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Etrusco A, Laganà AS, Chiantera V, Buzzaccarini G, Unfer V. Myo-inositol in assisted reproductive technology from bench to bedside. Trends Endocrinol Metab 2024; 35:74-83. [PMID: 37798243 DOI: 10.1016/j.tem.2023.09.005] [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] [Received: 05/05/2023] [Revised: 09/14/2023] [Accepted: 09/15/2023] [Indexed: 10/07/2023]
Abstract
Inositols are insulin-sensitizing compounds of promising efficacy in the management of polycystic ovary syndrome (PCOS). On the one hand, myo-inositol (myo-ins) plays a regulatory role in male and female reproductive function, influencing the development of oocytes, spermatozoa, and embryos. On the other hand, high concentrations of D-chiro-inositol (D-chiro-ins) in the ovary may adversely affect oocyte quality. This review analyses the available literature, which encourages the clinical use of myo-ins in assisted reproductive technologies (ARTs) due to its beneficial effects on female and male reproduction.
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Affiliation(s)
- Andrea Etrusco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy; Unit of Obstetrics and Gynecology, 'Paolo Giaccone' Hospital, Palermo, Italy
| | - Antonio Simone Laganà
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy; Unit of Obstetrics and Gynecology, 'Paolo Giaccone' Hospital, Palermo, Italy; The Experts Group on Inositol in Basic and Clinical Research (EGOI)
| | - Vito Chiantera
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy; Unit of Gynecologic Oncology, National Cancer Institute - IRCCS - Fondazione 'G. Pascale', Naples, Italy
| | - Giovanni Buzzaccarini
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Vittorio Unfer
- The Experts Group on Inositol in Basic and Clinical Research (EGOI); UniCamillus-Saint Camillus International University of Health Sciences, 00131 Rome, Italy.
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Bashiri Z, Sheibak N, Amjadi F, Zandieh Z. The role of myo-inositol supplement in assisted reproductive techniques. HUM FERTIL 2023; 26:1044-1060. [PMID: 35730666 DOI: 10.1080/14647273.2022.2073273] [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: 05/15/2021] [Accepted: 10/20/2021] [Indexed: 11/04/2022]
Abstract
Assisted reproductive techniques can help many infertile couples conceive. Therefore, there is a need for an effective method to overcome the widespread problems of infertile men and women. Oocyte and sperm quality can increase the chances of successful in vitro fertilisation. The maturation environment in which gametes are present can affect their competency for fertilisation. It is well established that myo-inositol (MI) plays a pivotal role in reproductive physiology. It participates in cell membrane formation, lipid synthesis, cell proliferation, cardiac regulation, metabolic alterations, and fertility. This molecule also acts as a direct messenger of insulin and improves glucose uptake in various reproductive tissues. Evidence suggests that MI regulates events such as gamete maturation, fertilisation, and embryo growth through intracellular Ca2 + release and various signalling pathways. In addition to the in-vivo production of MI from glucose in the reproductive organs, its synthesis by in vitro-cultured sperm and follicles has also been reported. Therefore, MI is suggested as a therapeutic approach to maintain sperm and oocyte health in men and women with reproductive disorders and individuals of reproductive age.
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Affiliation(s)
- Zahra Bashiri
- Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Omid Fertility and Infertility Clinic, Hamedan, Iran
| | - Nadia Sheibak
- Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemehsadat Amjadi
- Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Zandieh
- Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), Iran University of Medical Sciences, Tehran, Iran
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Beresniak A, Russo M, Forte G, Laganà AS, Oliva MM, Aragona C, Chiantera V, Unfer V. A Markov-model simulation of IVF programs for PCOS patients indicates that coupling myo-Inositol with rFSH is cost-effective for the Italian Health System. Sci Rep 2023; 13:17789. [PMID: 37853019 PMCID: PMC10584971 DOI: 10.1038/s41598-023-44055-0] [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: 04/04/2023] [Accepted: 10/03/2023] [Indexed: 10/20/2023] Open
Abstract
Accumulating evidence suggests that oral supplementation with myo-Inositol (myo-Ins) is able to reduce the amount of gonadotropins and days of controlled ovarian hyperstimulation (COS) necessary to achieve adequate oocyte maturation in assisted reproduction technology (ART) protocols, particularly in women affected by polycystic ovary syndrome (PCOS). We used computational calculations based on simulation modellings. We simulated in vitro fertilization (IVF) procedures-with or without intracytoplasmic sperm injection (ICSI)-with 100,000 virtual patients, accounting for all the stages of the entire IVF procedure. A Monte Carlo technique was used to account for data uncertainty and to generate the outcome distribution at each stage. We considered virtual patients with PCOS undergoing IVF cycles to achieve pregnancy. Computational data were retrieved from clinical experience and published data. We investigated three parameters related to ART protocols: cost of single procedure; efficacy to achieve ongoing pregnancy at 12 gestational weeks; overall cost per single pregnancy. The administration of oral myo-Ins during COH protocols, compared to the standard COH with recombinant Follicle Stimulating Hormone (rFSH) only, may be considered a potential strategy to reduce costs of ART for the Italian Health System.
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Affiliation(s)
| | | | | | - Antonio Simone Laganà
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00161, Rome, Italy
- Unit of Obstetrics and Gynecology, "Paolo Giaccone" Hospital, 90127, Palermo, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127, Palermo, Italy
| | - Mario Montanino Oliva
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00161, Rome, Italy
- Department of Obstetrics and Gynecology, Santo Spirito Hospital, 00193, Rome, Italy
| | - Cesare Aragona
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00161, Rome, Italy
- Systems Biology Group, Rome, Italy
| | - Vito Chiantera
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127, Palermo, Italy
- Unit of Gynecologic Oncology, National Cancer Institute-IRCCS-Fondazione "G. Pascale", 80131, Naples, Italy
| | - Vittorio Unfer
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00161, Rome, Italy.
- UniCamillus-Saint Camillus International University of Health Sciences, Rome, Italy.
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Ren Y, Xie Y, Xu Q, Long M, Zheng Y, Li L, Niu C. University students' fertility awareness and its influencing factors: a systematic review. Reprod Health 2023; 20:85. [PMID: 37280685 DOI: 10.1186/s12978-023-01628-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/25/2023] [Indexed: 06/08/2023] Open
Abstract
INTRODUCTION In recent years, a growing number of researchers have begun to study fertility awareness (FA). Evidence suggests that college students in their reproductive years have a common understanding of fertility, risk factors for infertility, and assisted reproductive technologies. Therefore, this systematic review summarizes these studies and explores the factors affecting college students' fertility awareness. METHODS A systematic literature search of databases (PUBMED/MEDLINE, Cochrane, Web of Science, Embase, and EBSCO) was conducted from inception to September 2022. Studies that assessed the levels of fertility awareness and factors influencing college students were considered for the review. The qualities of the included studies were evaluated using the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. This systematic review is reported according to the preferred reporting items for systematic review (PRISMA) guidelines. RESULTS Twenty-one articles met the eligibility criteria and were included. The preliminary results showed that participants reported low to moderate FA. Female medical students demonstrated higher levels of fertility awareness. The association between age, years of education, and FA was insufficient. CONCLUSION The results of the current study suggest that increased FA interventions are warranted, especially for the male, non-medical student population. Governments and educational institutions should strengthen education programs for young students on reproductive health to help them raise awareness about childbirth, and society should provide family support for young people.
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Affiliation(s)
- Yue Ren
- School of Nursing School of Public, Health Yangzhou University, Mid Jiangyang Road 136, Yangzhou, Jiangsu, People's Republic of China
| | - Yue Xie
- School of Nursing School of Public, Health Yangzhou University, Mid Jiangyang Road 136, Yangzhou, Jiangsu, People's Republic of China
| | - Qulian Xu
- School of Nursing School of Public, Health Yangzhou University, Mid Jiangyang Road 136, Yangzhou, Jiangsu, People's Republic of China
| | - Miaochen Long
- School of Nursing School of Public, Health Yangzhou University, Mid Jiangyang Road 136, Yangzhou, Jiangsu, People's Republic of China
| | - Ying Zheng
- School of Nursing School of Public, Health Yangzhou University, Mid Jiangyang Road 136, Yangzhou, Jiangsu, People's Republic of China
| | - Lin Li
- Department of Obstetrics and Gynecology, Yangzhou University Affiliated Hospital, Yangzhou, China
| | - Changmin Niu
- School of Nursing School of Public, Health Yangzhou University, Mid Jiangyang Road 136, Yangzhou, Jiangsu, People's Republic of China.
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Monastra G, Gambioli R, Unfer V, Forte G, Maymo-Masip E, Comitato R. D-Chiro-Inositol and Myo-Inositol Induce WAT/BAT Trans-Differentiation in Two Different Human Adipocyte Models (SGBS and LiSa-2). Int J Mol Sci 2023; 24:ijms24087421. [PMID: 37108582 PMCID: PMC10139407 DOI: 10.3390/ijms24087421] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/11/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
White adipose tissue/brown adipose tissue trans-differentiation is one of the main study targets for therapies against obesity and metabolic diseases. In recent years, numerous molecules able to induce such trans-differentiation have been identified; however, their effect in obesity therapies has not been as expected. In the present study, we investigated whether myo-inositol and its stereoisomer D-chiro-inositol could be involved in the browning of white adipose tissue. Our preliminary results clearly indicate that both, at 60 μM concentration, induce the upregulation of uncoupling protein 1 mRNA expression, the main brown adipose tissue marker, and increase mitochondrial copy number as well as oxygen consumption ratio. These changes demonstrate an activation of cell metabolism. Therefore, our results show that human differentiated adipocytes (SGBS and LiSa-2), assume the features typical of brown adipose tissue after both treatments. Furthermore, in the cell lines examined, we proved that D-chiro-inositol and myo-Inositol induce an increase in the expression of estrogen receptor mRNAs, suggesting a possible modulation by these isomers. We also found an increase in the mRNA of peroxisome proliferator-activated receptor gamma, a very important target in lipid metabolism and metabolic diseases. Our results open new opportunities for the use of inositols in therapeutic strategies to counteract obesity and its metabolic complications.
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Affiliation(s)
- Giovanni Monastra
- Systems Biology Group Lab, 00161 Rome, Italy
- Experts Group on Inositols in Basic and Clinical Research (EGOI), 00161 Rome, Italy
| | | | - Vittorio Unfer
- Experts Group on Inositols in Basic and Clinical Research (EGOI), 00161 Rome, Italy
- UniCamillus-Saint Camillus International University of Health Sciences, 00131 Rome, Italy
| | | | - Elsa Maymo-Masip
- Institut Investigació Sanitària Pere Virgili (IISPV), 43003 Tarragona, Spain
- CIBER de Diabetes y Enfermedades Metaboílicas Asociadas (CIBERDEM)-Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Raffaella Comitato
- Council for Agricultural Research and Economics-Research Centre for Food and Nutrition, 00178 Rome, Italy
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Arab S, Frank R, Ruiter J, Dahan MH. How to dose follitropin delta for the first insemination cycle according to the ESHRE and ASRM guidelines; a retrospective cohort study. J Ovarian Res 2023; 16:24. [PMID: 36707880 PMCID: PMC9883945 DOI: 10.1186/s13048-022-01079-w] [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: 12/30/2021] [Accepted: 12/16/2022] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Follitropin Delta (FD) is indicated exclusively for in-vitro fertilization however, being a gonadotropin it could be used for other purposes. A dosing algorithm exists for FD and IVF but is needed for intrauterine insemination (IUI) cycles. The objective of this study is to determine dosing for FD for the first controlled ovarian hyperstimulation (COH) cycle according to current stimulation guidelines. RESULTS A retrospective study of 157 subjects from a single university fertility center from January 2017 to March 2020, was performed. All patients stimulated with FD for IUI were included. The number of failed, normal, or overstimulation cycles was determined based on stimulating not more than 2 mature follicles. We then stratified the group based on the AFC, AMH, and body weight. Of 157 subjects, 49% stimulated correctly, 5.6% failed and 45.4% overstimulated. An analysis of the COH IUI cycles based on stratification and over or lack of stimulation per published guidelines found that women with a bodyweight < 80 kg or AMH ≥ 1.5 ng/ml or AFC ≥ 10 initially stimulate with FD 2.0 to 3.0mcg daily. For women with an AFC of 6-9 stimulate with Follitropin Delta 3.0mcg daily. For women with an AFC < 6 or serum AMH < 1.5 ng/ml stimulate with FD 3.0-4.0mcg daily. For women with body weight > 80 kg stimulate initially with daily with 4.0-6.0mcg FD. CONCLUSIONS Follitropin Delta can be used safely for controlled ovarian stimulation and insemination at doses easily dispensed by the current methods of delivery, within the current published guidelines for follicle development.
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Affiliation(s)
- Suha Arab
- grid.14709.3b0000 0004 1936 8649Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility Center, McGill University, 888 Boulevard de Maisonneuve East, Suit # 200, Montreal, QC H2l 4S8 Canada
| | - Russell Frank
- grid.14709.3b0000 0004 1936 8649Department of Obstetrics and Gynecology, McGill University, Montreal, QC Canada
| | - Jacob Ruiter
- grid.14709.3b0000 0004 1936 8649Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility Center, McGill University, 888 Boulevard de Maisonneuve East, Suit # 200, Montreal, QC H2l 4S8 Canada
| | - Michael H. Dahan
- grid.14709.3b0000 0004 1936 8649Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility Center, McGill University, 888 Boulevard de Maisonneuve East, Suit # 200, Montreal, QC H2l 4S8 Canada
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Wang K, Guan Y, Zhang Y, Jia R, Wu S, Yao Z, Zhang M, Li Z. Analysis of cumulative outcomes and influencing factors of patients with discrepancies between age and AMH levels in the early follicular phase prolonged protocol. Front Endocrinol (Lausanne) 2023; 14:1098131. [PMID: 36967754 PMCID: PMC10031014 DOI: 10.3389/fendo.2023.1098131] [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] [Received: 11/14/2022] [Accepted: 02/27/2023] [Indexed: 03/11/2023] Open
Abstract
OBJECTIVE To explore the cumulative outcomes and influencing factors of patients with discrepancies between age and Anti-Müllerian hormone (AMH) levels in the early follicular phase prolonged protocol. METHODS A total of 1282 cycles of in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) assisted pregnancy with the early follicular phase prolonged protocol in the Reproductive Medicine Center of the Third Affiliated Hospital of Zhengzhou University from September 2015 to December 2020 were retrospectively analyzed. They were divided into the young low-AMH group (n=1076) and the older high-AMH group (n=206). The primary outcomes included cumulative clinical pregnancy rate (CCPR) and cumulative live birth rate (CLBR). Secondary outcomes included the number of oocytes retrieved, number of available embryos, clinical pregnancy rate (CPR), live birth rate (LBR), miscarriage rate (MR), pregnancy complications, and neonatal outcomes. RESULTS The CPR (68.7% vs. 59.4%) and the LBR (60.7% vs. 43.1%) in the young low-AMH group were higher than those in the older high-AMH group. In contrast, the number of oocytes retrieved (11 vs. 17), number of available embryos (5 vs. 8), and MR (10.6% vs. 18.3%) in the young low-AMH group were lower. There was no significant difference between the two groups in the CCPR, CLBR, pregnancy complications, and neonatal outcomes. Logistic regression analysis showed that infertility duration, basal follicle-stimulating hormone (FSH), and antral follicle count (AFC) correlated with CCPR, while maternal age, type of infertility, basal FSH, AFC, and infertility duration correlated with CLBR. The area under the receiver operating characteristic curves (ROC) curve for the combined model of infertility duration, AFC, and basal FSH to predict cumulative pregnancy was 0.629 (95%CI:0.592-0.666), while the combined model of maternal age, AFC, basal FSH, infertility duration, and type of infertility to predict cumulative live birth was 0.649 (95%CI:0.615-0.682). CONCLUSION Although AMH levels are low by contrast, young patients have a favorable outcome after IVF/ICSI. In patients with discrepancies between age and AMH levels in the early follicular phase prolonged protocol, maternal age correlates better with cumulative live birth. The model that combines maternal age and other factors can help predict cumulative live birth, but its value is limited.
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KIANI AYSHAKARIM, DONATO KEVIN, DHULI KRISTJANA, STUPPIA LIBORIO, BERTELLI MATTEO. Dietary supplements for polycystic ovary syndrome. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 63:E206-E213. [PMID: 36479481 PMCID: PMC9710389 DOI: 10.15167/2421-4248/jpmh2022.63.2s3.2762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Polycystic ovary syndrome (PCOS) is one of the most prevalent female endocrine reproductive disorders, affecting between 4 to 18% of the women in their reproductive age. It is generally characterized by several clinical aspects, among which anovulation, inflammation and infertility. Moreover, PCOS has several health implications, including increased metabolic, reproductive, and psychological risks. Previously, metformin and to some extent thiazolidinediones were considered as drug of choice for PCOS management, but they had several side-effects, and controversial results were obtained about their efficiency, especially in non-insulin-resistant non-obese patients. Thus, alternative treatment options are now being studied for PCOS, including different natural molecules and complementary medicines (CM) for the improvement of their health, wellbeing and fertility. Recently, treatment of PCOS patients with different natural molecules, coming from nutritional supplements and herbal medicines, has attained satisfactory results with the absence of any side effects. In this review, four natural molecules, curcumin, vitamin D, inositol and CoQ10 are discussed for their therapeutic ability. These molecules proved to decrease insulin sensitivity and inflammation, to improve the restoration of ovarian function, and they could restore hormonal balance and regulate the menstrual cycle, all of which are the main features and major concerns for women suffering from PCOS.
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Affiliation(s)
| | - KEVIN DONATO
- MAGI Euregio, Bolzano, Italy
- Correspondence: Kevin Donato, MAGI Euregio, Via Maso della Pieve 60/A, 39100 Bolzano, Italy. E-mail:
| | | | - LIBORIO STUPPIA
- Department of Psychological, Health and Territorial Sciences, School of Medicine and Health Sciences, “G. d’Annunzio” University, Chieti, Italy
| | - MATTEO BERTELLI
- MAGI Euregio, Bolzano, Italy
- MAGI’s Lab, Rovereto, Italy
- MAGISNAT, Peachtree Corners, USA
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Elasam AN, Ahmed MA, Ahmed ABA, Sharif ME, Abusham A, Hassan B, Adam I. The prevalence and phenotypic manifestations of polycystic ovary syndrome (PCOS) among infertile Sudanese women: a cross-sectional study. BMC Womens Health 2022; 22:165. [PMID: 35562723 PMCID: PMC9102290 DOI: 10.1186/s12905-022-01762-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 05/06/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) is a global health problem associated with significant morbidity during reproductive age. Only a few published studies that address the clinical manifestations and phenotypic presentation of the disease have been conducted in Africa, including Sudan. Thus, this study aimed to evaluate the clinical and biochemical presentation of the different PCOS phenotypes among infertile Sudanese women. METHODS A cross-sectional, descriptive study was conducted from January to December 2019. A total of 368 infertile women with PCOS (based on the Rotterdam criteria) were recruited from a fertility center in Khartoum, Sudan. Clinical, hormonal, and ultrasonographic characteristics were described and compared between the four phenotypes of PCOS. RESULTS Majority (321 [87.2%]) of the women had oligo/anovulation (OA). Polycystic ovary morphology on ultrasound appeared in 236 (64.1%) women, acne in 171 (46.5%) women, acanthosis nigricans in 81 (22.0%) women, and hirsutism in 101 (27.4%) women. Phenotype D was the most prevalent among infertile Sudanese women (51.6%), followed by phenotype B (22.6%), phenotype C (18.2%), and phenotype A (7.6%). No statistical differences in the body mass index and hormonal profile between the four phenotypes were noted. Women with phenotype A were older and had high mean blood pressure, and a higher waist/hip ratio was observed among women with phenotype D. CONCLUSION Unlike the global distribution of PCOS phenotypes, Sudanese women uniquely expressed phenotype D as the most prevalent. More epidemiological studies are needed in the region due to geographical, ethnic, and genetic variations.
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Affiliation(s)
| | | | | | - Manal E. Sharif
- College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Abdalla Abusham
- College of Medicine, King Khalid University, Abha, Saudi Arabia
| | | | - Ishag Adam
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, 56219 Saudi Arabia
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Bainvoll L, Mandelbaum RS, Violette CJ, Matsuzaki S, Ho JR, Wright JD, Paulson RJ, Matsuo K. Association between hospital treatment volume and major complications in ovarian hyperstimulation syndrome. Eur J Obstet Gynecol Reprod Biol 2022; 272:240-246. [PMID: 35405452 DOI: 10.1016/j.ejogrb.2022.04.001] [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: 01/04/2022] [Revised: 03/24/2022] [Accepted: 04/03/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE An inverse relationship between hospital volume and adverse patient outcomes has been established for many conditions, but has not yet been examined in ovarian hyperstimulation syndrome (OHSS). Given the rarity of severe OHSS, but potential for high morbidity, this study aimed to elucidate the effect of hospital volume on inpatient OHSS-related complications. METHODS This is a retrospective observational study querying the National Inpatient Sample, 1/2001-12/2011. Study population was 11,878 patients with OHSS treated at 735 hospitals. Annualized hospital OHSS treatment volume was grouped as: low-volume (1 case/year), mid-volume (>1 but < 3.5 cases/year), and high-volume (≥3.5 cases/year). Main outcome measure was major complication rates stratified by hospital treatment volume, assessed by multinomial regression and binary logistic regression models. RESULTS A total of 2,415 (20.3%) patients were treated at low-volume centers, 5,023 (42.3%) at mid-volume centers, and 4,440 (37.4%) at high-volume centers. Patients treated at high-volume centers were more likely to be older and less comorbid with higher incomes and lower body mass index (P < 0.05). High-volume hospitals were more likely to be urban-teaching centers with large bed capacity (P < 0.001). Overall, 1,624 (13.7%) patients experienced a major complication during hospitalization. Patients treated at high-volume hospitals had lower rates of major complications (high: 11.0%, mid: 15.2%, low: 15.6%, P < 0.001). On multivariable analysis, treatment at high-volume hospitals was independently associated with a nearly 20% lower rate of major complications (odds ratio 0.82, 95% confidence interval 0.70-0.97, P = 0.021). CONCLUSION Our study suggests that higher hospital treatment volume for OHSS may be associated with improved outcomes.
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Affiliation(s)
- Liat Bainvoll
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA; Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Rachel S Mandelbaum
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA; Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Caroline J Violette
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Shinya Matsuzaki
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Jacqueline R Ho
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Jason D Wright
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Richard J Paulson
- Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA
| | - Koji Matsuo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA; Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA.
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Chen C, Li W, Yin M, Li M, Wu L, Si J, Zhao L, Li B, Yan Z, Lyu Q. Does the cell number of 0PN embryos on day 3 affect pregnancy and neonatal outcomes following single blastocyst transfer? BMC Pregnancy Childbirth 2022; 22:200. [PMID: 35279109 PMCID: PMC8918324 DOI: 10.1186/s12884-022-04492-7] [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: 10/26/2021] [Accepted: 02/17/2022] [Indexed: 11/30/2022] Open
Abstract
Background 0PN zygotes have a low cleavage rate, and the clinical outcomes of cleavage-stage embryo transfers are unsatisfactory. Blastocyst culturing is used to screen 0PN embryos, but whether the cell number of 0PN embryos on day 3 affects the clinical outcomes following single blastocyst transfer is unknown and would be helpful in evaluating the clinical value of these embryos. Methods This retrospective study compared 46,804 0PN zygotes, 242 0PN frozen-thawed single blastocyst transfers, and 92 corresponding 0PN singletons with 232,441 2PN zygotes, 3563 2PN frozen-thawed single blastocyst transfers, and 1250 2PN singletons from January 2015 to October 2019 at a tertiary-care academic medical centre. The 0PN and 2PN embryos were divided into two groups: the group with < 6 cells on day 3 and that with ≥ 6 cells. Embryo development, subsequent pregnancy and neonatal outcomes were compared between the two groups. Results The cleavage and available blastocyst rates of the 0PN zygotes were much lower than those of the 2PN zygotes (25.9% vs. 97.4%, P < 0.001; 13.9% vs. 23.4%, P < 0.001). In the < 6 cells group, the available blastocyst rate of the cleaved 0PN embryos was significantly lower than that of the 2PN embryos (2.5% vs. 12.7%, P < 0.001). However, in the ≥ 6 cells group, the available blastocyst rate of the 0PN cleaved embryos significantly improved, although it was slightly lower than that of the 2PN embryos (33.9% vs. 35.7%, P = 0.014). Importantly, compared to those of the 2PN single blastocyst transfers, the clinical pregnancy rate, live birth rate, Z-score and malformation rate of the 0PN single blastocyst transfers were not significantly different in either the < 6 cells group (30.4% vs. 39.8%, P = 0.362; 30.4% vs. 31.3%, P = 0.932; 0.89 ± 0.90 vs. 0.42 ± 1.02, P = 0.161; 0% vs. 2.6%, P = 1.000) or the ≥ 6 cells group (50.7% vs. 46.6%, P = 0.246; 39.7% vs. 38.3%, P = 0.677; 0.50 ± 1.23 vs. 0.47 ± 1.11, P = 0.861; 2.4% vs. 1.8%, P = 1.000). Conclusions The cell number on day 3 of 0PN embryos affected the subsequent formation of blastocysts but did not influence the subsequent pregnancy and neonatal outcomes of 0PN single blastocyst transfers, which may be beneficial to clinicians counselling patients on the clinical value of 0PN embryos. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04492-7.
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12
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Laganà AS, Forte G, Bizzarri M, Kamenov ZA, Bianco B, Kaya C, Gitas G, Alkatout I, Terzic M, Unfer V. Inositols in the ovaries: activities and potential therapeutic applications. Expert Opin Drug Metab Toxicol 2022; 18:123-133. [PMID: 35472446 DOI: 10.1080/17425255.2022.2071259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Myo-inositol (MI) and d-chiro-inositol (DCI) play a key role in ovarian physiology, as they are second messengers of insulin and gonadotropins. Ex-vivo and in-vitro experiments demonstrate that both isomers are deeply involved in steroid biosynthesis, and that reduced MI-to-DCI ratios are associated with pathological imbalance of sex hormones. AREAS COVERED This expert opinion provides an overview of the physiological distribution of MI and DCI in the ovarian tissues, and a thorough insight of their involvement into ovarian steroidogenesis. Insulin resistance and compensatory hyperinsulinemia dramatically reduce the MI-to-DCI ratio in the ovaries, leading to gynecological disorders characterized by hyperandrogenism, altered menstrual cycle and infertility. EXPERT OPINION Available evidence indicates that MI and DCI have very specific physiological roles and, seemingly, physiological MI-to-DCI ratios in the ovaries are crucial to maintain the correct homeostasis of steroids. Inositol treatments should be evaluated on the patients' specific conditions and needs, as long-term supplementation of high doses of DCI may cause detrimental effects on the ovarian functionality. In addition, the effects of inositol therapy on the different PCOS phenotypes should be further investigated in order to better tailor the supplementation.
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Affiliation(s)
- Antonio Simone Laganà
- The Experts Group on Inositols in Basic and Clinical Research (EGOI), Rome, Italy.,Unit of Gynecologic Oncology, ARNAS 'Civico - Di Cristina - Benfratelli', Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | | | - Mariano Bizzarri
- The Experts Group on Inositols in Basic and Clinical Research (EGOI), Rome, Italy.,Department of Experimental Medicine, Systems Biology Group Lab, Sapienza University of Rome, Rome, Italy
| | - Zdravko A Kamenov
- The Experts Group on Inositols in Basic and Clinical Research (EGOI), Rome, Italy.,Department of Internal Medicine, Medical University of Sofia, Sofia, Bulgaria
| | - Bianca Bianco
- Discipline of Sexual and Reproductive Health, and Populational Genetics - Department of Collective Health, Faculdade de Medicina do ABC/Centro Universitário FMABC, Santo André, Brazil
| | - Cihan Kaya
- Department of Obstetrics and Gynaecology, University of Health Sciences, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Georgios Gitas
- Department of Obstetrics and Gynecology, Charité Campus, Berlin, Germany
| | - Ibrahim Alkatout
- Department of Obstetrics and Gynecology, University Hospital Schleswig Holstein, Kiel, Germany
| | - Milan Terzic
- Department of Medicine, School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan.,National Research Center for Maternal and Child Health, Clinical Academic Department of Women's Health, University Medical Center, Nur-Sultan, Kazakhstan.,Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, 300 Halket Street, Pittsburgh, Pennsylvania, USA
| | - Vittorio Unfer
- The Experts Group on Inositols in Basic and Clinical Research (EGOI), Rome, Italy.,Systems Biology Group Lab, Rome, Italy
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13
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Gullo G, Etrusco A, Cucinella G, Perino A, Chiantera V, Laganà AS, Tomaiuolo R, Vitagliano A, Giampaolino P, Noventa M, Andrisani A, Buzzaccarini G. Fertility-Sparing Approach in Women Affected by Stage I and Low-Grade Endometrial Carcinoma: An Updated Overview. Int J Mol Sci 2021; 22:11825. [PMID: 34769256 PMCID: PMC8583899 DOI: 10.3390/ijms222111825] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/26/2021] [Accepted: 10/29/2021] [Indexed: 12/21/2022] Open
Abstract
Endometrial cancer (EC) is a deleterious condition which strongly affects a woman's quality of life. Although aggressive interventions should be considered to treat high-grade EC, a conservative approach should be taken into consideration for women wishing to conceive. In this scenario, we present an overview about the EC fertility-sparing approach state of art. Type I EC at low stage is the only histological type which can be addressed with a fertility-sparing approach. Moreover, no myometrium and/or adnexal invasion should be seen, and lymph-vascular space should not be involved. Regarding the pharmaceutical target, progestins, in particular medroxyprogesterone acetate (MPA) or megestrol acetate (MA), are the most employed agent in conservative treatment of early-stage EC. The metformin usage and hysteroscopic assessment is still under debate, despite promising results. Particularly strict and imperious attention should be given to the follow-up and psychological wellbeing of women, especially because of the double detrimental impairment: both EC and EC-related infertility consequences.
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Affiliation(s)
- Giuseppe Gullo
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, IVF UNIT, University of Palermo, 90146 Palermo, Italy; (G.G.); (G.C.); (A.P.)
| | - Andrea Etrusco
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, University of Palermo, 90146 Palermo, Italy;
| | - Gaspare Cucinella
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, IVF UNIT, University of Palermo, 90146 Palermo, Italy; (G.G.); (G.C.); (A.P.)
| | - Antonino Perino
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, IVF UNIT, University of Palermo, 90146 Palermo, Italy; (G.G.); (G.C.); (A.P.)
| | - Vito Chiantera
- Department of Gynecology Oncology, University of Palermo, 90146 Palermo, Italy;
| | - Antonio Simone Laganà
- Department of Obstetrics and Gynecology, “Filippo Del Ponte” Hospital, University of Insubria, 21100 Varese, Italy;
| | | | - Amerigo Vitagliano
- Department of Women’s and Children’s Health, Gynaecological Clinic, University of Padova, 35128 Padova, Italy; (A.V.); (M.N.); (A.A.)
| | | | - Marco Noventa
- Department of Women’s and Children’s Health, Gynaecological Clinic, University of Padova, 35128 Padova, Italy; (A.V.); (M.N.); (A.A.)
| | - Alessandra Andrisani
- Department of Women’s and Children’s Health, Gynaecological Clinic, University of Padova, 35128 Padova, Italy; (A.V.); (M.N.); (A.A.)
| | - Giovanni Buzzaccarini
- Department of Women’s and Children’s Health, Gynaecological Clinic, University of Padova, 35128 Padova, Italy; (A.V.); (M.N.); (A.A.)
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14
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Dietary Supplements for Female Infertility: A Critical Review of Their Composition. Nutrients 2021; 13:nu13103552. [PMID: 34684554 PMCID: PMC8541636 DOI: 10.3390/nu13103552] [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: 09/06/2021] [Accepted: 10/06/2021] [Indexed: 12/25/2022] Open
Abstract
Infertility is the condition of about 15% of couples that cannot get a conception after one year of unprotected sexual intercourse. In females, the reduced reproductive capacity underlies the most varied causes. Dietary supplements (DS) might be used to improve the pregnancy rate and a wide range of DS are proposed today to support female fertility. Although many authors demonstrated the positive effect of some of these products, the real efficacy of this approach is still debated. In order to evaluate the potential efficacy of DS for female infertility, we analysed the products marketed in Italy, using an original approach. A review of literature was performed to evaluate the effect of nutraceuticals on various female reproductive outcomes and to detect the minimal effective daily dose (mED) able to improve at least one of these. Thereafter, we conceived a formula to classify the expected efficacy of each DS. Each DS was scored and included into three classes of expected efficacy: higher, lower, and none. Ten out of 24 supplements (41.7%) resulted in the higher and 8 (34.3%) in the lower efficacy group, the remaining 6 DS (25.0%) were expected to have no efficacy. DS marketed in Italy are usually blends of many substances that are frequently employed at a negligible dose or without any evidence of efficacy. These findings raise serious doubt about the potential effectiveness of most commercial DS for female infertility.
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15
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Bezerra Espinola MS, Laganà AS, Bilotta G, Gullo G, Aragona C, Unfer V. D-chiro-inositol Induces Ovulation in Non-Polycystic Ovary Syndrome (PCOS), Non-Insulin-Resistant Young Women, Likely by Modulating Aromatase Expression: A Report of 2 Cases. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e932722. [PMID: 34615846 PMCID: PMC8503791 DOI: 10.12659/ajcr.932722] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Case series
Patients: Female, 19-year-old • Female, 23-year-old
Final Diagnosis: Anovulation
Symptoms: Oligomenorrhea
Medication: —
Clinical Procedure: —
Specialty: Obstetrics and Gynecology
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Affiliation(s)
- Maria Salomé Bezerra Espinola
- System Biology Group, Rome, Italy.,Alma Res Assisted Fertility Center, Rome, Italy.,The Experts Group on Inositol in Basic and Clinical Research (EGOI), Rome, Italy
| | - Antonio Simone Laganà
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), Rome, Italy.,Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
| | | | - Giuseppe Gullo
- IVF Unit, AOOR Villa Sofia Cervello, University of Palermo, Palermo, Italy
| | - Cesare Aragona
- System Biology Group, Rome, Italy.,The Experts Group on Inositol in Basic and Clinical Research (EGOI), Rome, Italy
| | - Vittorio Unfer
- System Biology Group, Rome, Italy.,The Experts Group on Inositol in Basic and Clinical Research (EGOI), Rome, Italy
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16
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Zhang XQ, Zhang LJ, Zhu XL, Xu H, Luo YQ, Yao L, Huang QW, Nong YQ, Liu WJ, Liu FH. The Clinical Efficacy of Three Different Follicle-Stimulating Hormones for Follicle Growth and Development in Long-Protocol Controlled Ovarian Hyperstimulation Treatment. Drug Des Devel Ther 2021; 15:3573-3580. [PMID: 34429586 PMCID: PMC8378929 DOI: 10.2147/dddt.s316189] [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] [Received: 04/16/2021] [Accepted: 07/08/2021] [Indexed: 12/05/2022] Open
Abstract
Objective To compare the use and clinical efficacy of three different follicle-stimulating hormones (FSHs) for follicle growth and development in long-protocol controlled ovarian hyperstimulation (COH). Methods A total of 540 gonadotropin-releasing hormone (GnRH) agonists’ long protocol treatment cycles at our hospital between January 2015 and May 2020 and met the inclusion criteria were retrospectively analyzed. The cycles were divided into three groups based on their indexes (groups A, B, and C). Each of the groups received a different type of FSH during treatment. A cross-group comparison was then undertaken to evaluate the growth and development of the three largest follicles and the patients’ pregnancy-related indexes between the normal-response and high-response populations. Results In the normal-response populations, the number of high-quality embryos obtained in groups A and B was significantly higher than in group C, and the FSH dosage was significantly lower than in group C (P < 0.05). There were more follicles with a diameter of 16–18 mm found in group A than in group C on the day of hCG injection (hCG day) (P < 0.05), but there were no significant differences in the groups in other indicators. In the high-response populations, the number of oocytes retrieved and high-quality embryos obtained in group A were significantly higher than in group C (P < 0.05), and the total dosage and duration of FSH stimulation in group C were significantly higher than groups A and B (P < 0.05). Conclusion Three different types of FSH led to comparable growth rates of the three largest follicles and clinical pregnancy rates per fresh cycle in long-protocol COH treatment.
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Affiliation(s)
- Xi-Qian Zhang
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, 511442, People's Republic of China
| | - Li-Jia Zhang
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, 511442, People's Republic of China
| | - Xiu-Lan Zhu
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, 511442, People's Republic of China
| | - Hong Xu
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, 511442, People's Republic of China
| | - Yan-Qun Luo
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, 511442, People's Republic of China
| | - Li Yao
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, 511442, People's Republic of China
| | - Qian-Wen Huang
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, 511442, People's Republic of China
| | - Ying-Qi Nong
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, 511442, People's Republic of China
| | - Wen-Juan Liu
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, 511442, People's Republic of China
| | - Feng-Hua Liu
- Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, 511442, People's Republic of China
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17
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De Luca MN, Colone M, Gambioli R, Stringaro A, Unfer V. Oxidative Stress and Male Fertility: Role of Antioxidants and Inositols. Antioxidants (Basel) 2021; 10:antiox10081283. [PMID: 34439531 PMCID: PMC8389261 DOI: 10.3390/antiox10081283] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/06/2021] [Accepted: 08/09/2021] [Indexed: 12/15/2022] Open
Abstract
Infertility is defined as a couple’s inability to conceive after at least one year of regular unprotected intercourse. This condition has become a global health problem affecting approximately 187 million couples worldwide and about half of the cases are attributable to male factors. Oxidative stress is a common reason for several conditions associated with male infertility. High levels of reactive oxygen species (ROS) impair sperm quality by decreasing motility and increasing the oxidation of DNA, of protein and of lipids. Multi-antioxidant supplementation is considered effective for male fertility parameters due to the synergistic effects of antioxidants. Most of them act by decreasing ROS concentration, thus improving sperm quality. In addition, other natural molecules, myo-inositol (MI) and d-chiro–inositol (DCI), ameliorate sperm quality. In sperm cells, MI is involved in many transduction mechanisms that regulate cytoplasmic calcium levels, capacitation and mitochondrial function. On the other hand, DCI is involved in the downregulation of steroidogenic enzyme aromatase, which produces testosterone. In this review, we analyze the processes involving oxidative stress in male fertility and the mechanisms of action of different molecules.
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Affiliation(s)
- Maria Nunzia De Luca
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00161 Rome, Italy; (M.N.D.L.); (R.G.); (V.U.)
- System Biology Group Lab, 00161 Rome, Italy
| | - Marisa Colone
- National Center for Drug Research and Evaluation, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy;
| | - Riccardo Gambioli
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00161 Rome, Italy; (M.N.D.L.); (R.G.); (V.U.)
- System Biology Group Lab, 00161 Rome, Italy
| | - Annarita Stringaro
- National Center for Drug Research and Evaluation, Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy;
- Correspondence:
| | - Vittorio Unfer
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00161 Rome, Italy; (M.N.D.L.); (R.G.); (V.U.)
- System Biology Group Lab, 00161 Rome, Italy
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18
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Moiseeva AV, Kudryavtseva VA, Nikolenko VN, Gevorgyan MM, Unanyan AL, Bakhmet AA, Sinelnikov MY. Genetic determination of the ovarian reserve: a literature review. J Ovarian Res 2021; 14:102. [PMID: 34362406 PMCID: PMC8349022 DOI: 10.1186/s13048-021-00850-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 07/23/2021] [Indexed: 12/30/2022] Open
Abstract
The ovarian reserve is one of the most important indicators of female fertility. It allows for the evaluation of the number of viable oocytes. This parameter is actively used in pregnancy planning and in assisted reproductive technology application, as it determines chances of successful fertilization and healthy pregnancy. Due to increased attention towards diagnostic tests evaluating the ovarian reserve, there has been a growing interest in factors that influence the state of the ovarian reserve. True reasons for pathological changes in the ovarian reserve and volume have not yet been explored in depth, and current diagnostic screening methods often fall short in efficacy. In the following review we analyze existing data relating to the study of the ovarian reserve through genetic testing, determining specific characteristics of the ovarian reserve through genetic profiling. We explore existing studies dedicated to finding specific genetic targets influencing the state of the ovarian reserve.
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Affiliation(s)
| | | | - Vladimir N Nikolenko
- Sechenov University, Mohovaya 11c10, Moscow, Russian Federation.,Moscow State University, Moscow, Russian Federation
| | | | - Ara L Unanyan
- Sechenov University, Mohovaya 11c10, Moscow, Russian Federation
| | | | - Mikhail Y Sinelnikov
- Sechenov University, Mohovaya 11c10, Moscow, Russian Federation. .,Research Institute of Human Morphology, Moscow, Russian Federation.
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19
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Melatonin and Myo-Inositol: Supporting Reproduction from the Oocyte to Birth. Int J Mol Sci 2021; 22:ijms22168433. [PMID: 34445135 PMCID: PMC8395120 DOI: 10.3390/ijms22168433] [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: 07/08/2021] [Revised: 07/30/2021] [Accepted: 08/03/2021] [Indexed: 12/16/2022] Open
Abstract
Human pregnancy is a sequence of events finely tuned by several molecular interactions that come with a new birth. The precise interlocking of these events affecting the reproductive system guarantees safe embryo formation and fetal development. In this scenario, melatonin and myo-inositol seem to be pivotal not only in the physiology of the reproduction process, but also in the promotion of positive gestational outcomes. Evidence demonstrates that melatonin, beyond the role of circadian rhythm management, is a key controller of human reproductive functions. Similarly, as the most representative member of the inositol’s family, myo-inositol is essential in ensuring correct advancing of reproductive cellular events. The molecular crosstalk mediated by these two species is directly regulated by their availability in the human body. To date, biological implications of unbalanced amounts of melatonin and myo-inositol in each pregnancy step are growing the idea that these molecules actively contribute to reduce negative outcomes and improve the fertilization rate. Clinical data suggest that melatonin and myo-inositol may constitute an optimal dietary supplementation to sustain safe human gestation and a new potential way to prevent pregnancy-associated pathologies.
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20
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Wawrzkiewicz-Jałowiecka A, Lalik A, Soveral G. Recent Update on the Molecular Mechanisms of Gonadal Steroids Action in Adipose Tissue. Int J Mol Sci 2021; 22:5226. [PMID: 34069293 PMCID: PMC8157194 DOI: 10.3390/ijms22105226] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/04/2021] [Accepted: 05/11/2021] [Indexed: 02/07/2023] Open
Abstract
The gonadal steroids, including androgens, estrogens and progestogens, are involved in the control of body fat distribution in humans. Nevertheless, not only the size and localization of the fat depots depend on the sex steroids levels, but they can also highly affect the functioning of adipose tissue. Namely, the gonadocorticoids can directly influence insulin signaling, lipid metabolism, fatty acid uptake and adipokine production. They may also alter energy balance and glucose homeostasis in adipocytes in an indirect way, e.g., by changing the expression level of aquaglyceroporins. This work presents the recent advances in understanding the molecular mechanism of how the gonadal steroids influence the functioning of adipose tissue leading to a set of detrimental metabolic consequences. Special attention is given here to highlighting the sexual dimorphism of adipocyte functioning in terms of health and disease. Particularly, we discuss the molecular background of metabolic disturbances occurring in consequence of hormonal imbalance which is characteristic of some common endocrinopathies such as the polycystic ovary syndrome. From this perspective, we highlight the potential drug targets and the active substances which can be used in personalized sex-specific management of metabolic diseases, in accord with the patient's hormonal status.
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Affiliation(s)
- Agata Wawrzkiewicz-Jałowiecka
- Department of Physical Chemistry and Technology of Polymers, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Anna Lalik
- Department of Systems Biology and Engineering, Silesian University of Technology, Akademicka 16, 44-100 Gliwice, Poland;
- Biotechnology Center, Silesian University of Technology, B. Krzywoustego 8, 44-100 Gliwice, Poland
| | - Graça Soveral
- Faculty of Pharmacy, Research Institute for Medicines (iMed.ULisboa), Universidade de Lisboa, 1649-003 Lisboa, Portugal;
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21
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Mathieu d’Argent E, Ravel C, Rousseau A, Morcel K, Massin N, Sussfeld J, Simon T, Antoine JM, Mandelbaume J, Daraï E, Kolanska K. High-Dose Supplementation of Folic Acid in Infertile Men Improves IVF-ICSI Outcomes: A Randomized Controlled Trial (FOLFIV Trial). J Clin Med 2021; 10:jcm10091876. [PMID: 33925981 PMCID: PMC8123699 DOI: 10.3390/jcm10091876] [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: 03/25/2021] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 02/05/2023] Open
Abstract
Dietary supplementation is commonly used in men with male infertility but its exact role is poorly understood. The aim of this multicenter, randomized, double-blind, placebo-controlled trial was to evaluate the impact of high-dose folic acid supplementation on IVF-ICSI outcomes. 162 couples with male infertility and an indication for IVF-ICSI were included for one IVF-ICSI cycle. Male partners of couples wishing to conceive, aged 18-60 years old, with at least one abnormal spermatic criterion were randomized in a 1:1 ratio to receive daily supplements containing 15 mg of folic acid or a placebo for 3 months from Day 0 until semen collection for IVF-ICSI. Sperm parameters and DNA fragmentation before and after the treatment and the biochemical and clinical pregnancy rates after the fresh embryo transfer were analyzed. We observed an increase in the biochemical pregnancy rate and a trend for a higher clinical pregnancy rate in the folic acid group compared to placebo (44.1% versus 22.4%, p = 0.01 and 35.6% versus 20.4%, p = 0.082, respectively). Even if no changes in sperm characteristics were observed, a decrease in DNA fragmentation in the folic acid group was noted (8.5 ± 4.5 vs. 6.4 ± 4.6, p < 0.0001). High-dose folic acid supplementation in men requiring IVF-ICSI for male infertility improves IVF-ICSI outcomes.
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Affiliation(s)
- Emmanuelle Mathieu d’Argent
- Service de Gynécologie Obstétrique et Médecine de la Reproduction, AP-HP Sorbonne Université site Tenon, 4 rue de la Chine, 75020 Paris, France; (J.S.); (J.-M.A.); (E.D.); (K.K.)
- Correspondence:
| | - Celia Ravel
- CHU Rennes, Laboratoire de Biologie de la Reproduction-CECOS, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)-UMR_S 1085, Université de Rennes, 35000 Rennes, France;
| | - Alexandra Rousseau
- Department of Clinical Pharmacology and Clinical Research Platform of East of Paris (URCEST-CRC-CRB), APHP Sorbonne Universite, Hôpital Saint Antoine, 75012 Paris, France; (A.R.); (T.S.)
| | - Karine Morcel
- Centre d’Assistance Médicale à la Procréation, Service de Gynécologie-Obstétrique, CHU de Brest, Hôpital Morvan, 29609 Brest, France;
| | - Nathalie Massin
- Centre Hospitalier Intercommunal de Créteil, Department of Gynecology, Obstetrics and Reproductive Medicine, Université Paris-Est Créteil, 94010 Créteil, France;
| | - Julie Sussfeld
- Service de Gynécologie Obstétrique et Médecine de la Reproduction, AP-HP Sorbonne Université site Tenon, 4 rue de la Chine, 75020 Paris, France; (J.S.); (J.-M.A.); (E.D.); (K.K.)
| | - Tabassome Simon
- Department of Clinical Pharmacology and Clinical Research Platform of East of Paris (URCEST-CRC-CRB), APHP Sorbonne Universite, Hôpital Saint Antoine, 75012 Paris, France; (A.R.); (T.S.)
| | - Jean-Marie Antoine
- Service de Gynécologie Obstétrique et Médecine de la Reproduction, AP-HP Sorbonne Université site Tenon, 4 rue de la Chine, 75020 Paris, France; (J.S.); (J.-M.A.); (E.D.); (K.K.)
| | - Jacqueline Mandelbaume
- Service de Biologie de la Reproduction, Centre d’Etudes et de Conservation des œufs et du Sperme Humains (CECOS), Hôpital Tenon, Assistance Publique-Hôpitaux de Paris (APHP), Université Paris 06, 75020 Paris, France;
| | - Emile Daraï
- Service de Gynécologie Obstétrique et Médecine de la Reproduction, AP-HP Sorbonne Université site Tenon, 4 rue de la Chine, 75020 Paris, France; (J.S.); (J.-M.A.); (E.D.); (K.K.)
| | - Kamila Kolanska
- Service de Gynécologie Obstétrique et Médecine de la Reproduction, AP-HP Sorbonne Université site Tenon, 4 rue de la Chine, 75020 Paris, France; (J.S.); (J.-M.A.); (E.D.); (K.K.)
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22
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Leisegang K, Almaghrawi W, Henkel R. The effect of Nigella sativa oil and metformin on male seminal parameters and testosterone in Wistar rats exposed to an obesogenic diet. Biomed Pharmacother 2021; 133:111085. [PMID: 33378981 DOI: 10.1016/j.biopha.2020.111085] [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: 08/03/2020] [Revised: 11/06/2020] [Accepted: 11/28/2020] [Indexed: 12/12/2022] Open
Abstract
Obesity is a significant global health and socio-economic challenge, and considered an important risk factor for poor health outcomes including male reproductive dysfunction and infertility. As excess adiposity causes testicular dysfunction and infertility, novel therapeutic strategies require investigation. Nigella sativa (Ns) seed oil and metformin have both demonstrated a potential positive effect on obesity, although both remain poorly investigated in male fertility. Therefore, this study aimed to determine the effect of Ns oil and metformin on total body weight (TBW), mitochondrial membrane potential (MMP), serum testosterone and semen parameters in an obese animal model. Wistar rats (n = 54) were divided into six groups: normal chow (NC), high sugar diet (HSD) only, HSD and saline, HSD and metformin (75 mg/Kg/day), HSD and Ns (200 mg/Kg/day) (NS200), HSD and Ns (400 mg/Kg/day) (NS400). Intervention was force fed for the last 8 weeks of the 14 weeks dietary exposures. Results showed that the HSD increased TBW (P = 0.001) and reduced sperm concentration (P = 0.013) and progressive motility (P = 0.009) compared to the NC group. Metformin, NS200 and NS400 improved TBW (P = 0.035, P = 0.006 and P = 0.005, respectively) and testosterone (P < 0.001) compared to the HSD saline group, where metformin and NS400 improved sperm concentration (P < 0.001 and P = 0.049, respectively) and MMP (P < 0.001). There were no changes in sperm motility and viability for all experimental exposures, although NS400 (P = 0.047) negatively affected sperm viability. Metformin and Ns may be novel treatment options in obesity-induced infertility, although a potential negative impact on viability is cautioned for high dose Ns. These results warrant further investigation of Ns and Metformin for the management of obese infertile males.
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Affiliation(s)
- Kristian Leisegang
- School of Natural Medicine, University of the Western Cape, Private Bag X17, Bellville 7535, South Africa.
| | - Walid Almaghrawi
- Department of Medical Biosciences, University of the Western Cape, Private Bag X17, Bellville 7535, South Africa
| | - Ralf Henkel
- Department of Medical Biosciences, University of the Western Cape, Private Bag X17, Bellville 7535, South Africa; American Center for Reproductive Medicine, Department of Urology, Cleveland Clinic, Cleveland, OH, United States; Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
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23
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Regidor PA, Mueller A, Sailer M, Gonzalez Santos F, Rizo JM, Moreno Egea F. Chronic Inflammation in PCOS: The Potential Benefits of Specialized Pro-Resolving Lipid Mediators (SPMs) in the Improvement of the Resolutive Response. Int J Mol Sci 2020; 22:ijms22010384. [PMID: 33396555 PMCID: PMC7795660 DOI: 10.3390/ijms22010384] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/04/2020] [Accepted: 12/10/2020] [Indexed: 12/13/2022] Open
Abstract
PCOS as the most common endocrine disorder of women in their reproductive age affects between 5–15% of the female population. Apart from its cardinal symptoms, like irregular and anovulatory cycles, hyperandrogenemia and a typical ultrasound feature of the ovary, obesity, and insulin resistance are often associated with the disease. Furthermore, PCOS represents a status of chronic inflammation with permanently elevated levels of inflammatory markers including IL-6 and IL-18, TNF-α, and CRP. Inflammation, as discovered only recently, consists of two processes occurring concomitantly: active initiation, involving “classical” mediators including prostaglandins and leukotrienes, and active resolution processes based on the action of so-called specialized pro-resolving mediators (SPMs). These novel lipid mediator molecules derive from the essential ω3-poly-unsaturated fatty acids (PUFAs) DHA and EPA and are synthesized via specific intermediates. The role and benefits of SPMs in chronic inflammatory diseases like obesity, atherosclerosis, and Diabetes mellitus has become a subject of intense research during the last years and since PCOS features several of these pathologies, this review aims at summarizing potential roles of SPMs in this disease and their putative use as novel therapeutics.
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Affiliation(s)
| | - Anna Mueller
- Exeltis Germany GmbH, Adalperostr. 84, 85737 Ismaning, Germany; (A.M.); (M.S.)
| | - Manuela Sailer
- Exeltis Germany GmbH, Adalperostr. 84, 85737 Ismaning, Germany; (A.M.); (M.S.)
| | | | | | - Fernando Moreno Egea
- Solutex SA. Avenida de la Transición Española 24, 28108 Alcobendas, Spain; (F.G.S.); (F.M.E.)
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24
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Effect of Excessive Body Weight and Psoriasis in Women Undergoing ICSI Procedure and State of Health of the Newborn. J Clin Med 2020; 9:jcm9113628. [PMID: 33187195 PMCID: PMC7696436 DOI: 10.3390/jcm9113628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 10/30/2020] [Accepted: 11/09/2020] [Indexed: 12/13/2022] Open
Abstract
Excessive body weight and some concomitant diseases, such as psoriasis, accompany women treated due to infertility by intracytoplasmic sperm injection (ICSI). This study is aimed to assess effect of obesity and psoriasis on quality of egg cells, embryos, course of pregnancy, and state of a newborn after treatment with ICSI. A total of 140 women were included into the study (110 healthy women and 30 with psoriasis). Among healthy women, BMI negatively correlated with total recovery rate, total oocyte score, blastocyst formation rate (BFR) and amount and quality of blastocysts (r < 0, p < 0.001). The relationships were similar in psoriasis, however apart from average blastocyst quality (p = 0.17) and BFR (p = 0.352). In healthy patients, BMI negatively correlated with gestational age at delivery (r = −0.444, p = 0.010) and APGAR (r = −0.481, p = 0.005). An excess of adipose tissue exerts an unfavourable effect on female reproductive functions, especially with a simultaneous burden of psoriasis. Excessive body weight is conducive to development of gestational diabetes and shortens the duration of pregnancy. The burden of psoriasis in combination with excessive body weight has an impact on the risk of occurrence of intrauterine growth restriction of foetus. Overweight and obesity negatively affect the state of a newborn, measured using APGAR scale.
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25
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Role of Inositols and Inositol Phosphates in Energy Metabolism. Molecules 2020; 25:molecules25215079. [PMID: 33139672 PMCID: PMC7663797 DOI: 10.3390/molecules25215079] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 10/27/2020] [Accepted: 10/27/2020] [Indexed: 12/12/2022] Open
Abstract
Recently, inositols, especially myo-inositol and inositol hexakisphosphate, also known as phytic acid or IP6, with their biological activities received much attention for their role in multiple health beneficial effects. Although their roles in cancer treatment and prevention have been extensively reported, interestingly, they may also have distinctive properties in energy metabolism and metabolic disorders. We review inositols and inositol phosphate metabolism in mammalian cells to establish their biological activities and highlight their potential roles in energy metabolism. These molecules are known to decrease insulin resistance, increase insulin sensitivity, and have diverse properties with importance from cell signaling to metabolism. Evidence showed that inositol phosphates might enhance the browning of white adipocytes and directly improve insulin sensitivity through adipocytes. In addition, inositol pyrophosphates containing high-energy phosphate bonds are considered in increasing cellular energetics. Despite all recent advances, many aspects of the bioactivity of inositol phosphates are still not clear, especially their effects on insulin resistance and alteration of metabolism, so more research is needed.
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26
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Santoro M, Aquila S, Russo G. Sperm performance in oligoasthenoteratozoospermic patients is induced by a nutraceuticals mix, containing mainly myo-inositol. Syst Biol Reprod Med 2020; 67:50-63. [PMID: 33094655 DOI: 10.1080/19396368.2020.1826067] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The action of myo-inositol (MI), belonging to the inositol family, has been shown to improve sperm quality. To further elucidate the efficacy of this substance in male fertility, we investigated in vivo the effects of a nutraceuticals mix, containing mainly myo-inositol (MI) and in vitro the action of the MI on human male gamete performance. Sperm samples were evaluated from 51 men: 21 healthy normozoospermic and 30 oligoasthenoteratozoospermic (OAT). In the latter group, 15 patients were orally treated with the nutraceutical mix and in the remaining 15 patients only MI was used directly on their ejaculated sperm. Comparing the pathologic samples with respect to normal samples we observed that motility, viability, Bcl-2 phosphorylation, and cholesterol efflux increased after in vitro and in vivo treatments. Glucose-6-phosphate dehydrogenase activity as well as triglycerides level and lipase activity highlighted an enhancement of energy expenditure upon the treatment. Uncapacitated sperm is characterized by an anabolic metabolism, to generate an energy reservoir which will be spent during the capacitation, an energy-consuming process needed to acquire the competence for the fertilization. Intriguingly, our finding highlights that the treatment with these substances facilitated the switch from uncapacitated to capacitated sperm, promoting the acquisition of the male gamete fertilizing capacity. Our data suggested that these substances act both directly on sperm and on spermatogenesis, improving the performance of OAT sperm invitro and invivo. The positive effects of these treatments could be of great help for men and couples who have difficulty to conceive achild in anatural way and/or during medical-assisted reproduction.Abbreviations: 30 OAT-untreated patients; B: 15 OAT patients treated in vivo; Bovine serum albumin (BSA); C: 15 OAT patients treated in vitro; cholesterol oxidase-peroxidase (CHOD-POD); H: Normozoospermic samples; HM: sperm from normospermic patients treated in vitro with MI; MI: Myoinositol: IM: Immobile motility; NP: Non-progressive motility; OAT: Oligoasthenoteratozoospermic; PPP: Pentose Phosphate Pathway; PR: Progressive motility; WHO: World Health Organization.
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Affiliation(s)
- Marta Santoro
- Department of Pharmacy and Sciences of Health and Nutrition Sciences, University of Calabria, Arcavacata Di Rende, Italy.,Health Center, University of Calabria Arcavacata Di Rende, Italy
| | - Saveria Aquila
- Department of Pharmacy and Sciences of Health and Nutrition Sciences, University of Calabria, Arcavacata Di Rende, Italy.,Health Center, University of Calabria Arcavacata Di Rende, Italy
| | - Giampiero Russo
- Family Counseling Center (ASP Cosenza), Arcavacata Di Rende, Italy
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Kim SY, Park ES, Kim HW. Effectiveness of Non-Pharmacological Interventions for Overweight or Obese Infertile Women: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207438. [PMID: 33066039 PMCID: PMC7650570 DOI: 10.3390/ijerph17207438] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/27/2020] [Accepted: 10/05/2020] [Indexed: 12/23/2022]
Abstract
Obesity is a well-known risk factor for infertility, and nonpharmacological treatments are recommended as effective and safe, but evidence is still lacking on whether nonpharmacological interventions improve fertility in overweight or obese women. The aim of this study was to systematically assess the current evidence in the literature and to evaluate the impact of nonpharmacological interventions on improving pregnancy-related outcomes in overweight or obese infertile women. Seven databases were searched for randomized controlled trials (RCTs) of nonpharmacological interventions for infertile women with overweight or obesity through August 16, 2019 with no language restriction. A meta-analysis was conducted of the primary outcomes. A total of 21 RCTs were selected and systematically reviewed. Compared to the control group, nonpharmacological interventions significantly increased the pregnancy rate (relative risk (RR), 1.37; 95% CI, 1.04–1.81; p = 0.03; I2 = 58%; nine RCTs) and the natural conception rate (RR, 2.17, 95% CI, 1.41–3.34; p = 0.0004; I2 = 19%, five RCTs). However, they had no significant effect on the live birth rate (RR, 1.36, 95% CI, 0.94–1.95; p=0.10, I2 = 65%, eight RCTs) and increased the risk of miscarriage (RR: 1.57, 95% CI, 1.05–2.36; p = 0.03; I2 = 0%). Therefore, nonpharmacological interventions could have a positive effect on the pregnancy and natural conception rates, whereas it is unclear whether they improve the live birth rate. Further research is needed to demonstrate the integrated effects of nonpharmacological interventions involving psychological outcomes, as well as pregnancy-related outcomes.
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Affiliation(s)
- Seo Yun Kim
- College of Nursing, Seoul National University, Seoul 03080, Korea;
| | - Eun-Sun Park
- Medical Library, Seoul National University, Seoul 03080, Korea;
| | - Hae Won Kim
- Research Institute of Nursing Science, College of Nursing, Seoul National University, Seoul 03080, Korea
- Correspondence: ; Tel.: +82-2-740-8820
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28
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Aksu K, Akincioglu H, Gulcin I, Kelebekli L. Concise syntheses and some biological activities of dl-2,5-di-O-methyl-chiro-inositol, dl-1,4-di-O-methyl-scyllo-inositol, and dl-1,6-dibromo-1,6-dideoxy-2,5-di-O-methyl-chiro-inositol. Arch Pharm (Weinheim) 2020; 354:e2000254. [PMID: 32997390 DOI: 10.1002/ardp.202000254] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/07/2020] [Accepted: 09/10/2020] [Indexed: 11/11/2022]
Abstract
The regio- and stereospecific synthesis of O-methyl-chiro-inositols and O-methyl-scyllo-inositol was achieved, starting from p-benzoquinone. After preparing dimethoxy conduritol-B as a key compound, regiospecific bromination of the alkene moiety of dimethoxy conduritol-B and acid-catalyzed ring opening of dimethoxydiacetate conduritol-B epoxide with Ac2 O afforded the desired new chiro-inositol derivatives and scyllo-inositol derivative, respectively. Spectroscopic methods were employed for the characterization of all synthesized compounds. The novel inositols (11-17) had effective inhibition profiles against human carbonic anhydrase isoenzymes I and II (hCA I and II) and acetylcholinesterase (AChE). The novel inositols 11-17 were found to be effective inhibitors against AChE, hCA I, and hCA II enzymes. Ki values were calculated in the range of 87.59 ± 7.011 to 237.95 ± 17.75 μM for hCA I, 65.08 ± 12.39 to 538.98 ± 61.26 μM for hCA II, and 193.28 ± 43.13 to 765.08 ± 209.77 μM for AChE, respectively. Also, due to the inhibitory effects of the novel inositols 11-17 against the tested enzymes, these novel inositols are potential drug candidates to treat some diseases such as glaucoma, epilepsy, leukemia, and Alzheimer's disease.
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Affiliation(s)
- Kadir Aksu
- Department of Chemistry, Faculty of Sciences and Arts, Ordu University, Ordu, Turkey
| | - Hulya Akincioglu
- Department of Chemistry, Faculty of Sciences and Arts, Agri Ibrahim Cecen University, Agri, Turkey
| | - Ilhami Gulcin
- Department of Chemistry, Faculty of Sciences, Ataturk University, Erzurum, Turkey
| | - Latif Kelebekli
- Department of Chemistry, Faculty of Sciences and Arts, Ordu University, Ordu, Turkey
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29
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Mahey R, Gupta M, Bansiwal R, Sethi A. Successful IVF outcome after repeat laparoscopic ovarian drilling in a case of resistant PCOS. BMJ Case Rep 2020; 13:13/9/e235628. [PMID: 32912889 DOI: 10.1136/bcr-2020-235628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Ovulation induction (OVI) is the first-line treatment option for infertile women with polycystic ovary syndrome (PCOS). We report a case of resistant PCOS who responded to OVI after laparoscopic ovarian drilling (LOD) but suffered miscarriages in first trimester on three occasions, had late-onset moderate ovarian hyperstimulation syndrome (OHSS) in one cycle and recurrent anovulation. She underwent one in vitro fertilisation (IVF) cycle but it resulted in poor oocyte yield (four oocytes) and failed conception. Second LOD followed by IVF resulted in successful outcome in terms of good oocyte yield and successful live birth as well as supernumerary embryos frozen for future use. Repeat LOD may be considered in selected PCOS patients who fail to have successful pregnancy outcome despite multiple OVI cycles, have chronic anovulation, persistently raised serum antimullerian hormone and luteinising hormone, history of OHSS during OVI and prior poor response in IVF cycle.
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Affiliation(s)
- Reeta Mahey
- Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Monica Gupta
- Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Reeta Bansiwal
- Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Ankita Sethi
- Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi, Delhi, India
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30
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Laganà AS, Garzon S, Unfer V. New clinical targets of d-chiro-inositol: rationale and potential applications. Expert Opin Drug Metab Toxicol 2020; 16:703-710. [PMID: 32552009 DOI: 10.1080/17425255.2020.1785429] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Inositols have a key role in ovarian physiology and the literature reports a wealth of studies about the major isomer, myo-inositol (MI). However, information about d-chiro-inositol (DCI) is still scarce, despite the ratio MI:DCI is tissue-specific and actively maintained by an insulin-dependent epimerase enzyme. AREAS COVERED This expert opinion provides an overview of the physiological contribution of DCI in regulating steroidogenesis. DCI indeed mediates the intracellular signaling of insulin, which induces the biosynthesis of androgens. Studies on second messengers of insulin also revealed that DCI has a specific role in modulating the activity of aromatase enzyme. Specifically, recent findings demonstrated that DCI influences the enzyme gene expression, thus reducing the conversion of androgens into estrogens. EXPERT OPINION Available evidence suggests that the effects of DCI administration may be similar to those of aromatase inhibitors, but without causing hypo-estrogenic states. Therefore, DCI treatments should be evaluated for either estrogen-dependent gynecological conditions or low testosterone states in male subjects.
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Affiliation(s)
- Antonio Simone Laganà
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria , Varese, Italy.,The Experts Group on Inositol in Basic and Clinical Research (EGOI): https://www.inositolgroup.com
| | - Simone Garzon
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria , Varese, Italy
| | - Vittorio Unfer
- The Experts Group on Inositol in Basic and Clinical Research (EGOI): https://www.inositolgroup.com.,Systems Biology Group Lab, "Sapienza" University , Piazza Biroldi 1, 21100 Varese, Italy
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31
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Huang J, Xie L, Lin J, Lu X, Song N, Cai R, Kuang Y. Adherence to healthy dietary patterns and outcomes of assisted reproduction: a systematic review and meta-analysis. Int J Food Sci Nutr 2020; 72:148-159. [PMID: 32633179 DOI: 10.1080/09637486.2020.1787958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This systematic review and meta-analysis aimed to evaluate the association between adherence to a healthy dietary pattern and outcomes of assisted reproductive techniques (ARTs). PubMed, Embase and Web of Science were searched for eligible studies through December 2019 according to the population, intervention, comparison, outcome and study design (PICOS) criteria. Eight prospective cohort studies (S) reporting pregnancy outcomes (O) of higher vs lower adherence to a healthy dietary pattern (I/C) in women undergoing ART treatment (P) were included, involving a total of 2229 women with 2067 embryo transfer cycles. The pooled odds ratio (OR) for positive pregnancy test, clinical pregnancy and ongoing pregnancy/live birth was 0.82 (95% confidence interval [CI] 0.65-1.03), 0.99 (95% CI 0.68-1.44) and 1.30 (95% CI 0.81-2.09), respectively. In conclusion, greater adherence to a healthy dietary pattern rich in vegetables, fruits, whole grains, legumes and fish, may not be significantly related to ART success.
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Affiliation(s)
- Jialyu Huang
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Luyao Xie
- Department of Nutrition, Shanghai Jiao Tong University School of Public Health, Shanghai, PR China
| | - Jiaying Lin
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Xuefeng Lu
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Ning Song
- Department of Histology, Embryology, Genetics and Developmental Biology, Shanghai Key Laboratory of Reproductive Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Renfei Cai
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
| | - Yanping Kuang
- Department of Assisted Reproduction, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China
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