD scholarship and O.C. was supported by TUBITAK-1059B191601275. M.P.M. consults for MitoQ Inc. and holds patents in mitochondria-targeted therapies. R.L.R. is an inventor on patents relating to the use of BGP-15 to improve gamete quality. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Usama Al-Zubaidi
- Development and Stem Cell Program and Department of Anatomy and Developmental Biology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC 3800, Australia.,Applied Embryology Department, High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, AL-Nahrain University, Baghdad, Iraq
| | - Deepak Adhikari
- Development and Stem Cell Program and Department of Anatomy and Developmental Biology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC 3800, Australia
| | - Ozgur Cinar
- Development and Stem Cell Program and Department of Anatomy and Developmental Biology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC 3800, Australia.,Department of Histology and Embryology, Ankara University School of Medicine, Ankara, Turkey
| | - Qing-Hua Zhang
- Development and Stem Cell Program and Department of Anatomy and Developmental Biology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC 3800, Australia
| | - Wai Shan Yuen
- Development and Stem Cell Program and Department of Anatomy and Developmental Biology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC 3800, Australia
| | - Michael P Murphy
- MRC Mitochondrial Biology Unit, University of Cambridge, Hills Road, Cambridge CB2 0XY, UK
| | - Luk Rombauts
- Monash IVF, Melbourne, VIC, Australia.,Department of Obstetrics and Gynaecology, Monash University, Melbourne, VIC, Australia
| | - Rebecca L Robker
- Development and Stem Cell Program and Department of Anatomy and Developmental Biology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC 3800, Australia.,School of Medicine, Robinson Research Institute, The University of Adelaide, Adelaide, SA 5005, Australia
| | - John Carroll
- Development and Stem Cell Program and Department of Anatomy and Developmental Biology, Monash Biomedicine Discovery Institute, Monash University, Melbourne, VIC 3800, Australia
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75
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Kordowitzki P, Haghani A, Zoller JA, Li CZ, Raj K, Spangler ML, Horvath S. Epigenetic clock and methylation study of oocytes from a bovine model of reproductive aging. Aging Cell 2021; 20:e13349. [PMID: 33797841 PMCID: PMC8135012 DOI: 10.1111/acel.13349] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/05/2021] [Accepted: 03/07/2021] [Indexed: 12/24/2022] Open
Abstract
Cattle are an attractive animal model of fertility in women due to their high degree of similarity relative to follicle selection, embryo cleavage, blastocyst formation, and gestation length. To facilitate future studies of the epigenetic underpinnings of aging effects in the female reproductive axis, several DNA methylation-based biomarkers of aging (epigenetic clocks) for bovine oocytes are presented. One such clock was germane to only oocytes, while a dual-tissue clock was highly predictive of age in both oocytes and blood. Dual species clocks that apply to both humans and cattle were also developed and evaluated. These epigenetic clocks can be used to accurately estimate the biological age of oocytes. Both epigenetic clock studies and epigenome-wide association studies revealed that blood and oocytes differ substantially with respect to aging and the underlying epigenetic signatures that potentially influence the aging process. The rate of epigenetic aging was found to be slower in oocytes compared to blood; however, oocytes appeared to begin at an older epigenetic age. The epigenetic clocks for oocytes are expected to address questions in the field of reproductive aging, including the central question: how to slow aging of oocytes.
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Affiliation(s)
- Paweł Kordowitzki
- Institute of Animal Reproduction and Food Research of Polish Academy of SciencesOlsztynPoland
- Institute for Veterinary MedicineNicolaus Copernicus UniversityTorunPoland
| | - Amin Haghani
- Department of Human GeneticsDavid Geffen School of MedicineUniversity of CaliforniaLos AngelesCAUSA
| | - Joseph A. Zoller
- Department of BiostatisticsFielding School of Public HealthUniversity of CaliforniaLos AngelesCAUSA
| | - Caesar Z. Li
- Department of BiostatisticsFielding School of Public HealthUniversity of CaliforniaLos AngelesCAUSA
| | - Ken Raj
- Radiation Effects DepartmentCentre for Radiation, Chemical and Environmental HazardsPublic Health EnglandDidcotUK
| | | | - Steve Horvath
- Department of Human GeneticsDavid Geffen School of MedicineUniversity of CaliforniaLos AngelesCAUSA
- Department of BiostatisticsFielding School of Public HealthUniversity of CaliforniaLos AngelesCAUSA
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76
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Bizerea-Moga TO, Pitulice L, Bizerea-Spiridon O, Moga TV. Evaluation of Serum Selenium Status by Age and Gender: A Retrospective Observational Cohort Study in Western Romania. Nutrients 2021; 13:nu13051497. [PMID: 33925066 PMCID: PMC8145713 DOI: 10.3390/nu13051497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/21/2021] [Accepted: 04/26/2021] [Indexed: 01/19/2023] Open
Abstract
Selenium, residing in a series of selenoproteins, plays an important role in both female and male reproductive function. Of particular significance for reproduction is the antioxidant glutathione peroxidase (GPx), a main selenoenzyme, whose level is regulated by the availability of Se in the body. We hypothesized that changes in Se status, closely related to GPx activity, would result in an increased risk of reproductive dysfunction in individuals. We retrospectively investigated the serum selenium (SeS) concentrations of 1264 apparently healthy people, aged 16–89 years, from Western Romania. The general analysis revealed a non-normal SeS distribution with a median SeS of 100.26 ± 18.32 μg/L and a significant difference in SeS levels between age groups. The analysis of the young group (16–35 years) revealed that up to 50% of individuals did not reach the SeS threshold corresponding to maximum GPx activity (80 μg/L), and a significant imbalance between the genders was apparent when looking at SeS values outside the range. Our results correlated with the general diminished reproductive ability registered in Romania during the last few years. Serum selenium content proves to offer a proper reflection of the fertility competence of the young population, and its monitoring is important for guiding dietary adjustments and attaining normal reproductive function.
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Affiliation(s)
- Teofana Otilia Bizerea-Moga
- Department XI of Pediatrics—1st Pediatric Discipline, “Victor Babeș” University of Medicine and Pharmacy Timișoara, Eftimie Murgu Sq no 2, 300041 Timișoara, Romania;
- 1st Pediatric Clinic, “Louis Țurcanu” Children’s Clinical and Emergency Hospital, Iosif Nemoianu 2, 300011 Timișoara, Romania
| | - Laura Pitulice
- Department of Biology-Chemistry, West University of Timişoara, Pestallozi 16, 300115 Timişoara, Romania;
- Laboratory of Advanced Researches in Environmental Protection, Oituz 4, 300086 Timişoara, Romania
- Correspondence: ; Tel.: +40-744-517-275
| | - Otilia Bizerea-Spiridon
- Department of Biology-Chemistry, West University of Timişoara, Pestallozi 16, 300115 Timişoara, Romania;
- Laboratory of Advanced Researches in Environmental Protection, Oituz 4, 300086 Timişoara, Romania
| | - Tudor Voicu Moga
- Department VII of Internal Medicine—Gastroenterology Discipline, “Victor Babeș” University of Medicine and Pharmacy Timișoara, Eftimie Murgu Sq no 2, 300041 Timișoara, Romania;
- Gastroenterology and Hepatology Clinic, “Pius Brînzeu” County Emergency Clinical Hospital, Liviu Rebreanu 156, 300723 Timișoara, Romania
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77
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Sunkara SK, Zheng W, D'Hooghe T, Longobardi S, Boivin J. Time as an outcome measure in fertility-related clinical studies: long-awaited. Hum Reprod 2021; 35:1732-1739. [PMID: 32644107 PMCID: PMC7398622 DOI: 10.1093/humrep/deaa138] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 04/27/2020] [Indexed: 01/11/2023] Open
Abstract
Time taken to achieve a live birth is an important consideration that is central to managing patient expectations during infertility treatment. However, time-related endpoints are not reported as standard in the majority of fertility-related clinical studies and there is no internationally recognized consensus definition for such endpoints. There is, therefore, a need for meaningful discussions around the selection of appropriate time-related treatment outcome measures for studies evaluating fertility treatments that will be relevant to diverse stakeholders (e.g. patients, healthcare professionals, clinical scientists, authorities and industry). Here, we provide a proposal for the evaluation of time-related outcome measures in fertility-related clinical studies, alongside associated definitions.
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Affiliation(s)
- Sesh K Sunkara
- Division of Women's Health, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Wenjing Zheng
- Global Medical Affairs Fertility, Research and Development, Merck KGaA, Darmstadt, Germany
| | - Thomas D'Hooghe
- Global Medical Affairs Fertility, Research and Development, Merck KGaA, Darmstadt, Germany.,Research Group Reproductive Medicine, Department of Development and Regeneration, Organ Systems, Group Biomedical Sciences, KU Leuven (University of Leuven), Leuven, Belgium.,Department of Obstetrics and Gynecology, Yale University, New Haven, CT, USA
| | - Salvatore Longobardi
- Global Clinical Development, Merck Serono S.p.A, Rome, Italy, an affiliate of Merck KGaA, Darmstadt, Germany
| | - Jacky Boivin
- School of Psychology, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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78
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Hu J, Molinari E, Darmon S, Zhang L, Patrizio P, Barad DH, Gleicher N. Predictive value of cytoplasmic granulation patterns during in vitro fertilization in metaphase II oocytes: Part I, poor-prognosis patients. Fertil Steril 2021; 116:431-443. [PMID: 33865566 DOI: 10.1016/j.fertnstert.2021.02.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/09/2021] [Accepted: 02/11/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To determine whether 4 cytoplasmic granulation patterns of human metaphase II oocytes have a predictive value for in vitro fertilization outcomes. DESIGN A retrospective cohort study. SETTING An academically affiliated private clinical infertility and research center. PATIENT(S) A total of 2,690 consecutive fresh autologous oocytes collected from women aged 41.2 ± 5.0 years between 2017 and 2019. INTERVENTION(S) Determination of granulation pattern in every oocyte during intracytoplasmic sperm injection as fine, central, dispersed, and newly introduced uneven granulations. MAIN OUTCOME MEASURE(S) Fertilization outcomes (2 pronuclei [2PN], <2PN, and >2PN rates), pregnancy, and live birth rates for different granulation patterns at different ages. RESULT(S) Fine granulation produced the highest 2PN rate, followed by central, uneven, and dispersed granulation (91.8%, 83.9%, 77.9%, and 54.8%, respectively). Differences in fertilization were surprisingly relatively independent of age and other variables. Overall, compared with fine granulation, dispersed granulation resulted in lower pregnancy rates (4.6% vs. 10.7%) and known-outcome analysis (1.3% vs. 5.6%) as well as lower live birth rates (3.0% vs. 8.9%) and known-outcome analysis (0.6% vs. 5.6%). The known-outcome analysis demonstrated that uneven granulation had lower live birth rates than fine granulation (2.3% vs. 5.6%). Unexpectedly, the ooplasm granulation patterns were largely disassociated from embryo morphologic grades. CONCLUSION(S) We, for the first time, demonstrated that 4 distinct cytoplasmic granulation patterns in metaphase II oocytes had, largely independent of age and other variables, a predictive value for fertilization, pregnancy, and live birth outcomes in in vitro fertilization cycles of poor-prognosis patients. These data suggest that upstream ooplasm granulation patterns deserve closer attention in terms of embryo selection.
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Affiliation(s)
- Jianjun Hu
- The Center for Human Reproduction, New York, New York.
| | | | - Sarah Darmon
- The Center for Human Reproduction, New York, New York
| | - Lin Zhang
- The Center for Human Reproduction, New York, New York
| | - Pasquale Patrizio
- Department of Obstetrics and Gynecology and Reproductive Sciences, Yale University Medical School, New Haven, Connecticut
| | - David H Barad
- The Center for Human Reproduction, New York, New York; The Foundation for Reproductive Medicine, New York, New York
| | - Norbert Gleicher
- The Center for Human Reproduction, New York, New York; The Foundation for Reproductive Medicine, New York, New York; Stem Cell Biology and Molecular Embryology Laboratory, Rockefeller University, New York, New York; Department of Obstetrics and Gynecology, Vienna University School of Medicine, Vienna, Austria
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79
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Lazzari E, Mogi R, Canudas-Romo V. Educational composition and parity contribution to completed cohort fertility change in low-fertility settings. Population Studies 2021; 75:153-167. [PMID: 33780319 DOI: 10.1080/00324728.2021.1895291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Extensive literature has documented the contribution of rising women's education to decreases in completed cohort fertility (CCF). A key question related to the education-fertility relationship is to what extent the decrease in fertility is the result of changes in educational composition vs changes in fertility behaviours within educational categories. This study quantified the effect of educational expansion on fertility levels by decomposing the overall change in CCF into educational composition and education-specific fertility, and explored the changes in parity-specific components of CCF by education for cohorts born between 1940 and 1970. The results show that, despite the decline in CCF being caused mostly by changes in fertility behaviours, educational composition had a considerable impact for some cohorts. The decline in third and higher-order births played a central role in the fall in CCF across educational groups, while the effects of transitions to first and second births varied substantially.
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80
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Hougaard KS. Next Generation Reproductive and Developmental Toxicology: Crosstalk Into the Future. FRONTIERS IN TOXICOLOGY 2021; 3:652571. [PMID: 35295122 PMCID: PMC8915852 DOI: 10.3389/ftox.2021.652571] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 02/17/2021] [Indexed: 12/13/2022] Open
Affiliation(s)
- Karin Sørig Hougaard
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- *Correspondence: Karin Sørig Hougaard
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81
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Kim H, Choe SA, Kim OJ, Kim SY, Kim S, Im C, Kim YS, Yoon TK. Outdoor air pollution and diminished ovarian reserve among infertile Korean women. Environ Health Prev Med 2021; 26:20. [PMID: 33573606 PMCID: PMC7879617 DOI: 10.1186/s12199-021-00942-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 01/31/2021] [Indexed: 11/10/2022] Open
Abstract
Background Mounting evidence implicates an association between ambient air pollution and impaired reproductive potential of human. Our study aimed to assess the association between air pollution and ovarian reserve in young, infertile women. Methods Our study included 2276 Korean women who attended a single fertility center in 2016–2018. Women’s exposure to air pollution was assessed using concentrations of particulate matter (PM10 and PM2.5), nitrogen dioxide (NO2), carbon monoxide (CO), sulfur dioxide (SO2), and ozone (O3) that had been collected at 269 air quality monitoring sites. Exposure estimates were computed for 1, 3, 6, and 12 months prior to the ovarian reserve tests. Anti-Müllerian hormone (AMH) ratio (defined as an observed-to-expected AMH based on age) and low AMH (defined as < 0.5 ng/mL) were employed as indicators of ovarian reserve. We included a clustering effect of 177 districts in generalized estimating equations approach. A secondary analysis was conducted restricting the analyses to Seoul residents to examine the association in highly urbanized setting. Results The mean age was 36.6 ± 4.2 years and AMH level was 3.3 ± 3.1 ng/mL in the study population. Average AMH ratio was 0.8 ± 0.7 and low AMH was observed in 10.3% of women (n=235). The average concentration of six air pollutants was not different between the normal ovarian reserve and low AMH groups for all averaging periods. In multivariable models, an interquartile range (IQR)-increase in 1 month-average PM10 was associated with decrease in AMH ratio among total population (β= −0.06, 95% confidence interval: −0.11, 0.00). When we restrict our analysis to those living in Seoul, IQR-increases in 1 and 12 month-average PM2.5 were associated with 3% (95% CI: −0.07, 0.00) and 10% (95% CI: −0.18, −0.01) decrease in AMH ratio. The ORs per IQR increase in the six air pollutants were close to null in total population and Seoul residents. Conclusions In a cohort of infertile Korean women, there was a suggestive evidence of the negative association between ambient PM concentration and ovarian reserve, highlighting the potential adverse impact of air pollution on women’s fertility. Supplementary Information The online version contains supplementary material available at 10.1186/s12199-021-00942-4.
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Affiliation(s)
- Hannah Kim
- Department of Obstetrics and Gynecology, CHA Fertility Center Seoul Station, CHA University School of Medicine, Seoul, 04637, Korea
| | - Seung-Ah Choe
- Department of Obstetrics and Gynecology, CHA Fertility Center Seoul Station, CHA University School of Medicine, Seoul, 04637, Korea. .,Department of Preventive Medicine, Korea University College of Medicine, Seoul, 02841, South Korea. .,Department of Epidemiology & Health Informatics, Graduate School of Public Health, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Korea.
| | - Ok-Jin Kim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Gyeonggi-do, 10408, Korea
| | - Sun-Young Kim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, Gyeonggi-do, 10408, Korea
| | - Seulgi Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, 08826, Korea
| | - Changmin Im
- Department of Geography, Korea University, Seoul, 02841, South Korea
| | - You Shin Kim
- Department of Obstetrics and Gynecology, CHA Fertility Center Seoul Station, CHA University School of Medicine, Seoul, 04637, Korea
| | - Tae Ki Yoon
- Department of Obstetrics and Gynecology, CHA Fertility Center Seoul Station, CHA University School of Medicine, Seoul, 04637, Korea
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82
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Hlaváčová J, Flegr J, Řežábek K, Calda P, Kaňková Š. Association between latent toxoplasmosis and fertility parameters of men. Andrology 2021; 9:854-862. [PMID: 33420759 DOI: 10.1111/andr.12969] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/14/2020] [Accepted: 01/03/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND About a third of people in the world are infected with Toxoplasma gondii. This parasite has been found in the reproductive organs and semen of males of many animal species as well as humans. The effects of toxoplasmosis on sperm count, motility and morphology were confirmed in rats. A higher prevalence of toxoplasmosis has been observed in infertile men. On the other hand, no significant effect of infection on semen parameters in men was found in one already published study. OBJECTIVES To compare the prevalence of toxoplasmosis in men with and without semen pathology and to examine in detail the possible impact of infection on semen volume, sperm count, motility and morphology. MATERIALS AND METHODS The pre-registered cross-sectional study included 669 men who visited the Centre for Assisted Reproduction in Prague from June 2016 until June 2018. RESULTS The incidence of fertility problems was significantly higher in the 163 Toxoplasma-infected men (48.47%) than in the 506 Toxoplasma-free men (42.29%), τ = 0.049, P = 0.029. After correction for multiple tests, we found significantly lower sperm concentration, concentration of progressively motile sperm, and concentration of non-progressively motile sperm in Toxoplasma-positive men than in Toxoplasma-negative men using partial Kendall correlation with age controlled. In addition, toxoplasmosis correlated with sperm quality in smokers but not in non-smokers. DISCUSSION AND CONCLUSION Our results suggest that latent toxoplasmosis affects certain semen parameters (sperm count and motility), but does not seem to affect sperm morphology and semen volume. Impairment of semen parameters may be either a side effect of the presence of Toxoplasma gondii in male reproductive organs or a product of manipulation activity of the parasite aimed to increase the efficiency of the sexual route of its transmission. Tobacco smoking also appears to exacerbate the negative impact of toxoplasmosis on semen parameters.
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Affiliation(s)
- Jana Hlaváčová
- Department of Philosophy and History of Science, Faculty of Science, Charles University, Prague, Czech Republic
| | - Jaroslav Flegr
- Department of Philosophy and History of Science, Faculty of Science, Charles University, Prague, Czech Republic
| | - Karel Řežábek
- Centre for Assisted Reproduction, Department of Obstetrics and Gynaecology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Pavel Calda
- Fetal Medicine Centre, Department of Obstetrics and Gynaecology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Šárka Kaňková
- Department of Philosophy and History of Science, Faculty of Science, Charles University, Prague, Czech Republic
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83
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Onogi S, Ezoe K, Nishihara S, Fukuda J, Kobayashi T, Kato K. Endometrial thickness on the day of the LH surge: an effective predictor of pregnancy outcomes after modified natural cycle-frozen blastocyst transfer. Hum Reprod Open 2021; 2020:hoaa060. [PMID: 33511290 PMCID: PMC7821991 DOI: 10.1093/hropen/hoaa060] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 10/14/2020] [Indexed: 01/08/2023] Open
Abstract
STUDY QUESTION Can the endometrial thickness (EMT) on the day of the LH surge predict pregnancy outcomes after single vitrified-warmed blastocyst transfers (SVBTs) in modified natural cycles? SUMMARY ANSWER Decreased EMT on the day of the LH surge is associated with older female age and a shortened proliferation phase and may be associated with low live birth and high chemical pregnancy rates. WHAT IS KNOWN ALREADY The relation between EMT on the day of embryo transfer (ET) and pregnancy outcomes remains controversial; although numerous studies reported an association between decreased EMT on the day of ET and a reduced likelihood of pregnancy, recent studies demonstrated that the EMT on the day of ET had limited independent prognostic value for pregnancy outcomes after IVF. The relation between EMT on the day of the LH surge and pregnancy outcomes after SVBT in modified natural cycles is currently unknown. STUDY DESIGN, SIZE, DURATION In total, 808 SVBTs in modified natural cycles, performed from November 2018 to October 2019, were analysed in this retrospective cohort study. Associations of EMT on the days of the LH surge with SVBT and clinical and ongoing pregnancy rates were statistically evaluated. Clinical and ongoing pregnancy rates were defined as the ultrasonographic observation of a gestational sac 3 weeks after SVBTs and the observation of a foetal heartbeat 5 weeks after SVBTs, respectively. Similarly, factors potentially associated with the EMT on day of the LH surge, such as patient and cycle characteristics, were investigated. PARTICIPANTS/MATERIALS, SETTING, METHODS The study includes IVF/ICSI patients aged 24–47 years, who underwent their first SVBT in the study period. After monitoring follicular development and serum hormone levels, ovulation was triggered via a nasal spray containing a GnRH agonist. After ovulation was confirmed, SVBTs were performed on Day 5. The EMT was evaluated by transvaginal ultrasonography on the day of the LH surge and immediately before the SVBT procedure. MAIN RESULTS AND THE ROLE OF CHANCE Of the original 901 patients, 93 who were outliers for FSH or proliferative phase duration data were excluded from the analysis. Patients were classified according to quartiles of EMT on day of the LH surge, as follows: EMT < 8.1 mm, 8.1 mm ≤ EMT < 9.1 mm, 9.1 mm ≤ EMT < 10.6 mm and EMT ≥ 10.6 mm. Decreased EMT on day of the LH surge was associated with lower live birth (P = 0.0016) and higher chemical pregnancy (P = 0.0011) rates. Similarly, patients were classified according to quartiles of EMT on day of the SVBT, as follows: EMT < 9.1 mm, 9.1 mm ≤ EMT < 10.1 mm, 10.1 mm ≤ EMT < 12.1 mm and EMT ≥ 12.1 mm. A decreased EMT on the day of SVBT was associated with a lower live birth rate (P = 0.0095) but not chemical pregnancy rate (P = 0.1640). Additionally, multivariate logistic regression analysis revealed a significant correlation between EMT on day of the LH surge and ongoing pregnancy; however, no correlation was observed between EMT on the day of SVBT and ongoing pregnancy (adjusted odds ratio 0.952; 95% CI, 0.850–1.066; P = 0.3981). A decreased EMT on day of the LH surge was significantly associated with greater female age (P = 0.0003) and a shortened follicular/proliferation phase (P < 0.0001). LIMITATIONS, REASONS FOR CAUTION The data used in this study were obtained from a single-centre cohort; therefore, multi-centre studies are required to ascertain the generalisability of these findings to other clinics with different protocols and/or patient demographics. WIDER IMPLICATIONS OF THE FINDINGS This is the first report demonstrating a significant correlation between EMT on day of the LH surge and pregnancy outcomes after frozen blastocyst transfer in modified natural cycles. Our results suggest that EMT on day of the LH surge may be an effective predictor of the live birth rate. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by resources from the Kato Ladies Clinic. The authors have no conflicts of interest to declare.
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Affiliation(s)
| | - Kenji Ezoe
- Kato Ladies Clinic, Tokyo 160-0023, Japan
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Caughey LE, White KM. Psychosocial determinants of women's intentions and willingness to freeze their eggs. Fertil Steril 2021; 115:742-752. [PMID: 33478776 DOI: 10.1016/j.fertnstert.2020.09.150] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To examine the psychosocial factors that influence Australian women's intentions to freeze their eggs. DESIGN Initially, a qualitative elicitation study followed by a larger-scale quantitative study. SETTING Both studies were conducted online. PATIENTS A total of 234 Australian women 25-43 years of age, who identifed as heterosexual, had no children, were open to the idea of having children, were currently not pregnant, and did not have a diagnosis of medical infertility. INTERVENTION None. MAIN OUTCOME MEASURE(S) Intentions and willingness of women to freeze their eggs. RESULT(S) Hierarchical multiple regression analyses showed that after accounting for demographic variables, there was strong support for the psychosocial predictors of attitude, pressure from others, and control perceptions as predictors of women's intentions to freeze their eggs. Of the additional variables, cognitive bias (influence of the media) was significant, and the final model accounted for 52.7% of variance in women's intentions to freeze their eggs. CONCLUSION(S) This study was the first to predict women's intentions to freeze their eggs using a well-established decision-making model, the theory of planned behavior. Messages designed to develop a positive attitude toward egg freezing, and to encourage an increased perception of personal control of the egg freezing process, as well as approval from others, could support women to investigate egg freezing, in consultation with appropriate medical advice, as an option when faced with possible future infertility. Effective strategies broaden fertility options for women faced with age-related fertility decline, maximize women's chances of a successful pregnancy, and, critically, prevent the often substantial psychological distress associated with involuntary childlessness.
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Affiliation(s)
- Lucy E Caughey
- School of Psychology and Counselling, Queensland University of Technology, Brisbane City, Queensland, Australia.
| | - Katherine M White
- School of Psychology and Counselling, Queensland University of Technology, Brisbane City, Queensland, Australia
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Liu R, Bai S, Jiang X, Luo L, Tong X, Zheng S, Wang Y, Xu B. Multifactor Prediction of Embryo Transfer Outcomes Based on a Machine Learning Algorithm. Front Endocrinol (Lausanne) 2021; 12:745039. [PMID: 34795639 PMCID: PMC8593232 DOI: 10.3389/fendo.2021.745039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/15/2021] [Indexed: 11/17/2022] Open
Abstract
In vitro fertilization-embryo transfer (IVF-ET) technology make it possible for infertile couples to conceive a baby successfully. Nevertheless, IVF-ET does not guarantee success. Frozen embryo transfer (FET) is an important supplement to IVF-ET. Many factors are correlated with the outcome of FET which is unpredictable. Machine learning is a field of study that predict various outcomes by defining data attributes and using relevant data and calculation algorithms. Machine learning algorithm has been widely used in clinical research. The present study focuses on making predictions of early pregnancy outcomes in FET through clinical characters, including age, body mass index (BMI), endometrial thickness (EMT) on the day of progesterone treatment, good-quality embryo rate (GQR), and type of infertility (primary or secondary), serum estradiol level (E2) on the day of embryo transfer, and serum progesterone level (P) on the day of embryo transfer. We applied four representative machine learning algorithms, including logistic regression (LR), conditional inference tree, random forest (RF) and support vector machine (SVM) to build prediction models and identify the predictive factors. We found no significant difference among the models in the sensitivity, specificity, positive predictive rate, negative predictive rate or accuracy in predicting the pregnancy outcome of FET. For example, the positive/negative predictive rate of the SVM (gamma = 1, cost = 100, 10-fold cross validation) is 0.56 and 0.55. This approach could provide a reference for couples considering FET. The prediction accuracy of the present study is limited, which suggests that there may be some other more effective predictors to be developed in future work.
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Affiliation(s)
- Ran Liu
- Reproductive and Genetic Hospital, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Shun Bai
- Reproductive and Genetic Hospital, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Xiaohua Jiang
- Reproductive and Genetic Hospital, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Lihua Luo
- Reproductive and Genetic Hospital, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Xianhong Tong
- Reproductive and Genetic Hospital, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Shengxia Zheng
- Reproductive and Genetic Hospital, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Ying Wang
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- *Correspondence: Ying Wang, ; Bo Xu,
| | - Bo Xu
- Reproductive and Genetic Hospital, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
- *Correspondence: Ying Wang, ; Bo Xu,
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Guo Y, Liu S, Hu S, Li F, Jin L. High Serum Anti-Müllerian Hormone Concentrations Are Associated With Poor Pregnancy Outcome in Fresh IVF/ICSI Cycle but Not Cumulative Live Birth Rate in PCOS Patients. Front Endocrinol (Lausanne) 2021; 12:673284. [PMID: 34122349 PMCID: PMC8187895 DOI: 10.3389/fendo.2021.673284] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 04/23/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To investigate the association between baseline serum Anti-Müllerian hormone (AMH) levels and IVF/ICSI outcomes in women with polycystic ovary syndrome (PCOS). DESIGN Retrospective study. SETTING Reproductive medicine center in a hospital. POPULATION 2436 PCOS patients (Rotterdam criteria) who underwent their first fresh IVF/ICSI cycles were divided into three groups on the basis of the <25th (Group 1, n=611), 25 to 75th (Group 2, n=1216), or >75th (Group 3, n=609) percentile of baseline serum AMH level. INTERVENTIONS Baseline serum AMH levels measured on the 2-3 days of spontaneous menstrual cycle before IVF/ICSI treatment. MAIN OUTCOME MEASURES Live birth rate (LBR), cumulative live birth rate (CLBR), clinical pregnancy rate (CPR), and normal fertilization rate (FR). RESULTS The LBR, CPR, and FR were significantly increased in Group 1 than Group 2 and Group 3, however, CLBR was similar between the three groups. The LBR were 46.6%, 40.5%, and 39.4% in Group 1, Group 2, and Group 3 respectively. The CPR were 53.0%, 47.0%, and 45.5%, respectively. The FR was highest in Group 1 (61.7%, P<0.05), but there was no uniform reverse trend with the AMH level. CLBR were 68.7%, 70.4%, and 71.3%, respectively. Although women in Group 1 were older (p < 0.05) and had higher body mass index (BMI) (p < 0.05), binomial logistic regression analysis used age, BMI, FSH, and AMH as independent variables indicated that only AMH was significantly associated with LBR and CPR. Nevertheless, binomial logistic regression analysis used age, BMI, FSH, AMH, and the number of retrieved oocytes as independent variables indicated that only the number of retrieved oocytes was significantly correlated with CLBR. After stratifying by age, the negative relationship between baseline AMH level and LBR and CPR remained only in the patients <30 years old. CONCLUSIONS Higher baseline AMH level in PCOS women resulted in lower LBR, CPR, and FR but did not influence CLBR.
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Affiliation(s)
| | | | | | - Fei Li
- *Correspondence: Lei Jin, ; Fei Li,
| | - Lei Jin
- *Correspondence: Lei Jin, ; Fei Li,
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87
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Li F, Lu R, Zeng C, Li X, Xue Q. Development and Validation of a Clinical Pregnancy Failure Prediction Model for Poor Ovarian Responders During IVF/ICSI. Front Endocrinol (Lausanne) 2021; 12:717288. [PMID: 34497586 PMCID: PMC8419272 DOI: 10.3389/fendo.2021.717288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 08/02/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUNDS Despite the great advances in assisted reproductive technology (ART), poor ovarian response (POR) is still one of the most challenging tasks in reproductive medicine. This predictive model we developed aims to predict the individual probability of clinical pregnancy failure for poor ovarian responders (PORs) under in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). METHODS The nomogram was developed in 281 patients with POR according to the Bologna criteria from January 2016 to December 2019, with 179 in the training group and 102 in the validation group. Univariate and multivariate logistic regression analyses were used to identify characteristics that were associated with clinical pregnancy failure. The nomogram was constructed based on regression coefficients. Performance was evaluated using both calibration and discrimination. RESULTS Age >35 years, body mass index (BMI) >24 kg/m2, basic follicle-stimulating hormone (FSH) >10 mIU/ml, basic E2 >60 pg/ml, type B or C of endometrium on human chorionic gonadotropin (hCG) day, and the number of high-quality embryos <2 were associated with pregnancy failure of POR patients. The area under the receiver operating characteristic curve (AUC) of the training set is 0.786 (95% confidence interval (CI): 0.710-0.861), and AUC in the validation set is 0.748 (95% CI: 0.668-0.827), showing a satisfactory goodness of fit and discrimination ability in this nomogram. CONCLUSION Our nomogram can predict the probability of clinical pregnancy failure in PORs before embryo transfer in IVF/ICSI procedure, to help practitioners make appropriate clinical decisions and to help infertile couples manage their expectations.
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Melado L, Vitorino R, Coughlan C, Bixio LD, Arnanz A, Elkhatib I, De Munck N, Fatemi HM, Lawrenz B. Ethnic and Sociocultural Differences in Ovarian Reserve: Age-Specific Anti-Müllerian Hormone Values and Antral Follicle Count for Women of the Arabian Peninsula. Front Endocrinol (Lausanne) 2021; 12:735116. [PMID: 34745004 PMCID: PMC8567992 DOI: 10.3389/fendo.2021.735116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Anti-Müllerian hormone (AMH) and antral follicle count (AFC) age-specific reference values form the basis of infertility treatments, yet they were based upon studies performed primarily on Caucasian populations. However, they may vary across different age-matched ethnic populations. This study aimed to describe age-specific serum AMH and AFC for women native to the Arabian Peninsula. METHODS A retrospective large-scale study was performed including 2,495 women, aged 19 to 50 years, native to the Arabian Peninsula. AMH and AFC were measured as part of their fertility assessment at tertiary-care fertility centres. Age-specific values and nomograms were calculated. RESULTS 2,495 women were evaluated. Mean, standard deviation and median values were calculated for AMH and AFC by 1-year and 5-years intervals. Median age was 34.81 years, median AMH was 1.76ng/ml and median AFC was 11. From the total group, 40.60% presented with AMH levels below 1.3ng/mL. For women <45 years old, the decrease in AFC was between -0.6/-0.8 per year. Up to 36 years old, the decrease of AMH was 0.1ng/ml. However, from 36 to 40 years old, an accelerated decline of 0.23ng/ml yearly was noted. In keeping with local customs, 71.23% of women wore the hijab and 25.76% the niqab. AMH and AFC were significantly lower for niqab group compared with hijab group (p=0.02 and p=0.04, respectively). CONCLUSION This is to-date the largest data set on age-specific AMH and AFC values in women from the Arabian Peninsula aiming to increase clinical awareness of the ovarian reserve in this population.
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Affiliation(s)
- Laura Melado
- Medical Department, ART Fertility Clinics, Abu Dhabi, United Arab Emirates
- *Correspondence: Laura Melado,
| | - Raquel Vitorino
- Medical Department, ART Fertility Clinics, Abu Dhabi, United Arab Emirates
| | - Carol Coughlan
- Medical Department, Advanced Reproductive Technologies (ART) Fertility Clinics, Dubai, United Arab Emirates
| | | | - Ana Arnanz
- Medical Department, ART Fertility Clinics, Abu Dhabi, United Arab Emirates
- Departamento de Biomedicina y Biotecnología, Universidad de Alcalá, Madrid, Spain
| | - Ibrahim Elkhatib
- Medical Department, ART Fertility Clinics, Abu Dhabi, United Arab Emirates
| | - Neelke De Munck
- Medical Department, ART Fertility Clinics, Abu Dhabi, United Arab Emirates
| | - Human M. Fatemi
- Medical Department, ART Fertility Clinics, Abu Dhabi, United Arab Emirates
| | - Barbara Lawrenz
- Medical Department, ART Fertility Clinics, Abu Dhabi, United Arab Emirates
- Medical Department, Women’s University Hospital Tuebingen, Tuebingen, Germany
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Trawick E, Pecoriello J, Quinn G, Goldman KN. Guidelines informing counseling on female age-related fertility decline: a systematic review. J Assist Reprod Genet 2021; 38:41-53. [PMID: 33188440 PMCID: PMC7822973 DOI: 10.1007/s10815-020-01967-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/04/2020] [Indexed: 12/29/2022] Open
Abstract
PURPOSE To identify, appraise, and assess clinical practice guidelines informing patient counseling on female age-related fertility decline. METHODS Searched electronic database records from January 1, 2006, to September 10, 2018, and professional society websites. The search terms included iterations of "guideline," "counseling," "preconception," "age-related fertility decline," and "reproductive life planning." English-language professional organization guidelines addressing patient counseling on age-specific reproductive health topics were included. Assessed the methodological quality of included guidelines using the AGREE II instrument. Guidelines were categorized as high quality or low quality based on AGREE II scores. Extracted age-specific reproductive health recommendations of high-quality guidelines. RESULTS The search identified 2918 records. Nineteen records addressed counseling on age-related fertility decline; only 6 focused only on reproductive aging, with the remaining 13 covering related topics. Eleven met criteria for high quality. All high-quality guidelines had high "rigor of development" scores on AGREE II. Ten high-quality guidelines stated an age at which female fertility declines, ranging from 30 to "late 30s." One recommended a specific age at which patients should be counseled. Five of eleven high-quality guidelines did not discuss the obstetric and perinatal risks of advanced maternal age. CONCLUSIONS Few high-quality guidelines address counseling on female age-related fertility decline, and existing guidance on reproductive aging counseling is inconsistent and incomplete. Greater rigor of development and incorporation of age-specific counseling recommendations into clinical practice guidelines could lead to improved patient anticipatory guidance and more informed reproductive choices.
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Affiliation(s)
- Emma Trawick
- Department of Obstetrics and Gynecology, NYU School of Medicine, 462 First Avenue, NBV 9N1-C, New York, NY, 10016, USA
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 676 North Saint Clair Street, Suite 2300, Chicago, IL, 60611, USA
| | - Jillian Pecoriello
- Department of Obstetrics and Gynecology, NYU School of Medicine, 462 First Avenue, NBV 9N1-C, New York, NY, 10016, USA
| | - Gwendolyn Quinn
- Department of Obstetrics and Gynecology, NYU School of Medicine, 462 First Avenue, NBV 9N1-C, New York, NY, 10016, USA
| | - Kara N Goldman
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, 676 North Saint Clair Street, Suite 2300, Chicago, IL, 60611, USA.
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Xie SH, Fang R, Huang M, Dai J, Thrift AP, Anderson LA, Chow WH, Bernstein L, Gammon MD, Risch HA, Shaheen NJ, Reid BJ, Wu AH, Iyer PG, Liu G, Corley DA, Whiteman DC, Caldas C, Pharoah PD, Hardie LJ, Fitzgerald RC, Shen H, Vaughan TL, Lagergren J. Association Between Levels of Sex Hormones and Risk of Esophageal Adenocarcinoma and Barrett's Esophagus. Clin Gastroenterol Hepatol 2020; 18:2701-2709.e3. [PMID: 31756444 PMCID: PMC7580878 DOI: 10.1016/j.cgh.2019.11.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 10/31/2019] [Accepted: 11/10/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND & AIMS Esophageal adenocarcinoma (EAC) occurs most frequently in men. We performed a Mendelian randomization analysis to investigate whether genetic factors that regulate levels of sex hormones are associated with risk of EAC or Barrett's esophagus (BE). METHODS We conducted a Mendelian randomization analysis using data from patients with EAC (n = 2488) or BE (n = 3247) and control participants (n = 2127), included in international consortia of genome-wide association studies in Australia, Europe, and North America. Genetic risk scores or single-nucleotide variants were used as instrumental variables for 9 specific sex hormones. Logistic regression provided odds ratios (ORs) with 95% CIs. RESULTS Higher genetically predicted levels of follicle-stimulating hormones were associated with increased risks of EAC and/or BE in men (OR, 1.14 per allele increase; 95% CI, 1.01-1.27) and in women (OR, 1.28; 95% CI, 1.03-1.59). Higher predicted levels of luteinizing hormone were associated with a decreased risk of EAC in men (OR, 0.92 per SD increase; 95% CI, 0.87-0.99) and in women (OR, 0.93; 95% CI, 0.79-1.09), and decreased risks of BE (OR, 0.88; 95% CI, 0.77-0.99) and EAC and/or BE (OR, 0.89; 95% CI, 0.79-1.00) in women. We found no clear associations for other hormones studied, including sex hormone-binding globulin, dehydroepiandrosterone sulfate, testosterone, dihydrotestosterone, estradiol, progesterone, or free androgen index. CONCLUSIONS In a Mendelian randomization analysis of data from patients with EAC or BE, we found an association between genetically predicted levels of follicle-stimulating and luteinizing hormones and risk of BE and EAC.
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Affiliation(s)
- Shao-Hua Xie
- Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
| | - Rui Fang
- Department of Epidemiology and Biostatistics, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Mingtao Huang
- Department of Epidemiology and Biostatistics, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Juncheng Dai
- Department of Epidemiology and Biostatistics, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China; Jiangsu Key Lab of Cancer Biomarkers, Prevention, and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China
| | - Aaron P Thrift
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas; Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Lesley A Anderson
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Wong-Ho Chow
- Department of Epidemiology, MD Anderson Cancer Center, Houston, Texas
| | - Leslie Bernstein
- Department of Population Sciences, Beckman Research Institute, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Marilie D Gammon
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Harvey A Risch
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
| | - Nicholas J Shaheen
- Division of Gastroenterology and Hepatology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Brian J Reid
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Anna H Wu
- Department of Preventive Medicine, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California
| | - Prasad G Iyer
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Geoffrey Liu
- Pharmacogenomic Epidemiology, Ontario Cancer Institute, Toronto, Ontario, Canada
| | - Douglas A Corley
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - David C Whiteman
- Cancer Control, Queensland Institute of Medical Research (QIMR) Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Carlos Caldas
- Cancer Research UK, Cambridge Institute, Cambridge, United Kingdom
| | - Paul D Pharoah
- Department of Oncology, University of Cambridge, Cambridge, United Kingdom; Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Laura J Hardie
- Division of Epidemiology, Leeds Institute of Cardiovascular and Metabolic Medicine, School of Medicine, University of Leeds, Leeds, United Kingdom
| | - Rebecca C Fitzgerald
- Medical Research Council Cancer Unit, Hutchison-Medical Research Council Research Centre, University of Cambridge, Cambridge, United Kingdom
| | - Hongbing Shen
- Department of Epidemiology and Biostatistics, International Joint Research Center on Environment and Human Health, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China; Jiangsu Key Lab of Cancer Biomarkers, Prevention, and Treatment, Collaborative Innovation Center for Cancer Medicine, Nanjing Medical University, Nanjing, China
| | - Thomas L Vaughan
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Jesper Lagergren
- Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden; School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
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Passet-Wittig J, Bujard M, McQuillan J, Greil AL. Is perception of inability to procreate a temporal phenomenon?: A longitudinal exploration of changes and determinants among women and men of reproductive age in Germany. ADVANCES IN LIFE COURSE RESEARCH 2020; 45:100339. [PMID: 36698273 DOI: 10.1016/j.alcr.2020.100339] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 03/16/2020] [Accepted: 03/16/2020] [Indexed: 06/17/2023]
Abstract
Continued postponement of births and increasing use of reproductive medicine enhance the relevance of infertility and related perceptions for fertility research. Fertility researchers tend to assume that an existing perception of inability to procreate is a stable trait among persons of reproductive age. This assumption is questionable from a life course perspective and has not been thoroughly investigated. Therefore we investigate the prevalence, stability, and correlates of perceived inability to procreate. We apply between-within logit models to annual panel data (2008-2015) to study variation in perceived inability to procreate within individuals over time and between individuals. We find that approximately every 20th person of reproductive age is affected. There is considerable instability among those who ever perceive an inability to procreate: On average, 39 % of women and 48 % of men who perceive an inability in one year change to not perceiving an inability in the next year. Multivariate analysis shows that increases in age and perception of one's partner as unable to procreate are associated with higher odds of perceiving an inability to procreate. Not using contraception is associated with higher odds of perceiving an inability to procreate. Perceived procreative ability further differs by parity, level of education, immigration background, and religious denomination. In summary, perception of inability to procreate is a temporal phenomenon that is shaped by lifecourse contexts and social group differences.
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Affiliation(s)
- Jasmin Passet-Wittig
- Federal Institute for Population Research, Friedrich-Ebert-Allee 4, 65185, Wiesbaden, Germany.
| | - Martin Bujard
- Federal Institute for Population Research, Friedrich-Ebert-Allee 4, 65185, Wiesbaden, Germany
| | - Julia McQuillan
- Department of Sociology, University of Nebraska-Lincoln, 709 Oldfather Hall, Lincoln, NE, 68588-0324, USA
| | - Arthur L Greil
- Liberal Arts & Sciences, 1 Saxon Drive, Alfred, NY, 14802, Alfred University, USA
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Yang L, Lin X, Tang H, Fan Y, Zeng S, Jia L, Li Y, Shi Y, He S, Wang H, Hu Z, Gong X, Liang X, Yang Y, Liu X. Mitochondrial DNA mutation exacerbates female reproductive aging via impairment of the NADH/NAD + redox. Aging Cell 2020; 19:e13206. [PMID: 32744417 PMCID: PMC7511885 DOI: 10.1111/acel.13206] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/17/2020] [Accepted: 06/28/2020] [Indexed: 12/24/2022] Open
Abstract
Mammals' aging is correlated with the accumulation of somatic heteroplasmic mitochondrial DNA (mtDNA) mutations. Whether and how aging accumulated mtDNA mutations modulate fertility remains unknown. Here, we analyzed oocyte quality of young (≤30 years old) and elder (≥38 years old) female patients and show the elder group had lower blastocyst formation rate and more mtDNA point mutations in oocytes. To test the causal role of mtDNA point mutations on infertility, we used polymerase gamma (POLG) mutator mice. We show that mtDNA mutation levels inversely correlate with fertility, interestingly mainly affecting not male but female fertility. mtDNA mutations decrease female mice's fertility by reducing ovarian primordial and mature follicles. Mechanistically, accumulation of mtDNA mutations decreases fertility by impairing oocyte's NADH/NAD+ redox state, which could be rescued by nicotinamide mononucleotide treatment. For the first time, we answer the fundamental question of the causal effect of age-accumulated mtDNA mutations on fertility and its sex dependence, and show its distinct metabolic controlling mechanism.
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Affiliation(s)
- Liang Yang
- CAS Key Laboratory of Regenerative Biology Joint School of Life Sciences Hefei Institute of Stem Cell and Regenerative Medicine Guangzhou Institutes of Biomedicine and Health Chinese Academy of SciencesGuangzhou Medical University Guangzhou China
- Guangzhou Regenerative Medicine and Health Guangdong Laboratory Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine South China Institute for Stem Cell Biology and Regenerative Medicine Institute for Stem Cell and Regeneration Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China; University of Chinese Academy of Sciences Beijing China
| | - Xiaobing Lin
- CAS Key Laboratory of Regenerative Biology Joint School of Life Sciences Hefei Institute of Stem Cell and Regenerative Medicine Guangzhou Institutes of Biomedicine and Health Chinese Academy of SciencesGuangzhou Medical University Guangzhou China
- Guangzhou Regenerative Medicine and Health Guangdong Laboratory Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine South China Institute for Stem Cell Biology and Regenerative Medicine Institute for Stem Cell and Regeneration Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China; University of Chinese Academy of Sciences Beijing China
| | - Haite Tang
- CAS Key Laboratory of Regenerative Biology Joint School of Life Sciences Hefei Institute of Stem Cell and Regenerative Medicine Guangzhou Institutes of Biomedicine and Health Chinese Academy of SciencesGuangzhou Medical University Guangzhou China
- Guangzhou Regenerative Medicine and Health Guangdong Laboratory Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine South China Institute for Stem Cell Biology and Regenerative Medicine Institute for Stem Cell and Regeneration Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China; University of Chinese Academy of Sciences Beijing China
| | - Yuting Fan
- The Sixth Affiliated Hospital of Sun Yat‐sen University Guangzhou China
| | - Sheng Zeng
- State Key Laboratory of Respiratory Disease Guangzhou Regenerative Medicine and Health Guangdong Laboratory Guangzhou Institutes of Biomedicine and Health Chinese Academy of Sciences Guangzhou China
| | - Lei Jia
- The Sixth Affiliated Hospital of Sun Yat‐sen University Guangzhou China
| | - Yukun Li
- CAS Key Laboratory of Regenerative Biology Joint School of Life Sciences Hefei Institute of Stem Cell and Regenerative Medicine Guangzhou Institutes of Biomedicine and Health Chinese Academy of SciencesGuangzhou Medical University Guangzhou China
- Guangzhou Regenerative Medicine and Health Guangdong Laboratory Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine South China Institute for Stem Cell Biology and Regenerative Medicine Institute for Stem Cell and Regeneration Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China; University of Chinese Academy of Sciences Beijing China
| | - Yanan Shi
- The Sixth Affiliated Hospital of Sun Yat‐sen University Guangzhou China
| | - Shujing He
- The Sixth Affiliated Hospital of Sun Yat‐sen University Guangzhou China
| | - Hao Wang
- CAS Key Laboratory of Regenerative Biology Joint School of Life Sciences Hefei Institute of Stem Cell and Regenerative Medicine Guangzhou Institutes of Biomedicine and Health Chinese Academy of SciencesGuangzhou Medical University Guangzhou China
- Guangzhou Regenerative Medicine and Health Guangdong Laboratory Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine South China Institute for Stem Cell Biology and Regenerative Medicine Institute for Stem Cell and Regeneration Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China; University of Chinese Academy of Sciences Beijing China
| | - Zhijuan Hu
- CAS Key Laboratory of Regenerative Biology Joint School of Life Sciences Hefei Institute of Stem Cell and Regenerative Medicine Guangzhou Institutes of Biomedicine and Health Chinese Academy of SciencesGuangzhou Medical University Guangzhou China
- Guangzhou Regenerative Medicine and Health Guangdong Laboratory Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine South China Institute for Stem Cell Biology and Regenerative Medicine Institute for Stem Cell and Regeneration Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China; University of Chinese Academy of Sciences Beijing China
| | - Xiao Gong
- Department of Epidemiology and Biostatistics School of Public Health Guangdong Pharmaceutical University Guangzhou China
| | - Xiaoyan Liang
- The Sixth Affiliated Hospital of Sun Yat‐sen University Guangzhou China
| | - Yi Yang
- Synthetic Biology and Biotechnology Laboratory State Key Laboratory of Bioreactor Engineering Shanghai Collaborative Innovation Center for Biomanufacturing Technology East China University of Science and Technology Shanghai China
| | - Xingguo Liu
- CAS Key Laboratory of Regenerative Biology Joint School of Life Sciences Hefei Institute of Stem Cell and Regenerative Medicine Guangzhou Institutes of Biomedicine and Health Chinese Academy of SciencesGuangzhou Medical University Guangzhou China
- Guangzhou Regenerative Medicine and Health Guangdong Laboratory Guangdong Provincial Key Laboratory of Stem Cell and Regenerative Medicine South China Institute for Stem Cell Biology and Regenerative Medicine Institute for Stem Cell and Regeneration Guangzhou Institutes of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, China; University of Chinese Academy of Sciences Beijing China
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Kanda A, Nobukiyo A, Sotomaru Y. Effect of Cetrorelix administration on ovarian stimulation in aged mice. Exp Anim 2020; 70:31-36. [PMID: 32863284 PMCID: PMC7887618 DOI: 10.1538/expanim.20-0058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
In mice, ovarian stimulation via hormone administration is an effective method for
obtaining many ova simultaneously, but its effect is reduced by the influence of aging. In
this study, we demonstrate that this problem can be improved by administering the
gonadotropin-releasing hormone antagonist Cetrorelix prior to ovarian stimulation. Before
12-month-old female mice were injected with 5 IU pregnant mare serum gonadotropin and 5 IU
human chorionic gonadotropin, we administered 5 µg/kg Cetrorelix for 7
consecutive days (7 times) or 3 times once every 3 days. As a result, 8.7 ± 1.9 (mean ±
SEM, n=10) and 9.8 ± 1.3 (n=10) oocytes were obtained, respectively, as opposed to 4.7 ±
1.2 oocytes (n=9) in the case of no administration. Collagen staining of ovarian tissue
showed that Cetrorelix administration reduced the degree of fibrosis, which improved
ovarian function. In addition, equivalent fertilization and fetal development rates
between control and Cetrorelix-treated aged mouse-derived oocytes were confirmed by
in vitro fertilization and embryo transfer (Fertilization rate;
control: 92.2% vs. 3 times: 96.9%/7 times: 88.5%, Birth rate; control: 56.4% vs. 3 times:
58.3%/7 times: 51.8%), indicating the normality of the obtained oocytes. It is concluded
that Cetrorelix improved the effect of superovulation in aged mice without reducing oocyte
quality. This procedure will contribute to animal welfare by extending the effective
utilization of aged female breeding mice.
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Affiliation(s)
- Akifumi Kanda
- Natural Science Center for Basic Research and Development, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Asako Nobukiyo
- Natural Science Center for Basic Research and Development, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Yusuke Sotomaru
- Natural Science Center for Basic Research and Development, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
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Pericuesta E, Laguna-Barraza R, Ramos-Ibeas P, Gutierrez-Arroyo JL, Navarro JA, Vera K, Sanjuan C, Baixeras E, de Fonseca FR, Gutierrez-Adan A. D-Chiro-Inositol Treatment Affects Oocyte and Embryo Quality and Improves Glucose Intolerance in Both Aged Mice and Mouse Models of Polycystic Ovarian Syndrome. Int J Mol Sci 2020; 21:E6049. [PMID: 32842637 PMCID: PMC7504697 DOI: 10.3390/ijms21176049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/17/2020] [Accepted: 08/20/2020] [Indexed: 12/15/2022] Open
Abstract
Polycystic ovarian syndrome (PCOS) is the main cause of female infertility. It is a multifactorial disorder with varying clinical manifestations including metabolic/endocrine abnormalities, hyperandrogenism, and ovarian cysts, among other conditions. D-Chiro-inositol (DCI) is the main treatment available for PCOS in humans. To address some of the mechanisms of this complex disorder and its treatment, this study examines the effect of DCI on reproduction during the development of different PCOS-associated phenotypes in aged females and two mouse models of PCOS. Aged females (8 months old) were treated or not (control) with DCI for 2 months. PCOS models were generated by treatment with dihydrotestosterone (DHT) on Days 16, 17, and 18 of gestation, or by testosterone propionate (TP) treatment on the first day of life. At two months of age, PCOS mice were treated with DCI for 2 months and their reproductive parameters analyzed. No effects of DCI treatment were produced on body weight or ovary/body weight ratio. However, treatment reduced the number of follicles with an atretic cyst-like appearance and improved embryo development in the PCOS models, and also increased implantation rates in both aged and PCOS mice. DCI modified the expression of genes related to oocyte quality, oxidative stress, and luteal sufficiency in cumulus-oocyte complexes (COCs) obtained from the aged and PCOS models. Further, the phosphorylation of AKT, a main metabolic sensor activated by insulin in the liver, was enhanced only in the DHT group, which was the only PCOS model showing glucose intolerance and AKT dephosphorylation. The effect of DCI in the TP model seemed mediated by its influence on oxidative stress and follicle insufficiency. Our results indicate that DCI works in preclinical models of PCOS and offer insight into its mechanism of action when used to treat this infertility-associated syndrome.
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Affiliation(s)
- Eva Pericuesta
- Departamento de Reproducción Animal, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA), 28040 Madrid, Spain; (E.P.); (R.L.-B.); (P.R.-I.); (J.L.G.-A.)
| | - Ricardo Laguna-Barraza
- Departamento de Reproducción Animal, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA), 28040 Madrid, Spain; (E.P.); (R.L.-B.); (P.R.-I.); (J.L.G.-A.)
| | - Priscila Ramos-Ibeas
- Departamento de Reproducción Animal, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA), 28040 Madrid, Spain; (E.P.); (R.L.-B.); (P.R.-I.); (J.L.G.-A.)
| | - Julia L. Gutierrez-Arroyo
- Departamento de Reproducción Animal, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA), 28040 Madrid, Spain; (E.P.); (R.L.-B.); (P.R.-I.); (J.L.G.-A.)
| | - Juan A. Navarro
- Laboratorio de Neuropsicofarmacología, Unidad de Gestión Clínica de Salud Mental, Instituto IBIMA, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain; (J.A.N.); (K.V.); (F.R.d.F.)
| | - Katia Vera
- Laboratorio de Neuropsicofarmacología, Unidad de Gestión Clínica de Salud Mental, Instituto IBIMA, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain; (J.A.N.); (K.V.); (F.R.d.F.)
| | - Carlos Sanjuan
- Euronutra S.L., Calle Johannes Kepler 3, 29590 Málaga, Spain;
| | - Elena Baixeras
- Departamento de Bioquímica y Biología Molecular, Facultad de Medicina, Universidad de Málaga, 29010 Málaga, Spain;
| | - Fernando Rodríguez de Fonseca
- Laboratorio de Neuropsicofarmacología, Unidad de Gestión Clínica de Salud Mental, Instituto IBIMA, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain; (J.A.N.); (K.V.); (F.R.d.F.)
| | - Alfonso Gutierrez-Adan
- Departamento de Reproducción Animal, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria (INIA), 28040 Madrid, Spain; (E.P.); (R.L.-B.); (P.R.-I.); (J.L.G.-A.)
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Association of Infertility Treatment with Perception of Infant Crying, Bonding Impairment and Abusive Behavior towards One's Infant: A Propensity-Score Matched Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176099. [PMID: 32825723 PMCID: PMC7503237 DOI: 10.3390/ijerph17176099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 11/17/2022]
Abstract
Background: Although previous qualitative studies suggested the link between infertility treatment and negative emotions towards infants, few empirical population-based studies have investigated the association of infertility treatment with the perception of infant crying, bonding impairment, and abusive behavior towards one’s infant. Methods: Women who participated in a four month health-checkup program in Aichi Prefecture, Japan (n = 6590) were asked to a complete a questionnaire that included infertility treatment history, perception of infant crying, maternal–infant bonding impairment assessed by the Mother to Infant Bonding Scale Japanese version, and abusive behavior towards one’s infant. Outcomes were dichotomized, and a conditional logistic regression was applied, using the propensity score match for infertility treatment exposure adjusted for known covariates. Results: A total of 690 participants (11.1%) reported infertility treatment history, and 625 cases were matched. We found that mothers with infertility treatment history were 1.36 times more likely to perceive a higher frequency of infant crying (95% confidence interval (CI):1.05–1.78), but no association with maternal–infant bonding impairment (odds ratio (OR): 1.18; 95% CI: 0.81–1.72) and abusive behavior towards the infant (OR: 0.82; 95% CI: 0.49–1.36). Conclusions: Infertility treatment may be associated with the perception of a higher frequency of infant crying, but it is not associated with bonding impairment and abusive behavior. Further longitudinal study is needed to replicate the findings.
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96
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Blasco V, Pinto FM, Fernández-Atucha A, González-Ravina C, Fernández-Sánchez M, Candenas L. Female infertility is associated with an altered expression of the neurokinin B/neurokinin B receptor and kisspeptin/kisspeptin receptor systems in ovarian granulosa and cumulus cells. Fertil Steril 2020; 114:869-878. [PMID: 32811673 DOI: 10.1016/j.fertnstert.2020.05.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/17/2020] [Accepted: 05/05/2020] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To analyze and compare the expression profile of TAC3, TACR3, KISS1, and KISS1R in mural granulosa and cumulus cells from healthy oocyte donors and patients with different infertility etiologies, including advanced maternal age, endometriosis, and low ovarian response. DESIGN Genetic association study. SETTING Private fertility clinic and public research laboratory. PATIENT(S) Healthy oocyte donors and infertile women undergoing in vitro fertilization (IVF) treatment. INTERVENTION(S) IVF. MAIN OUTCOME MEASURE(S) Gene expression levels of KISS1, KISS1R, TAC3, and TACR3 in human mural granulosa and cumulus cells. RESULT(S) Infertile women showed statistically significantly altered expression levels of KISS1 (-2.57 ± 2.30 vs. -1.37 ± 2.11), TAC3 (-1.21 ± 1.40 vs. -1.49 ± 1.98), and TACR3 (-0.77 ± 1.36 vs. -0.03 ± 0.56) when compared with healthy oocyte donors. Advanced maternal age patients, endometriosis patients, and low responders showed specific and altered expression profiles in comparison with oocyte donors. CONCLUSION(S) Abnormal expression levels of KISS1/KISS1R and TAC3/TACR3 systems in granulosa cells might be involved in the decreased fertility associated to advanced maternal age, endometriosis, and low ovarian response.
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Affiliation(s)
- Victor Blasco
- Instituto de Investigaciones Químicas, CSIC, Seville, Spain; IVI-RMA Seville, Seville, Spain
| | | | | | | | - Manuel Fernández-Sánchez
- IVI-RMA Seville, Seville, Spain; IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain; Departamento de Cirugía, Universidad de Sevilla, Seville, Spain; Departamento de Biología Molecular e Ingeniería Bioquímica, Universidad Pablo de Olavide, Seville, Spain.
| | - Luz Candenas
- Instituto de Investigaciones Químicas, CSIC, Seville, Spain
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97
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Bernardi LA, Luck M, Kyweluk MA, Feinberg EC. Knowledge gaps in the understanding of fertility among non-medical graduate students. F S Rep 2020; 1:177-185. [PMID: 34223241 PMCID: PMC8244259 DOI: 10.1016/j.xfre.2020.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/03/2020] [Accepted: 08/01/2020] [Indexed: 11/24/2022] Open
Abstract
Objective To assess knowledge of female and male fertility among students enrolled in a Master of Business Administration (MBA) program. Design Web-based cross-sectional survey. Setting Academic setting. Patient(s) Not applicable. Intervention(s) None. Main Outcome Measure(s) Knowledge of how female and male age impacts reproduction, fecundability, and success rates with in vitro fertilization (IVF). Result(s) A total of 133 female and male MBA students completed the survey. Nearly 10% of participants were not aware that women are born with a fixed number of oocytes and that oocyte quantity and quality decline with age. More than 30% of participants overestimated fecundability in women aged ≥35 years, and >50% overestimated IVF success rates in women older than 40 years. Fifteen percent of participants did not know that men have stem cells in the testes, and >25% were not aware that men experience a decrease in sperm concentration and quality with age. Nearly 30% believed that a man’s age never impacts reproductive outcomes. Less than 30% of participants correctly estimated fecundability and IVF success rates based on male age. Conclusion(s) These data highlight important knowledge gaps in a highly educated group of MBA students, most whom desire future childbearing. Specifically, there is a lack of understanding of both male and female reproductive aging and an overestimation of treatment success. As delayed childbearing continues, particularly among those with high educational attainment, attention should be focused on introducing broad fertility education at a younger age to improve future reproductive success.
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Affiliation(s)
- Lia A Bernardi
- Division of Reproductive Endocrinology and Infertility, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Marissa Luck
- Division of Reproductive Endocrinology and Infertility, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Moira A Kyweluk
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Eve C Feinberg
- Division of Reproductive Endocrinology and Infertility, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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98
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Musa S, Osman S. Risk profile of Qatari women treated for infertility in a tertiary hospital: a case-control study. FERTILITY RESEARCH AND PRACTICE 2020; 6:12. [PMID: 32742710 PMCID: PMC7385950 DOI: 10.1186/s40738-020-00080-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 06/25/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Female infertility is a multifactorial condition constituting a worldwide public health problem. The ability to reproduce is an important product of any marriage, hence infertility may exert a negative impact on physical, financial, social and emotional wellbeing of affected couples. The cornerstone to the management of any disease, including infertility, is prevention. Identifying the modifiable risk factors of female infertility will aid at prevention, early detection, and treatment of medical conditions that can threaten fertility as well as promoting healthy behaviours that can preserve it. AIM To explore the risk profile of infertility among Qatari women and compare risk factors distribution among primary vs. secondary infertility. METHODOLOGY A hospital-based case control study was conducted from September 17th, 2017- February 10th, 2018. Cases (n = 136) were enrolled from infertility clinic and controls (pregnant women, n = 272), were enrolled from antenatal clinic, Women Hospital, Hamad Medical Corporation (HMC). Interview questionnaire was utilized to collect data about sociodemographic, risk factors related to infertility and patient health Questionnaire (PHQ)-2. Body Mass Index (BMI) was calculated. Logistic regression was used to identify the associated factors to infertility. Statistical significance was set at 0.05. RESULTS Forty three primary and ninety three secondary infertility cases were included. Risk factors were age > 35 years (OR = 3.7, 95% CI: 1.41-9.83), second-hand smoking (OR = 2.44, 95% CI:1.26-4.73), steady weight gain (OR = 4.65,, 95% CI: 2.43-8.91), recent weight gain (OR = 4.87, 95% CI: 2.54-9.32), menstrual cycle irregularities (OR = 4.20, 95% CI:1.14-15.49), fallopian tube blockage (OR = 5.45, 95% CI: 1.75-16.95), and symptoms suggestive of sexually transmitted infections (STIs) including chronic lower abdominal/pelvic pain (OR = 3.46, 95% CI: 1.57-7.63), abnormal vaginal discharge (OR = 3.32, 95% CI:1.22-9.03) and dyspareunia (OR = 7.04, 95% CI: 2.76-17.95). Predictive factors for secondary infertility were; longer time from previous conception (OR = 5.8, 95% CI: 3.28-10.21), history of stillbirth (OR = 2.63, 95% CI: 1.04-6.67) or miscarriage (OR = 2.11, 95% CI: 1.21-3.68) and postpartum infection (OR = 3.75, 95% CI: 1.27-11.06). Protective factors were higher education level (OR = 0.44, 95% CI: 0.25-0.78), higher income (OR = 0.17, 95% CI: 0.06-0.49), and awareness/loyalty to fertility window (OR = 0.33, 95% CI: 0.21-0.52 and OR = 0.29, 95% CI: 0.19-0.44, consequently). CONCLUSION This study highlighted the opportunities to strengthen public health as well as hospital-based health promotion programs importantly toward behavioural-related risk factors (e.g. smoking, obesity, STIs etc.). Moreover, detecting, preventing, and managing modifiable risk factors through awareness, screening and early management of chronic diseases, may contribute at reduction of incidence and severity of infertility. Such interventions can be delivered at premarital, family planning, post-natal and antenatal clinics at primary health care with early referral to secondary care if required.
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Affiliation(s)
- Sarah Musa
- Department of Family & Community Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Sherif Osman
- Department of Tropical Health, High Institute of Public Health, Alexandria University, Alexandria, Egypt
- Department of Family & Community Medicine, Primary Health Care Corporation, Doha, Qatar
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99
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Maldonado-Cárceles AB, Mínguez-Alarcón L, Souter I, Gaskins AJ, Arvizu M, Williams PL, Ford JB, Chavarro JE. Dietary patterns and ovarian reserve among women attending a fertility clinic. Fertil Steril 2020; 114:610-617. [PMID: 32712021 DOI: 10.1016/j.fertnstert.2020.04.030] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 03/28/2020] [Accepted: 04/14/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To investigate the associations between dietary patterns and antral follicle count (AFC), a marker of ovarian reserve. DESIGN Prospective cohort study. SETTING Fertility center at an academic hospital. PATIENT(S) A total of 363 women seeking preconception evaluation and infertility care at the Massachusetts General Hospital who participated in the Environment and Reproductive Health Study. INTERVENTION(S) None. At enrollment, women reported diet through a food frequency questionnaire, from which we computed three dietary pattern adherence scores: the Mediterranean diet, the Fertility diet, and the Profertility diet. MAIN OUTCOME MEASURE(S) The AFC was assessed with a transvaginal ultrasound performed on the third day of an unstimulated menstrual cycle or on the third day of a P withdrawal bleed. RESULT(S) Higher adherence to the three dietary patterns examined were unrelated to AFC. The multivariable adjusted AFC means and 95% confidence intervals for women in the highest compared with the lowest quartile of adherence score were 13.9 (13.0-14.9) and 13.5 (12.6-14.4) for the Mediterranean diet, 14.0 (13.2-14.9) and 13.5 (12.7-14.3) for the Fertility diet, and 12.5 (11.6-13.5) and 13.3 (12.5-14.2) for the Profertility diet. CONCLUSION(S) Dietary patterns were unrelated to AFC among a cohort of women presenting at a fertility center. Due to the limited and heterogeneous current evidence, it is important to evaluate this association in further studies, and in particular among women from the general population.
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Affiliation(s)
- Ana B Maldonado-Cárceles
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Health and Social Sciences, Division of Preventive Medicine and Public Health, University of Murcia School of Medicine, Murcia, Spain.
| | - Lidia Mínguez-Alarcón
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Irene Souter
- Massachusetts General Hospital Fertility Center and Harvard Medical School, Boston, Massachusetts
| | - Audrey J Gaskins
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Mariel Arvizu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Paige L Williams
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jennifer B Ford
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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100
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Popovic M, Bialecka M, Gomes Fernandes M, Taelman J, Van Der Jeught M, De Sutter P, Heindryckx B, Chuva De Sousa Lopes SM. Human blastocyst outgrowths recapitulate primordial germ cell specification events. Mol Hum Reprod 2020; 25:519-526. [PMID: 31211841 PMCID: PMC6802404 DOI: 10.1093/molehr/gaz035] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 04/29/2019] [Indexed: 01/08/2023] Open
Abstract
Our current knowledge of the mechanisms leading to human primordial germ cell (PGC) specification stems solely from differentiation experiments starting from human pluripotent stem cells. However, information regarding the origin of PGCs in vivo remains obscure. Here we apply an improved system for extended in vitro culture of human embryos to investigate the presence of PGC-like cells (PGCLCs) 12 days post fertilization (dpf). Good quality blastocysts (n = 141) were plated at 6 dpf and maintained in hypoxia, in medium supplemented with Activin A until 12 dpf. We primarily reveal that 12 dpf outgrowths recapitulate human peri-implantation events and demonstrate that blastocyst quality significantly impacts both embryo viability at 12 dpf, as well as the presence of POU5F1+ cells within viable outgrowths. Moreover, detailed examination of 12 dpf blastocyst outgrowths revealed a population of POU5F1+, SOX2– and SOX17+ cells that may correspond to PGCLCs, alongside POU5F1+ epiblast-like cells and GATA6+ endoderm-like cells. Our findings suggest that, in human, PGC precursors may become specified within the epiblast and migrate either transiently to the extra-embryonic mesoderm or directly to the dorsal part of the yolk sac endoderm around 12 dpf. This is a descriptive analysis and as such the conclusion that POU5F1+ and SOX17+ cells represent bona fide PGCs can only be considered as preliminary. In the future, other PGC markers may be used to further validate the observed cell populations. Overall, our findings provide insights into the origin of the human germline and may serve as a foundation to further unravel the molecular mechanisms governing PGC specification in human.
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Affiliation(s)
- Mina Popovic
- Ghent Fertility And Stem cell Team (G-FAST), Department of Reproductive Medicine, Ghent University Hospital, Ghent, Belgium
| | - Monika Bialecka
- Department of Anatomy and Embryology, Leiden University Medical Center, Einthovenweg, Leiden, The Netherlands
| | - Maria Gomes Fernandes
- Department of Anatomy and Embryology, Leiden University Medical Center, Einthovenweg, Leiden, The Netherlands
| | - Jasin Taelman
- Ghent Fertility And Stem cell Team (G-FAST), Department of Reproductive Medicine, Ghent University Hospital, Ghent, Belgium.,Department of Anatomy and Embryology, Leiden University Medical Center, Einthovenweg, Leiden, The Netherlands
| | - Margot Van Der Jeught
- Ghent Fertility And Stem cell Team (G-FAST), Department of Reproductive Medicine, Ghent University Hospital, Ghent, Belgium
| | - Petra De Sutter
- Ghent Fertility And Stem cell Team (G-FAST), Department of Reproductive Medicine, Ghent University Hospital, Ghent, Belgium
| | - Björn Heindryckx
- Ghent Fertility And Stem cell Team (G-FAST), Department of Reproductive Medicine, Ghent University Hospital, Ghent, Belgium
| | - Susana M Chuva De Sousa Lopes
- Ghent Fertility And Stem cell Team (G-FAST), Department of Reproductive Medicine, Ghent University Hospital, Ghent, Belgium.,Department of Anatomy and Embryology, Leiden University Medical Center, Einthovenweg, Leiden, The Netherlands
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