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Skåra KH, Hernáez Á, Næss Ø, Fraser A, Lawlor DA, Burgess S, Brumpton BM, Magnus MC. Cardiovascular disease risk factors and infertility: multivariable analyses and one-sample Mendelian randomization analyses in the Trøndelag Health Study. Hum Reprod Open 2024; 2024:hoae033. [PMID: 38911051 PMCID: PMC11190059 DOI: 10.1093/hropen/hoae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 05/03/2024] [Indexed: 06/25/2024] Open
Abstract
STUDY QUESTION Are cardiovascular disease (CVD) risk factors causally associated with higher risk of infertility among women and men? SUMMARY ANSWER We found evidence to support a causal relationship between smoking initiation and history of infertility in women. WHAT IS KNOWN ALREADY Several CVD risk factors are associated with history of infertility. Previous studies using Mendelian randomization (MR) further support a causal relationship between BMI and infertility in women. STUDY DESIGN SIZE DURATION We used data from the Trøndelag Health Study (HUNT) in Norway, a prospective population-based cohort study, including 26 811 women and 15 598 men participating in three survey collections in 1995-1997 (HUNT2), 2006-2008 (HUNT3), and 2017-2019 (HUNT4). PARTICIPANTS/MATERIALS SETTING METHODS Our outcome was women's self-reported history of infertility, defined as ever having tried to conceive for 12 months or more or having used ART. We assigned the history of infertility reported by women to their male partners; therefore, the measure of infertility was on the couple level. We used both conventional multivariable analyses and one-sample MR analyses to evaluate the association between female and male CVD risk factors (including BMI, blood pressure, lipid profile measurements, and smoking behaviours) and history of infertility in women and men, separately. MAIN RESULTS AND THE ROLE OF CHANCE A total of 4702 women (18%) and 2508 men (16%) were classified with a history of infertility. We found a higher risk of infertility among female smokers compared to non-smokers in both multivariable and MR analyses (odds ratio (OR) in multivariable analysis, 1.20; 95% CI, 1.12-1.28; OR in MR analysis, 1.13; CI, 1.02-1.26), and potentially for higher BMI (OR in multivariable analysis, 1.13; CI, 1.09-1.18; OR in MR analysis, 1.11, CI, 0.92-1.34). In multivariable analysis in women, we also found evidence of associations between triglyceride levels, high-density lipoprotein cholesterol, lifetime smoking index, and smoking intensity with higher risk of infertility. However, these results were not consistent in MR analyses. We found no robust or consistent associations between male CVD risk factors and infertility. LIMITATIONS REASONS FOR CAUTION Our main limitation was that the CVD risk factors measured might not adequately capture the relevant time periods for when couples were trying to conceive. Additionally, we did not have information on causes of infertility in either women or men. WIDER IMPLICATIONS OF THE FINDINGS Women with infertility could have a worse CVD risk factor profile and thus public health interventions aimed at reducing the impact of some CVD risk factors, such as smoking and BMI, could reduce the burden of infertility. However, additional MR studies of the relationship between CVD risk factors and infertility with a larger sample size would be of value. STUDY FUNDING/COMPETING INTERESTS The study was supported by a grant from the European Research Council under the European Union's Horizon 2020 research and innovation program (grant agreements no. 947684). This research was also supported by the Research Council of Norway through its Centres of Excellence funding scheme (project no. 262700) and partly funded by the Research Council of Norway, project: Women's fertility-an essential component of health and well-being (project no. 320656). D.A.L. and A.F. work in a unit that is supported by the University of Bristol and the UK Medical Research Council (MC_UU_00011/6). D.A.L.'s contribution to the article is supported by the European Research Council (101021566), the British Heart Foundation (CH/F/20/90003 and AA/18/7/34219). S.B.'s contribution to the article is supported by the Wellcome Trust (225790/Z/22/Z). B.M.B. is funded by The Liaison Committee for education, research and innovation in Central Norway; and the Joint Research Committee between St. Olavs Hospital and the Faculty of Medicine and Health Sciences, NTNU. The genotyping in HUNT was financed by the National Institute of Health (NIH); University of Michigan; The Research Council of Norway; The Liaison Committee for education, research and innovation in Central Norway; and the Joint Research Committee between St. Olavs Hospital and the Faculty of Medicine and Health Sciences, NTNU. None of the funding organizations influenced the study design, reporting, or interpretation of results. The views expressed in the present article are those of the authors and not necessarily any acknowledged funding organization. D.A.L. reports grants from Medtronic Ltd and Roche Diagnostics outside the submitted work. The other authors have no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Karoline H Skåra
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Álvaro Hernáez
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Consorcio CIBER, M.P. Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
- Blanquerna School of Health Sciences, Universitat Ramon Llull, Barcelona, Spain
| | - Øyvind Næss
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Abigail Fraser
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Stephen Burgess
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Ben M Brumpton
- HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing, NTNU Norwegian University of Science and Technology, Levanger, Norway
- HUNT Research Centre, Department of Public Health and Nursing, NTNU Norwegian University of Science and Technology, Levanger, Norway
- Clinic of Medicine, St Olavs Hospital, Trondheim University, Trondheim, Norway
| | - Maria C Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
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Li P, Langer M, Vilsmaier T, Kramer M, Sciuk F, Kolbinger B, Jakob A, Rogenhofer N, Dalla-Pozza R, Thaler C, Haas NA, Oberhoffer FS. Vascular Health of Females with History of Assisted Reproductive Technology. J Cardiovasc Dev Dis 2024; 11:66. [PMID: 38392280 PMCID: PMC10889395 DOI: 10.3390/jcdd11020066] [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: 02/06/2024] [Accepted: 02/12/2024] [Indexed: 02/24/2024] Open
Abstract
The use of assisted reproductive technologies (ART) for the treatment of infertility is gaining popularity. Limited data on the overall vascular health of females with history of ART are available. This pilot study aimed to investigate the overall vascular health of females with history of ART compared to individuals who conceived spontaneously. The assessment of overall vascular health included the measurement of brachial blood pressure, central blood pressure, and pulse wave velocity, as well as the evaluation of the arterial stiffness and carotid intima-media thickness (cIMT) of the common carotid arteries. Conventional blood lipids including lipoprotein a (Lp(a)) were also determined. In total, 45 females with history of ART and 52 females who conceived spontaneously were included (mean age: 47.72 ± 5.96 years vs. 46.84 ± 7.43 years, p = 0.525). An initial comparison revealed a significantly higher prevalence of elevated Lp(a) in ART females (p = 0.011). However, after multiple comparison correction, the significant result disappeared (p = 0.132). Within the cohort of ART females, no significantly higher cardiovascular risk was detected regarding vascular function. The potentially higher prevalence of elevated Lp(a) in ART females must be further investigated in future studies, as it might contribute to the impaired reproductive process in this cohort.
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Affiliation(s)
- Pengzhu Li
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Magdalena Langer
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Theresa Vilsmaier
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Marie Kramer
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Franziska Sciuk
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Brenda Kolbinger
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, University Hospital, LMU Munich, 81377 Munich, Germany
| | - André Jakob
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Nina Rogenhofer
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Robert Dalla-Pozza
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Christian Thaler
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Nikolaus Alexander Haas
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Felix Sebastian Oberhoffer
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, 81377 Munich, Germany
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Leone Roberti Maggiore U, Chiappa V, Ceccaroni M, Roviglione G, Savelli L, Ferrero S, Raspagliesi F, Spanò Bascio L. Epidemiology of infertility in women with endometriosis. Best Pract Res Clin Obstet Gynaecol 2024; 92:102454. [PMID: 38183767 DOI: 10.1016/j.bpobgyn.2023.102454] [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: 11/19/2023] [Accepted: 12/21/2023] [Indexed: 01/08/2024]
Abstract
Endometriosis is a benign, chronic, inflammatory condition affecting up to 10 % of women and characterised by the presence of glands and stroma tissue outside the uterus. Epidemiological and clinical studies demonstrate a consistent association between endometriosis and infertility. However, this relationship is far to be clearly understood and several mechanisms are involved. Available data show that patients with endometriosis have an increased estimated risk of infertility between two and four times compared with the general population. On the other hand, the probability of patients with infertility to have endometriosis is reported up to about 50 % of the cases. Future studies should aim to better elucidate the mechanisms behind endometriosis-associated infertility in order to offer the more appropriate and tailored management for the patients.
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Affiliation(s)
| | - Valentina Chiappa
- Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Marcello Ceccaroni
- Department of Obstetrics and Gynecology, Gynecologic Oncology and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS "Sacro Cuore - Don Calabria" Hospital, Negrar di Valpolicella, Verona, Italy
| | - Giovanni Roviglione
- Department of Obstetrics and Gynecology, Gynecologic Oncology and Minimally Invasive Pelvic Surgery, International School of Surgical Anatomy, IRCCS "Sacro Cuore - Don Calabria" Hospital, Negrar di Valpolicella, Verona, Italy
| | - Luca Savelli
- Obstetrics and Gynecology Unit, Morgagni-Pierantoni Hospital, Forlì, Italy
| | - Simone Ferrero
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy; Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Francesco Raspagliesi
- Gynecologic Oncology Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
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Derbala MK, Mosallam TE, Sindi RA. Embryo transfer into anestrous recipient mares prepared using clomiphene citrate and short-acting progesterone. J Equine Vet Sci 2024; 133:105006. [PMID: 38237704 DOI: 10.1016/j.jevs.2024.105006] [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: 05/03/2023] [Revised: 01/01/2024] [Accepted: 01/15/2024] [Indexed: 02/12/2024]
Abstract
Embryo transfer (ET) is an important technology for genetic improvement programs in the equine industry. Many protocols have been used for preparation of recipients. This study evaluates a new protocol for preparation of acyclic embryo recipient mares using clomiphene citrate (CC) and short-acting oral progesterone (Altrenogest). Seventy-two native breed recipient mares were divided into 2 groups. Group 1(G1) included 60 non-cyclic mares with follicular structures ≤ 15 mm in diameter that received CC and Altrenogest. Group 2 (G2) included 12 cyclic recipient mares that served as a control group. G1 mares were treated with oral CC at a dose of 250 mg for 4 days followed by oral administration of Altrenogest for 6 days. Ultrasonography was carried out for evaluation of uterine echotexture response to hormonal treatment, and pregnancy diagnosis post ET. Serum estradiol and progesterone concentrations were also assessed. All data were statistically analyzed. The results revealed that the serum progesterone concentrations in G1 were higher than G2 (P < 0.001). There was no difference in the estradiol concentrations between both groups during diestrus phase (P > 0.05). The pregnancy rate was higher in G1 (83.3 %) than G 2 (66.6 %). In conclusion, using oral CC and Altrenogest, as a new protocol, was effective for preparation of acyclic recipient mares in this study.
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Affiliation(s)
- M K Derbala
- Animal Reproduction Research Institute (ARRI), Agriculture Research Center (ARC), 5 - Hadyek EL-Behoth St. Haram, PO: 12556, Giza, Egypt.
| | - T E Mosallam
- Animal Reproduction Research Institute (ARRI), Agriculture Research Center (ARC), 5 - Hadyek EL-Behoth St. Haram, PO: 12556, Giza, Egypt
| | - R A Sindi
- Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Umm Al-Qura University, Saudi Arabia and Department of Health Sciences, School of Education, Health and Behavioral Sciences, Dar AL-Hekma University, Jeddah, Saudia Arabia
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5
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Li X, Jin J, Long X, Weng R, Xiong W, Liang J, Liu J, Sun J, Cai X, Zhang L, Liu Y. METTL3-regulated m6A modification impairs the decidualization of endometrial stromal cells by regulating YTHDF2-mediated degradation of FOXO1 mRNA in endometriosis-related infertility. Reprod Biol Endocrinol 2023; 21:99. [PMID: 37891533 PMCID: PMC10605339 DOI: 10.1186/s12958-023-01151-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Endometriosis-related infertility is a common worldwide reproductive health concern. Despite ongoing research, the causes of infertility remain unclear. Evidence suggests that epigenetic regulation is crucial in reproduction. However, the role of N6-methyladenosine (m6A) modification of RNA in endometriosis-related infertility requires further investigation. METHODS We examined the expression of m6A and methyltransferase-like 3 (METTL3) in endometrial samples taken from normal fertile women in the proliferative phase (the NP group) or the mid-secretory phase (the NS group) or from women with endometriosis-related infertility at the mid-secretory phase (the ES group). We treated primary endometrial stromal cells (ESCs) with medroxyprogesterone acetate and 8-Bromo-cyclic adenosine monophosphate for in vitro decidualization and detected the expression of m6A, METTL3, and decidual markers. We analyzed the expression of m6A, METTL3, and forkhead box O1 (FOXO1) in ESCs from normal fertile women (the ND group) or women with endometriosis-related infertility (the ED group). We also assessed the expression of m6A, METTL3, and decidual markers, as well as the embryo adhesion rate, upon METTL3 overexpression or knockdown. Additionally, we investigated the role of METTL3 in embryo implantation in vivo by applying mice with endometriosis. Furthermore, we performed RNA stability assays, RNA immunoprecipitation (RIP), and methylated RIP assays to explore the mechanisms underlying the regulation of FOXO1 by METTL3-mediated m6A. RESULTS The expression of m6A and METTL3 was reduced only in the NS group; the NP and ES groups demonstrated increased m6A and METTL3 levels. m6A and METTL3 levels decreased in ESCs with prolonged decidual treatment. Compared to the ND group, m6A and METTL3 levels in the ED group increased after decidual treatment, whereas the expression of FOXO1 decreased. METTL3 overexpression suppressed the expression of decidual markers and embryo implantation in vitro; METTL3 knockdown exhibited the opposite effect. Inhibition of METTL3 promoted embryo implantation in vivo. Furthermore, we observed that METTL3-mediated m6A regulated the degradation of FOXO1 mRNA through YTHDF2, a m6A binding protein. CONCLUSIONS METTL3-regulated m6A promotes YTHDF2-mediated decay of FOXO1 mRNA, thereby affecting cellular decidualization and embryo implantation. These findings provide novel insights into the development of therapies for women with endometriosis-related infertility.
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Affiliation(s)
- Xiaoou Li
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Jie Jin
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Xuefeng Long
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Ruiwen Weng
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Wenqian Xiong
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Jiaxin Liang
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Junjun Liu
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Jingwen Sun
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Xueqin Cai
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China
| | - Ling Zhang
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China.
| | - Yi Liu
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China.
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Yifu P, Yanan L. A two sample Mendelian randomization to explore the causal relationships between endometriosis and female infertility. Endocrine 2023; 81:637-638. [PMID: 37314641 DOI: 10.1007/s12020-023-03417-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 06/04/2023] [Indexed: 06/15/2023]
Affiliation(s)
- Pu Yifu
- Laboratory of Genetic Metabolic Diseases and Perinatal Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second Hospital, Sichuan University, Chengdu, China
| | - Li Yanan
- The Second Affiliated Hospital of Shandong First Medical University, Taian, Shandong province, China.
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Liu J, Han W, Wang H, Wang Z, Li B, Hong L. Spatiotemporal Trends and Age-Period-Cohort Analysis for the Burden of Endometriosis-Related Infertility: An Analysis of the Global Burden of Disease Study 2019. J Pers Med 2023; 13:1284. [PMID: 37763053 PMCID: PMC10533190 DOI: 10.3390/jpm13091284] [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: 07/21/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Endometriosis is a common nonfatal gynecological disease, and infertility is one of its main dangers. Endometriosis-related infertility causes serious damage to women's health and places a burden on women of reproductive age. The aim of this study was to describe the current burden of endometriosis-associated infertility and to analyze its spatiotemporal trends. METHODS Age-standardized prevalence rate (ASPR) data from 1990 to 2019 for Endometriosis-related primary infertility (ERPI) and secondary infertility (ERSI) were obtained from the Global Burden of Disease Study (GBD) 2019. These data spanning three decades cover the global, sociodemographic index (SDI) regions, GBD regions, and 204 countries and territories. Spatiotemporal trends were analyzed by calculating the estimated annual percentage change (EAPC) and using a time-period-cohort model. RESULTS Globally, the ASPR of ERPI and ERSI showed a weak downward trend from 1990 to 2019, with EAPCs of -1.25 (95% CI: -1.39 to -1.11) and -0.6 (95% CI: -0.67 to -0.53), respectively. The spatiotemporal trends in ERPI and ERSI varied substantially between regions and age groups. When endometriosis-related infertility burden was linked to SDI values, a strong negative correlation was observed between the ASPR of ERSI and its EAPC and SDI values. When modeling with age-period-cohort, ERPI burden was found to be highest at ages 20-25 years, while ERSI burden was persistently higher at ages 20-45 years. Using 2000-2004 as the reference period, both ERPI and ERSI burden decreased with each year among women. Significant variability in burden between regions was found for the birth cohort factor. CONCLUSIONS The global burden of endometriosis-related infertility declined minimally from 1990 to 2019. However, this burden varied considerably across regions, age groups, periods, and birth cohorts. The results of this study reflect spatiotemporal trends in the burden of endometriosis-related infertility over the study period and may be used to help improve health management, develop timely and effective prevention and control strategies, and provide epidemiologic theoretical evidence for reducing the burden for endometriosis-related infertility.
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Affiliation(s)
| | | | | | | | | | - Li Hong
- Department of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan 430060, China (W.H.)
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Surendran S, Prasannan P, Jeyaram Y, Palanivel V, Pandian A, Ramasubbu R. Knowledge on ethnogynaecology of Indian Tribes- a comprehensive review. JOURNAL OF ETHNOPHARMACOLOGY 2023; 303:115880. [PMID: 36368564 DOI: 10.1016/j.jep.2022.115880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 10/17/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Ethnogynaecology is an emerging branch of science dealing with the treatment of gynaecological ailments by tribals, local healers, and traditional practitioners. The ethnogynaecological importance of medicinal plants in India is a fertile area to conduct more scientific studies to evaluate their potentialities, to isolate bioactive compounds, and thereby to develop drugs for the common gynaecological health-related issues faced by women everywhere. OBJECTIVES The Indigenous medical knowledge systems of India have not been properly documented with special reference to ethnogynaecology. This review aims to document the knowledge of ethnogynaecology among tribals, villagers, and local people inhabiting different parts of India and the bioactive compounds responsible for the action. This review provides a vast record of medicinal plants and their parts used, types of formulations, dosage, and ethno-gynaecological usage. MATERIALS AND METHODS The detailed investigation of ethnobotanical and ethnogynaecological-related literature published between 1985 and 2021 by different scientific tools such as journals, books, and current electronic databases like Springer Link, SciFinder, Google Scholar, Web of Science, Wiley, ACS, Science Direct and Pubmed have been considered for the present study. The study included 300 articles published between 1985 and 2021 by scientific search using various standard databases. The tribals, vaidyas, traditional practitioners, indigenous medical healers, and local people of different regions in India have recognized the importance of ethnogynaecological uses of plants. The study on ethnogynaecology is limited to a few common but significant gynaecological issues including abortion, contraception, infertility, menstruation, leucorrhoea, and obstetrics. The phytocompound compounds isolated from various parts of the plants and responsibility for the gynaecological action were documented. RESULTS The major ethnogynaecological disorders recorded by various studies are leucorrhoea, abortion, contraceptives, infertility and related issues, and obstetrics including the irregular physiological process of menstruation. The ethnogynaecological and ethnobotanical information has been recorded from almost all the states of India; the highest number of records on ethnogynaecology was reported from the state of Madhya Pradesh. The most explored tribal populations to record ethnogynaecological knowledge belong to the following tribes: Bhil, Munda, Irula, Kani, Malayali, Meena, Paliyar, Muthuvar, Oraon, Narikuravar, Mannan, Malayarayan, and Malapandaram. Moreover, limited or no study has been attempted to prove the knowledge of ethnogynaecology of these tribes and the efficiency of their crude drugs against pharmacological actions. The paste prepared from various parts of the plants has been used widely as primary health care materials for abortion, obstetrics, menstruation, female infertility and male infertility. Phenols, glucoside, steroids and fatty acids reported with cytotoxic activities are connected to several gynaecological disorders whereas flavonoid, coumarin, sitosterol disrupt pregnancy. The phenolic compounds induced spontaneous abortion due to the major composition aristolochic acid, ceryl alcohol, β-sitosterol. Coreopsin, butin, isobutrin, monospermoside, palastrin, butrin. Mucunine, lecithin, prurieninine, gluthione and luteolin, Indicine, kaempferol, apigenin and quercetin effected therapeutic activity against leucorrhoea. Lignin, friedelin and beta-sitosterol are reported with abortifacient properties and therapeutic ability for leucorrhoea and menorrhagia. Tannins, mimusopsic acids, taraxerol and spinaserol effected fertility problems in women and tannins, saponins, flavonoids, steroids, terpenoids and alkaloids which effected infertility. CONCLUSION This review reported comprehensive data on ethnogynaecological knowledge published from available literature and evident that the indigenous medical system of Indian tribes has also contributed considerably to the healthcare system and drug development of India. The fresh plant parts were identified as effective materials against various gynaecological illnesses including infertility. The root is considered an excellent plant part against obstetrics followed by abortion, menstruation, and leucorrhoea. These studies need experimental proof as well as standardization to confirm their efficiency. Promoting the sustainable use and the equitable sharing of benefits to the knowledge provider is a pathway for harnessing the conservation of this knowledge.
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Affiliation(s)
- Saranya Surendran
- Department of Biology, The Gandhigram Rural Institute (Deemed to be University), Dindigul, Tamil Nadu, India
| | - Priya Prasannan
- Department of Biology, The Gandhigram Rural Institute (Deemed to be University), Dindigul, Tamil Nadu, India
| | - Yasotha Jeyaram
- Department of Botany, PRIST Deemed University, Thanjavur, Tamil Nadu, India
| | - Venkatesh Palanivel
- Department of Biology, The Gandhigram Rural Institute (Deemed to be University), Dindigul, Tamil Nadu, India
| | - Arjun Pandian
- Department of Biotechnology, PRIST Deemed University, Thanjavur, Tamil Nadu, India; Institute of Biotechnology, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences (SIMATS), Thandalam, Chennai, 602 105, Tamil Nadu, India
| | - Raju Ramasubbu
- Department of Biology, The Gandhigram Rural Institute (Deemed to be University), Dindigul, Tamil Nadu, India.
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Bonavina G, Taylor HS. Endometriosis-associated infertility: From pathophysiology to tailored treatment. Front Endocrinol (Lausanne) 2022; 13:1020827. [PMID: 36387918 PMCID: PMC9643365 DOI: 10.3389/fendo.2022.1020827] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/06/2022] [Indexed: 11/13/2022] Open
Abstract
Despite the clinically recognized association between endometriosis and infertility, the mechanisms implicated in endometriosis-associated infertility are not fully understood. Endometriosis is a multifactorial and systemic disease that has pleiotropic direct and indirect effects on reproduction. A complex interaction between endometriosis subtype, pain, inflammation, altered pelvic anatomy, adhesions, disrupted ovarian reserve/function, and compromised endometrial receptivity as well as systemic effects of the disease define endometriosis-associated infertility. The population of infertile women with endometriosis is heterogeneous, and diverse patients' phenotypes can be observed in the clinical setting, thus making difficult to establish a precise diagnosis and a single mechanism of endometriosis related infertility. Moreover, clinical management of infertility associated with endometriosis can be challenging due to this heterogeneity. Innovative non-invasive diagnostic tools are on the horizon that may allow us to target the specific dysfunctional alteration in the reproduction process. Currently the treatment should be individualized according to the clinical situation and to the suspected level of impairment. Here we review the etiology of endometriosis related infertility as well as current treatment options, including the roles of surgery and assisted reproductive technologies.
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Affiliation(s)
- Giulia Bonavina
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, United States
| | - Hugh S Taylor
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, United States
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10
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Skåra KH, Åsvold BO, Hernáez Á, Fraser A, Rich-Edwards JW, Farland LV, Næss Ø, Lawlor DA, Brumpton B, Magnus MC. Risk of cardiovascular disease in women and men with subfertility: the Trøndelag Health Study. Fertil Steril 2022; 118:537-547. [PMID: 35840354 DOI: 10.1016/j.fertnstert.2022.05.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 05/25/2022] [Accepted: 05/25/2022] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To investigate the association between subfertility and risk of cardiovascular disease (CVD) outcomes. DESIGN Prospective study. SETTING Population-based cohort. PATIENT(S) We studied 31,629 women and 17,630 men participating in the Trøndelag Health Study. INTERVENTION(S) Self-reported subfertility. As men were not directly asked about fertility, male partners of female participants were identified through linkage to the Medical Birth Registry of Norway and assigned the fertility information obtained from their partners. MAIN OUTCOME MEASURE(S) The primary outcomes were stroke and coronary heart disease in women and men with and without a history of subfertility. The secondary outcomes were myocardial infarction and angina (subgroups of coronary heart disease) and any CVD (stroke or coronary heart disease). Information on CVD was available by linkage to hospital records. We used Cox proportional hazards models adjusted for age at participation in the Trøndelag Health Study (linear + squared), birth year, smoking history, cohabitation, and education. Cardiometabolic factors were assessed in separate models. RESULT(S) A total of 17% of women and 15% of men reported subfertility. In women, subfertility was modestly associated with an increased risk of stroke (age-adjusted hazard ratio [aaHR], 1.19; 95% confidence interval [CI], 1.02-1.39; adjusted hazard ratio [aHR]; 1.18; 95% CI, 1.01-1.37) and coronary heart disease (aaHR, 1.19; 95% CI, 1.06-1.33; aHR, 1.16; 95% CI, 1.03-1.30) compared with fertile women. In men, we observed a weak positive association for stroke (aaHR, 1.11; 95% CI, 0.91-1.34; aHR, 1.10; 95% CI, 0.91-1.33) and a weak inverse association for coronary heart disease (aaHR, 0.92; 95% CI, 0.81-1.05; aHR, 0.93; 95% CI, 0.81-1.06). CONCLUSION(S) We observed modestly increased risks of CVD outcomes in women and some weak associations in men, although with no strong statistical evidence on sex differences. We acknowledge that we were only able to include men linked to pregnancies ending at 12 completed gestational weeks or later, potentially resulting in selection bias and misclassification of history of subfertility in analyses of male partners. Despite the large sample size, our results indicate the need for larger studies to obtain precise results in both sexes and determine whether there are true sex differences.
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Affiliation(s)
- Karoline H Skåra
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.
| | - Bjørn O Åsvold
- K.G. Jebsen Centre for Genetic Epidemiology, Department of Public Health and Nursing, NTNU - Norwegian University of Science and Technology, Trondheim, Norway; HUNT Research Centre, Department of Public Health and Nursing, NTNU - Norwegian University of Science and Technology, Levanger, Norway; Department of Endocrinology, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Álvaro Hernáez
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway; Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain; Blanquerna School of Health Sciences, Universitat Ramon Llull, Barcelona, Spain
| | - Abigail Fraser
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; National Institute for Health Research Bristol Biomedical Research Centre, Bristol, United Kingdom
| | - Janet W Rich-Edwards
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts; Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Leslie V Farland
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona; Department of Obstetrics and Gynecology, College of Medcine-Tucson, University of Arizona, Tucson, Arizona
| | - Øyvind Næss
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway; Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; National Institute for Health Research Bristol Biomedical Research Centre, Bristol, United Kingdom
| | - Ben Brumpton
- K.G. Jebsen Centre for Genetic Epidemiology, Department of Public Health and Nursing, NTNU - Norwegian University of Science and Technology, Trondheim, Norway; HUNT Research Centre, Department of Public Health and Nursing, NTNU - Norwegian University of Science and Technology, Levanger, Norway; Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Maria C Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
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11
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Kanaka V, Proikakis S, Drakakis P, Loutradis D, Tsangaris GT. Implementing a preimplantation proteomic approach to advance assisted reproduction technologies in the framework of predictive, preventive, and personalized medicine. EPMA J 2022; 13:237-260. [PMID: 35719135 PMCID: PMC9203609 DOI: 10.1007/s13167-022-00282-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 05/05/2022] [Indexed: 10/28/2022]
Abstract
AbstractThe evolution of the field of assisted reproduction technology (ART) in the last 40 years has significantly contributed to the management of global infertility. Despite the great numbers of live births that have been achieved through ART, there is still potential for increasing the success rates. As a result, there is a need to create optimum conditions in order to increase ART efficacy. The selection of the best sperm, oocyte, and embryo, as well as the achievement of optimal endometrial receptivity, through the contribution of new diagnostic and treatment methods, based on a personalized proteomic approach, may assist in the attainment of this goal. Proteomics represent a powerful new technological development, which seeks for protein biomarkers in human tissues. These biomarkers may aid to predict the outcome, prevent failure, and monitor in a personalized manner in vitro fertilization (IVF) cycles. In this review, we will present data from studies that have been conducted in the search for such biomarkers in order to identify proteins related to good sperm, oocyte, and embryo quality, as well as optimal endometrial receptivity, which may later lead to greater results and the desirable ART outcome.
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12
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Mattos LAD, Sauer LJ, Blasbalg R, Petta CA, Pereira RM, Carvalho LFPD. Hysterosalpingography using Magnetic Resonance Imaging for infertility patients. JBRA Assist Reprod 2021; 25:403-411. [PMID: 33900058 PMCID: PMC8312299 DOI: 10.5935/1518-0557.20210002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 01/04/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Some studies have shown that it is possible to evaluate tubal permeability through MRI. Our aim is to perform a prospective study and to perform a comprehensive review in the literature regarding HSG-MRI. METHODS We carried out a PUBMED search using the following keywords: hysterosalpingogram, hysterosalpingography, magnetic resonance imaging and MRI. As inclusion criteria, we included only papers published in English, and exams ran on humans. We also conducted a prospective inclusion of patients who had visited a human reproduction clinic between May/2017 and April/2019 for laboratory image diagnoses using HSG-MRI. RESULTS Following the inclusion and exclusion criteria, we included seven original papers. Review papers and those written in a language other than English, were excluded. Between the period of May/2017 and April/2019, we selected ten patients for our study. The average exam duration was 30 minutes. Cervical catheterization was possible in all cases. There were no major complications. We highlight that in 8/9 of patients, we could directly visualize uterine tubes with contrast (excluding one patient with bilateral tubal ligation). CONCLUSIONS Our initial experience with HSG-MRI shows promise. We demonstrated an optimized protocol for conducting an HSG-MRI (with excellent image quality). HSG-MRI had some advantages, such as not using ionized radiation, less pain and being able to analyze pelvic anatomy. Patients referred for a pelvic MRI as part of a more detailed investigation into infertility can also benefit from undergoing a simultaneous HSG using MRI.
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Affiliation(s)
- Leandro Accardo de Mattos
- ALTA Excellency Diagnostic/DASA Department of Diagnostic Imaging/DASA, São Paulo Brazil
- Department of Diagnostic Imaging, Federal University of São Paulo, São Paulo, Brazil
| | - Luísa Jacques Sauer
- ALTA Excellency Diagnostic/DASA Department of Diagnostic Imaging/DASA, São Paulo Brazil
| | - Roberto Blasbalg
- ALTA Excellency Diagnostic/DASA Department of Diagnostic Imaging/DASA, São Paulo Brazil
| | | | | | - Luiz Fernando Pina de Carvalho
- Baby Center - Center for Reproductive Medicine, São Paulo, Brazil
- College - Institute of Clinical Research and Teaching Development, São Paulo, Brazil
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13
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Hamad A, Alhalabi N, Nmr N, Abbas F, Al-Hammami H, Ibrahim N, Alhalabi M. Impact of Thyroid Autoimmunity in euthyroid women on the outcomes of In Vitro Fertilization. Ann Med Surg (Lond) 2021; 67:102473. [PMID: 34178319 PMCID: PMC8214029 DOI: 10.1016/j.amsu.2021.102473] [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: 05/01/2021] [Revised: 05/26/2021] [Accepted: 06/04/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Infertility is inadequately acknowledged as a problem in developing countries. Thyroid Autoimmunity (TAI) has been neatly investigated for its association with unfavorable pregnancy and reproductive consequences. We aim to evaluate Clinical Pregnancy Rate (CPR) as a primary outcome following In Vitro Fertilization/Intra Cytoplasmic Sperm Injection (IVF/ICSI) in women with Thyroid Autoimmunity (TAI). METHODS A Retrospective cohort study included 584 women who underwent IVF/ICSI treatment between November 2012 and April 2017 in Orient Hospital, Damascus, Syria. Patients were tested for TAI before IVF/ICSI procedure. RESULTS CPR did not significantly differ between TAI positive and TAI negative groups (p > 0.05). Subgroup analysis for only primary infertility patients showed a statistically significant difference in CPR between TAI positive and TAI negative groups. CONCLUSION Although several arguments were in favor of the relation between IVF/ICSI outcomes and Thyroid autoimmune disease, the presence of TAI positivity did not adversely affect the clinical pregnancy rate.
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Affiliation(s)
- Ahed Hamad
- Faculty of Medicine, Damascus University, Damascus, Syria
- Al-Zahrawi Maternity Hospital, Damascus, Syria
| | - Nawras Alhalabi
- Faculty of Medicine, Damascus University, Damascus, Syria
- Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Nazht Nmr
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Fatima Abbas
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Hisham Al-Hammami
- Department of Obstetrics and Gynecology, Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Nazir Ibrahim
- Department of Internal Medicine, Faculty of Medicine, Syrian Private University, Damascus, Syria
| | - Marwan Alhalabi
- Division of Reproductive Medicine, Embryology and Genetics, Faculty of Medicine, Damascus University, Damascus, Syria
- Assisted Reproduction Unit, Orient Hospital, Damascus, Syria
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14
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Li X, Wang Y, Ma R, Liu X, Song B, Duan Y, Guo J, Feng G, Cui T, Wang L, Hao J, Wang H, Gu Q. Reconstruction of functional uterine tissues through recellularizing the decellularized rat uterine scaffolds by MSCs in vivo and in vitro. Biomed Mater 2021; 16:035023. [PMID: 33660616 DOI: 10.1088/1748-605x/abd116] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Infertile people who suffered from loss of uterine structures and/or functions can be treated through gestational surrogacy or uterus transplantation, which remains challenging due to the ethical and social issues, the lack of donor organs as well as technical and safety risks. One promising solution is to regenerate and reconstruct a bioartificial uterus for transplantation through the engineering of uterine architecture and appropriate cellular constituents. Here, we developed a well-defined system to regenerate a functional rat uterine through recellularization of the decellularized uterine matrix (DUM) patches reseeded with human mesenchymal stem cells (hMSCs). Engraftment of the recellularized DUMs on the partially excised uteri yielded a functional rat uterus with a pregnancy rate and number of fetuses per uterine horn comparable to that of the control group with an intact uterus. Particularly, the recellularized DUMs enhanced the regeneration of traumatic uterine in vivo because of MSC regulation. The established system here will shed light on the treatment of uterine infertility with heterogeneous DUMs/cell resources through tissue engineering in the future.
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Affiliation(s)
- Xia Li
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
| | - Yiming Wang
- State Key Laboratory of Membrane Biology, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
| | - Ruoyu Ma
- State Key Laboratory of Membrane Biology, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
| | - Xin Liu
- State Key Laboratory of Membrane Biology, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
| | - Biaobiao Song
- State Key Laboratory of Membrane Biology, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
- School of Life Sciences, University of Science and Technology of China, Hefei 230026, People's Republic of China
| | - Yongchao Duan
- State Key Laboratory of Membrane Biology, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
| | - Jia Guo
- State Key Laboratory of Membrane Biology, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
| | - Guihai Feng
- State Key Laboratory of Membrane Biology, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
| | - Tongtong Cui
- State Key Laboratory of Membrane Biology, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
| | - Liu Wang
- State Key Laboratory of Membrane Biology, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
| | - Jie Hao
- State Key Laboratory of Membrane Biology, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
| | - Hongmei Wang
- State Key Laboratory of Membrane Biology, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
| | - Qi Gu
- State Key Laboratory of Membrane Biology, State Key Laboratory of Stem Cell and Reproductive Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
- Savaid Medical School, University of Chinese Academy of Sciences, Beijing 100049, People's Republic of China
- Institute for Stem Cell and Regeneration, Chinese Academy of Sciences, Beijing 100101, People's Republic of China
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15
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Husain W, Imran M. Infertility as seen by the infertile couples from a collectivistic culture. JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 49:354-360. [PMID: 33131049 DOI: 10.1002/jcop.22463] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/09/2020] [Accepted: 10/05/2020] [Indexed: 06/11/2023]
Abstract
Infertility in collectivistic cultures is usually regarded as a matter of social stigmatization instead of a biomedical problem. It has adverse sociocultural consequences, especially for the female spouse. The current study, by involving 20 infertile couples, was a qualitative research focusing on the sociocultural experiences of the infertile couples about the nature, causes, and consequences of infertility. The findings of the current study clearly depicted the sociocultural factors involved in interpreting infertility as a matter of shame and bad reputation for the couple and its family. The study has filled a significant knowledge gap and will be useful in identifying and addressing the cultural barriers in the treatment of infertility.
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Affiliation(s)
- Waqar Husain
- Department of Humanities, COMSATS University, Islamabad, Pakistan
| | - Mibarrah Imran
- Department of Humanities, COMSATS University, Islamabad, Pakistan
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16
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Magnus MC, Fraser A, Rich-Edwards JW, Magnus P, Lawlor DA, Håberg SE. Time-to-pregnancy and risk of cardiovascular disease among men and women. Eur J Epidemiol 2021; 36:383-391. [PMID: 33492547 PMCID: PMC8076115 DOI: 10.1007/s10654-021-00718-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 01/05/2021] [Indexed: 01/01/2023]
Abstract
A few studies indicate that women with prolonged time-to-pregnancy (TTP) have an increased risk of cardiovascular disease (CVD). This has not been studied in men. We evaluated CVD risk by self-reported TTP among parous women (n = 64,064) and men (n = 50,533) participating in the Norwegian Mother, Father and Child Cohort Study. TTP was categorized as 0–3 (reference), 4–12 and > 12 months. CVD diagnosed between 2008 and 2017 were available from the national patient and general practitioner databases. Risk of CVD by TTP was estimated using Cox regression adjusting for baseline age, education, BMI, smoking, diabetes, and number of offspring in both sexes, and history of endometriosis, ovarian cysts, preterm birth and pre-eclampsia for women. Mean age was 33 for women and 35 for men at baseline (years). The rate of any CVD was 24 per 1000 person years among women and 22 per 1000 person years among men. Longer TTP was associated with increased rate of CVD among women, with adjusted hazard ratios (HRs) of 1.07 (95% CI: 1.03, 1.09) for TTP 4–12 months and 1.14 (1.08, 1.20) for TTP > 12 months. Among men, respective HRs for CVD were 1.06 (1.00, 1.10) for TTP 4–12 months and 1.07 (1.01, 1.14) for TTP > 12 months. We observed sex-differences in the relationship with CVD subtypes but none were statistically significant. In conclusion, both men and women with a prolonged TTP had a small increased risk of CVD, clinical significance of which is unclear. Further studies are necessary to investigate in detail what underlying causes of prolonged TTP might be reflected in the increased risk of CVD. Longer follow-up is required to confirm these preliminary findings.
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Affiliation(s)
- Maria C Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, P.O. Box 222, 0213, Skøyen, Oslo, Norway. .,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK. .,Population Health Sciences, Bristol Medical School, Bristol, UK.
| | - Abigail Fraser
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,Population Health Sciences, Bristol Medical School, Bristol, UK.,Bristol NIHR Biomedical Research Centre, Bristol, UK
| | - Janet W Rich-Edwards
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Boston, USA.,Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, USA
| | - Per Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, P.O. Box 222, 0213, Skøyen, Oslo, Norway
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,Population Health Sciences, Bristol Medical School, Bristol, UK.,Bristol NIHR Biomedical Research Centre, Bristol, UK
| | - Siri E Håberg
- Centre for Fertility and Health, Norwegian Institute of Public Health, P.O. Box 222, 0213, Skøyen, Oslo, Norway
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17
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Işik Ulusoy S, Colak E. Effects of Temperamental Characteristics on Depression-Anxiety Levels and the Quality of Life in Infertile Women. Medeni Med J 2020; 35:226-235. [PMID: 33110675 PMCID: PMC7584259 DOI: 10.5222/mmj.2020.96646] [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: 07/23/2020] [Accepted: 09/12/2020] [Indexed: 11/05/2022] Open
Abstract
Objective It is known that the risk of anxiety disorders and depression in infertile women increases and their quality of life deteriorates. Temperamental characteristics are considered as predictors of mood disorders. The aim of this study was to investigate temperamental characteristics in infertile women and their effects on depression and anxiety levels, and the quality of life, and to reveal the differences and level of relationship compared to healthy women. Method Fourty-four female patients with primary infertility and 30 healthy female controls were included in this study. Temperamental characteristics of the participants were assessed with Temperament Evaluation of Memphis, Pisa, Paris and San Diego-Autoquestionnaire version (TEMPS-A). Depression and anxiety severity were evaluated with Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI). To evaluate the quality of life, Short Form 36 (SF-36) health survey questionnaire was also applied. Results Hyperthymic temperament scores were higher in infertile women than the control group (p=0.001). BDI scores were positively correlated with depressive and cyclothymic temperament scores, and BAI scores were positively correlated with depressive and anxious temperament scores. A negative correlation was found between hyperthymic temperament and BAI and BDI scores. Hyperthymic temperament scores were positively correlated with both physical and mental subdimension scores of the quality of life scale. Conclusion In this study, hyperthymic temperament in infertile women was shown to be protective against anxiety and depression and it also improves the quality of life. Additional studies are needed to clarify the relationship between hyperthymic temperament and ovarian hormones or other biological parameters.
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Affiliation(s)
- Selen Işik Ulusoy
- Baskent University, Faculty of Medicine, Konya Research and Training Hospital, Department of Psychiatry, Konya, Turkey
| | - Eser Colak
- Baskent University, Faculty of Medicine, Konya Research and Training Hospital, Department of Obstetrics and Gynecology, Konya, Turkey
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18
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Rahnama R, Mahmoudi AR, Kazemnejad S, Salehi M, Ghahiri A, Soltanghoraee H, Vafaei S, Rezaei A, Zarnani AH. Thyroid peroxidase in human endometrium and placenta: a potential target for anti-TPO antibodies. Clin Exp Med 2020; 21:79-88. [PMID: 32980989 DOI: 10.1007/s10238-020-00663-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 09/12/2020] [Indexed: 11/29/2022]
Abstract
Autoimmune thyroid disease is the most common endocrine disorder during pregnancy. Thyroid autoantibodies (TAs) have been suggested to serve a role in implantation failure and spontaneous abortion. Until now, there are no data on the potential interaction of TAs with human reproductive organs. Here, we set out for the first time to test this hypothesis by studying the expression of thyroid peroxidase (TPO) at gene and protein level in human reproductive organs. Endometrial samples were taken from normal women, and placenta tissues were collected after full-term caesarian section. Expression of TPO messenger RNA (mRNA) was investigated by qRT-PCR. In addition, polyclonal anti-TPO antibodies were produced and the expression of TPO protein in mentioned tissues was evaluated by immunohistochemistry and Western blot analysis. The reactivity of anti-TPO antibody in human embryos was evaluated by immunofluorescent staining. For the first time, our study showed that TPO is expressed at gene and protein levels in endometrium and placenta. TPO expression was mainly localized to glandular and luminal epithelial cells in the endometrium. In placenta, the syncytiotrophoblasts and invasive trophoblast cells were the main cell types that expressed TPO protein. Specific band of approximately 110 kDa was observed in all endometrial and placental tissues by Western blot analysis. However, no expression of TPO protein was observed in human embryo. TPO expression in endometrium and placenta may explain higher frequency of abortion and infertility in patients with thyroid autoimmunity.
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Affiliation(s)
- Reyhane Rahnama
- Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad-Reza Mahmoudi
- Immunology Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
| | - Somayeh Kazemnejad
- Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Mansour Salehi
- Department of Genetic, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ataollah Ghahiri
- Department of Gynecology and Obstetrics, Al-Zahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Haleh Soltanghoraee
- Avicenna Infertility Clinic, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Sedigheh Vafaei
- Reproductive Immunology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Abbas Rezaei
- Department of Immunology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Amir Hassan Zarnani
- Reproductive Immunology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran. .,Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. .,Immunology Research Center (IRC), Iran University of Medical Sciences, Tehran, Iran.
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Blasco V, Pinto FM, Fernández-Atucha A, González-Ravina C, Fernández-Sánchez M, Candenas L. Female infertility is associated with an altered expression of the neurokinin B/neurokinin B receptor and kisspeptin/kisspeptin receptor systems in ovarian granulosa and cumulus cells. Fertil Steril 2020; 114:869-878. [PMID: 32811673 DOI: 10.1016/j.fertnstert.2020.05.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/17/2020] [Accepted: 05/05/2020] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To analyze and compare the expression profile of TAC3, TACR3, KISS1, and KISS1R in mural granulosa and cumulus cells from healthy oocyte donors and patients with different infertility etiologies, including advanced maternal age, endometriosis, and low ovarian response. DESIGN Genetic association study. SETTING Private fertility clinic and public research laboratory. PATIENT(S) Healthy oocyte donors and infertile women undergoing in vitro fertilization (IVF) treatment. INTERVENTION(S) IVF. MAIN OUTCOME MEASURE(S) Gene expression levels of KISS1, KISS1R, TAC3, and TACR3 in human mural granulosa and cumulus cells. RESULT(S) Infertile women showed statistically significantly altered expression levels of KISS1 (-2.57 ± 2.30 vs. -1.37 ± 2.11), TAC3 (-1.21 ± 1.40 vs. -1.49 ± 1.98), and TACR3 (-0.77 ± 1.36 vs. -0.03 ± 0.56) when compared with healthy oocyte donors. Advanced maternal age patients, endometriosis patients, and low responders showed specific and altered expression profiles in comparison with oocyte donors. CONCLUSION(S) Abnormal expression levels of KISS1/KISS1R and TAC3/TACR3 systems in granulosa cells might be involved in the decreased fertility associated to advanced maternal age, endometriosis, and low ovarian response.
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Affiliation(s)
- Victor Blasco
- Instituto de Investigaciones Químicas, CSIC, Seville, Spain; IVI-RMA Seville, Seville, Spain
| | | | | | | | - Manuel Fernández-Sánchez
- IVI-RMA Seville, Seville, Spain; IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain; Departamento de Cirugía, Universidad de Sevilla, Seville, Spain; Departamento de Biología Molecular e Ingeniería Bioquímica, Universidad Pablo de Olavide, Seville, Spain.
| | - Luz Candenas
- Instituto de Investigaciones Químicas, CSIC, Seville, Spain
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Wall DJ, Reinhold C, Akin EA, Ascher SM, Brook OR, Dassel M, Henrichsen TL, Learman LA, Maturen KE, Patlas MN, Robbins JB, Sadowski EA, Saphier C, Uyeda JW, Glanc P. ACR Appropriateness Criteria® Female Infertility. J Am Coll Radiol 2020; 17:S113-S124. [PMID: 32370955 DOI: 10.1016/j.jacr.2020.01.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 01/30/2020] [Indexed: 12/12/2022]
Abstract
The most common known causes of female infertility are male factor (26%), ovulatory failure (21%), and tubal damage (14%), while in 28% a couple's infertility remains unexplained. Female-specific causes of infertility include deterioration of oocyte quality with increasing maternal age; ovulatory disorders, most notably polycystic ovarian syndrome; history of salpingitis such as that caused by chlamydia infection; endometriosis; and uterine cavity abnormalities interfering with implantation causing inability to become pregnant or causing recurrent pregnancy loss. These potential causes of female infertility are discussed in this document and the appropriate imaging recommendations for each variant are provided. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
| | | | - Esma A Akin
- George Washington University Hospital, Washington, District of Columbia
| | - Susan M Ascher
- Georgetown University Hospital, Washington, District of Columbia
| | - Olga R Brook
- Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Mark Dassel
- Cleveland Clinic, Cleveland, Ohio; American College of Obstetricians and Gynecologists
| | | | - Lee A Learman
- Virginia Tech Carilion School of Medicine, Roanoke, Virginia; American College of Obstetricians and Gynecologists
| | | | | | | | | | - Carl Saphier
- Women's Ultrasound, LLC, Englewood, New Jersey; American College of Obstetricians and Gynecologists
| | | | - Phyllis Glanc
- Specialty Chair, University of Toronto and Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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21
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Approbato FC, Approbato MS, Maia MCS, Lima YARD, Barbosa MA, Benetti BBDC. Bilateral but not unilateral tubal obstruction is associated with positive chlamydia serology. JBRA Assist Reprod 2020; 24:20-23. [PMID: 31397549 PMCID: PMC6993167 DOI: 10.5935/1518-0557.20190049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective: To assess the association between positive Chlamydia trachomatis (C. trachomatis) serology and unilateral or bilateral tubal obstruction. Methods: This was a cross sectional study that evaluated the association of positive C. trachomatis serology (Immunofluorescence Indirect Serology, IIF or Enzyme Immune Essay, EIE), in two infertile groups: A. 243 patients (27 with unilateral obstruction and 216 without it). B. 247 patients (31 with bilateral obstruction and 216 without it). The exclusion criteria were tubal ligation (tubectomy) and tubal surgery. The statistical test (SPSS 17.0) was the Chi-Square with a p=5%. Tubal obstruction was diagnosed through hysterosalpingography (HSG). Results: The mean age of the patients without obstruction was 33.6 years, SD 4.9. The mean age of the patients with unilateral obstruction was 33.7 years SD 4.9. The mean age of the patients with bilateral obstruction was 33.6 years, SD 4.9. There was no statistically significant difference between the age groups. In group A (unilateral obstruction versus serology) the Chi-Square was 0.02 (p=n.s.) and the Attributable Risk (AR) = 0.7%. In Group B (bilateral obstruction versus serology) the Chi-Square test was 9.87 (p<0.005) and the AR = 14.8%. Conclusion: This study found a strong and statistically significant association between bilateral tubal obstruction and C. trachomatis positive serology. The power of the test was 86%. There was no association between unilateral obstruction and positive serology.
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Affiliation(s)
- Fabiana C Approbato
- Brazil Human Reproduction Laboratory. Obstetric and Gynecology Dept. Federal University of Goias State, Brazil
| | - Mário S Approbato
- Brazil Human Reproduction Laboratory. Obstetric and Gynecology Dept. Federal University of Goias State, Brazil
| | - Mônica C S Maia
- Brazil Human Reproduction Laboratory. Obstetric and Gynecology Dept. Federal University of Goias State, Brazil
| | - Yanna A R de Lima
- Brazil Human Reproduction Laboratory. Obstetric and Gynecology Dept. Federal University of Goias State, Brazil
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22
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Krassas GE, Markou KB. The impact of thyroid diseases starting from birth on reproductive function. Hormones (Athens) 2019; 18:365-381. [PMID: 31734887 DOI: 10.1007/s42000-019-00156-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 10/30/2019] [Indexed: 12/19/2022]
Abstract
The aim of this review is to provide relevant information regarding the impact of thyroid disease, starting from birth and mainly concerning hyperthyroidism and hypothyroidism, on reproduction. Hyperthyroidism occurs much less commonly in children than hypothyroidism, with Graves' disease (GD) being the most common cause of thyrotoxicosis in children. Children born with neonatal GD have no defects in the reproductive system that could be related to hyperthyroidism. Current treatment options include antithyroid drugs (ATD), surgery, and radioactive iodine (RAI). In males, normal thyroid function seems important, at least in some parameters, for maintenance of semen quality via genomic or non-genomic mechanisms, either by locally acting on Sertoli cells, Leydig cells, or germ cells, or by affecting crosstalk between the HPT axis and the HPG axis. Sexual behavior may also be affected in thyroxic men, although many of these patients may have normal free testosterone levels. In women, menstrual irregularities are the most common reproduction-related symptoms in thyrotoxicosis, while this disorder is also associated with reduced fertility, although most women remain ovulatory. An increase in sex hormone-binding globulin (SHBG) and androgens, thyroid autoimmunity, and an impact on uterine oxidative stress are the main pathophysiological mechanisms which may influence female fertility. Thyroid hormones are responsible for normal growth and development during pre- and postnatal life, congenital hypothyroidism (CH) being the most common cause of neonatal thyroid disorders, affecting about one newborn infant in 3500. The reproductive tract appears to develop normally in cretins. Today, CH-screening programs allow for early identification and treatment, and, as a result, affected children now achieve normal or near-normal development. Hypothyroidism in males is associated with decreased libido or impotence. Although little is currently known about the effects of hypothyroidism on spermatogenesis and fertility, it has been established that sperm morphology and motility are mainly affected. In women of reproductive age, hypothyroidism results in changes in cycle length and amount of bleeding. Moreover, a negative effect on fertility and higher miscarriage rates has also been described.
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Affiliation(s)
- Gerasimos E Krassas
- IASEIO Medical Center, Tz. Kennendy 115B, Pylea, 55535, Thessaloniki, Greece.
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23
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Rizzuto I, Behrens RF, Smith LA. Risk of ovarian cancer in women treated with ovarian stimulating drugs for infertility. Cochrane Database Syst Rev 2019; 6:CD008215. [PMID: 31207666 PMCID: PMC6579663 DOI: 10.1002/14651858.cd008215.pub3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND This is an updated version of the original Cochrane Review published in the Cochrane Library in 2013 (Issue 8) on the risk of ovarian cancer in women using infertility drugs when compared to the general population or to infertile women not treated. The link between fertility drugs and ovarian cancer remains controversial. OBJECTIVES To evaluate the risk of invasive ovarian cancer and borderline ovarian tumours in women treated with ovarian stimulating drugs for subfertility. SEARCH METHODS The original review included published and unpublished observational studies from 1990 to February 2013. For this update, we extended the searches from February 2013 to November 2018; we evaluated the quality of the included studies and judged the certainty of evidence by using the GRADE approach. We have reported the results in a Summary of findings table to present effect sizes across all outcome types. SELECTION CRITERIA In the original review and in this update, we searched for randomised controlled trials (RCTs) and non-randomised studies and case series including more than 30 participants. DATA COLLECTION AND ANALYSIS At least two review authors independently conducted eligibility and 'Risk of bias' assessments and extracted data. We grouped studies based on the fertility drug used for two outcomes: borderline ovarian tumours and invasive ovarian cancer. We conducted no meta-analyses due to expected methodological and clinical heterogeneity. MAIN RESULTS We included 13 case-control and 24 cohort studies (an additional nine new cohort and two case-control studies), which included a total of 4,684,724 women.Two cohort studies reported an increased incidence of invasive ovarian cancer in exposed subfertile women compared with unexposed women. One reported a standardised incidence ratio (SIR) of 1.19 (95% confidence interval (CI) 0.54 to 2.25) based on 17 cancer cases. The other cohort study reported a hazard ratio (HR) of 1.93 (95% CI 1.18 to 3.18), and this risk was increased in women remaining nulligravid after using clomiphene citrate (HR 2.49, 95% CI 1.30 to 4.78) versus multiparous women (HR 1.52, 95% CI 0.67 to 3.42) (very low-certainty evidence). The slight increase in ovarian cancer risk among women having between one and three cycles of in vitro fertilisation (IVF) was reported, but this was not clinically significant (P = 0.18). There was no increase in risk of invasive ovarian cancer after use of infertility drugs in women with the BRCA mutation according to one cohort and one case-control study. The certainty of evidence as assessed using GRADE was very low.For borderline ovarian tumours, one cohort study reported increased risk in exposed women with an SIR of 3.61 (95% CI 1.45 to 7.44), and this risk was greater after treatment with clomiphene citrate (SIR 7.47, 95% CI 1.54 to 21.83) based on 12 cases. In another cohort study, the risk of a borderline ovarian tumour was increased, with an HR of 4.23 (95% CI 1.25 to 14.33), for subfertile women treated with IVF compared with a non-IVF-treated group with more than one year of follow-up. A large cohort reported increased risk of borderline ovarian tumours, with HR of 2.46 (95% CI 1.20 to 5.04), and this was based on 17 cases. A significant increase in serous borderline ovarian tumours was reported in one cohort study after the use of progesterone for more than four cycles (risk ratio (RR) 2.63, 95% CI 1.04 to 6.64). A case-control study reported increased risk after clomiphene citrate was taken, with an SIR of 2.5 (95% CI 1.3 to 4.5) based on 11 cases, and another reported an increase especially after human menopausal gonadotrophin was taken (odds ratio (OR) 9.38, 95% CI 1.66 to 52.08). Another study estimated an increased risk of borderline ovarian tumour, but this estimation was based on four cases with no control reporting use of fertility drugs. The certainty of evidence as assessed using GRADE was very low.However, although some studies suggested a slight increase in risks of ovarian cancer and borderline ovarian tumour, none provided moderate- or high-certainty evidence, as summarised in the GRADE tables. AUTHORS' CONCLUSIONS Since the last version of this review, only a few new relevant studies have provided additional findings with supporting evidence to suggest that infertility drugs may increase the risk of ovarian cancer slightly in subfertile women treated with infertility drugs when compared to the general population or to subfertile women not treated. The risk is slightly higher in nulliparous than in multiparous women treated with infertility drugs, and for borderline ovarian tumours. However, few studies have been conducted, the number of cancers is very small, and information on the dose or type of fertility drugs used is insufficient.
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Affiliation(s)
- Ivana Rizzuto
- East Suffolk and North Essex NHS Foundation TrustGynaecology Oncology DepartmentHeath RoadIpswichSuffolkUKIP4 5PD
| | - Renee F Behrens
- Hampshire Hospitals NHS Foundation TrustRoyal Hampshire HospitalRomsey RoadWinchesterHampshireUKSO23 9TE
| | - Lesley A Smith
- Institute of Clinical and Applied Health ResearchUniversity of HullHullUKHU6 7RX
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24
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Conforti A, Mascia M, Cioffi G, De Angelis C, Coppola G, De Rosa P, Pivonello R, Alviggi C, De Placido G. Air pollution and female fertility: a systematic review of literature. Reprod Biol Endocrinol 2018; 16:117. [PMID: 30594197 PMCID: PMC6311303 DOI: 10.1186/s12958-018-0433-z] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 10/24/2018] [Indexed: 12/31/2022] Open
Abstract
Air pollution is a cause of concern for human health. For instance, it is associated with an increased risk for cancer, cardiovascular and respiratory disorders. In vitro and in vivo studies suggested that air pollutants could act as endocrine disruptors, promote oxidative stress and exert genotoxic effect. Whether air pollution affects female infertility is under debate. The aim of the present study was to conduct a systematic review of studies that evaluated the impact of air pollution on female infertility. We systematically searched the MEDLINE (PubMed) and SCOPUS databases to identify all relevant studies published before October 2017. No time or language restrictions were adopted, and queries were limited to human studies. We also hand-searched the reference lists of relevant studies to ensure we did not miss pertinent studies. The risk of bias and quality assessment of the studies identified were performed using the Newcastle-Ottawa Scale. Primary outcomes were conception rate after spontaneous intercourse and live birth rate after in vitro fertilization (IVF) procedures. Secondary outcomes were first trimester miscarriage, stillbirths, infertility, number of oocytes and embryo retrieved. Eleven articles were included in the analysis. We found that in the IVF population, nitrogen dioxide and ozone were associated with a reduced live birth rate while particulate matter of 10 mm was associated with increased miscarriage. Furthermore, in the general population, particulate matter of 2.5 mm and between 2.5 and 10 mm were associated with reduced fecundability, whereas sulfur dioxide, carbon monoxide and nitrogen dioxide might promote miscarriage and stillbirths. The main limitation of our findigns resides in the fact that the desegn of studies included are observational and retrospective. Furthermore, there was a wide heterogenity among studies. Although larger trials are required before drawing definitive conclusions, it seems that air pollution could represent a matter of concern for female infertility.
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Affiliation(s)
- Alessandro Conforti
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Sezione di Ginecologia ed Ostetricia, Centro di Sterilità Università "Federico II" di Napoli, Naples, Italy.
| | - Marika Mascia
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Sezione di Ginecologia ed Ostetricia, Centro di Sterilità Università "Federico II" di Napoli, Naples, Italy
| | - Giuseppina Cioffi
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Sezione di Ginecologia ed Ostetricia, Centro di Sterilità Università "Federico II" di Napoli, Naples, Italy
| | - Cristina De Angelis
- I.O.S. & COLEMAN Srl, Naples, Italy
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Centro di Andrologia, Medicina della Riproduzione e della Sessualità Maschile e Femminile, Università "Federico II" di Napoli, Naples, Italy
| | | | - Pasquale De Rosa
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Sezione di Ginecologia ed Ostetricia, Centro di Sterilità Università "Federico II" di Napoli, Naples, Italy
| | - Rosario Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Centro di Andrologia, Medicina della Riproduzione e della Sessualità Maschile e Femminile, Università "Federico II" di Napoli, Naples, Italy
| | - Carlo Alviggi
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Sezione di Ginecologia ed Ostetricia, Centro di Sterilità Università "Federico II" di Napoli, Naples, Italy
- Centro nazionale delle ricerche, Istituto per l'Endocrinologia e l'Oncologia Sperimentale (IEOS), Naples, Italy
| | - Giuseppe De Placido
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Sezione di Ginecologia ed Ostetricia, Centro di Sterilità Università "Federico II" di Napoli, Naples, Italy
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Tanywe A, Matchawe C, Fernandez R, Lapkin S. Experiences of women living with infertility in Africa: a qualitative systematic review protocol. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2018; 16:1772-1778. [PMID: 30204667 DOI: 10.11124/jbisrir-2017-003625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
REVIEW QUESTION What are the experiences of women living with infertility in Africa?
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Affiliation(s)
- Asahngwa Tanywe
- Cameroon Centre for Evidence Based Health Care: a Joanna Briggs Institute Centre of Excellence
- Centre for Behavioral and Social Research, Cameroon, Africa
| | - Chelea Matchawe
- Cameroon Centre for Evidence Based Health Care: a Joanna Briggs Institute Centre of Excellence
- Institute of Medical Research and Medicinal Plant Studies (IMPM), Yaoundé, Cameroon, Africa
| | - Ritin Fernandez
- Centre for Evidence Based Initiatives in Health Care: a Joanna Briggs Institute Centre of Excellence, University of Wollongong, Wollongong, Australia
- St George Hospital, Sydney, New South Wales, Australia
| | - Samuel Lapkin
- Centre for Evidence Based Initiatives in Health Care: a Joanna Briggs Institute Centre of Excellence, University of Wollongong, Wollongong, Australia
- St George Hospital, Sydney, New South Wales, Australia
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26
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Starrs AM, Ezeh AC, Barker G, Basu A, Bertrand JT, Blum R, Coll-Seck AM, Grover A, Laski L, Roa M, Sathar ZA, Say L, Serour GI, Singh S, Stenberg K, Temmerman M, Biddlecom A, Popinchalk A, Summers C, Ashford LS. Accelerate progress-sexual and reproductive health and rights for all: report of the Guttmacher-Lancet Commission. Lancet 2018; 391:2642-2692. [PMID: 29753597 DOI: 10.1016/s0140-6736(18)30293-9] [Citation(s) in RCA: 454] [Impact Index Per Article: 75.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 02/02/2018] [Accepted: 02/08/2018] [Indexed: 01/10/2023]
Affiliation(s)
| | - Alex C Ezeh
- African Population and Health Research Center, Nairobi, Kenya; School of Public Health, University of Witwatersrand, Johannesburg, South Africa; Center for Global Development, Washington, DC, USA
| | | | - Alaka Basu
- Department of Development Sociology, Cornell University, Ithaca, NY, USA
| | - Jane T Bertrand
- Tulane School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Robert Blum
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | | | | | | | - Monica Roa
- Independent Consultant, Islamabad, Pakistan
| | | | - Lale Say
- World Health Organization, Geneva, Switzerland
| | - Gamal I Serour
- International Islamic Center For Population Studies And Research, Al Azhar University, Cairo, Egypt
| | | | | | - Marleen Temmerman
- Department of Obstetrics and Gynaecology, Aga Khan University, Nairobi, Kenya
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Guinter MA, McLain AC, Merchant AT, Sandler DP, Steck SE. A dietary pattern based on estrogen metabolism is associated with breast cancer risk in a prospective cohort of postmenopausal women. Int J Cancer 2018; 143:580-590. [PMID: 29574860 DOI: 10.1002/ijc.31387] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 02/14/2018] [Accepted: 02/28/2018] [Indexed: 12/27/2022]
Abstract
Increased exposure to estrogen is a risk factor for postmenopausal breast cancer, and dietary factors can influence estrogen metabolism. However, studies of diet and breast cancer have been inconclusive. We developed a dietary pattern associated with levels of unconjugated estradiol and the ratio of 2- and 16-hydroxylated estrogen metabolites in a subsample of Prostate, Lung, Colorectal and Ovarian Screening Trial (PLCO) participants (n = 653) using reduced rank regression, and examined its association with postmenopausal breast cancer prospectively in the larger PLCO cohort (n = 27,488). The estrogen-related dietary pattern (ERDP) was comprised of foods with positively-weighted intakes (non-whole/refined grains, tomatoes, cruciferous vegetables, cheese, fish/shellfish high in ω-3 fatty acids, franks/luncheon meats) and negatively-weighted intakes (nuts/seeds, other vegetables, fish/shellfish low in ω-3 fatty acids, yogurt, coffee). A 1-unit increase in the ERDP score was associated with an increase in total (HR: 1.09, 95% CI: 1.01-1.18), invasive (HR: 1.13; 95% CI: 1.04-1.24) and estrogen receptor (ER)-positive (HR: 1.13, 95% CI: 1.02-1.24) breast cancer risk after adjustment for confounders. Associations were observed for the fourth quartile of ERDP compared with the first quartile for overall breast cancer (HR: 1.14; 95% CI: 0.98-1.32), invasive cases (HR: 1.20, 95% CI: 1.02-1.42) and ER-positive cases (HR: 1.19; 95% CI: 0.99-1.41). The increased risk associated with increasing ERDP score was more apparent in strata of some effect modifiers (postmenopausal hormone therapy non-users and non-obese participants) where the relative estrogen exposure due to that factor was lowest, although the p values for interaction were not statistically significant. Results suggest a dietary pattern based on estrogen metabolism is positively associated with postmenopausal breast cancer risk, possibly through an estrogenic influence.
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Affiliation(s)
- Mark A Guinter
- Behavioral and Epidemiology Research Group, American Cancer Society, Atlanta, GA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Alexander C McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC
| | - Susan E Steck
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC.,Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
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28
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Patiño-García D, Cruz-Fernandes L, Buñay J, Palomino J, Moreno RD. Reproductive Alterations in Chronically Exposed Female Mice to Environmentally Relevant Doses of a Mixture of Phthalates and Alkylphenols. Endocrinology 2018; 159:1050-1061. [PMID: 29300862 DOI: 10.1210/en.2017-00614] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 12/21/2017] [Indexed: 01/27/2023]
Abstract
Endocrine-disrupting chemicals (EDCs) are exogenous compounds that modify hormone biosynthesis, causing adverse effects to human health. Among them, phthalates and alkylphenols are important due to their wide use in plastics, detergents, personal care products, cosmetics, and food packaging. However, their conjoint effects over reproductive female health have not been addressed. The aim of this work was to test the effect of chronically exposed female mice to a mixture of three phthalates [bis (2-ethylhexyl), dibutyl, and benzyl butyl] and two alkylphenols (4-nonylphenol and 4-tert-octylphenol) from conception to adulthood at environmentally relevant doses. These EDCs were administered in two doses: one below the minimal risk dose to cause adverse effects on human development and reproduction [1 mg/kg body weight (BW)/d of the total mixture] and the other one based on the reference value close to occupational exposure in humans (10 mg/kg BW/d of the total mixture). Our results show that both doses had similar effects regarding the uterus and ovary relative weight, estrous cyclicity, serum levels of progesterone and 17β-estradiol, and expression of key elements in the steroidogenesis pathway (acute steroidogenic regulatory protein and CYP19A1). However, only the 1-mg/kg BW/d dose delayed the onset of puberty and the transition from preantral to antral follicles, whereas the 10-mg/kg BW/d dose decreased the number of antral follicles and gonadotropin receptor expression. In addition, we observed changes in several fertility parameters in exposed females and in their progeny (F2 generation). In conclusion, our results indicate that chronic exposure to a complex EDC mixture, at environmentally relevant doses, modifies reproductive parameters in female mice.
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Affiliation(s)
- Daniel Patiño-García
- Departamento de Fisiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Leonor Cruz-Fernandes
- Departamento de Fisiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Julio Buñay
- Departamento de Fisiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jaime Palomino
- Departamento de Fisiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ricardo D Moreno
- Departamento de Fisiología, Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
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Hosotani M, Ichii O, Nakamura T, Kanazawa SO, Elewa YHA, Kon Y. Autoimmune abnormality affects ovulation and oocyte-pick-up in MRL/MpJ-Faslpr/lpr mice. Lupus 2017; 27:82-94. [DOI: 10.1177/0961203317711772] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Ovulation and oocyte-pick-up are essential processes in fertilization. Herein, we found associations between autoimmune disease and the aforementioned processes in mice. At three and six months, along with the evaluation of autoimmune disease indices, the ovary, mesosalpinx, and oviducts were histologically examined in C57BL/6, MRL/MpJ, and MRL/MpJ-Fas lpr/lpr mice as healthy control, mild and severe models of autoimmune disease, respectively. In superovulated mice, the number of “oocyte cumulus complexes” found in the ampulla was macroscopically counted, and that of “ovulated oocytes” was histologically evaluated, as indicated by ruptured follicles or corpora hemorrhagica in ovaries. Finally, the oocyte-pick-up rate was calculated. In MRL/MpJ-Fas lpr/lpr mice, the oocyte-pick-up rate decreased with disease-related deterioration, unlike in other mouse strains. Further, more ovulated oocytes were found in MRL/MpJ mice than in C57BL/6 mice, and this number significantly decreased with aging in MRL/MpJ-Fas lpr/lpr mice. Numerous T-cells infiltrated into the infundibulum or a part of the mesosalpinx in aged MRL/MpJ-Fas lpr/lpr mice, and their infundibulum showed swelling and fewer ciliated epithelial cells compared to that of C57BL/6 mice. In conclusion, the progression of severe autoimmune disease affected the oocyte-pick-up process through histopathological changes in the infundibulum. These results provide important insights into female infertility associated with autoimmune disease.
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Affiliation(s)
- M Hosotani
- Laboratory of Anatomy, Department of Biomedical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - O Ichii
- Laboratory of Anatomy, Department of Biomedical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - T Nakamura
- Laboratory of Anatomy, Department of Biomedical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
- Section of Biological Safety Research, Chitose Laboratory, Japan Food Research Laboratories, Chitose, Hokkaido, Japan
| | - S O Kanazawa
- Laboratory of Anatomy, Department of Biomedical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Y Hosny Ali Elewa
- Laboratory of Anatomy, Department of Biomedical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
- Department of Histology and Cytology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Y Kon
- Laboratory of Anatomy, Department of Biomedical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
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Sessions-Bresnahan DR, Carnevale EM. Age-associated changes in granulosa cell transcript abundance in equine preovulatory follicles. Reprod Fertil Dev 2017; 27:906-13. [PMID: 25775380 DOI: 10.1071/rd14467] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 02/17/2015] [Indexed: 01/24/2023] Open
Abstract
Age-related changes in follicle paracrine signalling are not defined, and follicular gene transcript abundance could predict oocyte viability. Granulosa cells from preovulatory follicles of mares considered Young (n=12; 4-14 years), Mid-aged (n=9; 15-19 years) and Old (n=14; 20-27 years) were evaluated for transcript abundance related to systemic and follicle-specific pathways. Gene transcript abundance for receptors of insulin, adiponectin and peroxisome proliferating factor-γ were higher or tended to be higher in Mid-aged or Old than Young mares. Transcript abundance for interleukin (IL)-6 was elevated in Old versus Young mares, and IL-6 signal transducer was elevated in Old versus younger groups. Expression of tumour necrosis factor (TNF) receptor superfamily member 1A was higher in Mid-aged than Young mares, whereas TNF-inducible gene 6 protein mRNA tended to decrease in Mid-aged versus Young and Old mares. Genes for LH receptor and steroidogenic acute regulatory protein tended to be increased in Old versus Mid-aged and Young mares, respectively. Young and Old mares had higher mRNA for tissue-type plasminogen activator than Mid-aged mares. Thioredoxin-2 mRNA was higher in Old than younger groups. We observed age-related changes in mRNA of receptors for metabolic hormones, inflammatory processes, steroidogenic hormones, tissue remodelling and mitochondrial function, which could contribute to and/or mark alterations in follicular function and fertility.
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Affiliation(s)
| | - Elaine M Carnevale
- Department of Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA
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Mahapatra D, Chandra AK. Biphasic action of iodine in excess at different doses on ovary in adult rats. J Trace Elem Med Biol 2017; 39:210-220. [PMID: 27908417 DOI: 10.1016/j.jtemb.2016.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 08/30/2016] [Accepted: 10/18/2016] [Indexed: 12/01/2022]
Abstract
Iodine consumption in excess of its recommended levels over a prolonged period of time is well known to cause thyroid disorders. The thyroid hormones on the other hand are responsible in maintenance of the physiology of the reproductive system. Excess iodine intake affects male reproductive physiology. However, the effects of excess iodine on the ovarian structure and function is yet to be established. The present study has thus been undertaken to investigate the effect of excess iodine on the ovarian physiology. Excess iodine was administered through oral gavage in the form of potassium iodide (KI) for duration of 60days, at two different doses. The doses used were 100 EI, i.e., 100 times more than the recommended level but tolerable to the thyroid gland and 500 EI, i.e., 500 times more than the recommended level that altered thyroid physiology. The animals were divided into three groups, one control group, and the other two receiving two separate doses (100 EI and 500 EI) of excess KI. Estrous cyclical changes, ovarian morphological changes, ovarian iodine accumulation and ovarian steroidogenic enzyme activities were analysed. The thyroid functional status was studied from the serum thyroid hormones levels. The overall results revealed a biphasic action of excess iodine that depends on its dose. At 100 EI, excess iodine did not alter thyroid physiology but lead to the development of a hypoestrogenic state. There was an increased accumulation of iodine in the ovary with decreased activity of ovarian steroidogenic enzymes and lowered serum estradiol levels. However, at 500 EI, excess iodine developed a hyperthyroid condition, which further leads to a hyperestrogenic state. There was an increased activity of serum steroidogenic enzymes as well as elevated serum estradiol levels. Fertility index was zero in both the 100 EI and 500 EI treated groups of experimental animals. Thus excess iodine (100 EI) ingestion within tolerable range though maintained a euthyroid condition yet developed a state of hypofunctioning ovary. Conversely, excessive iodine (500 EI) is intolerable to thyroid, develops a hyperthyroid condition that leads to a hyperfunctioning ovary. Therefore prolonged exposure of iodine in excess exerts biphasic mode of action depending on the dose in female reproductive physiology and both the doses used in this study affected fertility equally.
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Affiliation(s)
- Dakshayani Mahapatra
- Endocrinology and Reproductive Physiology Laboratory, Department of Physiology, University of Calcutta, 92, A.P.C Road, Kolkata-700009, India
| | - Amar K Chandra
- Endocrinology and Reproductive Physiology Laboratory, Department of Physiology, University of Calcutta, 92, A.P.C Road, Kolkata-700009, India.
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Campo H, Cervelló I, Simón C. Bioengineering the Uterus: An Overview of Recent Advances and Future Perspectives in Reproductive Medicine. Ann Biomed Eng 2016; 45:1710-1717. [PMID: 28028711 DOI: 10.1007/s10439-016-1783-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 12/20/2016] [Indexed: 01/24/2023]
Abstract
Since the initial in vitro attempts to more complex models, research on uterine regeneration is moving towards the creation of a functional bioengineered uterus with possible clinical applications. We describe here the most relevant advances in bioengineering of the uterus published in the last decades considering the use of stem cells and biomaterials as well as future developing techniques in Regenerative Medicine.
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Affiliation(s)
- Hannes Campo
- Dept of Obst&Gyn, Fundación Instituto Valenciano de Infertilidad (FIVI), School of Medicine, Valencia University and Instituto Universitario IVI/INCLIVA, Valencia, Spain
| | - Irene Cervelló
- Dept of Obst&Gyn, Fundación Instituto Valenciano de Infertilidad (FIVI), School of Medicine, Valencia University and Instituto Universitario IVI/INCLIVA, Valencia, Spain.
| | - Carlos Simón
- Dept of Obst&Gyn, Fundación Instituto Valenciano de Infertilidad (FIVI), School of Medicine, Valencia University and Instituto Universitario IVI/INCLIVA, Valencia, Spain.,Department of Obstetrics & Gynaecology, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
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Campo H, Baptista PM, López-Pérez N, Faus A, Cervelló I, Simón C. De- and recellularization of the pig uterus: a bioengineering pilot study. Biol Reprod 2016. [DOI: 10.1095/biolre/bio143396] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Hannes Campo
- Fundación Instituto Valenciano de Infertilidad, Department of Obstetrics and Gynecology, School of Medicine, Valencia University and Instituto Valenciano de Infertilidad/INCLIVA, Valencia, Spain
| | - Pedro M Baptista
- Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain
- Instituto de Investigacion Sanitaria de Aragon, Zaragoza, Spain
- Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas, Zaragoza, Spain
- Department of Biomedical and Aerospace Engineering, Universidad Carlos III, Madrid, Spain
| | - Nuria López-Pérez
- Fundación Instituto Valenciano de Infertilidad, Department of Obstetrics and Gynecology, School of Medicine, Valencia University and Instituto Valenciano de Infertilidad/INCLIVA, Valencia, Spain
| | - Amparo Faus
- Fundación Instituto Valenciano de Infertilidad, Department of Obstetrics and Gynecology, School of Medicine, Valencia University and Instituto Valenciano de Infertilidad/INCLIVA, Valencia, Spain
| | - Irene Cervelló
- Fundación Instituto Valenciano de Infertilidad, Department of Obstetrics and Gynecology, School of Medicine, Valencia University and Instituto Valenciano de Infertilidad/INCLIVA, Valencia, Spain
| | - Carlos Simón
- Fundación Instituto Valenciano de Infertilidad, Department of Obstetrics and Gynecology, School of Medicine, Valencia University and Instituto Valenciano de Infertilidad/INCLIVA, Valencia, Spain
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford University, Stanford, California
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Chura LR, Norman RJ. Impact of Lifestyle Factors on Ovarian Function and Reproductive Health in Women. WOMENS HEALTH 2016; 3:511-3. [DOI: 10.2217/17455057.3.5.511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Lindsay R Chura
- University of Adelaide, Discipline of Obstetrics and Gynaecology, Research Centre for Reproductive Health, School of Pediatrics and Reproductive Health, Medical School, Adelaide South Australia, Australia, Tel: +1 518 456 2557
| | - Robert J Norman
- University of Adelaide, Discipline of Obstetrics and Gynaecology, Research Centre for Reproductive Health, School of Pediatrics and Reproductive Health, Medical School, Adelaide South Australia, Australia, Tel: +1 518 456 2557
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Leung VWY, Soon JA, Lynd LD, Marra CA, Levine M. Population-based evaluation of the effectiveness of two regimens for emergency contraception. Int J Gynaecol Obstet 2016; 133:342-6. [PMID: 26969148 DOI: 10.1016/j.ijgo.2015.10.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 10/08/2015] [Accepted: 02/11/2016] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To estimate and compare the effectiveness of the levonorgestrel and Yuzpe regimens for hormonal emergency contraception in routine clinical practice. METHODS A retrospective population-based study included women who accessed emergency contraceptives for immediate use prescribed by community pharmacists in British Columbia, Canada, between December 2000 and December 2002. Linked administrative healthcare data were used to discern the timings of menses, unprotected intercourse, and any pregnancy-related health services. A panel of experts evaluated the compatibility of observed pregnancies with the timing of events. The two regimens were compared with statistical adjustments for potential confounding. RESULTS Among 7493 women in the cohort, 4470 (59.7%) received levonorgestrel and 3023 (40.3%) the Yuzpe regimen. There were 99 (2.2%) compatible pregnancies in the levonorgestrel group and 94 (3.1%) in the Yuzpe group (P=0.017). The estimated odds ratio for levonorgestrel compared with the Yuzpe regimen after adjusting for potential confounders was 0.64 (95% confidence interval 0.47-0.87). Against an expected pregnancy rate of approximately 5%, the relative and absolute risk reductions were 56.0% and 2.8%, respectively, for levonorgestrel and 36.7% and 1.8% for the Yuzpe regimen. CONCLUSION The levonorgestrel regimen is more effective than the Yuzpe regimen in routine use. The data suggest that both regimens are less effective than has been observed in randomized trials.
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Affiliation(s)
- Vivian W Y Leung
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Judith A Soon
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Larry D Lynd
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada; Centre for Health Evaluation and Outcomes Sciences, Providence Health Research Institute, Vancouver, BC, Canada
| | - Carlo A Marra
- School of Pharmacy, Memorial University, St. John's, NL, Canada
| | - Marc Levine
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.
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Hosseini S, Shokri F, Tokhmechy R, Savadi-Shiraz E, Jeddi-Tehrani M, Rahbari M, Zarnani AH. Menstrual blood contains immune cells with inflammatory and anti-inflammatory properties. J Obstet Gynaecol Res 2015; 41:1803-12. [DOI: 10.1111/jog.12801] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Accepted: 06/09/2015] [Indexed: 12/30/2022]
Affiliation(s)
- Samira Hosseini
- Department of Immunology, School of Public Health; Tehran University of Medical Sciences; Tehran Iran
| | - Fazel Shokri
- Department of Immunology, School of Public Health; Tehran University of Medical Sciences; Tehran Iran
| | - Reihaneh Tokhmechy
- Reproductive Biotechnology Research Center; Avicenna Research Institute, ACECR; Tehran Iran
| | - Elham Savadi-Shiraz
- Reproductive Biotechnology Research Center; Avicenna Research Institute, ACECR; Tehran Iran
| | - Mahmood Jeddi-Tehrani
- Monoclonal Antibody Research Center; Avicenna Research Institute, ACECR; Tehran Iran
| | - Marjaneh Rahbari
- Reproductive Biotechnology Research Center; Avicenna Research Institute, ACECR; Tehran Iran
| | - Amir-Hassan Zarnani
- Reproductive Immunology Research Center, Avicenna Research Institute; ACECR; Tehran Iran
- Immunology Research Center; Iran University of Medical Sciences; Tehran Iran
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37
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Oyeyipo I, Maartens P, du Plessis S. Diet-induced obesity alters kinematics of rat spermatozoa. ASIAN PACIFIC JOURNAL OF REPRODUCTION 2015. [DOI: 10.1016/j.apjr.2015.06.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Heitmann RJ, Hill MJ, James AN, Schimmel T, Segars JH, Csokmay JM, Cohen J, Payson MD. Live births achieved via IVF are increased by improvements in air quality and laboratory environment. Reprod Biomed Online 2015. [PMID: 26194882 DOI: 10.1016/j.rbmo.2015.04.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Infertility is a common disease, which causes many couples to seek treatment with assisted reproduction techniques. Many factors contribute to successful assisted reproduction technique outcomes. One important factor is laboratory environment and air quality. Our facility had the unique opportunity to compare consecutively used, but separate assisted reproduction technique laboratories, as a result of a required move. Environmental conditions were improved by strategic engineering designs. All other aspects of the IVF laboratory, including equipment, physicians, embryologists, nursing staff and protocols, were kept constant between facilities. Air quality testing showed improved air quality at the new IVF site. Embryo implantation (32.4% versus 24.3%; P < 0.01) and live birth (39.3% versus 31.8%, P < 0.05) were significantly increased in the new facility compared with the old facility. More patients met clinical criteria and underwent mandatory single embryo transfer on day 5 leading to both a reduction in multiple gestation pregnancies and increased numbers of vitrified embryos per patient with supernumerary embryos available. Improvements in IVF laboratory conditions and air quality had profound positive effects on laboratory measures and patient outcomes. This study further strengthens the importance of the laboratory environment and air quality in the success of an IVF programme.
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Affiliation(s)
- Ryan J Heitmann
- Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 10 CRC, 10 Center Drive, National Institutes of Health, Bethesda, MD 20892, USA; Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889, USA.
| | - Micah J Hill
- Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 10 CRC, 10 Center Drive, National Institutes of Health, Bethesda, MD 20892, USA; Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889, USA
| | - Aidita N James
- ART Institute of Washington, Inc., 8901 Wisconsin Ave, Bethesda, MD 20889, USA
| | - Tim Schimmel
- ART Institute of Washington, Inc., 8901 Wisconsin Ave, Bethesda, MD 20889, USA
| | - James H Segars
- Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 10 CRC, 10 Center Drive, National Institutes of Health, Bethesda, MD 20892, USA
| | - John M Csokmay
- Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 10 CRC, 10 Center Drive, National Institutes of Health, Bethesda, MD 20892, USA; Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889, USA
| | - Jacques Cohen
- ART Institute of Washington, Inc., 8901 Wisconsin Ave, Bethesda, MD 20889, USA
| | - Mark D Payson
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889, USA; Dominion Fertility, 46 S. Glebe Road, Suite 301, Arlington, VA 22204, USA
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41
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Abstract
Infertility is a major, multifaceted issue worldwide whose prevalence is increasing in both high- and low-income countries. The reasons are numerous, and may differ among world regions, but lifestyle and nutritional factors, epidemic infections, and sexually transmitted diseases are major determinants in most latitudes. Three other reasons may explain the increasing incidence of infertility. First, owing to the widespread use of contraception, the choice of delaying the first pregnancy until the third decade of life places men and women at higher risk for sexually transmitted diseases, and women at higher risk for uterine fibroids, endometriosis, polycystic ovary syndrome, and chronic anovulation. Second, prolonged exposure to chronic stress and environmental pollutants may play a critical role in decreasing fertility. Third, gonadotoxic oncologic treatments allow many patients to survive cancer, at the cost of their fertility. This consideration may justify the development of treatments that preserve fertility.
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Affiliation(s)
- Felice Petraglia
- Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, University of Siena, Policlinico "Le Scotte", Siena, Italy.
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Rizzuto I, Behrens RF, Smith LA. Risk of ovarian cancer in women treated with ovarian stimulating drugs for infertility. Cochrane Database Syst Rev 2013; 2013:CD008215. [PMID: 23943232 PMCID: PMC6457641 DOI: 10.1002/14651858.cd008215.pub2] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND The use of assisted reproductive techniques is increasing, but the possible link between fertility drugs and ovarian cancer remains controversial. OBJECTIVES To evaluate the risk of ovarian cancer in women treated with ovulation stimulating drugs for subfertility. SEARCH METHODS We searched for published and unpublished observational studies from 1990 to February 2013. The following databases were used: the Cochrane Gynaecological Cancer Collaborative Review Group's Trial Register, Cochrane Central Register of Controlled Trials (CENTRAL) 2013, Issue 1, MEDLINE (to February week 4 2013), EMBASE (to 2013 week 09) and databases of conference abstracts. We also scanned reference lists of retrieved articles. The search was not restricted by language of publication. SELECTION CRITERIA We searched for randomised controlled trials (RCTs) and non-randomised studies, and case series including more than 30 participants, reporting on women with exposure to ovarian stimulating drugs for treatment of subfertility and histologically confirmed borderline or invasive ovarian cancer. DATA COLLECTION AND ANALYSIS At least two review authors independently conducted eligibility and 'Risk of bias' assessment, and extracted data. We grouped studies based on the fertility drug used for two outcomes: borderline ovarian tumours and invasive ovarian cancer. We expressed findings as adjusted odds ratio (OR), risk ratio (RR), hazard ratio (HR) or crude OR if adjusted values were not reported and standardised incidence ratio (SIR) where reported. We conducted no meta-analyses due to expected methodological and clinical heterogeneity. MAIN RESULTS We included 11 case-control studies and 14 cohort studies, which included a total of 182,972 women.Seven cohort studies showed no evidence of an increased risk of invasive ovarian cancer in subfertile women treated with any drug compared with untreated subfertile women. Seven case-control studies showed no evidence of an increased risk, compared with control women of a similar age. Two cohort studies reported an increased incidence of invasive ovarian cancer in subfertile women treated with any fertility drug compared with the general population. One of these reported a SIR of 5.0 (95% confidence interval (CI) 1.0 to 15), based on three cancer cases, and a decreased risk when cancer cases diagnosed within one year of treatment were excluded from the analysis(SIR 1.67, 95% CI 0.02 to 9.27). The other cohort study reported an OR of 2.09 (95% CI 1.39 to 3.12), based on 26 cases.For borderline ovarian tumours, exposure to any fertility drug was associated with a two to three-fold increased risk in two case-control studies. One case-control study reported an OR of 28 (95% CI 1.5 to 516), which was based on only four cases. In one cohort study, there was more than a two-fold increase in the incidence of borderline tumours compared with the general population (SIR 2.6, 95% CI 1.4 to 4.6) and in another the risk of a borderline ovarian tumour was HR 4.23 (95% CI 1.25 to 14.33) for subfertile women treated with in vitro fertilisation (IVF) compared with a non-IVF treated group with more than one year of follow-up.There was no evidence of an increased risk in women exposed to clomiphene alone or clomiphene plus gonadotrophin, compared with unexposed women. One case-control study reported an increased risk in users of human menopausal gonadotrophin (HMG)(OR 9.4, 95% CI 1.7 to 52). However, this estimate is based on only six cases with a history of HMG use. AUTHORS' CONCLUSIONS We found no convincing evidence of an increase in the risk of invasive ovarian tumours with fertility drug treatment. There may be an increased risk of borderline ovarian tumours in subfertile women treated with IVF. Studies showing an increase in the risk of ovarian cancer had a high overall risk of bias, due to retrospective study design, lack of accounting for potential confounding and estimates based on a small number of cases. More studies at low risk of bias are needed.
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Affiliation(s)
- Ivana Rizzuto
- East and North Hertfordshire NHS TrustLister HospitalCoreys Mill LaneStevenageUKSG1 4AB
| | - Renee F Behrens
- Hampshire Hospitals NHS Foundation TrustRoyal Hampshire HospitalRomsey RoadWinchesterUKSO23 9TE
| | - Lesley A Smith
- Oxford Brookes UniversityDepartment of Psychology, Social Work and Public HealthJack Straws LaneMarstonOxfordUKOX3 0FL
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Ott J, Pecnik P, Promberger R, Pils S, Seemann R, Hermann M, Frigo P. Dehydroepiandrosterone in women with premature ovarian failure and Hashimoto's thyroiditis. Climacteric 2013; 17:92-6. [DOI: 10.3109/13697137.2013.800040] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Mansourian AR. Female reproduction physiology adversely manipulated by thyroid disorders: a review of literature. Pak J Biol Sci 2013; 16:112-20. [PMID: 24171272 DOI: 10.3923/pjbs.2013.112.120] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Proper thyroid function is vital to have a healthy reproduction system. Female sex hormones are altered due to hypothyroidism and hyperthyroidism. Female reproduction system is negatively manipulated by both hyperthyroidism and hypothyroidism and menstrual disorders are the ultimate consequences. Hypomenorrhea, polymenorrhea and oligomenorrhea are the clinical manifestation associated with hyperthyroidism and hypothyroidism, respectively. The female infertility is also adversely affected by thyrotoxicosis and myxedema, the clinical presentation of hyper and hypothyroidism. The simultaneous existence of autoimmunity which is present among some portion of pregnant women may aggravate the clinical manifestation of thyroid disorders in female reproductive physiology. Abortion, premature infants, low birth infant, are among clinical presentation of overt hypothyroidism. Auto antibody against thyroid stimulating hormone receptor and eventual hyperthyroidism considered as risk factors which require extra attention while the thyroid disorder is clinically managed during pregnancy to prevent the fetus from abnormal metabolism. The aim of this review is to elaborate the adverse role of hyperthyroidism and hypothyroidism in female reproduction physiology.
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Affiliation(s)
- Azad Reza Mansourian
- Metabolic Disorders Research Center, Gorgan Medical School Golestan University of Medical Sciences, Gorgan, Iran
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Igietseme JU, Omosun Y, Partin J, Goldstein J, He Q, Joseph K, Ellerson D, Ansari U, Eko FO, Bandea C, Zhong G, Black CM. Prevention of Chlamydia-induced infertility by inhibition of local caspase activity. J Infect Dis 2013; 207:1095-104. [PMID: 23303804 DOI: 10.1093/infdis/jit009] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Tubal factor infertility (TFI) represents 36% of female infertility and genital infection by Chlamydia trachomatis (C. trachomatis) is a major cause. Although TFI is associated with host inflammatory responses to bacterial components, the molecular pathogenesis of Chlamydia-induced infertility remains poorly understood. We investigated the hypothesis that activation of specific cysteine proteases, the caspases, during C. trachomatis genital infection causes the disruption of key fertility-promoting molecules required for embryo development and implantation. We analyzed the effect of caspase inhibition on infertility and the integrity of Dicer, a caspase-sensitive, fertility-promoting ribonuclease III enzyme, and key micro-RNAs in the reproductive system. Genital infection with the inflammation- and caspase-inducing, wild-type C. trachomatis serovar L2 led to infertility, but the noninflammation-inducing, plasmid-free strain did not. We confirmed that caspase-mediated apoptotic tissue destruction may contribute to chlamydial pathogenesis. Caspase-1 or -3 deficiency, or local administration of the pan caspase inhibitor, Z-VAD-FMK into normal mice protected against Chlamydia-induced infertility. Finally, the oviducts of infected infertile mice showed evidence of caspase-mediated cleavage inactivation of Dicer and alteration in critical miRNAs that regulate growth, differentiation, and development, including mir-21. These results provide new insight into the molecular pathogenesis of TFI with significant implications for new strategies for treatment and prevention of chlamydial complications.
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Affiliation(s)
- Joseph U Igietseme
- National Center for Emerging Zoonotic and Infectious Diseases, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA.
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Abstract
OBJECTIVES To review causes and risk factors associated with infertility, relevant diagnostic procedures, and available pharmacologic and nonpharmacologic treatment options; to identify common dosing, administration, adverse effects, and key counseling points associated with infertility treatments; and to describe the role of the pharmacist in caring for patients with infertility. DATA SOURCES Available clinical literature identified through searches of Medline and review of major textbooks in reproductive medicine. STUDY SELECTION Studies were selected primarily to reflect current infertility treatment practices in the United States. The specific criteria evaluated included date of the study; date of publication; study population, including diagnosis, baseline characteristics, and nationality; and number of participants. DATA SYNTHESIS Treatment of infertility often involves the use of both pharmacologic and nonpharmacologic therapy. This article provides an overview of these pharmacologic treatments and provides two tables that outline the key administration and safety concerns with these products. Nonpharmacologic procedures associated with diagnosis and treatment also are outlined. CONCLUSION Pharmacists are an excellent resource for patients suffering from infertility. First, pharmacists answer questions about administration and safety of these medications. Second, pharmacists discuss available treatment options and assist with referrals to specialists as needed. Third, pharmacists can provide emotional support for patients who may otherwise suffer in silence.
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Affiliation(s)
- Carriann Smith
- College of Pharmacy and Health Sciences, Butler University, 4600 Sunset Ave., Indianapolis, IN 46208, USA.
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Codner E, Merino PM, Tena-Sempere M. Female reproduction and type 1 diabetes: from mechanisms to clinical findings. Hum Reprod Update 2012; 18:568-85. [PMID: 22709979 DOI: 10.1093/humupd/dms024] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The functional reproductive alterations seen in women with type 1 diabetes (T1D) have changed as therapy has improved. Historically, patients with T1D and insufficient metabolic control exhibited a high prevalence of amenorrhea, hypogonadism and infertility. This paper reviews the impact of diabetes on the reproductive axis of female T1D patients treated with modern insulin therapy, with special attention to the mechanisms by which diabetes disrupts hypothalamic-pituitary-ovarian function, as documented mainly by animal model studies. METHODS A comprehensive MEDLINE search of articles published from 1966 to 2012 was performed. Animal model studies on experimental diabetes and human studies on T1D were examined and cross-referenced with terms that referred to different aspects of the gonadotropic axis, gonadotrophins and gonadal steroids. RESULTS Recent studies have shown that women with T1D still display delayed puberty and menarche, menstrual irregularities (especially oligomenorrhoea), mild hyperandrogenism, polycystic ovarian syndrome, fewer live born children and possibly earlier menopause. Animal models have helped us to decipher the underlying basis of these conditions and have highlighted the variable contributions of defective leptin, insulin and kisspeptin signalling to the mechanisms of perturbed reproduction in T1D. CONCLUSIONS Despite improvements in insulin therapy, T1D patients still suffer many reproductive problems that warrant specific diagnoses and therapeutic management. Similar to other states of metabolic stress, T1D represents a challenge to the correct functioning of the reproductive axis.
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Affiliation(s)
- E Codner
- Institute of Maternal and Child Research (IDIMI), School of Medicine, University of Chile, Casilla 226-3, Santiago, Chile.
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Wiser A, Gonen O, Ghetler Y, Shavit T, Berkovitz A, Shulman A. Monitoring stimulated cycles during in vitro fertilization treatment with ultrasound only--preliminary results. Gynecol Endocrinol 2012; 28:429-31. [PMID: 22456062 DOI: 10.3109/09513590.2011.633666] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate if monitoring patients by ultrasound (US) only during in vitro fertilization (IVF) treatment is safe. DESIGN Randomized prospective study. INTERVENTION Patients undergoing their first IVF treatment were randomized into two groups. The ultrasound only group (study group) was monitored by US for follicle size and endometrial thickness without blood tests. In this group, only one blood test was taken before human chorionic gonadotropin (hCG) injection, to ensure a safe level of estradiol (E(2)) regarding ovarian hyperstimulation syndrome (OHSS) risk. The control group was monitored by ultrasound plus serum estradiol and progesterone concentration at each visit. MAIN OUTCOME MEASURE Clinical pregnancy rate. RESULTS No differences were found between the groups in the parameters of IVF treatment, induction days, number of ampoules, E(2) level of hCG, as well as embryo quality. The clinical pregnancy rate was not statistically different between the groups, 57.5% vs. 40.0%, respectively (p = 0.25). No OHSS cases were found among the study or control groups. CONCLUSION Ultrasound as a single monitoring tool for IVF cycles is reliable, safe, patient friendly, and reduces treatment expenses. In an era of cost effectiveness awareness, this regimen should be considered for routine management in IVF programs.
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Affiliation(s)
- Amir Wiser
- IVF Unit, Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel.
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Clinician-induced (iatrogenic) damage incurred during human infertility treatment: Detrimental effects of sperm selection methods and cryopreservation upon the viability, DNA integrity, and function of human sperm. ASIAN PACIFIC JOURNAL OF REPRODUCTION 2012. [DOI: 10.1016/s2305-0500(13)60052-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Codner E, Soto N, Merino PM. Contraception, and pregnancy in adolescents with type 1 diabetes: a review. Pediatr Diabetes 2012; 13:108-23. [PMID: 21995767 DOI: 10.1111/j.1399-5448.2011.00825.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Adolescence is a critical period for girls with type 1 diabetes mellitus (T1D). Reproductive issues, such as menstrual abnormalities, risk of an unplanned pregnancy, and contraception, should be addressed during this phase of life. This paper reviews several reproductive issues that are important in the care of adolescents, including pubertal development, menstrual abnormalities, ovulatory function, reproductive problems, the effects of hyperglycemia, contraception, and treatment of an unplanned pregnancy. A review of the literature was conducted. A MEDLINE search January 1966 to March 2011 was performed using the following MESH terms: puberty, menarche, ovary, polycystic ovary syndrome, menstruation, contraception, contraception-barrier, contraceptives-oral-hormonal, sex education, family planning services, and pregnancy in adolescence. This literature search was cross-referenced with an additional search on diabetes mellitus-type 1, diabetes complications, and pregnancy in diabetes. All published studies were searched regardless of the language of origin. Bibliographies were reviewed to extract additional relevant sources.
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Affiliation(s)
- Ethel Codner
- Institute of Maternal and Child Research (I.D.I.M.I.), School of Medicine, University of Chile, Santiago, Chile.
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