1
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Fan J, Chen C, Zhong Y. A cohort study on IVF outcomes in infertile endometriosis patients: the effects of rapamycin treatment. Reprod Biomed Online 2024; 48:103319. [PMID: 37914557 DOI: 10.1016/j.rbmo.2023.103319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/18/2023] [Accepted: 07/25/2023] [Indexed: 11/03/2023]
Abstract
RESEARCH QUESTION Can rapamycin, used as an anti-senescence drug before IVF cycles, improve the IVF outcomes of women with endometriosis by reducing oxidative stress and senescence? DESIGN This retrospective analysis involved 168 endometriosis patients undergoing two successive IVF cycles. The treatment group (n = 80) received 3 months of rapamycin before the second IVF cycle, while the non-treatment group (n = 88) had no adjuvant treatment. The first and second IVF cycles were compared between and within groups. Follicular fluid from both IVF cycles (treatment group n = 28, non-treatment group n = 32) were tested for senescence-associated and oxidative stress-related markers. RESULTS Comparing the follicular fluid from the second cycles, the rapamycin treatment group showed decreased markers of oxidative stress (8-hydroxydesoxyguanosine, malondialdehyde) and increased antioxidant markers (superoxidase dismutase, glutathione peroxidase) (all P < 0.001); the expression of senescence-related markers p16 and p21 was also significantly lower in the treatment group than in the non-treatment group (P < 0.001). Comparing the second IVF cycles, the treatment group needed fewer days of ovarian stimulation, with increased numbers of oocytes obtained and mature oocytes compared with the non-treatment group (all P < 0.001). Furthermore, rates of fertilization, implantation and clinical pregnancy were significantly higher in the treatment group (P = 0.008, 0.034 and 0.038 respectively), as was the live birth rate (P = 0.003). No structural abnormalities were seen in fetuses born to women treated with rapamycin. CONCLUSIONS This study suggested an association between short-term rapamycin treatment and improved pregnancy outcomes via IVF. This result needs to be further investigated in prospective randomized controlled clinical trials.
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Affiliation(s)
- Jiao Fan
- Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
| | - Cuina Chen
- Dongguan Donghua Hospital, Dongguan, China
| | - Yiping Zhong
- The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
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2
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Barroso-Villa G, Valdespin-Fierro C, Weiser-Smeke AE, Machargo-Gordillo AP, Flores-Pliego A, Palma-Lara I, Oehninger S. Follicular fluid biomarkers for prediction of human IVF outcome in women with poor ovarian response. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2023. [DOI: 10.1186/s43043-023-00128-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Abstract
Background
The aim of controlled ovarian stimulation is to achieve an optimal number of mature oocytes to obtain good-quality embryos. High follicular fluid (FF) concentrations of FSH, hCG, and LH promote oocyte maturation and are associated with a higher probability of fertilization. LH concentrations in FF are consistently higher in follicles that will lead to a successful IVF outcome. The levels of some of these FF biomarkers may vary among different ovarian stimulation schemes; however, the effects of corifollitropin alfa, recombinant FSH (rFSH), LH (rLH), and highly purified urinary menotropins uhMG on these biomarkers are still unknown. The objective of this study was to characterize the profile of FF biomarkers (leptin, vascular endothelial growth factor (VEGF), metalloproteinases (MMPs), and NO2−/NO3−) according to three different protocols of controlled ovarian stimulation (COS) in poor ovarian responders (POR) and to evaluate the association between these profiles and clinical outcomes. Three groups of POR patients were examined according to the protocols used.
Results
Group C showed significant higher levels in all biomarkers (p < 0001). FF samples from Group B had the lowest levels of VEGF and Pro-MMP-9. Group A showed the lowest concentration of pro-MMP-2. The VEGF level and number of captured oocytes were positively correlated in Group C (r = 0.534, p = 0.01). MMP-9 and fertilization rate were negatively correlated in Group C (r = −0.476, p = 0.02). We found negative correlations between proMMP-2 and serum estradiol levels on the day of rhCG administration.
Conclusion
We found significant variations in the biomarker concentrations between the different controlled ovarian stimulation schemes used in POR patients. These differences can be potentially explained by the nature and composition of the gonadotropins. Our results support the hypothesis that some of these molecules should be thoroughly investigated as noninvasive predictors of egg quality.
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3
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Ansariniya H, Yavari A, Javaheri A, Zare F. Oxidative stress-related effects on various aspects of endometriosis. Am J Reprod Immunol 2022; 88:e13593. [PMID: 35781369 DOI: 10.1111/aji.13593] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 06/14/2022] [Accepted: 06/25/2022] [Indexed: 11/26/2022] Open
Abstract
Endometriosis is a chronic and relatively common disease in women of childbearing age. Complications of this disease include a wide range of disorders. The cause of this disease is not known for sure, but several hypotheses have been proposed for it. In this disease, the entry of endometrial tissues into the peritoneal cavity causes oxidative stress through the Fenton reaction and inflammation in this site. Oxidative stress can be associated with many complications of endometriosis. In this review, an attempt has been made to discuss the effects of oxidative stress on various complications of this disease. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Hossein Ansariniya
- Department of Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Reproductive Immunology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Abolfazl Yavari
- Reproductive Immunology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Atiyeh Javaheri
- Reproductive Immunology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Obstetrics and Gynecology, Faculty of Medicine, Shahid Sadughi University of Medical Sciences, Yazd, Iran
| | - Fateme Zare
- Reproductive Immunology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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4
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Wu S, Hu S, Fan W, Zhang X, Wang H, Li C, Deng J. Nitrite exposure may induce infertility in mice. J Toxicol Pathol 2022; 35:75-82. [PMID: 35221497 PMCID: PMC8828601 DOI: 10.1293/tox.2021-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 10/26/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Shanshan Wu
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, 26 Jingwu Road, Zhengzhou 450002, China
| | - Sang Hu
- Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Wenjuan Fan
- Luohe Medical College, Luohe City, Henan Province, China
| | - Xiaojing Zhang
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, 26 Jingwu Road, Zhengzhou 450002, China
| | - Haili Wang
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, 26 Jingwu Road, Zhengzhou 450002, China
| | - Chaojie Li
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, 26 Jingwu Road, Zhengzhou 450002, China
| | - Jinbo Deng
- National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, 26 Jingwu Road, Zhengzhou 450002, China
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5
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Staicu FD, Canha-Gouveia A, Soriano-Úbeda C, Martínez-Soto JC, Adoamnei E, Chavarro JE, Matás C. Nitrite and Nitrate Levels in Follicular Fluid From Human Oocyte Donors Are Related to Ovarian Response and Embryo Quality. Front Cell Dev Biol 2021; 9:647002. [PMID: 33937241 PMCID: PMC8079729 DOI: 10.3389/fcell.2021.647002] [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: 12/28/2020] [Accepted: 03/08/2021] [Indexed: 12/14/2022] Open
Abstract
Nitric oxide, a key regulatory molecule in the follicular fluid, has been suggested as a possible biomarker to predict ovarian response in stimulated cycles and the potential of the retrieved oocytes for developing high-quality embryos. Nevertheless, a consensus on whether or not nitric oxide can help in this context has not been reached. We simultaneously measured the oxidation products of nitric oxide, nitrite, and nitrate, via high-performance liquid chromatography (HPLC)-UV in follicular fluid samples from 72 oocyte donors. We found no associations of follicular fluid nitrite, nitrate, total nitric oxide, or nitrate/nitrite ratio with total or metaphase II (MII) oocyte yield. However, nitrite and nitrate levels were related to the yield of MII oocytes when this outcome was expressed as a proportion of all oocytes retrieved. The adjusted MII proportion in the lowest and highest nitrite levels were 68% (58–77%) and 79% (70–85%), respectively (p, linear trend = 0.02), whereas the adjusted MII proportion in extreme tertiles of nitrate levels were 79% (70–85%) and 68% (57–77%) (p, linear trend = 0.03). In addition, nitrate levels showed a suggestive inverse correlation with embryos with maximum or high potential of implantation (p = 0.07). These results suggest that the follicular fluid concentrations of nitrite and nitrate may be a useful tool in predicting how healthy oocyte donors respond to superovulation and the implantation potential of the embryos produced from their oocytes.
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Affiliation(s)
- Florentin-Daniel Staicu
- Department of Physiology, Faculty of Veterinary Science, International Excellence Campus for Higher Education and Research (Campus Mare Nostrum), University of Murcia, Murcia, Spain.,Biomedical Research Institute of Murcia (IMIB), Murcia, Spain
| | - Analuce Canha-Gouveia
- Department of Physiology, Faculty of Veterinary Science, International Excellence Campus for Higher Education and Research (Campus Mare Nostrum), University of Murcia, Murcia, Spain.,Biomedical Research Institute of Murcia (IMIB), Murcia, Spain
| | - Cristina Soriano-Úbeda
- Department of Physiology, Faculty of Veterinary Science, International Excellence Campus for Higher Education and Research (Campus Mare Nostrum), University of Murcia, Murcia, Spain.,Biomedical Research Institute of Murcia (IMIB), Murcia, Spain.,Department of Veterinary and Animal Sciences, University of Massachusetts Amherst, Amherst, MA, United States
| | | | - Evdochia Adoamnei
- Biomedical Research Institute of Murcia (IMIB), Murcia, Spain.,Department of Nursing, School of Nursing, University of Murcia, Murcia, Spain
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States.,Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Carmen Matás
- Department of Physiology, Faculty of Veterinary Science, International Excellence Campus for Higher Education and Research (Campus Mare Nostrum), University of Murcia, Murcia, Spain.,Biomedical Research Institute of Murcia (IMIB), Murcia, Spain
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6
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Lan Y, Yang X, Liang Y, Lei L, Li Y, Wang S. Vasomotor tone-associated factors and pregnancy outcomes of women who undergo in vitro fertilization. Growth Factors 2021; 39:28-36. [PMID: 34969347 DOI: 10.1080/08977194.2021.2021899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Vasomotor tone-associated factors play important roles in normal pregnancy, but their roles in the pregnancy outcome of women who undergo in vitro fertilization and embryo transfer (IVF-ET) remain unclear. A total of 82 infertile women who underwent successful IVF-ET were enrolled, including 18 pregnancy losses, 11 complications, and 53 normal deliveries. The serum NO and iNOS levels were significantly higher in the pregnancy loss group and significantly lower in the complication group than in the normal delivery group (p < 0.05). Significantly increased ET-1 and decreased PGI2 were found in both the pregnancy loss and complication groups compared with those in the normal delivery group (p < 0.05). NO, iNOS, and ET-1 are risk factors and PGI2 is a protective factor for pregnancy loss. ET-1 + PGI2 (AUC, 0.897; sensitivity, 90.6%; specificity, 83.3%) showed a relatively good predictive value for pregnancy loss following IVF-ET.
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Affiliation(s)
- Yonglian Lan
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Xiaokui Yang
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Yu Liang
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Lingling Lei
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Ying Li
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Shuyu Wang
- Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
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7
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Abstract
Advanced maternal age is associated with the natural oocyte depletion, leading to low oocyte yield, high infertility treatment cancellation rates, and eventual decreases in pregnancy rates. Various innovative interventions have been introduced to improve the outcome of infertility treatment for aging patients. Numerous published data demonstrated that early follicle development was regulated by intraovarian growth factors through autocrine or paracrine mechanisms. Platelet-rich plasma (PRP), a plasma fraction of peripheral blood with a high concentration of platelets, has been implemented in regenerative medicine in the last decade. The plasma contains a variety of growth factors that were suggested to be able to enhance angiogenesis regeneration and the cell proliferation process. The initial report showed that an intraovarian injection of PRP improved the hormonal profile and increased the number of retrieved oocytes in patients with diminished ovarian reserve. Subsequently, several studies with larger sample sizes have reported that this approach resulted in several healthy live births with no apparent complications. However, the use of ovarian PRP treatment needs to be fully investigated, because no randomized controlled trial has yet been performed to confirm its efficacy.
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8
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Sfakianoudis K, Tsioulou P, Maziotis E, Grigoriadis S, Glava A, Nitsos N, Giannelou P, Makrakis E, Pantou A, Rapani A, Koutsilieris M, Mastorakos G, Pantos K, Simopoulou M. Investigating apoptotic, inflammatory, and growth markers in poor responders undergoing natural in vitro fertilization cycles: a pilot study. Ann N Y Acad Sci 2020; 1489:78-90. [PMID: 33188643 DOI: 10.1111/nyas.14517] [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: 05/01/2020] [Revised: 08/12/2020] [Accepted: 10/07/2020] [Indexed: 11/28/2022]
Abstract
This study investigates follicular fluid (FF) from patients with poor and normal ovarian response undergoing natural assisted reproductive technology cycles. We report about (1) cell-free DNA (cfDNA), which reflects apoptosis; (2) corticotropin-releasing hormone (CRH); (3) interleukin (IL)-15, which reflects inflammation; (4) granulocyte colony-stimulating factor (G-CSF); (5) vascular endothelial growth factor (VEGF); and (6) insulin-like growth factor I (IGF-I), which reflects follicular growth. Forty-four poor responders and 44 normal responders-according to the Bologna criteria-were recruited. FF samples were prepared for cfDNA quantification employing Q-PCR and for CRH, IL-15, G-CSF, VEGF, and IGF-I quantification employing ELISA. Statistically nonsignificant different levels of FF cfDNA, CRH, IL-15, VEGF, and IGF-I were observed. Interestingly, statistically significant higher G-CSF levels were observed in normal responders (302.48 ± 474.36 versus 200.10 ± 426.79 pg/mL, P = 0.003). Lower cfDNA integrity was observed in cycles resulting in clinical pregnancy for both groups (normal: 0.07 ± 0.04 versus 0.25 ± 0.17 ng/μL, P < 0.001; poor: 0.10 ± 0.06 versus 0.26 ± 0.12 ng/μL, P < 0.001). The results predominantly showcase similarities between normal and poor responders pertaining to inflammatory, apoptotic, and growth factors. This may be attributed to the employment of natural cycles in order to exclude controlled ovarian stimulation as a factor-indicating its detrimental effect. As G-CSF levels presented significantly higher in normal responders, its vital role in understanding a compromised ovarian response is highlighted.
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Affiliation(s)
| | - Petroula Tsioulou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Maziotis
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Sokratis Grigoriadis
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Argyro Glava
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Nitsos
- Genesis Athens Clinic, Center for Human Reproduction, Athens, Greece
| | - Polina Giannelou
- Genesis Athens Clinic, Center for Human Reproduction, Athens, Greece.,Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Makrakis
- Third Department of Obstetrics and Gynecology, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Agni Pantou
- Genesis Athens Clinic, Center for Human Reproduction, Athens, Greece
| | - Anna Rapani
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Michael Koutsilieris
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Mastorakos
- Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Mara Simopoulou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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9
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Lv Y, Du S, Huang X, Hao C. Follicular fluid estradiol is an improved predictor of in vitro fertilization/intracytoplasmic sperm injection and embryo transfer outcomes. Exp Ther Med 2020; 20:131. [PMID: 33082863 PMCID: PMC7557525 DOI: 10.3892/etm.2020.9256] [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: 09/29/2018] [Accepted: 08/20/2019] [Indexed: 11/25/2022] Open
Abstract
The present study is a clinical trial analyzing follicular fluid. The current study aimed to assess whether a correlation exists among estradiol (E2), anti-Mullerian hormone (AMH) and prokineticin 1 (PROK1) levels in the follicular fluid. A total of 81 infertile patients (53 with primary infertility and 28 with secondary infertility) who received routine in vitro fertilization (IVF) and embryo transfer (ET) or intracytoplasmic sperm injection at Yuhuangding Hospital (Yantai, China) were included in the present study. On the day of egg retrieval, follicular puncture and follicular fluid extraction were performed on patients using double lumen needles under the guidance of a vaginal ultrasound. In 77 cases, follicular fluid was collected from the follicle with the largest diameter. A total of 53 cases underwent ET and subsequent pregnancy outcomes were traced. Concentrations of E2, AMH and PROK1 in the single follicular fluid specimens were determined. The concentration of E2 in follicular fluid from the largest follicles in absolute pregnancy group was significantly lower than that in absolute non-pregnancy group. The concentrations of PROK1 and AMH in follicular fluid from the largest follicles in absolute pregnancy group were not significantly different from those in absolute non-pregnancy group. The concentration of E2 was associated with the dosage of gonadotropin, but was not associated with age, AMH and PROK1 levels in follicular fluid, fertilization rate or number of usable blastocysts. The area under curve revealed that E2 level in the follicular fluid exhibited a low predictive value for pregnancy outcome. The present study demonstrated that E2 level is a better predictor for the outcome of IVF-ET than AMH or PROK1 levels in the follicular fluid.
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Affiliation(s)
- Yan Lv
- Clinical Medical College of Shandong University, Jinan, Shandong 250012, P.R. China.,Department of Gynecology and Reproductive Medicine, Jinan People's Hospital, Jinan, Shandong 271100, P.R. China
| | - Shengye Du
- Department of Obstetrics, Jinan People's Hospital, Jinan, Shandong 271100, P.R. China
| | - Xin Huang
- Reproduction Medical Center, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 264000, P.R. China
| | - Cuifang Hao
- Reproduction Medical Center, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong 264000, P.R. China
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10
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Wood SH, Sills ES. Intraovarian vascular enhancement via stromal injection of platelet-derived growth factors: Exploring subsequent oocyte chromosomal status and in vitro fertilization outcomes. Clin Exp Reprod Med 2020; 47:94-100. [PMID: 32466629 PMCID: PMC7315860 DOI: 10.5653/cerm.2019.03405] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 12/24/2019] [Indexed: 12/19/2022] Open
Abstract
The inverse correlation between maternal age and pregnancy rate represents a major challenge for reproductive endocrinology. The high embryo ploidy error rate in failed in vitro fertilization (IVF) cycles reflects genetic misfires accumulated by older oocytes over time. Despite the application of different follicular recruitment protocols during IVF, gonadotropin modifications are generally futile in addressing such damage. Even when additional oocytes are retrieved, quality is frequently poor. Older oocytes with serious cytoplasmic and/or chromosomal errors are often harvested from poorly perfused follicles, and ovarian vascularity and follicular oxygenation impact embryonic chromosomal competency. Because stimulation regimens exert their effects briefly and immediately before ovulation, gonadotropins alone are an ineffective antidote to long-term hypoxic pathology. In contrast, the tissue repair properties (and particularly the angiogenic effects) of platelet-rich plasma (PRP) are well known, with applications in other clinical contexts. Injection of conventional PRP and/or its components (e.g., isolated platelet-derived growth factors as a cell-free substrate) into ovarian tissue prior to IVF has been reported to improve reproductive outcomes. Any derivative neovascularity may modulate oocyte competence by increasing cellular oxygenation and/or lowering concentrations of intraovarian reactive oxygen species. We propose a mechanism to support intrastromal angiogenesis, improved follicular perfusion, and, crucially, embryo ploidy rescue. This last effect may be explained by mRNA upregulation coordinated by PRP-associated molecular signaling, as in other tissue systems. Additionally, we outline an intraovarian injection technique for platelet-derived growth factors and present this method to help minimize reliance on donor oocytes and conventional hormone replacement therapy.
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Affiliation(s)
| | - E Scott Sills
- Gen 5 Fertility Center, San Diego, CA, USA.,Applied Biotechnology Research Group, University of Westminster, London, UK
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11
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Ranjbaran A, Nejabati HR, Ghasemnejad T, Latifi Z, Hamdi K, Hajipour H, Raffel N, Bahrami-Asl Z, Hakimi P, Mihanfar A, Nouri M, Fattahi A. Follicular Fluid Levels of Adrenomedullin 2, Vascular Endothelial Growth Factor and its Soluble Receptors Are Associated with Ovarian Response During ART Cycles. Geburtshilfe Frauenheilkd 2019; 79:86-93. [PMID: 30686838 PMCID: PMC6336467 DOI: 10.1055/a-0764-4765] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 10/08/2018] [Accepted: 10/18/2018] [Indexed: 12/14/2022] Open
Abstract
Introduction
Adrenomedullin 2 (ADM2) and vascular endothelial growth factor (VEGF) affect ovarian function, especially angiogenesis and follicular development. The actions of VEGF can be antagonized by its soluble receptors, soluble Fms-like tyrosine kinase-1 (sFlt-1) and soluble VEGF receptor 2 (sVEGFR-2), as they decrease its free form. In the present study, we evaluated the relationship between follicular fluid (FF) levels of AMD2, VEGF and its soluble receptors, and ICSI outcomes.
Materials and Methods
ICSI cycle outcomes were evaluated and FF levels of VEGF, sFlt-1, sVEGFR-2 and ADM2 were determined using ELISA kits.
Results
FF levels of ADM2, VEGF, and sVEGFR-2 were significantly higher in non-responders compared to other ovarian response groups (p < 0.05). There were significant correlations between ADM2, VEGF and sVEGFR-2 levels as well as VEGF/sFlt-1 and VEGF/sVEGFR-2 ratios (r = 0.586, 0.482, 0.260, and − 0.366, respectively). Based on the ROC curve, the cutoff value for ADM2 as a non-responder predictor was 348.55 (pg/ml) with a sensitivity of 67.7% and a specificity of 94.6%.
Conclusions
For the first time we measured FF ADM2 levels to determine the relationship to VEGF and its soluble receptors. We suggest that ADM2 could be a potential predictive marker for non-responders. Although the exact function of ADM2 in ovarian angiogenesis is not yet understood, our study may shed light on the possible role of ADM2 in folliculogenesis and ovulation.
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Affiliation(s)
- Ali Ranjbaran
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Reza Nejabati
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Biochemistry and Clinical Laboratories, Faculty of Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Tohid Ghasemnejad
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zeinab Latifi
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Biochemistry and Clinical Laboratories, Faculty of Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kobra Hamdi
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamed Hajipour
- Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nathalie Raffel
- Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Zahra Bahrami-Asl
- Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parvin Hakimi
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Aynaz Mihanfar
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Nouri
- Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Fattahi
- Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Obstetrics and Gynecology, Erlangen University Hospital, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
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12
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Effects of acupuncture on ovarian blood supply and pregnancy outcomes in patients receiving assisted reproduction. JOURNAL OF ACUPUNCTURE AND TUINA SCIENCE 2018. [DOI: 10.1007/s11726-018-1059-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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13
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Follicular fluid vascular endothelial growth factor is associated with type of infertility and interferon alpha correlates with endometrial thickness in natural cycle in vitro fertilization. Reprod Biol 2018; 18:289-294. [PMID: 29945770 DOI: 10.1016/j.repbio.2018.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 05/28/2018] [Accepted: 06/16/2018] [Indexed: 11/24/2022]
Abstract
The aim of this study was to analyse the presence of vascular endothelial growth factor (VEGF) and interferon alpha (IFN-α) in the follicular fluid (FF) and their possible influence, as pro-angiogenic or anti-angiogenic factors, on in vitro fertilization outcome. The concentrations of VEGF and IFN-α were correlated with oocyte and embryo quality, concentrations of hormones in the serum, perifollicular blood flow and endometrial thickness. VEGF was detected in all FF samples (median 706.6 pg/ml, range 182.9-6638 pg/ml). IFN-α was detected in 60% of the samples (median 6.5 pg/ml, range 0-79.4 pg/ml), while in 40% of the samples its levels were below the test detection limit. VEGF and IFN-α concentrations did not correlate with the cause of infertility, concentrations of FSH, LH, E2 and prolactin, oocyte or embryo quality. Significantly higher concentrations of VEGF have been found in women with primary compared with secondary infertility (p = 0.011, Mann Whitney test). The concentrations of VEGF and IFN-α did not correlate with the resistance index (RI) on days of hCG administration, follicular aspiration and embryo transfer. However, the concentrations of IFN-α correlated with endometrial thickness on the day of embryo transfer (Spearman correlation coefficient ρ = 0.4107; P < 0.05) but not on days of hCG administration and follicular aspiration. The mechanism of VEGF association with the previous ability of having a child needs to be clarified in future studies. The results of this study indicate a possible role of IFN-α in pathways of endometrial remodelling.
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Kianpour M, Nematbakhsh M, Ahmadi SM. Asymmetric dimethylarginine (ADMA), nitric oxide metabolite, and estradiol levels in serum and peritoneal fluid in women with endometriosis. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2015; 20:484-9. [PMID: 26257805 PMCID: PMC4525348 DOI: 10.4103/1735-9066.160997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 01/07/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND Increase in nitric oxide (NO) concentration accompanied by alteration in peritoneal immune defense reactions is involved in the pathogenesis of endometriosis. Asymmetric dimethylarginine is an endogenous competitive inhibitor of NO synthase. This study was designed to compare NO metabolite (nitrite), asymmetric dimethylarginine, and estradiol concentrations in serum and peritoneal fluid (PF) of patients with and without endometriosis. MATERIALS AND METHODS Subjects were assigned to two groups based on their laparoscopic results. The groups consisted of women with and without endometriosis (90 and 89 participants, respectively). The serum and peritoneal levels of nitrite (stable NO metabolite), asymmetric dimethylarginine, and estradiol were measured using enzyme-linked immunosorbent assay (ELISA) kits. These parameters were analyzed and compared between the groups statistically using SPSS software version 16. RESULTS Both nitrite and asymmetric dimethylarginine levels were significantly higher in the serum of the participants from both groups than those in the PF group (P < 0.05). However, no significant difference in the asymmetric dimethylarginine level was detected between the two groups. In addition, the PF level of nitrite increased significantly in patients with endometriosis when compared with non-endometriosis subjects (P < 0.05). The PF levels of estradiol in both groups were significantly higher than the serum levels of estradiol (P < 0.05). CONCLUSIONS The NO metabolite level of PF implies the possible role of NO in the pathogenesis of endometriosis.
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Affiliation(s)
- Maryam Kianpour
- Nursing and Midwifery Care Research and Department of Midwifery, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi Nematbakhsh
- Water and Electrolytes Research Center and Department of Physiology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Hashemitabar M, Bahmanzadeh M, Mostafaie A, Orazizadeh M, Farimani M, Nikbakht R. A proteomic analysis of human follicular fluid: comparison between younger and older women with normal FSH levels. Int J Mol Sci 2014; 15:17518-40. [PMID: 25268621 PMCID: PMC4227176 DOI: 10.3390/ijms151017518] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 09/03/2014] [Accepted: 09/09/2014] [Indexed: 01/10/2023] Open
Abstract
The follicular fluid (FF) is produced during folliculogenesis and contains a variety of proteins that play important roles in follicle development and oocyte maturation. Age-related infertility is usually considered as a problem that can be solved by assisted reproduction technology. Therefore, the identification of novel biomarkers that are linked to reproductive aging is the subject of this study. FF was obtained from healthy younger (20–32 years old) and older (38–42 years old) women undergoing intracytoplasmic sperm injection (ICSI) due to male factor infertility. The FF was analyzed by two-dimensional gel electrophoresis (2-DE). The power of two-dimensional gel electrophoresis and the identification of proteins were exploited using matrix-assisted laser desorption-ionization time-of-flight/time-of-flight (MALDI-TOF-TOF) mass spectrometry. Twenty three protein spots showed reproducible and significant changes in the aged compared to the young group. Of these, 19 protein spots could be identified using MALDI-TOF-TOF-MS. As a result of MASCOT search, five unique downregulated proteins were identified in the older group. These were identified as serotransferrin, hemopexin precursor, complement C3, C4 and kininogen. A number of protein markers were found that may help develop diagnostic methods of infertility.
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Affiliation(s)
- Mahmoud Hashemitabar
- Cellular and Molecular Research Center, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz 1579461357, Iran.
| | - Maryam Bahmanzadeh
- Cellular and Molecular Research Center, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz 1579461357, Iran.
| | - Ali Mostafaie
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah 6714415185, Iran.
| | - Mahmoud Orazizadeh
- Cellular and Molecular Research Center, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz 1579461357, Iran.
| | - Marzieh Farimani
- Endometr and Endometriosis Research Center, Hamedan University of Medical Sciences, Hamedan 6517789971, Iran.
| | - Roshan Nikbakht
- Fertility and Infertility & Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz 6193673166, Iran.
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16
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Altermatt J, Marolf A, Wrigley R, Carnevale E. Effects of FSH and LH on ovarian and follicular blood flow, follicular growth and oocyte developmental competence in young and old mares. Anim Reprod Sci 2012; 133:191-7. [DOI: 10.1016/j.anireprosci.2012.06.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2009] [Revised: 06/26/2012] [Accepted: 06/27/2012] [Indexed: 10/28/2022]
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17
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Nitric oxide concentrations, estradiol-17β progesterone ratio in follicular fluid, and COC quality with respect to perifollicular blood flow in cows. Anim Reprod Sci 2012; 130:9-15. [DOI: 10.1016/j.anireprosci.2011.12.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Revised: 10/26/2011] [Accepted: 12/23/2011] [Indexed: 11/20/2022]
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18
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Savchev SI, Moragianni VA, Senger D, Penzias AS, Thornton K, Usheva A. Follicular Fluid-Specific Distribution of Vascular Endothelial Growth Factor Isoforms and sFlt-1 in Patients Undergoing IVF and Their Correlation With Treatment Outcomes. Reprod Sci 2010; 17:1036-42. [DOI: 10.1177/1933719110376980] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Stefan I. Savchev
- Division of Endocrinology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Vasiliki A. Moragianni
- Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Donald Senger
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA
| | - Alan S. Penzias
- Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA, Boston IVF, Waltham, MA, USA
| | - Kim Thornton
- Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA, Boston IVF, Waltham, MA, USA
| | - Anny Usheva
- Division of Endocrinology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA,
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19
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Jordan A, Herzog K, Ulbrich SE, Beindorff N, Honnens A, Krüger L, Miyamoto A, Bollwein H. Genital blood flow and endometrial gene expression during the preovulatory period after Prostaglandin F(2alpha)-induced luteolysis in different luteal phases in cows. J Reprod Dev 2009; 55:309-15. [PMID: 19305127 DOI: 10.1262/jrd.20140] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to examine the hypothesis that follicular and uterine perfusion as well as endometrial gene expression during the ovulatory period differs after induction of luteolysis during the 1(st) follicular wave compared with the 2(nd) wave or in intact cycle. Nine healthy non-lactating Holstein-Friesian cows were examined during three estrous cycles. A prostaglandin F(2alpha) analogue (PGF) was administered randomly either on Day 7 (1(st) wave cycle) or Day 11 (2(nd) wave cycle) after detection of ovulation (=Day 1). No hormonal treatment was used in the intact cycle with spontaneous ovulation. Transrectal Doppler sonography was conducted daily after PGF injection and in the intact cycle beginning on Day 18 of the estrous cycle until ovulation. Follicular blood flow (FBF) was determined by measuring the maximum area of colour pixels on digitalized images of the follicles. Uterine blood flow was quantified by the time-averaged maximum velocity (UTAMV) and pulsatility index (PI) in both uterine arteries. Blood flow measurements were carried out on Days -1 and 0. Endometrial biopsy specimens were taken on Day 1 and analyzed for the gene expressions of estrogen, progesterone, oxytocin and VEGF receptors and eNOS and iNOS using RT-PCR. The interval from PGF injection to ovulation was shorter (P<0.05) in 1(st) wave cycles than in 2(nd) wave cycles. On Days 0 and -1, FBF was greater (P<0.05) in 1(st) wave cycles than in intact and 2(nd) wave cycles. On Day -1, UTAMV was greater (P<0.05) in 1(st) wave cycles than in intact and 2(nd) wave cycles. There were no differences (P>0.05) in FBF and UTAMV values between 2(nd) wave and intact cycles. No differences (P>0.05) were detected in the gene expressions of endometrial receptors and enzymes between intact, 1(st) and 2(nd) wave cycles. The results show that follicular and uterine perfusion during the ovulatory phase are higher after induction of luteolysis during the 1(st) follicular wave compared with the 2(nd) wave or intact cycle. There were no effects on endometrial gene expression.
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Affiliation(s)
- Anne Jordan
- Clinic for Cattle, University of Veterinary Medicine Hannover
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20
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Altered vascular endothelial growth factor expression during GnRH antagonist protocol in women of reproductive age with normal baseline hormone profiles. Fertil Steril 2009; 91:744-8. [DOI: 10.1016/j.fertnstert.2007.12.068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2007] [Revised: 12/24/2007] [Accepted: 12/24/2007] [Indexed: 11/17/2022]
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21
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Glenn DR, McClure N, Cosby SL, Stevenson M, Lewis SE. Sildenafil citrate (Viagra) impairs fertilization and early embryo development in mice. Fertil Steril 2009; 91:893-9. [DOI: 10.1016/j.fertnstert.2007.12.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2007] [Revised: 12/05/2007] [Accepted: 12/05/2007] [Indexed: 10/22/2022]
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22
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Review of the role of the plasminogen activator system and vascular endothelial growth factor in subfertility. Fertil Steril 2008; 90:2340-50. [DOI: 10.1016/j.fertnstert.2007.10.026] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2006] [Revised: 10/03/2007] [Accepted: 10/03/2007] [Indexed: 11/20/2022]
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23
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Redding GP, Bronlund JE, Hart AL. Mathematical modelling of oxygen transport-limited follicle growth. Reproduction 2007; 133:1095-106. [PMID: 17636164 DOI: 10.1530/rep-06-0171] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Mathematical modelling was used to investigate oxygen transport in the developing ovarian follicle. In contrast to previous findings, the results show that oxygen can reach the oocyte in large preantral follicles. This is largely due to the inclusion of fluid voidage in the model and improved estimates of oxygen diffusion coefficients through the granulosa. The results also demonstrate that preantral follicles will eventually reach a size beyond which further growth will result in the follicle becoming increasingly anoxic. The predicted size range at which this occurs is consistent with the size range at which antrum formation is observed in many mammals. This suggests that the antrum formation stage of follicular growth may be pivotal to the further development and ultimate fate of the follicle, and that antrum formation itself may represent a mechanism by which the follicle can overcome oxygen limitations. This was supported through extension of the model to the antral follicle, which showed that antrum formation can provide a way in which the follicle can continue to grow and yet avoid becoming hypoxic. The results of the model were consistent with observed follicle development.
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Affiliation(s)
- G P Redding
- Institute of Technology and Engineering, Massey University, Private Bag 11222, Palmerston North 4410, New Zealand.
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24
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Wang Q, Sun QY. Evaluation of oocyte quality: morphological, cellular and molecular predictors. Reprod Fertil Dev 2007; 19:1-12. [PMID: 17389130 DOI: 10.1071/rd06103] [Citation(s) in RCA: 199] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Mounting evidence that oocyte quality profoundly affects fertilisation an d subsequent embryo development drives the continued search for reliable predictors of oocyte developmental competence. In the present review, we provide an overall summary and analysis of potential criteria that can be used to evaluate oocyte quality. These criteria are specifically classified as morphological and cellular/molecular predictors. Traditional methods for the evaluation of oocyte quality are based on morphological classification of thefollicle, cumulus-oocytecomplex, polar body and/or meiotic spindle. Although the use of morphological characteristics as predictors of oocyte quality is controversial, such a grading system can provide valuable information for the preselection of oocytes with higher developmental competence and, therefore, may maximise embryo developmental outcome. Several intrinsic markers (such as mitochondrial status and glucose-6-phosphate dehydrogenase 1 activity) and extrinsic markers (such as apoptosis of follicular cells and levels of the transforming growth factor-beta superfamily in follicular fluid or serum) have also been reported as useful indicators of oocyte competence and embryo quality. Compared with the morphological parameters, these cellular and molecular predictors of oocyte quality may prove to be more precise and objective, although further studies and refinement of techniques are needed.
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Affiliation(s)
- Qiang Wang
- State Key Laboratory of Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100080, China
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25
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Coppus SFPJ, van der Veen F, Bossuyt PMM, Mol BWJ. Quality of reporting of test accuracy studies in reproductive medicine: impact of the Standards for Reporting of Diagnostic Accuracy (STARD) initiative. Fertil Steril 2006; 86:1321-9. [PMID: 16978620 DOI: 10.1016/j.fertnstert.2006.03.050] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2005] [Revised: 03/28/2006] [Accepted: 03/28/2006] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the extent to which test accuracy studies published in two leading reproductive medicine journals in the years 1999 and 2004 adhered to the Standards for Reporting of Diagnostic Accuracy (STARD) initiative parameters, and to explore whether the introduction of the STARD statement has led to an improved quality of reporting. DESIGN Structured literature search. Articles that reported on the diagnostic performance of a test in comparison with a reference standard were eligible for inclusion. For each article we scored how well the 25 items of the STARD checklist were reported. These items deal with the study question, study participants, study design, test methods, reference standard, statistical methods, reporting of results, and conclusions. We calculated the total number of reported STARD items per article, summary scores for each STARD item, and the average number of reported STARD items per publication year. SETTING Not applicable. PATIENT(S) Not applicable. INTERVENTION(S) Not applicable. MAIN OUTCOME MEASURE(S) Quality of reporting. RESULT(S) We found 24 studies reporting on test accuracy in reproductive medicine in 1999 and 27 studies in 2004. The mean number of reported STARD items for articles published in 1999 was 12.1 +/- 3.3 (range 6.5-20) and 12.4 +/- 3.2 (range 7-17.5) in 2004, after publication of the STARD statement. Overall, less than half of the studies reported adequately on 50% or more of the STARD items. The reporting of individual items showed a wide variation. There was no significant improvement in mean number of reported items for the articles published after the introduction of the STARD statement. CONCLUSION(S) Authors of test accuracy studies in the two leading fertility journals poorly report the design, conduct, methodology, and statistical analysis of their study. Strict adherence to the STARD guidelines should be encouraged.
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Affiliation(s)
- Sjors F P J Coppus
- Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, the Netherlands.
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26
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Abstract
Endometriosis is a chronic pleomorphic disorder with pelvic or systemic manifestations, and is characterized by the presence of endometrial glands and stroma. In the United States, the prevalence of the disease is estimated to range from 2 to 50% in women of reproductive age. No single theory can explain the histogenesis and the pleomorphic manifestations of endometriosis. Endometriosis is being reported in younger age women and manifesting with increasing severity, hence the need to understand the role of oxidative stress (OS) in endometriosis. The presence of elevated concentrations of free radicals and lowered antioxidant potential leads to OS. The development of OS in the local peritoneal environment may be one of the links in the chain of events leading to endometriosis. Redox levels may modulate the severity and the dynamics of endometriosis and progression of the disease. OS has been implicated in infertility associated with endometriosis. Recent literature reviewed investigates the role of molecular mechanisms and genetic pathways that may modulate cellular response to OS. Antioxidant supplementation, immunomodulators, and selective progesterone receptor modulators with antioxidant effects have been investigated as possible treatments for endometriosis, but compelling evidence on the benefits of the various modalities is lacking. Results of the limited number of animal and human trials need to be corroborated by larger randomized controlled trials.
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Affiliation(s)
- Sajal Gupta
- Centre for Advanced Research in Human Reproduction, Infertility, and Sexual Function, Glickman Urological Institute and Department of Obstetrics-Gynecology, The Cleveland Clinic Foundation, OH, USA
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27
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Agarwal A, Gupta S, Sharma RK. Role of oxidative stress in female reproduction. Reprod Biol Endocrinol 2005; 3:28. [PMID: 16018814 PMCID: PMC1215514 DOI: 10.1186/1477-7827-3-28] [Citation(s) in RCA: 896] [Impact Index Per Article: 47.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2005] [Accepted: 07/14/2005] [Indexed: 01/18/2023] Open
Abstract
In a healthy body, ROS (reactive oxygen species) and antioxidants remain in balance. When the balance is disrupted towards an overabundance of ROS, oxidative stress (OS) occurs. OS influences the entire reproductive lifespan of a woman and even thereafter (i.e. menopause). OS results from an imbalance between prooxidants (free radical species) and the body's scavenging ability (antioxidants). ROS are a double-edged sword - they serve as key signal molecules in physiological processes but also have a role in pathological processes involving the female reproductive tract. ROS affect multiple physiological processes from oocyte maturation to fertilization, embryo development and pregnancy. It has been suggested that OS modulates the age-related decline in fertility. It plays a role during pregnancy and normal parturition and in initiation of preterm labor. Most ovarian cancers appear in the surface epithelium, and repetitive ovulation has been thought to be a causative factor. Ovulation-induced oxidative base damage and damage to DNA of the ovarian epithelium can be prevented by antioxidants. There is growing literature on the effects of OS in female reproduction with involvement in the pathophysiology of preeclampsia, hydatidiform mole, free radical-induced birth defects and other situations such as abortions. Numerous studies have shown that OS plays a role in the pathophysiology of infertility and assisted fertility. There is some evidence of its role in endometriosis, tubal and peritoneal factor infertility and unexplained infertility. This article reviews the role OS plays in normal cycling ovaries, follicular development and cyclical endometrial changes. It also discusses OS-related female infertility and how it influences the outcomes of assisted reproductive techniques. The review comprehensively explores the literature for evidence of the role of oxidative stress in conditions such as abortions, preeclampsia, hydatidiform mole, fetal embryopathies, preterm labour and preeclampsia and gestational diabetes. The review also addresses the growing literature on the role of nitric oxide species in female reproduction. The involvement of nitric oxide species in regulation of endometrial and ovarian function, etiopathogenesis of endometriosis, and maintenance of uterine quiescence, initiation of labour and ripening of cervix at parturition is discussed. Complex interplay between cytokines and oxidative stress in the etiology of female reproductive disorders is discussed. Oxidant status of the cell modulates angiogenesis, which is critical for follicular growth, corpus luteum formation endometrial differentiation and embryonic growth is also highlighted in the review. Strategies to overcome oxidative stress and enhance fertility, both natural and assisted are delineated. Early interventions being investigated for prevention of preeclampsia are enumerated. Trials investigating combination intervention strategy of vitamin E and vitamin C supplementation in preventing preeclampsia are highlighted. Antioxidants are powerful and there are few trials investigating antioxidant supplementation in female reproduction. However, before clinicians recommend antioxidants, randomized controlled trials with sufficient power are necessary to prove the efficacy of antioxidant supplementation in disorders of female reproduction. Serial measurement of oxidative stress biomarkers in longitudinal studies may help delineate the etiology of some of the diosorders in female reproduction such as preeclampsia.
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Affiliation(s)
- Ashok Agarwal
- Center for Advanced Research in Human Reproduction, Infertility, and Sexual Function, Glickman Urological Institute and Department of Obstetrics-Gynecology; The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA
| | - Sajal Gupta
- Center for Advanced Research in Human Reproduction, Infertility, and Sexual Function, Glickman Urological Institute and Department of Obstetrics-Gynecology; The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA
| | - Rakesh K Sharma
- Center for Advanced Research in Human Reproduction, Infertility, and Sexual Function, Glickman Urological Institute and Department of Obstetrics-Gynecology; The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA
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28
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Current World Literature. Curr Opin Obstet Gynecol 2005. [DOI: 10.1097/01.gco.0000169110.00376.bd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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