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Yarkiner Z, Boynukalın FK, Coban Ö. Assessment of Repetitive Controlled Ovarian Stimulation (COS) Cycles on Oocyte Donors: Impact on Oocyte Quality and Viable Embryo Yield. Reprod Sci 2024:10.1007/s43032-024-01584-x. [PMID: 38767768 DOI: 10.1007/s43032-024-01584-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 04/29/2024] [Indexed: 05/22/2024]
Abstract
The utilization of donor eggs has broadened the options for Assisted Reproductive Technology (ART) among women facing challenges with egg quantity or quality. Given that donors are typically selected from young and fertile individuals, In Vitro Fertilization with egg donation (IVF-ED) tends to exhibit higher rates of implantation, pregnancy, and live births compared to IVF with the woman's own eggs, especially for females over 35 years old. This has led to a projected increase in the demand for IVF-ED, surpassing the number of available donors. Consequently, many centers opt to use oocyte donors for multiple cycles. However, the correlation between repeated Controlled Ovarian Stimulation (COS) cycles and the performance of donors in terms of viable blastocyst stage embryo (VEC) or blastocyst embryo rate is not definitively established and remains of interest. This study aims to explore the preimplantation characteristics of embryo development and oocyte maturation status based on the number of donor COS cycles, employing a Generalized Linear Mixed Model (GLMM) framework. The study encompasses 1965 embryo transfer (ET) cycles involving 399 donors who underwent a minimum of two and a maximum of nine controlled ovarian hyperstimulation (COS) cycles. The findings indicate that, with the patient undergoing six or more cycles of ovarian stimulation, despite a 3.9% increase in both maturation and fertilization rates, there is a corresponding decrease of 4.5% in VEC rate and 4.7% in blastulation rates. In essence, an escalating number of donor COS cycles appears to be associated with a disadvantageous reduction in embryo quality.
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Affiliation(s)
- Zalihe Yarkiner
- Department of Basic Sciences and Humanities, Faculty of Arts and Sciences, Cyprus International University, Nicosia, Cyprus.
| | - Fazilet Kübra Boynukalın
- Infertility Department, Turkey, Obstetrics and Gynaecology, Istanbul, Bahçeci Fulya IVF Center, Üsküdar University, Istanbul, Turkey
| | - Önder Coban
- British Cyprus IVF Hospital, Embryology, Nicosia, Cyprus
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Abu-Zaid A, Gari A, Sabban H, Alshahrani MS, Khadawardi K, Badghish E, AlSghan R, Bukhari IA, Alyousef A, Abuzaid M, Alsharif SA, Alomar O, Alamery AH, Baradwan S. Comparison of Letrozole and Clomiphene Citrate in Pregnancy Outcomes in Patients with Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis. Reprod Sci 2024; 31:883-905. [PMID: 38030814 DOI: 10.1007/s43032-023-01404-8] [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: 06/08/2023] [Accepted: 11/04/2023] [Indexed: 12/01/2023]
Abstract
Clomiphene citrate (CC) and letrozole are the predominant medical interventions for the management of infertility in patients with polycystic ovary syndrome (PCOS). To comprehensively summarize the evidence, a systematic review and meta-analysis of randomized clinical trials (RCTs) was carried out to assess the effect of letrozole and CC on pregnancy outcomes in PCOS patients. We searched PubMed/MEDLINE, Scopus, and Cochrane Central Register of Controlled Trials from inception to January 2023. We included RCTs conducted on PCOS women comparing letrozole to CC and assessing endometrial thickness, the number and size of follicles, and ovulation and pregnancy rates. The endpoints were summarized as risk ratio (RR) or standardized mean difference (SMD) with 95% confidence interval (CI) using the random-effects model. Heterogeneity was examined using the I2 statistic. Fifty trials met our inclusion criteria. The mean endometrial thickness was significantly higher in the letrozole group compared to CC group (SMD: 0.89; 95% CI: 0.49, 1.28; I2=97.72%); however, the number of follicles was higher in the CC group (SMD: -0.56; 95% CI: -0.96, -0.17; I2=96.34%). Furthermore, letrozole intake induced higher ovulation rate (RR: 1.20; 95% CI: 1.13, 1.26; I2=54.49%) and pregnancy rate (RR: 1.44; 95% CI: 1.28, 1.62; I2=65.58%) compared to CC. Compared to CC, letrozole has a positive effect on endometrial thickness, monofollicular development, and ovulation and pregnancy rates suggesting that letrozole may be a strong alternative to CC as a first-line medical intervention for chronic anovulation in PCOS women. Larger studies are warranted to further clarify these findings.
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Affiliation(s)
- Ahmed Abu-Zaid
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
| | - Abdulrahim Gari
- Department of Obstetrics and Gynecology, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
- Department of Obstetrics and Gynecology, Almurjan Hospital, Jeddah, Saudi Arabia
| | - Hussein Sabban
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
- Department of Obstetrics and Gynecology, Faculty of Medicine at Rabigh, King Abdulaziz University, Rabigh, Saudi Arabia
| | - Majed Saeed Alshahrani
- Department of Obstetrics and Gynecology, Faculty of Medicine, Najran University, Najran, Saudi Arabia
| | - Khalid Khadawardi
- Department of Obstetrics and Gynecology, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Ehab Badghish
- Department of Obstetrics and Gynecology, Maternity and Children Hospital, Makkah, Saudi Arabia
| | - Rayan AlSghan
- Department of Obstetrics and Gynecology, Maternity and Children Hospital, AlKharj, Saudi Arabia
| | - Ibtihal Abdulaziz Bukhari
- Department of Obstetrics and Gynecology, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Abdullah Alyousef
- Department of Obstetrics and Gynecology, King Abdullah bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
| | - Mohammed Abuzaid
- Department of Obstetrics and Gynecology, Muhayil General Hospital, Muhayil, Saudi Arabia
| | - Saud Abdullah Alsharif
- Department of Obstetrics and Gynecology, College of Medicine, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Osama Alomar
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Aliyah Hadi Alamery
- Department of Obstetrics and Gynecology, Specialized Medical Center, Riyadh, Saudi Arabia
| | - Saeed Baradwan
- Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
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3
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Zheng L, Yang L, Guo Z, Yao N, Zhang S, Pu P. Obesity and its impact on female reproductive health: unraveling the connections. Front Endocrinol (Lausanne) 2024; 14:1326546. [PMID: 38264286 PMCID: PMC10803652 DOI: 10.3389/fendo.2023.1326546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/19/2023] [Indexed: 01/25/2024] Open
Abstract
In the modern era, the escalating global prevalence of obesity has profound implications on female reproductive health. Obesity, transcending mere lifestyle choices, has evolved into a complex disorder affecting physiological and metabolic functions. Concurrently, female infertility is rising as a significant global health issue. Obesity, with its extensive systemic effects, is pinpointed as a major disruptor. The convergence of these health challenges reveals a multifaceted scenario: on one hand, obesity directly impacts female reproductive health, particularly in the context of conditions like polycystic ovary syndrome (PCOS) and menstrual disturbances; on the other, the psychosocial consequences of infertility might intensify weight-gain patterns, forming a challenging cycle. Additionally, the economic implications of treating obesity-related infertility are considerable. This review delves into the myriad ways obesity affects female reproductive health, drawing insights from epidemiological, clinical, and molecular studies. It explores the epidemiological relationship between obesity and PCOS, the influence of obesity on menstrual disturbances, and the broader impact of obesity on female infertility. Weight loss, through pharmacological interventions, surgical methods, or lifestyle adjustments, emerges as a promising strategy. Lastly, the efficacy of assisted reproductive technologies, such as IVF, is influenced by obesity, underscoring the importance of an optimal body mass index. The review also highlights the molecular and physiological mechanisms underlying the impact of obesity on female reproductive health, including the disruption of the hypothalamic-pituitary-ovary axis, altered adipokine secretion, and the role of chronic inflammation and oxidative stress.
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Affiliation(s)
- Lei Zheng
- Department of Breast Surgery, Xingtai City People’s Hospital, Xingtai, Hebei, China
| | - Lixian Yang
- Department of Breast Surgery, Xingtai City People’s Hospital, Xingtai, Hebei, China
| | - Ziru Guo
- Department of Breast Surgery, Xingtai City People’s Hospital, Xingtai, Hebei, China
| | - Nan Yao
- Department of General Surgery, Aerospace Center Hospital, Beijing, China
| | - Shiyu Zhang
- Department of Breast Surgery, Xingtai City People’s Hospital, Xingtai, Hebei, China
| | - Pengpeng Pu
- Department of Breast Surgery, Xingtai City People’s Hospital, Xingtai, Hebei, China
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Sato M, Endo M, Tomooka K, Kuroda K, Ueda Y, Sato S, Ikemoto Y, Imai Y, Mitsui K, Tanaka A, Sugiyama R, Nakagawa K, Sato Y, Kuribayashi Y, Kitade M, Itakura A, Takeda S, Tanigawa T. Risk Factors for Alcohol Consumption after Starting Assisted Reproductive Technology Treatment among Japanese Women: Japan-Female Employment and Mental Health in Assisted Reproductive Technology (J-FEMA) Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7152. [PMID: 38131704 PMCID: PMC10742806 DOI: 10.3390/ijerph20247152] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/25/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023]
Abstract
AIMS To determine the association between drinking habits and social factors among women undergoing assisted reproductive technology (ART) treatment in Japan. METHODS The study participants who provided answers for the questionnaire concerning alcohol consumption were 1017 female patients undergoing ART treatment were enrolled in the Japan-Female Employment and Mental Health in assisted reproductive technology (J-FEMA) study between August and December 2018. Patient characteristics, including demographic, clinical, and socioeconomic status, were assessed using a self-administered questionnaire which was distributed only once during the period, regardless of their first or follow-up examination. We defined current drinkers who drank ≥46 g of ethanol per week as the habitual drinking group. The risk factors for habitual drinking were analyzed using multivariable-adjusted logistic regression. RESULTS The proportion of habitual drinkers was 15.5% in this study population. The multivariable-adjusted odds ratios (95% confidence interval) for habitual drinking were 2.27 (0.99-5.21) for women aged ≥35 years versus those <35 years, 4.26 (1.98-9.16) for women having partners who currently drink compared to those with partners without current drinking, 1.84 (1.08-3.12) for women without a history of childbirth versus those with, and 1.77 (1.00-3.14) for working women compared with those not working. CONCLUSIONS In our study, habitual drinking among women undergoing ART treatment was significantly associated with older age, no history of childbirth, partner's current drinking status, and working.
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Affiliation(s)
- Mamiko Sato
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan
| | - Motoki Endo
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan
| | - Kiyohide Tomooka
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan
| | - Keiji Kuroda
- Department of Obstetrics and Gynaecology, Juntendo University Faculty of Medicine, Tokyo 113-8421, Japan
- Centre for Reproductive Medicine and Endoscopy, Sugiyama Clinic Marunouchi, Tokyo 100-0065, Japan
| | - Yuito Ueda
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan
| | - Setsuko Sato
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan
| | - Yuko Ikemoto
- Department of Obstetrics and Gynaecology, Juntendo University Faculty of Medicine, Tokyo 113-8421, Japan
| | - Yuya Imai
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan
| | - Kiyomi Mitsui
- Department of Hygiene, Public Health, and Preventive Medicine, Showa University, Tokyo 142-8555, Japan
| | - Atsushi Tanaka
- Saint Mother Hospital Infertility Clinic, Fukuoka 807-0825, Japan
| | - Rikikazu Sugiyama
- Centre for Reproductive Medicine and Endoscopy, Sugiyama Clinic Marunouchi, Tokyo 100-0065, Japan
- Centre for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Tokyo 116-0023, Japan
| | - Koji Nakagawa
- Centre for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Tokyo 116-0023, Japan
| | | | - Yasushi Kuribayashi
- Centre for Reproductive Medicine and Endoscopy, Sugiyama Clinic Marunouchi, Tokyo 100-0065, Japan
| | - Mari Kitade
- Department of Obstetrics and Gynaecology, Juntendo University Faculty of Medicine, Tokyo 113-8421, Japan
| | - Atsuo Itakura
- Department of Obstetrics and Gynaecology, Juntendo University Faculty of Medicine, Tokyo 113-8421, Japan
| | - Satoru Takeda
- Department of Obstetrics and Gynaecology, Juntendo University Faculty of Medicine, Tokyo 113-8421, Japan
| | - Takeshi Tanigawa
- Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan
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Kanters AE, Shubeck SP. The Importance of Parental Leave and Lactation Support for Surgeons. Clin Colon Rectal Surg 2023; 36:333-337. [PMID: 37564351 PMCID: PMC10411055 DOI: 10.1055/s-0043-1764288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
Despite the growing population of surgeons who will spend the bulk of their potential childbearing years in medical school, training, or early in practice, the stigma associated with pregnancy remains. The challenges of childbearing for surgeons also extend to the pregnancy experience from a health perspective including increased rates of infertility, miscarriage, and preterm labor. Given the unique demands of a surgical practice, surgeons may experience pressure to minimize the disruption of their work during and after pregnancy. This may include attempts at carrying a full workload until the day of delivery, reducing the length of planned parental leave, and not requesting accommodations for time to express milk. Concern for discrimination, clinical productivity expectations, and promotion timelines can limit a surgeon's ability to receive pregnancy-related support and adequate parental leave. Though not all surgeons will choose to pursue pregnancy, we must still acknowledge the need to support these individuals. Furthermore, this support should not be limited to the pregnancy alone but include postpartum support including that related to family leave and lactation. Here, we provide an overview of just some of the challenges faced by surgeons in the pursuit of parenthood and present the arguments for accommodations related to pregnancy, parental leave, and lactation.
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Affiliation(s)
- Arielle E. Kanters
- Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, Ohio
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6
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Schneider E, Hamer O, Smith C, Hill J. Beyond body mass index: a synthesis of lifestyle factors that may influence in vitro fertilisation outcomes. BRITISH JOURNAL OF MIDWIFERY 2023; 31:436-444. [PMID: 38808077 PMCID: PMC7616016 DOI: 10.12968/bjom.2023.31.8.436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
There are several lifestyle factors that are thought to potentially impact in vitro fertilisation outcomes, including body mass index, smoking, alcohol consumption, caffeine, dietary patterns and physical activity. Eligibility criteria for in vitro fertilisation in England often require individuals to be non-smokers, drug free and have a body mass index <30kg/m2. Some researchers have questioned the scientific and ethical basis for the use of body mass index thresholds in fertility treatment, citing evidence that other factors may have a greater effect on the chance of success of in vitro fertilisation. This article aims to briefly synthesise the current evidence on how other factors such as smoking, alcohol, recreational drugs, smoking, caffeine, dietary patterns and physical activity may impact in vitro fertilisation outcomes.
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Affiliation(s)
- E Schneider
- Liverpool University Hospitals NHS Foundation Trust
| | - O Hamer
- University of Central Lancashire
| | - C Smith
- University of Central Lancashire
| | - J Hill
- University of Central Lancashire
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Martino F, Bassareo PP, Martino E, Romeo F, Calcaterra G, Perrone Filardi P, Indolfi C, Nodari S, Montemurro V, Guccione P, Salvo GD, Chessa M, Pedrinelli R, Mercuro G, Barillà F. Cardiovascular prevention in childhood: a consensus document of the Italian Society of Cardiology Working Group on Congenital Heart Disease and Cardiovascular Prevention in Paediatric Age. J Cardiovasc Med (Hagerstown) 2023; 24:492-505. [PMID: 37409595 DOI: 10.2459/jcm.0000000000001488] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Cardiovascular diseases (CVD) may be manifested from a very early age. Genetic and environmental (epigenetic) factors interact to affect development and give rise to an abnormal phenotypical expression of genetic information, although not eliciting changes in the nucleotide sequence of DNA. It has been scientifically proven that increased oxidative stress (OS) caused by disease (overweight, obesity, diabetes), nutritional imbalances, unhealthy lifestyles (smoking, alcohol, substance abuse) in the mother during pregnancy may induce placental dysfunction, intrauterine growth restriction, prematurity, low birth weight, postnatal adiposity rebound, metabolic alterations and consequent onset of traditional cardiovascular risk factors. OS represents the cornerstone in the onset of atherosclerosis and manifestation of CVD following an extended asymptomatic period. OS activates platelets and monocytes eliciting the release of pro-inflammatory, pro-atherogenic and pro-oxidising substances resulting in endothelial dysfunction, decrease in flow-mediated arterial dilatation and increase in carotid intima-media thickness. The prevention of CVD is defined as primordial (aimed at preventing risk factors development), primary (aimed at early identification and treatment of risk factors), secondary (aimed at reducing risk of future events in patients who have already manifested a cardiovascular event), and tertiary (aimed at limiting the complex outcome of disease). Atherosclerosis prevention should be implemented as early as possible. Appropriate screening should be carried out to identify children at high risk who are apparently healthy and implement measures including dietary and lifestyle changes, addition of nutritional supplements and, lastly, pharmacological treatment if risk profiles fail to normalise. Reinstating endothelial function during the reversible stage of atherosclerosis is crucial.
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Affiliation(s)
- Francesco Martino
- Department of Internal Clinical, Anesthesiological and Cardiovascular Sciences, La Sapienza University, Rome, Italy
| | - Pier Paolo Bassareo
- University College of Dublin, School of Medicine, Mater Misericordiae University Hospital and Children's Health Ireland at Crumlin, Dublin, Ireland
| | - Eliana Martino
- Department of Internal Clinical, Anesthesiological and Cardiovascular Sciences, La Sapienza University, Rome, Italy
| | | | | | | | - Ciro Indolfi
- Division of Cardiology, Research Centre for Cardiovascular Diseases, Magna Graecia University, Catanzaro
| | - Savina Nodari
- Department of Medical Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST Spedali Civili, Brescia
| | | | - Paolo Guccione
- Department of Cardiology, Cardiac Surgery, Cardio-pulmonary Transplantation, IRCCS Bambino Gesu'Paediatric Hospital, Rome
| | - Giovanni Di Salvo
- Division of Paediatric Cardiology, Department of Women's and Children's Health, University of Padua, Padua
| | - Massimo Chessa
- ACHD UNIT, Pediatric and Adult Congenital Heart Centre, IRCCS-Policlinico San Donato, San Donato Milanese, Vita Salute San Raffaele University, Milan
| | - Roberto Pedrinelli
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa
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Brinson AK, da Silva SG, Hesketh KR, Evenson KR. Impact of Physical Activity and Sedentary Behavior on Spontaneous Female and Male Fertility: A Systematic Review. J Phys Act Health 2023; 20:600-615. [PMID: 37146984 PMCID: PMC7614776 DOI: 10.1123/jpah.2022-0487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 02/10/2023] [Accepted: 02/28/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Before pregnancy is recognized, ovulation, fertilization, and implantation must all occur. Physical activity and sedentary behavior may impact pregnancy success by altering each or all of these processes. The aim of this review was to review the association between physical activity and sedentary behavior with spontaneous female and male fertility. METHOD PubMed/MEDLINE, Web of Science, CINAHL, SPORTDiscus, and Embase were searched from inception to August 9, 2021. Eligible studies included randomized controlled trials or observational studies, published in English, describing an association between physical activity or sedentary behavior (exposures) and spontaneous fertility (outcome) among women or men. RESULTS Thirty-four studies from 31 unique populations were included in this review (12 cross-sectional studies, 10 cohort studies, 6 case-control studies, 5 randomized controlled trials, and one case-cohort study). Of the 25 studies among women, the majority identified mixed results (n = 11) or no association (n = 9) between physical activity and female fertility. Seven studies reported on female fertility and sedentary behavior, and 2 found sedentary behavior was associated with decreased female fertility. Of the 11 studies among men, most of the studies (n = 6) found that physical activity was associated with increased male fertility. Two of the studies reported on male fertility and sedentary behavior, and neither identified an association. CONCLUSIONS The association between spontaneous fertility and physical activity in both men and women remains unclear, and the association with sedentary behavior remains largely unexplored.
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Affiliation(s)
| | - Shana G. da Silva
- Federal University of Fronteira Sul, Passo Fundo, RS, Brazil University of North Carolina—Chapel Hill, Chapel Hill, NC, USA
| | - Kathryn R. Hesketh
- University of North Carolina—Chapel Hill, Chapel Hill, NC, USA UCL Great Ormond Street Institute of Child Health, London, UK MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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9
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Wootton RE, Lawn RB, Magnus MC, Treur JL, Corfield EC, Njølstad PR, Andreassen OA, Lawlor DA, Munafò MR, Håberg SE, Davey Smith G, Reichborn-Kjennerud T, Magnus P, Havdahl A. Associations between health behaviours, fertility and reproductive outcomes: triangulation of evidence in the Norwegian Mother, Father and Child Cohort Study (MoBa). BMC Med 2023; 21:125. [PMID: 37013617 PMCID: PMC10071662 DOI: 10.1186/s12916-023-02831-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 03/13/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Guidance to improve fertility includes reducing alcohol and caffeine consumption, achieving healthy weight-range and stopping smoking. Advice is informed by observational evidence, which is often biased by confounding. METHODS This study primarily used data from a pregnancy cohort, the Norwegian Mother, Father and Child Cohort Study. First, we conducted multivariable regression of health behaviours (alcohol and caffeine consumption, body-mass index (BMI), and smoking) on fertility outcomes (e.g. time to conception) and reproductive outcomes (e.g. age at first birth) (n = 84,075 females, 68,002 males), adjusting for birth year, education and attention-deficit and hyperactive-impulsive (ADHD) traits. Second, we used individual-level Mendelian randomisation (MR) to explore possible causal effects of health behaviours on fertility/reproductive outcomes (n = 63,376 females, 45,460 males). Finally, we performed summary-level MR for available outcomes in UK Biobank (n = 91,462-1,232,091) and controlled for education and ADHD liability using multivariable MR. RESULTS In multivariable regression analyses, higher BMI associated with fertility (longer time to conception, increased odds of infertility treatment and miscarriage), and smoking was associated with longer time to conception. In individual-level MR analyses, there was strong evidence for effects of smoking initiation and higher BMI on younger age at first birth, of higher BMI on increased time to conception, and weak evidence for effects of smoking initiation on increased time to conception. Age at first birth associations were replicated in summary-level MR analysis; however, effects attenuated using multivariable MR. CONCLUSIONS Smoking behaviour and BMI showed the most consistent associations for increased time to conception and a younger age at first birth. Given that age at first birth and time to conception are positively correlated, this suggests that the mechanisms for reproductive outcomes are distinct to the mechanisms acting on fertility outcomes. Multivariable MR suggested that effects on age at first birth might be explained by underlying liability to ADHD and education.
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Affiliation(s)
- Robyn E Wootton
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway.
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
- School of Psychological Science, University of Bristol, Bristol, UK.
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway.
| | - Rebecca B Lawn
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Maria C Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Jorien L Treur
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Elizabeth C Corfield
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Pål R Njølstad
- Center for Diabetes Research, Department of Clinical Science, University of Bergen, Bergen, Norway
- Children and Youth Clinic, Haukeland University Hospital, Bergen, Norway
| | - Ole A Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Oslo University Hospital, Oslo, Norway
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Marcus R Munafò
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Siri E Håberg
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Ted Reichborn-Kjennerud
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Per Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Alexandra Havdahl
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway
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10
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Graham ME, Jelin A, Hoon AH, Wilms Floet AM, Levey E, Graham EM. Assisted reproductive technology: Short- and long-term outcomes. Dev Med Child Neurol 2023; 65:38-49. [PMID: 35851656 PMCID: PMC9809323 DOI: 10.1111/dmcn.15332] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 01/05/2023]
Abstract
Assisted reproductive technology (ART) includes fertility treatment in which either eggs or embryos are handled outside a female's body to promote successful pregnancies and healthy offspring. Current ART procedures encompass in vitro fertilization with or without intracytoplasmic sperm injection. The most common complication of ART is related to the consequences of multiple pregnancy, which can be prevented or minimized by reducing the number of embryos transferred to the uterus, commonly single embryo transfer. ART has been shown to be variably associated with adverse short- and long-term perinatal outcomes, including cerebral palsy, autism, neurodevelopmental imprinting disorders, and cancer. However, there is uncertainty as to whether reported problems are related to the ART procedure itself, to factors related to infertility, to other medical and environmental factors, or a combination thereof. From a pathophysiological perspective, whether ART alters epigenetic mechanisms of gene expression, leading to later developmental, medical, and behavioral disorders, is an area of active investigation. With the meticulously conducted short- and long-term outcome studies completed so far, overall, and after controlling for multiple gestations and preterm delivery, the results suggest that ART is a safe procedure, offering hope to many parent(s) wishing for a healthy child. This paper highlights ART methods and the risk factors and confounders in the interpretation of short- and long-term outcome data, providing the reader with a means to evaluate findings and conclusions of outcome studies. WHAT THIS PAPER ADDS: Assisted reproductive technology (ART) is a relatively safe procedure. Single embryo implantation optimizes outcome. Informed consent, including the risks and benefits of ART, should be required. Ongoing longitudinal studies are necessary to fully understand ART outcomes.
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Affiliation(s)
- Mary Elaine Graham
- College of Arts and Sciences, Washington and Lee University, Lexington, VA, USA
| | - Angie Jelin
- Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA,Department of Gynecology and Obstetrics, Division of Maternal-Fetal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alexander H. Hoon
- Department of Pediatrics, Division of Developmental Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA,Phelps Center for Cerebral Palsy and Neurodevelopmental Medicine, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Anna Maria Wilms Floet
- Department of Pediatrics, Division of Developmental Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA,Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, USA,Center for Development and Learning, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Eric Levey
- Health Services for Children with Special Needs, Washington, DC, USA
| | - Ernest M. Graham
- Department of Gynecology and Obstetrics, Division of Maternal-Fetal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA,Neuroscience Intensive Care Nursery Program, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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11
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An assessment of coping with infertility stress and eating disorders in women undergoing IVF treatment. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-022-01780-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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12
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High physical activity and ovarian reserve: a prospective study of normo-ovulatory professional athletes. J Ovarian Res 2022; 15:107. [PMID: 36114550 PMCID: PMC9482187 DOI: 10.1186/s13048-022-01040-x] [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: 06/12/2022] [Accepted: 08/26/2022] [Indexed: 11/18/2022] Open
Abstract
Background This study investigated whether high physical activity affects ovarian reserve in normo-ovulatory, reproductive-age women. Methods This prospective, observational study compared 31 professional female athletes, with 31 women who did not engage in physical activity. It was conducted 2017–2020 in a tertiary medical center. Normo-ovulatory, professional athletes, ages 20–35 years were recruited from The Wingate Institute—the Israeli National Institute for Sport Excellence. They had high International Physical Activity Questionnaire (IPAQ) scores. Non-physically active women, matched by age and body mass index, were recruited from hospital staff. Women were evaluated for ovarian reserve markers on day 2–5 of the menstrual cycle, including follicular stimulating hormone, antral follicle count, anti-Mullerian hormone and Inhibin B. Results The average age of the high physical activity group was 29.9 ± 4.2 years and the nonactive group 31.6 ± 4.2 years (p = 0.062). Body mass index of both groups were similar (22.5 ± 5.0 vs. 21.4 ± 2.5, respectively; p = 0.1). No differences were observed with respect to follicle stimulating hormone (p = 0.12) and anti-Mullerian hormone (p = 0.16). A trend towards higher total antral follicle count in the high physical activity group vs. the non-active group (34.5 ± 12.9 vs. 28.1 ± 15.2, p = 0.08) and lower Inhibin B (68.1 ± 36.8 vs. 89.4 ± 46.1, p = 0.05). Menarche age correlated with anti-Mullerian hormone (r = 0.387, p = 0.003), as did total antral follicle count (r = 0.368, p = 0.004). IPAQ scores and basal follicle stimulating hormone levels were negatively correlated (r = − 0.292, p = 0.005). Conclusions Athletic, normo-ovulatory women have ovarian reserves that are at least as good as those of the general population. As this is the first study examining this issue, it could cautiously reassure women engaged in high physical activity regarding ovarian reserve.
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13
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Yan F, Zhao Q, Li Y, Zheng Z, Kong X, Shu C, Liu Y, Shi Y. The role of oxidative stress in ovarian aging: a review. J Ovarian Res 2022; 15:100. [PMID: 36050696 PMCID: PMC9434839 DOI: 10.1186/s13048-022-01032-x] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 08/21/2022] [Indexed: 11/29/2022] Open
Abstract
Ovarian aging refers to the process by which ovarian function declines until eventual failure. The pathogenesis of ovarian aging is complex and diverse; oxidative stress (OS) is considered to be a key factor. This review focuses on the fact that OS status accelerates the ovarian aging process by promoting apoptosis, inflammation, mitochondrial damage, telomere shortening and biomacromolecular damage. Current evidence suggests that aging, smoking, high-sugar diets, pressure, superovulation, chemotherapeutic agents and industrial pollutants can be factors that accelerate ovarian aging by exacerbating OS status. In addition, we review the role of nuclear factor E2-related factor 2 (Nrf2), Sirtuin (Sirt), mitogen-activated protein kinase (MAPK), protein kinase B (AKT), Forkhead box O (FoxO) and Klotho signaling pathways during the process of ovarian aging. We also explore the role of antioxidant therapies such as melatonin, vitamins, stem cell therapies, antioxidant monomers and Traditional Chinese Medicine (TCM), and investigate the roles of these supplements with respect to the reduction of OS and the improvement of ovarian function. This review provides a rationale for antioxidant therapy to improve ovarian aging.
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Affiliation(s)
- Fei Yan
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Qi Zhao
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Ying Li
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Zhibo Zheng
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Xinliang Kong
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Chang Shu
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People's Republic of China
| | - Yanfeng Liu
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People's Republic of China.
| | - Yun Shi
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People's Republic of China.
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14
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Ma M, Guo L, Liu X, Zheng Y, Gu C, Li B. Genetic correlation between female infertility and mental health and lifestyle factors: A linkage disequilibrium score regression study. Health Sci Rep 2022; 5:e797. [PMID: 36090619 PMCID: PMC9436294 DOI: 10.1002/hsr2.797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 12/04/2022] Open
Abstract
Background and Aims Female fertility is a heterogeneous condition of complete psychosocial and physical well-being. Observational studies have revealed that women with infertility have varying degrees of poor mental status and lifestyle choices in varying degrees. However, the genetic contribution to female infertility remains elusive. Our study aimed to explore the genetic correlations between female infertility and mental health and lifestyle factors. Methods The genome-wide association study (GWAS) data sets of characteristics related to mental health and lifestyle were obtained from the IEU OpenGWAS database. The GWAS data sets of female infertility were derived from the Finggen database. Linkage disequilibrium score regression was performed to systematically estimate the pairwise genetic correlations between female infertility and a set of mental health- and lifestyle-related traits. Results The genetic correlation analysis revealed a moderate and positive genetic correlation between depressive symptoms, major depressive disorder, and female infertility. Similarly, worry and the personality trait of neuroticism displayed a moderate positive genetic correlation with female infertility. Adversely, a negative and moderate genetic correlation was observed between strenuous sports or exercises and female infertility. Conclusion The study demonstrated genetic correlations between female infertility and mental health status, including depression, worry, and neuroticism. Additionally, we observed that females with better physical activity may have reduced risks of female infertility. These findings would serve as a fundamental resource for understanding the genetic mechanisms of the effects of mental health and lifestyle factors on female infertility.
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Affiliation(s)
- Miao Ma
- Department of Gynecology and ObstetricsObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
| | - Lu Guo
- Department of Gynecology and ObstetricsObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
| | - Xiaocheng Liu
- Department of Gynecology and ObstetricsObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
| | - Yingxin Zheng
- Department of Gynecology and ObstetricsObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
| | - Chao Gu
- Department of Gynecology and ObstetricsObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
| | - Bin Li
- Department of Gynecology and ObstetricsObstetrics and Gynecology Hospital of Fudan UniversityShanghaiChina
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15
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Kumar M, Zilate S, Gupta C. Effect of Stress and Caffeine on Male Infertility. Cureus 2022; 14:e28487. [PMID: 36176863 PMCID: PMC9513285 DOI: 10.7759/cureus.28487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 08/27/2022] [Indexed: 02/06/2023] Open
Abstract
Caffeine is a natural psychoactive chemical found in beverages made from coffee. In addition, it is added by the manufacturers of a large number of sodas and energy drinks. It does this by stimulating both the brain and the central nervous system, enabling you to avoid being sleepy while still keeping you attentive. A state of emotional or physical tension is defined as stress. It can be induced through the experience of something or thinking of something that causes you to feel uncomfortable, irritated, or nervous. Your body's response to adversity or demand is what we call stress. Among couples, male infertility is common. A failure in spermatogenesis is accountable for nearly half of all occurrences of infertility in marriage. Ageing, psychological stress, diet, physical exercise, coffee, hot water, hot scrotum, and cell phone usage are some of the few modifiable lifestyle variables that have a role in the development of infertility. Many hypotheses have been proposed to establish the link between stress in the workplace, life events (war, earthquake, etc.), and inability to conceive have been linked to inferior or degraded semen quality. In this review, we will discuss the effect on male fertility of elements including quality of life (such as exercise, diet, and other alterations to one's daily routine) and psychological stress. In addition, the effects on male fertility of elevated scrotal temperature, improper dietary habits, and physical inactivity will be discussed. The loss in male fertility, mainly due to ageing, inappropriate lifestyles, and environmental factors, is a significant public health concern in this century. Couples can enhance their quality of life and increase their chances of naturally conceiving a child by altering their way of life and supplementing it with nutraceutical antioxidants and an organised educational, environmental, dietary, and physical exercise program.
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16
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Nagórska M, Lesińska-Sawicka M, Obrzut B, Ulman D, Darmochwał-Kolarz D, Zych B. Health Related Behaviors and Life Satisfaction in Patients Undergoing Infertility Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159188. [PMID: 35954545 PMCID: PMC9367928 DOI: 10.3390/ijerph19159188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 07/25/2022] [Indexed: 02/05/2023]
Abstract
The aim of the study was to evaluate the level of life satisfaction and health behaviors presented by patients with diagnosed infertility. This cross-sectional study included 456 patients (235 women and 221 men) from infertile couples in southeastern Poland from June 2019 to February 2020. Participants completed a questionnaire on sociodemographic characteristics, the Health Behaviors Inventory (HBI), and the Satisfaction with Life Scale (SWLS). The average score of severity of health behaviors for the study group was 82.96 points. Satisfaction with life at a higher level was declared by 57.6% of respondents, at an average level was declared by 31.4%, and at a lower level was declared by 11%. The SWLS score for the entire study group was 24.11 points (6.82 points on the sten scale). Respondents who achieved a higher rate of life satisfaction also had a higher level of severity of health behaviors (p < 0.0001). There were no significant differences between male and female SWLS scores, although the women had significantly higher rates of severity of health behaviors than men. The level of health behavior is positively related to life satisfaction in infertile patients. Medical personnel should conduct health education on a healthy lifestyle that promotes the improvement of reproductive health.
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Affiliation(s)
- Małgorzata Nagórska
- Institute of Medical Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland; (B.O.); (D.D.-K.)
- Correspondence: ; Tel.: +48-12-872-11-45
| | | | - Bogdan Obrzut
- Institute of Medical Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland; (B.O.); (D.D.-K.)
| | - Dariusz Ulman
- Department of Obstetrics and Gynaecology, Pro-Familia Hospital, 35-001 Rzeszow, Poland;
| | - Dorota Darmochwał-Kolarz
- Institute of Medical Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland; (B.O.); (D.D.-K.)
| | - Barbara Zych
- Institute of Health Sciences, Medical College of Rzeszow University, 35-959 Rzeszow, Poland;
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17
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Personalized Nutrition in the Management of Female Infertility: New Insights on Chronic Low-Grade Inflammation. Nutrients 2022; 14:nu14091918. [PMID: 35565885 PMCID: PMC9105997 DOI: 10.3390/nu14091918] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 04/19/2022] [Accepted: 04/29/2022] [Indexed: 02/01/2023] Open
Abstract
Increasing evidence on the significance of nutrition in reproduction is emerging from both animal and human studies, suggesting a mutual association between nutrition and female fertility. Different “fertile” dietary patterns have been studied; however, in humans, conflicting results or weak correlations are often reported, probably because of the individual variations in genome, proteome, metabolome, and microbiome and the extent of exposure to different environmental conditions. In this scenario, “precision nutrition”, namely personalized dietary patterns based on deep phenotyping and on metabolomics, microbiome, and nutrigenetics of each case, might be more efficient for infertile patients than applying a generic nutritional approach. In this review, we report on new insights into the nutritional management of infertile patients, discussing the main nutrigenetic, nutrigenomic, and microbiomic aspects that should be investigated to achieve effective personalized nutritional interventions. Specifically, we will focus on the management of low-grade chronic inflammation, which is associated with several infertility-related diseases.
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18
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Ma X, Wu L, Wang Y, Han S, El-Dalatony MM, Feng F, Tao Z, Yu L, Wang Y. Diet and human reproductive system: Insight of omics approaches. Food Sci Nutr 2022; 10:1368-1384. [PMID: 35592285 PMCID: PMC9094499 DOI: 10.1002/fsn3.2708] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/29/2021] [Accepted: 11/21/2021] [Indexed: 12/24/2022] Open
Abstract
Nutrition and lifestyle have a great impact on reproduction and infertility in humans, as they are essential for certain processes such as implantation, placental growth, angiogenesis, and the transfer of nutrients from the mother to the fetus. The aim of this review is to provide the interconnection between nutrition and reproductive health through the insight of omics approaches (including metabolomics and nutrigenomics). The effect of various macronutrients, micronutrients, and some food‐associated components on male and female reproduction was discussed. Recent research work was collected through database search from 2010 to 2020 to identify eligible studies. Alterations of metabolic pathways in pregnant women were deliberated with an emphasis on different strategies of lifestyle and dietary interventions. Several nutritional methods, which are important for embryonic and child neurological development, nutritional supplements to lactation, and improved gestational length along with birth weight have been emphasized. Considerable advances in omics strategies show potential technological development for improving human reproductive health.
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Affiliation(s)
- Xiaoling Ma
- The First Hospital of Lanzhou University The First School of Clinical Medicine Lanzhou University Lanzhou China.,Gansu International Scientific and Technological Cooperation Base of Reproductive Medicine Transformation Application Key Laboratory for Reproductive Medicine and Embryo Lanzhou China
| | - Luming Wu
- The First Hospital of Lanzhou University The First School of Clinical Medicine Lanzhou University Lanzhou China
| | - Yinxue Wang
- The First Hospital of Lanzhou University The First School of Clinical Medicine Lanzhou University Lanzhou China
| | - Shiqiang Han
- Linxia Hui Autonomous Prefecture Maternity and Childcare Hospital Linxia China
| | - Marwa M El-Dalatony
- Gansu International Scientific and Technological Cooperation Base of Reproductive Medicine Transformation Application Key Laboratory for Reproductive Medicine and Embryo Lanzhou China
| | - Fei Feng
- The First Hospital of Lanzhou University The First School of Clinical Medicine Lanzhou University Lanzhou China
| | - Zhongbin Tao
- The First Hospital of Lanzhou University The First School of Clinical Medicine Lanzhou University Lanzhou China
| | - Liulin Yu
- The First Hospital of Lanzhou University The First School of Clinical Medicine Lanzhou University Lanzhou China.,Gansu International Scientific and Technological Cooperation Base of Reproductive Medicine Transformation Application Key Laboratory for Reproductive Medicine and Embryo Lanzhou China
| | - Yiqing Wang
- The First Hospital of Lanzhou University The First School of Clinical Medicine Lanzhou University Lanzhou China.,Gansu International Scientific and Technological Cooperation Base of Reproductive Medicine Transformation Application Key Laboratory for Reproductive Medicine and Embryo Lanzhou China
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19
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Misner MJ, Taborek A, Dufour J, Sharifi L, Khokhar JY, Favetta LA. Effects of Delta-9 Tetrahydrocannabinol (THC) on Oocyte Competence and Early Embryonic Development. FRONTIERS IN TOXICOLOGY 2022; 3:647918. [PMID: 35295104 PMCID: PMC8915882 DOI: 10.3389/ftox.2021.647918] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 02/26/2021] [Indexed: 12/17/2022] Open
Abstract
Recent changes in legal status and public perception of cannabis have contributed to an increase use amongst women of reproductive age. Concurrently, there is inadequate evidence-based knowledge to guide clinical practice regarding cannabis and its effects on fertility and early embryonic development. This study aimed to evaluate the effects of the primary psychoactive component of cannabis, delta-9 tetrahydrocannabinol (THC), during oocyte maturation, and its impact on the developing embryo. Bovine oocytes were matured in vitro for 24 h under clinically relevant doses of THC mimicking plasma levels achieved after therapeutic (0.032 μM) and recreational (0.32 and 3.2 μM) cannabis use. THC-treated oocytes were assessed for development and quality parameters at both the oocyte and embryo level. Characteristics of oocytes treated with cannabinoid receptor antagonists were also assessed. Oocytes treated with 0.32 and 3.2 μM THC, were significantly less likely to reach metaphase II (p < 0.01) and consequently had lower cleavage rates at day 2 post-fertilization (p < 0.0001). Treatment with cannabinoid receptor antagonists restored this effect (p < 0.05). Oocytes that did reach MII showed no differences in spindle morphology. Oocytes treated with 0.032 μM THC had significantly lower connexin mRNA (p < 0.05) (correlated with decreased quality), but this was not confirmed at the protein level. At the blastocyst stage there were no significant differences in developmental rates or the proportion of trophectoderm to inner cell mass cells between the control and treatment groups. These blastocysts, however, displayed an increased level of apoptosis in the 0.32 and 3.2 μM groups (p < 0.0001). Our findings suggest a possible disruptive effect of cannabis on oocyte maturation and early embryonic development.
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Affiliation(s)
- Megan J Misner
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
| | - Afton Taborek
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
| | - Jaustin Dufour
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
| | - Lea Sharifi
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
| | - Jibran Y Khokhar
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
| | - Laura A Favetta
- Department of Biomedical Sciences, University of Guelph, Guelph, ON, Canada
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20
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Gallo A. Reprotoxic Impact of Environment, Diet, and Behavior. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1303. [PMID: 35162326 PMCID: PMC8834893 DOI: 10.3390/ijerph19031303] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/14/2022] [Accepted: 01/22/2022] [Indexed: 02/01/2023]
Abstract
Reproductive health is progressively declining due to multiples endogenous and exogenous factors, such as environmental contaminants, diet and behavior. Accumulated evidences confirm that fertility and reproductive function have been adversely affected by exposure to chemical contaminants released in the environment. Today, the impact of diet and behavior on reproductive processes is also receiving special attention from the scientific community. Indeed, a close relationship between diet and fertility has been proven. Furthermore, a combination of unhealthy behavior, such as exposure to hazardous compounds and stress factors, poses living organisms at higher risk of reprotoxic effects. In particular, it has been described that poor life behaviors are associated with reduced male and female fertility due to decreased gamete quality and function. Most of the erroneous behaviors are, furthermore, a source of oxidative stress that, leading to epigenetic alterations, results in an impaired reproductive fitness. This review reports the detrimental impact of the most common environmental chemical stressors, diet, and behavior on reproductive functionality and success. Although clear evidences are still scarce, reassuring data are provided that a healthy diet and reverting unhealthy lifestyles may be of help to recover physiological reproductive conditions.
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Affiliation(s)
- Alessandra Gallo
- Department of Biology and Evolution of Marine Organisms, Stazione Zoologica Anton Dohrn, Villa Comunale, 80121 Naples, Italy
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21
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Crafa A, Cannarella R, LA Vignera S, Barbagallo F, Condorelli RA, Calogero AE. Semen analysis: a workflow for an appropriate assessment of the male fertility status. Minerva Endocrinol (Torino) 2021; 47:77-88. [PMID: 34825558 DOI: 10.23736/s2724-6507.21.03650-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Infertility is a worldwide problem that affects 9-15% of couples of reproductive age. In about half of the cases, it recognizes, alone or in combination, a male cause. In addition to a reproductive problem, male infertility can result from a systemic disease. Consequently, semen analysis, a fundamental test in the diagnosis of male infertility, represents a useful indicator not only of a man's reproductive capacity but also of his health and lifestyle. Given the key role of semen analysis, only accredited laboratories should perform it and experienced clinicians should be called into play in its interpretation. In this article, we have extensively examined how the macroscopic and microscopic parameters of semen analysis, alone or associated with each other, allow clinicians to orient towards specific diagnoses that can be confirmed by further ad hoc tests. On this basis, we also proposed a diagnostic flowchart focused on the results of the semen analysis.
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Affiliation(s)
- Andrea Crafa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Sandro LA Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Federica Barbagallo
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rosita A Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy -
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22
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Perceptions and Practice of Preconception Care by Healthcare Workers and High-Risk Women in South Africa: A Qualitative Study. Healthcare (Basel) 2021; 9:healthcare9111552. [PMID: 34828600 PMCID: PMC8618283 DOI: 10.3390/healthcare9111552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/07/2021] [Accepted: 11/08/2021] [Indexed: 12/26/2022] Open
Abstract
Preconception care is biomedical, behavioural, and social health interventions provided to women and couples before conception. This service is sometimes prioritised for women at high risk for adverse pregnancy outcomes. Evidence revealed that only very few women in Africa with severe chronic conditions receive or seek preconception care advice and assessment for future pregnancy. Thus, this study aimed to explore the perceptions and practice of preconception care by healthcare workers and high-risk women in Kwa-Zulu-Natal, South Africa. This exploratory, descriptive qualitative study utilised individual in-depth interviews to collect data from 24 women at high risk of adverse pregnancy outcomes and five healthcare workers. Thematic analysis was conducted using Nvivo version 12. Five main themes that emerged from the study include participants’ views, patients’ access to information, practices, and perceived benefits of preconception care. The healthcare workers were well acquainted with the preconception care concept, but the women had inconsistent acquaintance. Both groups acknowledge the role preconception care can play in the reduction of maternal and child mortality. A recommendation is made for the healthcare workers to use the ‘One key’ reproductive life plan question as an entry point for the provision of preconception care.
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23
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Neysanian GH, Taebi M, Rezaeian A, Nasr-Esfahani MH, Jahangirifar M. The Effects of Serum and Follicular Fluid Vitamin D Levels on Assisted Reproductive Techniques: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2021; 15:280-285. [PMID: 34913297 PMCID: PMC8530216 DOI: 10.22074/ijfs.2021.138605.1033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 05/08/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Based on studies on animal models, vitamin D plays an essential role in reproduction by controlling Ca and Mg levels. Despite these findings, the effects of vitamin D deficiency and supplementation on the outcome of assisted reproductive techniques (ART) remain controversial. Therefore, the aim of the present study was to assess the relationship between serum and follicular fluid 25-OH vitamin D levels on reproductive outcomes of infertile women. MATERIALS AND METHODS This prospective cohort study included 150 infertile women who underwent in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). The participants were allocated to one of the three groups according to their serum and follicular fluid 25-OH vitamin D concentrations (less than 10 ng/ml, between 10 and 30 ng/ ml and more than 30 ng/ml), and fertilization, cleavage and biochemical and clinical pregnancy rates were compared among the groups. Data was analyzed by SPSS software and using Chi-square and Spearman correlation coefficient. RESULTS Serum and follicular fluid vitamin D levels significantly correlated with biochemical (P=0.008), (P=0.003) and clinical pregnancy (P=0.017), (P=0.001) rates respectively . However, the quality of embryos (P=0.125), (P=0.106) and fertilization rate (P=0.082), (P=0.059) were not associated with the level of serum and follicular fluid vitamin D. CONCLUSION This study found that women with higher levels of vitamin D in their serum and follicular fluid are significantly more likely to achieve pregnancy but without affecting the quality of embryo and fertility rate.
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Affiliation(s)
- G Hazal Neysanian
- Department of Midwifery and Reproductive Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahboube Taebi
- Department of Midwifery and Reproductive Health, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Atefeh Rezaeian
- Department of Animal Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Mohammad Hossein Nasr-Esfahani
- Department of Animal Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran. .,Isfahan Fertility and Infertility Center, Isfahan, Iran
| | - Maryam Jahangirifar
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
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Sadiq U, Rana F, Munir M. Marital Quality, Self-compassion and Psychological Distress in Women with Primary Infertility. SEXUALITY AND DISABILITY 2021. [DOI: 10.1007/s11195-021-09708-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Laqqan MM, Yassin MM. Potential effect of tobacco cigarettes smoking on global DNA methylation status and protamines transcripts in human spermatozoa. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2021. [DOI: 10.1186/s43043-021-00066-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Abstract
Background
Epigenetics refers to an alteration in gene expression without alteration in the sequence of DNA and this process may be affected by environmental factors and lifestyle like cigarette smoking. This study was designed to evaluate the potential effect of cigarette smoking on the global DNA methylation status and the transcription level of protamine 1 and protamine 2 in human spermatozoa. A total of 188 semen samples were collected from men with a mean age of 34.9 ± 5.8 years old (98 heavy smokers and 90 non-smokers). The DNA and RNA were isolated from purified spermatozoa, then the status of global DNA methylation and the transcription level of protamine 1 and protamine 2 were evaluated using ELISA and qPCR, respectively. The chromatin non-condensation and DNA fragmentation in human spermatozoa were evaluated using chromomycin A3 staining and TUNEL assay, respectively.
Results
A significant increase has been found in the status of global DNA methylation in spermatozoa of heavy smokers compared to non-smokers (7.69 ± 0.69 ng/μl vs. 4.90 ± 0.40 ng/μl, P < 0.001). Additionally, a significant reduction has been found in transcription level of protamine 1 (25.49 ± 0.31 vs. 23.94 ± 0.40, P < 0.001) and protamine 2 (28.27 ± 0.39 vs. 23.45 ± 0.30, P < 0.001) in heavy smokers. A downregulation has been found in the transcription level of protamine 1 and protamine 2 with a fold change of 0.497 and 0.047, respectively. A significant increase has been shown in the level of DNA fragmentation and chromatin non-condensation in heavy smokers compared to non-smokers (P < 0.001). On the other hand, a significant positive correlation has been found between sperm chromatin non-condensation, sperm DNA fragmentation, transcription level of protamine 1, transcription level of protamine 2, and global DNA methylation status (r = 0.304, P < 0.001; r = 0.399, P < 0.001; r = 0.216, P = 0.003; r = 0.494, P < 0.001, respectively).
Conclusion
Tobacco cigarette smoking has a potential influence on the global DNA methylation and the transcription level of protamine genes in human spermatozoa, and consequently, affect negatively on the semen parameters.
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Influence of social determinants on fertility: a critical review. Curr Opin Obstet Gynecol 2021; 33:164-169. [PMID: 33186187 DOI: 10.1097/gco.0000000000000673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Intrinsic factors, such as age, weight and lifestyle habits, together with extrinsic factors, such as socioeconomic level, must be considered when it comes to reproductive healthcare. Over the last few years, studies that attempt to respond to the participation and interaction of these factors in subfertility have been published; however, some questions remain unanswered. RECENT FINDINGS Although there are little modifiable factors for women, it is possible to influence other factors, such as behavioural or cultural factors in order to minimize fertility problems; however, they are often highly influenced by each other. SUMMARY Advanced age, obesity, sedentary lifestyle, alcohol, tobacco and other compounds, have a clearly negative effect and may extend time-to-pregnancy, although the responsible mechanisms and the magnitude of the detriment that they produce in the reproductive health are yet to be studied. Economic context and new environmental factors are a current challenge for reproductive health too.
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Ungurianu A, Zanfirescu A, Nițulescu G, Margină D. Vitamin E beyond Its Antioxidant Label. Antioxidants (Basel) 2021; 10:634. [PMID: 33919211 PMCID: PMC8143145 DOI: 10.3390/antiox10050634] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/14/2021] [Accepted: 04/19/2021] [Indexed: 02/07/2023] Open
Abstract
Vitamin E, comprising tocopherols and tocotrienols, is mainly known as an antioxidant. The aim of this review is to summarize the molecular mechanisms and signaling pathways linked to inflammation and malignancy modulated by its vitamers. Preclinical reports highlighted a myriad of cellular effects like modulating the synthesis of pro-inflammatory molecules and oxidative stress response, inhibiting the NF-κB pathway, regulating cell cycle, and apoptosis. Furthermore, animal-based models have shown that these molecules affect the activity of various enzymes and signaling pathways, such as MAPK, PI3K/Akt/mTOR, JAK/STAT, and NF-κB, acting as the underlying mechanisms of their reported anti-inflammatory, neuroprotective, and anti-cancer effects. In clinical settings, not all of these were proven, with reports varying considerably. Nonetheless, vitamin E was shown to improve redox and inflammatory status in healthy, diabetic, and metabolic syndrome subjects. The anti-cancer effects were inconsistent, with both pro- and anti-malignant being reported. Regarding its neuroprotective properties, several studies have shown protective effects suggesting vitamin E as a potential prevention and therapeutic (as adjuvant) tool. However, source and dosage greatly influence the observed effects, with bioavailability seemingly a key factor in obtaining the preferred outcome. We conclude that this group of molecules presents exciting potential for the prevention and treatment of diseases with an inflammatory, redox, or malignant component.
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Affiliation(s)
- Anca Ungurianu
- Department of Biochemistry, Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, Traian Vuia 6, 020956 Bucharest, Romania;
| | - Anca Zanfirescu
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, Traian Vuia 6, 020956 Bucharest, Romania;
| | - Georgiana Nițulescu
- Department Pharmaceutical Technology, Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, Traian Vuia 6, 020956 Bucharest, Romania;
| | - Denisa Margină
- Department of Biochemistry, Faculty of Pharmacy, “Carol Davila” University of Medicine and Pharmacy, Traian Vuia 6, 020956 Bucharest, Romania;
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Elçi E, Güneş Elçi G, Çim N, Aras İ, Sayan S, Yıldızhan R. Energy drinks may affect the ovarian reserve and serum anti-mullerian hormone levels in a rat model. Turk J Obstet Gynecol 2021; 18:23-29. [PMID: 33715329 PMCID: PMC7962157 DOI: 10.4274/tjod.galenos.2020.07347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Objective Energy drinks have an impact on concentration levels, physical performance, speed of reaction, and focus, but these drinks cause many adverse effects and intoxication symptoms. The main goal of this study was to determine the effect of energy drink consumption on ovarian reserve and serum anti-mullerian hormone (AMH) levels. Materials and Methods Female Wistar albino rats (n=16) were included and randomized into two groups (n=8). Serum AMH levels were checked before and after energy drinks were given. Eight weeks later, the ovaries and uteruses of the rats were analyzed histopathologically. The number of follicles in the ovaries was counted. Results The total number of the preantral plus small antral follicles, which show the ovarian reserve, was decreased at the end of eight weeks in both the control group and the energy drink group. There was a statistical difference between them (p=0.021). Also, there was a statistically significant difference in the initial/final AMH (ng/mL) reduction levels between the control group and the energy drink group (p=0.002). AMH levels were decreased more in the energy drink group. Conclusion The consumption of energy drinks can lead to a decrease in ovarian reserve and AMH values and may cause weight gain.
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Affiliation(s)
- Erkan Elçi
- University of Health Sciences Turkey, Ümraniye Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Gülhan Güneş Elçi
- University of Health Sciences Turkey, Sancaktepe Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Numan Çim
- İstanbul Bilim University Faculty of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey
| | - İbrahim Aras
- Yüzüncü Yıl University Faculty of Medicine, Department of Pathology, Van, Turkey
| | - Sena Sayan
- Marmara University Faculty of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey
| | - Recep Yıldızhan
- İstanbul Bilim University Faculty of Medicine, Department of Obstetrics and Gynecology, İstanbul, Turkey
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Does a Career in Orthopaedic Surgery Affect a Woman's Fertility? J Am Acad Orthop Surg 2021; 29:e243-e250. [PMID: 32568992 DOI: 10.5435/jaaos-d-20-00198] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 05/16/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Orthopaedic surgery lags behind other specialties in the recruitment of women. Concerns about fertility, pregnancy, and childbearing may be a deterrent to women when considering orthopaedic surgery as a specialty. METHODS An anonymous 168-item survey was distributed to the members of Ruth Jackson Orthopedic Society and the Women in Orthopaedics, an online group exclusive to female orthopaedic surgeons. Respondents were queried regarding family planning, contraceptive length of use, fertility, perinatal work habits, age and stage at each pregnancy, pregnancy complications, and miscarriages. RESULTS Eight hundred one surveys were collected. Seven hundred fifty (94%) expressed interest in having children of their own, with 60% having at least one child at the time of the survey. The average maternal age at birth of the first child was 33.6 ± 3.6 years. Voluntary childlessness was reported by 6% (49/801) of survey respondents. Eighteen percent of this group stated that their choice as an orthopaedic surgeon served as a barrier to having children. Among those with children, childbearing was intentionally delayed by 53% because of their career choice (425/801). Fifty-two percent did not conceive their first child until the end of their training. Complications during pregnancy were reported among 24%. A total of 853 children were conceived by this cohort with assisted reproductive technology being used 106 times. Miscarriages were reported by 38% (304/801). Of those who miscarried, only 28% informed their employer and 8% took time off during or immediately after their miscarriage. CONCLUSION Most respondents desire to have children but two-thirds delay doing so because of their career choice and its demands. Having a family is an important part of life for many orthopaedic surgeons, and our study provides an updated description of the fertility and pregnancy characteristics of female orthopaedic surgeons to help guide present and future surgeons in their family planning.
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Kirca N, Ongen M. Perceived stress and sleep quality before oocyte pick-up, embryo transfer, and pregnancy test in women receiving in vitro fertilization treatment. Sleep Breath 2021; 25:1977-1985. [PMID: 33624218 DOI: 10.1007/s11325-021-02328-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/05/2021] [Accepted: 02/12/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Infertility is a major health problem that affects both the family and the community. Women receiving infertility treatment may suffer from stress and even experience sleep disturbance. Sleep quality is an important factor of human health and well-being. Sleep disturbances tend to occur among infertile women during in vitro fertilization treatment. Many studies have focused on the stress and sleep quality associated with their treatment in infertile women. However, few studies have investigated factors linked to their sleep disturbances. OBJECTIVE This study investigated the relationship between perceived stress and sleep quality before oocyte pick-up, in vitro fertilization-embryo transfer, and pregnancy test in women receiving in vitro fertilization treatment. MATERIAL AND METHODS This prospective, longitudinal study was conducted between January and May 2020. One hundred fifty-seven women receiving infertility treatment were included in the study. A personal information form, the Perceived Stress Scale (PSS), and the Pittsburgh Sleep Quality Index (PSQI) were used to collect data. RESULTS The relationship between the Perceived Stress Scale scores and the Pittsburgh Sleep Quality Index scores in all stages of infertility treatment was found to be positively significant at the p < .001 significance level. CONCLUSION Perceived stress level was high in women throughout the infertility treatment. Our study suggested that sleep quality was impaired as stress increased. TRIAL REGISTRATION 70904504/38.
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Affiliation(s)
- Nurcan Kirca
- Department of Obstetrics & Gynecological Nursing, Faculty of Nursing, Akdeniz University, Dumlupinar Boulevard, Antalya, Turkey.
| | - Meryem Ongen
- Department of Obstetrics & Gynecological Nursing, Faculty of Nursing, Akdeniz University, Dumlupinar Boulevard, Antalya, Turkey
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Ravichandran A, Babuji M, Gowri M, Karthikeyan M, Chandy A, Kunjummen AT, Kamath MS. Dietary pattern characterisation among subfertile South Asian women and the impact of vitamin B12 intake on frozen embryo transfer outcomes: a cross-sectional study. Hum Reprod Open 2021; 2021:hoaa068. [PMID: 33614988 PMCID: PMC7882060 DOI: 10.1093/hropen/hoaa068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 12/18/2020] [Indexed: 11/16/2022] Open
Abstract
STUDY QUESTION Is there a difference in dietary patterns among subfertile South Asian women undergoing frozen embryo transfer (FET)? SUMMARY ANSWER Significant regional differences in dietary pattern exist among subfertile South Asian women undergoing FET. WHAT IS KNOWN ALREADY Preconception consumption of certain food groups or adopting specific dietary patterns, such as the ‘Mediterranean diet’, and its level of adherence have been shown to enhance the odds of achieving a successful pregnancy in women undergoing ART. However, differences in geographic location, individual preference, cultural beliefs and local availability contribute to such dietary choices. There is also a predisposition to a vitamin B12 deficiency in those of South Asian ethnicity and a predominant pattern of vegetarian food intake. There is a paucity of studies analysing the type of dietary pattern followed by South Asian women, their vitamin B12 levels and the potential impact on ART treatment outcomes. STUDY DESIGN, SIZE, DURATION This is a cross-sectional study of 159 South Asian women aged 21–37 years, belonging to the Eastern (n = 75) and Southern (n = 84) regions of India plus Bangladesh, and undergoing a FET cycle at a tertiary level infertility clinic between February 2019 and March 2020. PARTICIPANTS/MATERIALS, SETTING, METHODS Women underwent dietary assessment using ‘24-hour dietary recall’ to capture daily nutrient consumption. A ‘Food Frequency Questionnaire’ listing commonly consumed foods was used to record frequency of intake. The primary outcome was the characterisation of regional dietary patterns in the cohorts using principal component analysis (PCA). Secondary outcomes included association of vitamin B12 intake and serum levels with clinical and ongoing pregnancy. MAIN RESULTS AND THE ROLE OF CHANCE Four components contributing to overall variance in dietary pattern were identified, namely: meat, poultry and seafood; green leafy vegetables and root tubers; fruits, dairy and sugar; nuts and oilseeds. PCA analysis showed a significantly higher consumption of two components in the East—meat, poultry and fish (P < 0.001); green leafy vegetables and root tubers (P < 0.001). All women reported taking preconception oral folic acid supplementation. The dietary intake of vitamin B12 and serum concentration correlated, showing a good validity of measured dietary intake (r = 0.398; P ≤ 0.001). Compared to the Southern region, participants from the East showed a higher daily median intake of vitamin B12 (1.11 versus 0.28 mcg, respectively; P < 0.001) and a higher serum vitamin B12 levels (441 versus 239 pg/ml, respectively; P < 0.001). Ongoing pregnancy showed no association with dietary vitamin B12 intake (relative risk 0.90; 95% CI, 0.68 to 1.19) or serum vitamin B12 levels (relative risk 0.99; 95% CI, 0.73 to 1.33) after adjustments for female age, body mass index (BMI) and geographic differences. Women belonging to different quartiles of serum vitamin B12 concentration had a similar likelihood of ongoing pregnancy. LIMITATIONS, REASONS FOR CAUTION Self-reported dietary assessment is prone to measurement errors owing to its subjective nature and recall bias. The study was not adequately powered to detect the impact of geographic differences in vitamin B12 intake and serum levels on FET treatment outcomes, the second objective. We adjusted for potential confounders, such as female age and BMI, but it is possible that residual confounders, such as physical activity, stress and use of dietary supplements, may have influenced the results. Extrapolation of the study findings to women undergoing ART in other populations should be made with caution. WIDER IMPLICATIONS OF THE FINDINGS Our study findings suggest important differences in local dietary patterns within the South Asian region. Hence a personalised approach to dietary assessment and intervention when undergoing ART based on population dynamics is warranted. The geographic differences in the vitamin B12 intake or serum levels did not have an impact on the FET outcomes. There is also a need to further investigate the impact of such dietary differences on ART treatment outcomes in a large study population. STUDY FUNDING/COMPETING INTEREST(S) No grant from funding agencies in the public, commercial, or not-for-profit sectors was obtained. The authors have nothing to disclose. TRIAL REGISTRATION NUMBER N/A
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Affiliation(s)
- Aravind Ravichandran
- Department of Reproductive Medicine, Christian Medical College, Vellore 632002, India
| | - Manimegalai Babuji
- Department of Dietetics, Christian Medical College, Vellore 632002, India
| | - Mahasampath Gowri
- Department of Biostatistics, Christian Medical College, Vellore 632002, India
| | | | - Achamma Chandy
- Department of Reproductive Medicine, Christian Medical College, Vellore 632002, India
| | - Aleyamma T Kunjummen
- Department of Reproductive Medicine, Christian Medical College, Vellore 632002, India
| | - Mohan S Kamath
- Department of Reproductive Medicine, Christian Medical College, Vellore 632002, India
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Chronopoulou E, Seifalian A, Stephenson J, Serhal P, Saab W, Seshadri S. Preconceptual care for couples seeking fertility treatment, an evidence-based approach. ACTA ACUST UNITED AC 2021. [DOI: 10.1016/j.xfnr.2020.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Dcunha R, Hussein RS, Ananda H, Kumari S, Adiga SK, Kannan N, Zhao Y, Kalthur G. Current Insights and Latest Updates in Sperm Motility and Associated Applications in Assisted Reproduction. Reprod Sci 2020; 29:7-25. [PMID: 33289064 PMCID: PMC7721202 DOI: 10.1007/s43032-020-00408-y] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/08/2020] [Accepted: 11/01/2020] [Indexed: 02/07/2023]
Abstract
Spermatozoon is a motile cell with a special ability to travel through the woman’s reproductive tract and fertilize an oocyte. To reach and penetrate the oocyte, spermatozoa should possess progressive motility. Therefore, motility is an important parameter during both natural and assisted conception. The global trend of progressive reduction in the number and motility of healthy spermatozoa in the ejaculate is associated with increased risk of infertility. Therefore, developing approaches for maintaining or enhancing human sperm motility has been an important area of investigation. In this review we discuss the physiology of sperm, molecular pathways regulating sperm motility, risk factors affecting sperm motility, and the role of sperm motility in fertility outcomes. In addition, we discuss various pharmacological agents and biomolecules that can enhance sperm motility in vitro and in vivo conditions to improve assisted reproductive technology (ART) outcomes. This article opens dialogs to help toxicologists, clinicians, andrologists, and embryologists in understanding the mechanism of factors influencing sperm motility and various management strategies to improve treatment outcomes.
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Affiliation(s)
- Reyon Dcunha
- Department of Clinical Embryology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Reda S Hussein
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.,Department of Obstetrics and Gynecology, Assiut University, Assiut City, Egypt
| | - Hanumappa Ananda
- Department of Clinical Embryology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Sandhya Kumari
- Department of Clinical Embryology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Satish Kumar Adiga
- Department of Clinical Embryology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Nagarajan Kannan
- Division of Experimental Pathology and Laboratory Medicine, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA.,Center for Regenerative Medicine, Mayo Clinic, Rochester, MN, 55905, USA.,Mayo Clinic Cancer Center, Mayo Clinic, Rochester, MN, 55905, USA
| | - Yulian Zhao
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.,Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Guruprasad Kalthur
- Department of Clinical Embryology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India. .,Division of Experimental Pathology and Laboratory Medicine, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA.
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Abdallah KS, Hunt S, Abdullah SA, Mol BWJ, Youssef MA. How and Why to Define Unexplained Infertility? Semin Reprod Med 2020; 38:55-60. [PMID: 33058088 DOI: 10.1055/s-0040-1718709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Unexplained infertility represents up to 30% of all cases of infertility. It is a diagnosis of exclusion, where no cause for infertility may be identified in the investigation of the couple, be it anovulation, fallopian tube blockage, or severe male factor. Unexplained infertility therefore cannot be considered a diagnosis to which a specific treatment is directed, rather that it indicates a failure to reach a diagnosis of the true cause of infertility. In this review, we explore the evidence base and potential limitations of the current routine infertility assessment. We also aim to highlight the importance of considering the prognosis of each individual couple through the process of assessment and propose a reconsidered approach to treatment, targeted to the prognosis rather than the diagnosis. Ultimately, a better understanding of the mechanisms of infertility will reduce the number of couples diagnosed with "unexplained" infertility.
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Affiliation(s)
- Karim S Abdallah
- Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt.,Department of Obstetrics and Gynecology, Monash University, Clayton, Australia
| | - Sarah Hunt
- Department of Obstetrics and Gynecology, Monash University, Clayton, Australia.,Department of Obstetrics and Gynecology, Monash Health, Clayton, Australia.,Monash IVF, Richmond, Australia
| | - Sayed A Abdullah
- Department of Obstetrics and Gynecology, Women's Health Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Ben W J Mol
- Department of Obstetrics and Gynecology, Monash University, Clayton, Australia.,Aberdeen Centre for Women's Health Research, University of Aberdeen, Aberdeen, United Kingdom
| | - Mohamed A Youssef
- Department of Obstetrics and Gynecology, Kasr Al-Ainy Hospital, Faculty of Medicine, Cairo University, Cairo, Egypt
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Impact of Body Condition Score on Oxidative Stress Status in Cow’s Reproductive Tract. MACEDONIAN VETERINARY REVIEW 2020. [DOI: 10.2478/macvetrev-2020-0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
It is well known in cattle that reproductive disorders are intimately associated with low or high body condition score (BCS). However, little is known concerning the relationship between BCS and oxidative stress, particularly in the reproductive tract. Thus, the aim of the present study was to investigate the oxidative stress biomarkers according to cows BCS values in the plasma, ovaries, oviductal, follicular and uterine fluids. The study was conducted on 58 cows classified in four classes (1, 2, 3 and 4) of BCS varying from1-1.5, 2-2.5, 3-3.5 and 4-4.5, respectively. The genital tracts and plasma were collected from slaughtered cows and processed within 5h after slaughtering. The number of ovarian follicles was measured using ultrasonography and the oxidative stress was assessed by considering total antioxidant status (TAS), catalase activity (CAT), and thiobarbituric acid-reactive substances (TBARS). The results showed that follicles number was significantly affected by BCS; cows with medium BCS (3) presented higher number of follicles than cows with low or high BCS (<3 or >3). Overall, BCS affects significantly the oxidative stress status at different levels of the reproductive tract. Cows with medium BCS (3) showed the best oxidative status than those with low or high values (BCS <3 or >3). In conclusion, the current results suggest that reproductive disorders observed in cows with low or high BCS values could be mediated through oxidative stress affecting consequently the reproductive tract and finally compromising fertility outputs.
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Pedro J, Brandão T, Fernandes J, Barros A, Xavier P, Schmidt L, Costa ME, Martins MV. Perceived Threat of Infertility and Women’s Intention to Anticipate Childbearing: The Mediating Role of Personally Perceived Barriers and Facilitators. J Clin Psychol Med Settings 2020; 28:457-467. [DOI: 10.1007/s10880-020-09743-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2020] [Indexed: 01/22/2023]
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Yang H, Kuhn C, Kolben T, Ma Z, Lin P, Mahner S, Jeschke U, von Schönfeldt V. Early Life Oxidative Stress and Long-Lasting Cardiovascular Effects on Offspring Conceived by Assisted Reproductive Technologies: A Review. Int J Mol Sci 2020; 21:ijms21155175. [PMID: 32707756 PMCID: PMC7432066 DOI: 10.3390/ijms21155175] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/18/2020] [Accepted: 07/20/2020] [Indexed: 02/06/2023] Open
Abstract
Assisted reproductive technology (ART) has rapidly developed and is now widely practised worldwide. Both the characteristics of ART (handling gametes/embryos in vitro) and the infertility backgrounds of ART parents (such as infertility diseases and unfavourable lifestyles or diets) could cause increased oxidative stress (OS) that may exert adverse influences on gametogenesis, fertilisation, and foetation, even causing a long-lasting influence on the offspring. For these reasons, the safety of ART needs to be closely examined. In this review, from an ART safety standpoint, the origins of OS are reviewed, and the long-lasting cardiovascular effects and potential mechanisms of OS on the offspring are discussed.
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Affiliation(s)
- Huixia Yang
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany; (H.Y.); (C.K.); (T.K.); (Z.M.); (P.L.); (S.M.); (V.v.S.)
| | - Christina Kuhn
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany; (H.Y.); (C.K.); (T.K.); (Z.M.); (P.L.); (S.M.); (V.v.S.)
- Department of Obstetrics and Gynecology, University Hospital Augsburg, 86156 Augsburg, Germany
| | - Thomas Kolben
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany; (H.Y.); (C.K.); (T.K.); (Z.M.); (P.L.); (S.M.); (V.v.S.)
| | - Zhi Ma
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany; (H.Y.); (C.K.); (T.K.); (Z.M.); (P.L.); (S.M.); (V.v.S.)
| | - Peng Lin
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany; (H.Y.); (C.K.); (T.K.); (Z.M.); (P.L.); (S.M.); (V.v.S.)
| | - Sven Mahner
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany; (H.Y.); (C.K.); (T.K.); (Z.M.); (P.L.); (S.M.); (V.v.S.)
| | - Udo Jeschke
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany; (H.Y.); (C.K.); (T.K.); (Z.M.); (P.L.); (S.M.); (V.v.S.)
- Department of Obstetrics and Gynecology, University Hospital Augsburg, 86156 Augsburg, Germany
- Correspondence: ; Tel.: +49-(0)821-400-165505
| | - Viktoria von Schönfeldt
- Department of Obstetrics and Gynecology, University Hospital, LMU Munich, 81377 Munich, Germany; (H.Y.); (C.K.); (T.K.); (Z.M.); (P.L.); (S.M.); (V.v.S.)
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Raimondo S, Gentile T, Gentile M, Donnarumma F, Esposito G, Morelli A, De Filippo S, Cuomo F. Comparing different sperm separation techniques for ART, through quantitative evaluation of p53 protein. J Hum Reprod Sci 2020; 13:117-124. [PMID: 32792760 PMCID: PMC7394090 DOI: 10.4103/jhrs.jhrs_117_19] [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: 11/04/2019] [Revised: 03/19/2020] [Accepted: 04/23/2020] [Indexed: 11/27/2022] Open
Abstract
Context: In the last 10 years, assisted reproductive technologies (ARTs) have offered infertile couples an opportunity to complete their reproductive project. However, the high failure rate could be explained with the complex human reproduction system. In ART, the decrease of the success is due to the conditions far from the natural ones. Aims: The aim of this study is to evaluate deoxyribonucleic acid (DNA) damage of spermatozoa before and after selection procedures, using a new technique able to quantize sperm DNA damage. Settings and Design: They were involved 43 males domiciled permanently in two areas with different Environmental Impact, HEI (high environmental impact) and LEI (Low environmental impact), they are aged between 24 and 31 years with various degrees of dyspermia. Subjects and Methods: The 43 males were divided into two groups: 21 in Group A (EIL) and 22 in Group B (EIH). The samples must be aliquoted into parts of 0.5 mL: Group (a) Control, no processing; Group (b) Swim-up (SUP) from semen; Group (c) classic SUP; Group (d) density gradient centrifugation (DGC). All samples were subjected to a quantitative dosage of p53 protein, before and after processing. Statistical Analysis Used: For the development of the probability and significance of the data, the Student's t-test was used. Results: From our data, it emerges that Groups D and B provide a superior quality about motility, vitality, and apoptosis indexes compared to other conventional techniques. In Group B, apoptosis is comparable to Group D, but they have slightly lower about motility and vitality. Group C is the one that has lower parameters than the other techniques. Regarding the evaluation of p53 protein, the results are conflicting with the evaluation of apoptosis; in fact, in Group D, the values are significantly higher than the other techniques. Conclusions: Sperm separation is an important moment in ART techniques. From our data, it emerges a greater fragility of DNA in the male spermatozoa who reside permanently in areas with high environmental impact.
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Affiliation(s)
| | - Tommaso Gentile
- Research Sector Laboratory Gentile S.a.s., Gragnano, Napoli, Italy
| | | | | | - Giusy Esposito
- Research Sector Laboratory Gentile S.a.s., Gragnano, Napoli, Italy
| | - Alessia Morelli
- Research Sector Laboratory Gentile S.a.s., Gragnano, Napoli, Italy
| | | | - Felice Cuomo
- Research Sector Laboratory Gentile S.a.s., Gragnano, Napoli, Italy
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Nikolaeva M, Arefieva A, Babayan A, Chagovets V, Kitsilovskaya N, Starodubtseva N, Frankevich V, Kalinina E, Krechetova L, Sukhikh G. Immunoendocrine Markers of Stress in Seminal Plasma at IVF/ICSI Failure: a Preliminary Study. Reprod Sci 2020; 28:144-158. [PMID: 32638280 DOI: 10.1007/s43032-020-00253-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 05/28/2020] [Accepted: 06/30/2020] [Indexed: 11/25/2022]
Abstract
We have previously shown that high level of seminal interleukin (IL)-18 is positively associated with a greater risk of pregnancy failure in women exposed to their partners' seminal plasma (SP) during the in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycle. Since IL-18 and IL-1β considered to be the key immune markers of stress, here we ask whether their increase in SP may be due to the stress experienced by men engaged in the IVF programs. Therefore, we correlated seminal IL-18 with IL-1β and both cytokines with the seminal steroids, whose increase indicates the activation of neuroendocrine stress response systems. Retrospective analysis of stored seminal samples was performed. Based on previously identified cutoff level for content of IL-18 per ejaculate, samples with high IL-18 content from IVF failure group (n = 9), as well as samples with low IL-18 content from IVF success group (n = 7), were included in the study. Seminal cytokines were evaluated using FlowCytomix™ technology. A set of 16 biologically active steroids in SP was quantified by liquid chromatography coupled with mass spectrometry. Concentrations and total amounts per ejaculate of cytokines and steroids were determined. A positive significant correlation was found between the levels of IL-18 and IL-1β. There was also a positive correlation between IL-18 or IL-1β and 17-α-hydroxypregnenolone, 17-α-hydroxyprogesterone, dehydroepiandrosterone (DHEA), DHEA sulfate (DHEAS), androstenedione, testosterone, dihydrotestosterone, progesterone, corticosterone, 11-deoxycorticosterone, and the ratio of DHEAS/cortisol. We suggested that stress-related overexpression of immune and hormonal factors in SP may be the key link between male stress and embryo implantation failure.
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Affiliation(s)
- Marina Nikolaeva
- Laboratory of Clinical Immunology, National Medical Research Center for Obstetrics, Gynecology and Perinatology of Ministry of Healthcare of Russian Federation, Oparina str. 4, Moscow, Russia, 117997.
| | - Alla Arefieva
- Laboratory of Clinical Immunology, National Medical Research Center for Obstetrics, Gynecology and Perinatology of Ministry of Healthcare of Russian Federation, Oparina str. 4, Moscow, Russia, 117997
| | - Alina Babayan
- Department of Assisted Technologies in Treatment of Infertility, National Medical Research Center for Obstetrics, Gynecology and Perinatology of Ministry of Healthcare of Russian Federation, Oparina str. 4, Moscow, Russia, 117997
| | - Vitaliy Chagovets
- Department of Systems Biology, National Medical Research Center for Obstetrics, Gynecology and Perinatology of Ministry of Healthcare of Russian Federation, Oparina str. 4, Moscow, Russia, 117997
| | - Natalia Kitsilovskaya
- Department of Systems Biology, National Medical Research Center for Obstetrics, Gynecology and Perinatology of Ministry of Healthcare of Russian Federation, Oparina str. 4, Moscow, Russia, 117997
| | - Natalia Starodubtseva
- Department of Systems Biology, National Medical Research Center for Obstetrics, Gynecology and Perinatology of Ministry of Healthcare of Russian Federation, Oparina str. 4, Moscow, Russia, 117997.,Moscow Institute of Physics and Technology, Institutskiy per. 9, Dolgoprudny, Moscow, Russia, 141701
| | - Vladimir Frankevich
- Department of Systems Biology, National Medical Research Center for Obstetrics, Gynecology and Perinatology of Ministry of Healthcare of Russian Federation, Oparina str. 4, Moscow, Russia, 117997
| | - Elena Kalinina
- Department of Assisted Technologies in Treatment of Infertility, National Medical Research Center for Obstetrics, Gynecology and Perinatology of Ministry of Healthcare of Russian Federation, Oparina str. 4, Moscow, Russia, 117997
| | - Lubov Krechetova
- Laboratory of Clinical Immunology, National Medical Research Center for Obstetrics, Gynecology and Perinatology of Ministry of Healthcare of Russian Federation, Oparina str. 4, Moscow, Russia, 117997
| | - Gennady Sukhikh
- Laboratory of Clinical Immunology, National Medical Research Center for Obstetrics, Gynecology and Perinatology of Ministry of Healthcare of Russian Federation, Oparina str. 4, Moscow, Russia, 117997.,First Moscow State Medical University named after I.M. Sechenov, Trubetskaya str. 8-2, Moscow, Russia, 119991
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Hutcherson NEC, Harris JB, Karaoui LR, Lakdawala L, Lodise NM, Stone RH, Vernon V. Infertility Management and Pharmacotherapy: What Every Pharmacist Should Know. J Pharm Pract 2020; 34:635-647. [PMID: 32588713 DOI: 10.1177/0897190020930969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Infertility is a significant public health concern in the United States. As such, utilization of infertility services, including pharmacotherapeutic treatments, is prevalent, and the role of the pharmacist as part of the health care team is essential. Pharmacists can assist patients by providing education on infertility causes, risk factor mitigation, referrals, nonpharmacologic and pharmacologic management options, navigation of the prescription process, and resource availability for the significant financial burden accompanying infertility treatment. In-depth pharmacotherapeutic information may not be readily available to pharmacists dispensing and counseling on these medications, and infertility management regimens are often varied and complicated requiring more in-depth counseling on use and administration. Given the complexity of infertility management, pharmacists are a valuable patient support and education resource. This article provides an in-depth review of infertility management strategies, both nonpharmacologic and pharmacologic.
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Affiliation(s)
- Nicole E Cieri- Hutcherson
- Department of Pharmacy Practice, 15497University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Buffalo, NY, USA
| | | | - Lamis R Karaoui
- Department of Pharmacy Practice, School of Pharmacy, 114792Lebanese American University, Byblos, Lebanon
| | - Lauren Lakdawala
- 1466Johns Hopkins Outpatient Pharmacy, Specialty Services, Baltimore, MD, USA
| | - Nicole M Lodise
- 1091Albany College of Pharmacy and Health Sciences, Albany, NY, USA
| | - Rebecca H Stone
- 1355University of Georgia College of Pharmacy, Athens, GA, USA
| | - Veronica Vernon
- Pharamcy Practice, 15461Butler University College of Pharmacy and Health Sciences, Indianapolis, IN, USA
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Lawn RB, Sallis HM, Wootton RE, Taylor AE, Demange P, Fraser A, Penton-Voak IS, Munafò MR. The effects of age at menarche and first sexual intercourse on reproductive and behavioural outcomes: A Mendelian randomization study. PLoS One 2020; 15:e0234488. [PMID: 32542040 PMCID: PMC7295202 DOI: 10.1371/journal.pone.0234488] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 05/26/2020] [Indexed: 01/29/2023] Open
Abstract
There is substantial variation in the timing of significant reproductive life events such as menarche and first sexual intercourse. Life history theory explains this variation as an adaptive response to an individual's environment and it is important to examine how traits within life history strategies affect each other. Here we applied Mendelian randomization (MR) methods to investigate whether there is a causal effect of variation in age at menarche and age at first sexual intercourse (markers or results of exposure to early life adversity) on outcomes related to reproduction, education and risky behaviour in UK Biobank (N = 114 883-181 255). Our results suggest that earlier age at menarche affects some traits that characterize life history strategies including earlier age at first and last birth, decreased educational attainment, and decreased age at leaving education (for example, we found evidence for a 0.26 year decrease in age at first birth per year decrease in age at menarche, 95% confidence interval: -0.34 to -0.17; p < 0.001). We find no clear evidence of effects of age at menarche on other outcomes, such as risk taking behaviour. Age at first sexual intercourse was also related to many life history outcomes, although there was evidence of horizontal pleiotropy which violates an assumption of MR and we therefore cannot infer causality from this analysis. Taken together, these results highlight how MR can be applied to test predictions of life history theory and to better understand determinants of health and social behaviour.
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Affiliation(s)
- Rebecca B. Lawn
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Hannah M. Sallis
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Robyn E. Wootton
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
- NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, United Kingdom
| | - Amy E. Taylor
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
| | - Perline Demange
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
- Département d’Etudes Cognitives, Ecole Normale Supérieure, Paris, France
| | - Abigail Fraser
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Ian S. Penton-Voak
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
- NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, United Kingdom
| | - Marcus R. Munafò
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
- NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, United Kingdom
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van Dijk MR, Koster MPH, Oostingh EC, Willemsen SP, Steegers EAP, Steegers-Theunissen RPM. A Mobile App Lifestyle Intervention to Improve Healthy Nutrition in Women Before and During Early Pregnancy: Single-Center Randomized Controlled Trial. J Med Internet Res 2020; 22:e15773. [PMID: 32412417 PMCID: PMC7260659 DOI: 10.2196/15773] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 10/30/2019] [Accepted: 12/16/2019] [Indexed: 01/29/2023] Open
Abstract
Background Unhealthy nutrition contributes to the worldwide rising prevalence of noncommunicable diseases. As most adverse reproductive outcomes originate during the periconception period, effective interventions targeting this period are needed. Therefore, we developed the lifestyle intervention Smarter Pregnancy to empower women to adapt a healthy diet prior to conception and during early pregnancy and performed a randomized controlled trial. Objective The objectives of this trial were to investigate compliance and effectiveness in women using the Smarter Pregnancy program. Methods Women aged between 18 and 45 years who were contemplating pregnancy or <13 weeks pregnant and their male partners living in the urban area of Rotterdam, the Netherlands, were eligible for participation. After baseline screening, the intervention group received personal online coaching based on identified inadequate intakes of vegetables, fruits, and folic acid supplements. The sum of these risk factors was used as a dietary risk score (DRS), ranging from 0 (healthy) to 9 (unhealthy). The control group did not receive coaching. We applied an intention-to-treat principle and used a multivariable linear regression model to evaluate the change in DRS after 24 weeks. Compliance was defined as the percentage of women who completed the screening questionnaire at 24 weeks. Results Of women recruited, 81.2% (177/218) completed the program (intervention: 91/218, 83.5%; control: 86/218, 78.9%; P=.95). After 24 weeks, the reduction in DRS of women in the intervention group was significantly larger than in the control group (β=.75, 95% CI 0.18-1.34). This reduction was mainly due to increased vegetable intake (β=.55, 95% CI 0.25-0.86). Conclusions The high compliance and the larger improvements in nutritional behaviors, especially vegetable intake, in women in the intervention group emphasizes the effectiveness of empowering women by using the lifestyle change intervention Smarter Pregnancy. Trial Registration Netherlands Trial Register: NL3927; https://www.trialregister.nl/trial/3927 International Registered Report Identifier (IRRID) RR2-10.1186/s12884-017-1228-5
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Affiliation(s)
- Matthijs R van Dijk
- Department of Obstetrics and Gynaecology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Maria P H Koster
- Department of Obstetrics and Gynaecology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Elsje C Oostingh
- Department of Obstetrics and Gynaecology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Sten P Willemsen
- Department of Biostatistics, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Eric A P Steegers
- Department of Obstetrics and Gynaecology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Régine P M Steegers-Theunissen
- Department of Obstetrics and Gynaecology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
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de Angelis C, Nardone A, Garifalos F, Pivonello C, Sansone A, Conforti A, Di Dato C, Sirico F, Alviggi C, Isidori A, Colao A, Pivonello R. Smoke, alcohol and drug addiction and female fertility. Reprod Biol Endocrinol 2020; 18:21. [PMID: 32164734 PMCID: PMC7069005 DOI: 10.1186/s12958-020-0567-7] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 01/21/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Considerable interest has been gathered on the relevant impact of preventable factors, including incorrect lifestyle and unhealthy habits, on female fertility. Smoking, alcohol and addictive drugs consumption represent a major concern, given the broad range of diseases which might be favored or exacerbated by these dependable attitudes. Despite the well-characterized effects of prenatal exposure on pregnancy outcomes and fetus health, a substantial proportion of women of reproductive age is still concerned with these habits. At present, the impact of smoke, alcohol and addictive drugs on women fertility, and, particularly, the specific targets and underlying mechanisms, are still poorly understood or debated, mainly due to the scarcity of well-designed studies, and to numerous biases. OBJECTIVE The current review will provide a comprehensive overview of clinical and experimental studies in humans and animals addressing the impact of smoke, alcohol and addictive drugs on female fertility, by also embracing effects on ovary, oviduct, and uterus, with particular reference to primary endpoints such as ovarian reserve, steroidogenesis, ovulation and menstrual cycle, oviduct function and uterus receptivity and implantation. A brief focus on polycystic ovary syndrome and endometriosis will be also included. METHODS A Pubmed literature search was performed with selected keywords; articles were individually retrieved by each author. No limitation was set for publication date. Articles in languages other than English were excluded. Additional articles were retrieved from references list of selected manuscripts. RESULTS AND CONCLUSIONS Currently, the most consistent evidences of a detrimental effect of smoke, alcohol and addictive drugs on specific domains of the female reproductive function are provided by experimental studies in animals. Overall, clinical studies suggest that smoking is associated to decreased fertility, although causal inference should be further demonstrated. Studies addressing the effect of alcohol consumption on female fertility provide conflicting results, although the majority reported lack of a correlation. Extremely scarce studies investigated the effects of addictive drugs on female fertility, and the specific actions of selected drugs have been difficult to address, due to multidrug consumption.
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Affiliation(s)
- Cristina de Angelis
- I.O.S. & COLEMAN Srl, Naples, Italy
- grid.4691.a0000 0001 0790 385XDipartimento di Medicina Clinica e Chirurgia, Università “Federico II” di Napoli, Via Sergio Pansini 5, 80131 Naples, Italy
- grid.4691.a0000 0001 0790 385XFERTISEXCARES Centro di Andrologia, Medicina della Riproduzione e della Sessualità Maschile e Femminile, Università “Federico II” di Napoli, Naples, Italy
- grid.4691.a0000 0001 0790 385XDipartimento di Sanità Pubblica, Università “Federico II” di Napoli, Naples, Italy
| | - Antonio Nardone
- grid.4691.a0000 0001 0790 385XDipartimento di Sanità Pubblica, Università “Federico II” di Napoli, Naples, Italy
| | - Francesco Garifalos
- grid.4691.a0000 0001 0790 385XDipartimento di Medicina Clinica e Chirurgia, Università “Federico II” di Napoli, Via Sergio Pansini 5, 80131 Naples, Italy
- grid.4691.a0000 0001 0790 385XFERTISEXCARES Centro di Andrologia, Medicina della Riproduzione e della Sessualità Maschile e Femminile, Università “Federico II” di Napoli, Naples, Italy
| | - Claudia Pivonello
- grid.4691.a0000 0001 0790 385XDipartimento di Medicina Clinica e Chirurgia, Università “Federico II” di Napoli, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Andrea Sansone
- grid.7841.aDepartment of Experimental Medicine, Faculty of Medicine and Dentistry, University of Rome “Sapienza”, viale Regina Elena 324, 00162 Roma, Italy
| | - Alessandro Conforti
- grid.4691.a0000 0001 0790 385XDepartment of Neuroscience, Reproductive Medicine, Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Carla Di Dato
- grid.7841.aDepartment of Experimental Medicine, Faculty of Medicine and Dentistry, University of Rome “Sapienza”, viale Regina Elena 324, 00162 Roma, Italy
| | - Felice Sirico
- grid.4691.a0000 0001 0790 385XDipartimento di Sanità Pubblica, Università “Federico II” di Napoli, Naples, Italy
| | - Carlo Alviggi
- grid.4691.a0000 0001 0790 385XDepartment of Neuroscience, Reproductive Medicine, Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Andrea Isidori
- grid.7841.aDepartment of Experimental Medicine, Faculty of Medicine and Dentistry, University of Rome “Sapienza”, viale Regina Elena 324, 00162 Roma, Italy
| | - Annamaria Colao
- grid.4691.a0000 0001 0790 385XDipartimento di Medicina Clinica e Chirurgia, Università “Federico II” di Napoli, Via Sergio Pansini 5, 80131 Naples, Italy
- grid.4691.a0000 0001 0790 385XFERTISEXCARES Centro di Andrologia, Medicina della Riproduzione e della Sessualità Maschile e Femminile, Università “Federico II” di Napoli, Naples, Italy
- grid.4691.a0000 0001 0790 385XCattedra Unesco “Educazione alla salute e allo sviluppo sostenibile”, Università “Federico II” di Napoli, Naples, Italy
| | - Rosario Pivonello
- grid.4691.a0000 0001 0790 385XDipartimento di Medicina Clinica e Chirurgia, Università “Federico II” di Napoli, Via Sergio Pansini 5, 80131 Naples, Italy
- grid.4691.a0000 0001 0790 385XFERTISEXCARES Centro di Andrologia, Medicina della Riproduzione e della Sessualità Maschile e Femminile, Università “Federico II” di Napoli, Naples, Italy
- grid.4691.a0000 0001 0790 385XCattedra Unesco “Educazione alla salute e allo sviluppo sostenibile”, Università “Federico II” di Napoli, Naples, Italy
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Kaya C, Aykaç A, Kaya Y, Taş M. The effect of modifiable lifestyle factors on semen quality. Rev Int Androl 2020; 18:151-158. [PMID: 31953028 DOI: 10.1016/j.androl.2019.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 04/16/2019] [Accepted: 09/22/2019] [Indexed: 01/18/2023]
Abstract
INTRODUCTION AND OBJECTIVES To examine the association between lifestyle factors (body mass index, smoking, alcohol consumption, coffee intake, physical activity, sauna and cell phone usage, wearing tight-fitting underwear), and conventional semen parameters. MATERIALS AND METHODS 1311 participants who attended the Andrology Clinic were included in the study. All participants were separated into two groups as men with normozoospermia and dysspermia. All participants answered a questionnaire which contains questions about the modifiable lifestyle factors. The total risk scores were calculated after all the positive lifestyle factors had been counted. RESULTS Men with normozoospermia and dysspermia consisted of 852 (65.0%) and 459 (35.0%) participants respectively. A negative relationship between the wearing of tight underwear and having normal semen parameters was detected between the two groups (p=0.004). While going to a sauna regularly was negatively related to semen concentration, wearing tight underwear was also related to both lower motility, normal morphology as well as semen concentration (p<0.05). While the total score of all participants was 5.22±1.34 point, there were no statistical differences between the two groups (p=0.332). It was found that having 3 more or fewer points was not related to any type of semen parameters and results of a spermiogram. CONCLUSION The clinicians should give advice to infertile male patients about changing their risky lifestyle, for infertility, to a healthy lifestyle for fertility. Better designed studies, with larger sample sizes using conventional semen analysis with sperm DNA analysis methods, should be planned to identify the possible effects of lifestyle factors on semen quality.
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Affiliation(s)
- Coşkun Kaya
- Eskisehir State Hospital, Department of Urology, Eskisehir, Turkey.
| | - Aykut Aykaç
- Karabük University School of Medicine, Department of Urology, Karabük, Turkey
| | - Yeliz Kaya
- Eskisehir Osmangazi University Health Science Faculty Department of Nursing, Eskisehir, Turkey
| | - Murat Taş
- Eskisehir State Hospital, Andrology Laboratory, Eskisehir, Turkey
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Kim M, Hong JE, Lee EY. The Relationship between Fatigue, Health-Promoting Behavior, and Depression among Infertile Women. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2019; 25:273-284. [PMID: 37679919 DOI: 10.4069/kjwhn.2019.25.3.273] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/23/2019] [Accepted: 08/26/2019] [Indexed: 09/09/2023] Open
Abstract
PURPOSE As the number of infertile couples has grown, many infertile women have experienced depression during the diagnosis and treatment of their infertility. This study aimed to identify the factors related to depression in infertile women who underwent reproductive treatments. METHODS The study subjects were 149 infertile women who underwent reproductive treatments. The data were collected by self-administered questionnaires from August 1 to December 24, 2018. The questionnaire consisted of questions about fatigue, health-promoting behavior, and depression. Analyses of the descriptive statistics, t-tests, one-way analysis of variance, correlation, and multiple regression were conducted using the SPSS 25.0 Windows program. RESULTS Thirty-six of the women in the study (24.2%) were in the probably depressed group and 113 (75.8%) were in the definitely depressed group and 100% of the subjects experienced symptoms of depression. Depression was positively correlated with fatigue and negatively correlated with health-promoting behavior. Multiple regression analysis revealed that fatigue and interpersonal relationships were factors significantly related to depression in the model (p<.001), with an explanatory power of 42.6%. CONCLUSION The results confirmed that fatigue and interpersonal relationships, which is a subfactor of health-promoting behavior, were factors related to depression. To alleviate depression in infertile women, efforts should be made to identify and reduce psychological and physical fatigue. In addition, minimizing relational difficulties that they experience during an infertility diagnosis and treatment and strengthening positive interpersonal relationships can be positive strategies to alleviate depression.
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Affiliation(s)
- Miok Kim
- Assistant Professor, College of Nursing, Dankook University, Cheonan, Korea
| | - Ju Eun Hong
- Assistant Professor, College of Nursing, Dankook University, Cheonan, Korea
| | - Eun Young Lee
- Assistant Professor, College of Nursing, Dankook University, Cheonan, Korea
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Salih Joelsson L, Elenis E, Wanggren K, Berglund A, Iliadou AN, Cesta CE, Mumford SL, White R, Tydén T, Skalkidou A. Investigating the effect of lifestyle risk factors upon number of aspirated and mature oocytes in in vitro fertilization cycles: Interaction with antral follicle count. PLoS One 2019; 14:e0221015. [PMID: 31419245 PMCID: PMC6697332 DOI: 10.1371/journal.pone.0221015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 07/30/2019] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION There is evidence demonstrating that certain lifestyle factors have a detrimental effect on fertility. Since such factors often coexist, possible synergistic effects merit further investigation. Thus we aimed to examine the cumulative impact of lifestyle factors on in vitro fertilization (IVF) early reproductive treatment outcomes and their interaction with measures of ovarian reserve. MATERIALS AND METHODS By following women who were starting their first fresh IVF cycle in 2 cohorts, the "Lifestyle study cohort" (hypothesis generating cohort, n = 242) and the "UppSTART study" (validation cohort, n = 432) in Sweden, we identified two significant risk factors acting independently, smoking and BMI, and then further assessed their cumulative effects. RESULTS Women with both these risk factors had an Incidence Rate Ratio (IRR) of 0.75 [(95% CI 0.61-0.94)] regarding the number of aspirated oocytes compared to women without these risk factors. Concerning the proportion of mature oocytes in relation to the total number of aspirated oocytes, the interaction between BMI and Antral Follicle Count (AFC) was significant (p-value 0.045): the lower the value of AFC, the more harmful the effect of BMI with the outcome. CONCLUSIONS Data shows that there is an individual as well as a cumulative effect of smoking and BMI on the number of aspirated and mature oocytes in fresh IVF treatment cycles. AFC might modify associations between BMI and the proportion of mature oocytes in relation to the total number of aspirated oocytes. These results highlight the importance of lifestyle factors on IVF early reproductive outcomes and provide additional evidence for the importance of preconception guidance for the optimization of IVF cycle outcome.
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Affiliation(s)
- Lana Salih Joelsson
- Institute of Women’s and Children’s, Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden
| | - Evangelia Elenis
- Institute of Women’s and Children’s, Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden
| | - Kjell Wanggren
- Department of Clinical Science, Intervention and Technology, Obstetrics and gynecology, Karolinska Institute, Stockholm, Sweden
| | - Anna Berglund
- National Centre for Knowledge on Men's Violence against women (NCK), Uppsala University, Uppsala, Sweden
| | - Anastasia N. Iliadou
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Carolyn E. Cesta
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Sunni L. Mumford
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, United States of America
| | | | - Tanja Tydén
- Institute of Women’s and Children’s, Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden
| | - Alkistis Skalkidou
- Institute of Women’s and Children’s, Obstetrics and Gynecology, Uppsala University, Uppsala, Sweden
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Pereira FEXG, Medeiros FDC, Rocha HAL, Silva KSD. Effects of omega-6/3 and omega-9/6 nutraceuticals on pain and fertility in peritoneal endometriosis in rats. Acta Cir Bras 2019; 34:e201900405. [PMID: 31066787 PMCID: PMC6583929 DOI: 10.1590/s0102-865020190040000005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 03/17/2019] [Indexed: 01/06/2023] Open
Abstract
Purpose: To evaluate the effects of the nutraceuticals omega-6/3 and omega-9/6 on endometriosis-associated infertility and pain. Methods: Controlled experimental study, with each group composed of eight female rats. Fertility groups: sham-operated control (0.9% saline solution); control with endometriosis (0.9% saline); omega-6/3 (1.2 g/kg/day); omega-9/6 (1.2 g/kg/day); and meloxicam (0.8 mg/kg/day). Pain groups: sham-operated control (0.9% saline); control with endometriosis (0.9% saline); omega-6/3 (1.2 g/kg/day); omega-9/6 (1.2 g/kg/day); medroxyprogesterone acetate (5 mg/kg/every 3 days); and meloxicam (0.8 mg/kg/day). Peritoneal endometriosis was surgically induced. Pain was evaluated with the writhing test. Fertility was evaluated by counting the number of embryos in the left hemi-uterus. Results: The mean number of writhings was as follows: sham-operated, 11.1 ± 2.9; control with endometriosis, 49.3 ± 4.4; omega-6/3, 31.5 ± 2.7; omega-9/6, 34.1 ± 4.5; medroxyprogesterone acetate, 2.1 ± 0.8; meloxicam, 1 ± 0.3. There was a significant difference between both controls and all drugs used for treatment. Regarding fertility, the mean values were as follows: sham-operated, 6.8 ± 0.6; control with endometriosis, 4.2 ± 0.7; omega-6/3, 4.7 ± 1; omega-9/6, 3.8 ± 0.9; and meloxicam, 1.8 ± 0.9. Conclusions: The omega-6/3 and omega-9/6 nutraceuticals decreased pain compared to the controls. There was no improvement in fertility in any of the tested groups.
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Affiliation(s)
- Francisco Edson Ximenes Gomes Pereira
- Fellow PhD degree, Postgraduate Program in Medical and Surgical Sciences, Department of Surgery, Universidade Federal do Ceará (UFC), Fortaleza-Ce, Brazil. Conception of the study, technical procedures, acquisition of the data, manuscript writing
| | - Francisco das Chagas Medeiros
- PhD, Associate Professor, Department of Maternal and Child Health, UFC, Fortaleza-Ce, Brazil. Conception, design, intellectual and scientific content of the study; critical revision; final approval
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Silvestris E, Lovero D, Palmirotta R. Nutrition and Female Fertility: An Interdependent Correlation. Front Endocrinol (Lausanne) 2019; 10:346. [PMID: 31231310 PMCID: PMC6568019 DOI: 10.3389/fendo.2019.00346] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 05/13/2019] [Indexed: 12/12/2022] Open
Abstract
Besides aging, a number of non-modifiable lifestyle-related factors, such as smoking, elevated consumption of caffeine and alcohol, stress, agonist sports, chronic exposure to environmental pollutants, and other nutritional habits exert a negative impact on a women's fertility. In particular, metabolic disorders including diabetes, obesity, and hyperlipidemia commonly associated to hypercaloric diets are suspected to affect a woman's fertility either by direct damage to oocyte health and differentiation, or by indirect interference with the pituitary-hypothalamic axis, resulting in dysfunctional oogenesis. Obese women show decreased insulin sensitivity determining persistent hyperinsulinemia, which may be involved in the pathogenesis of Polycystic Ovary Syndrome. Thus, the reduced insulin secretion induced by dietary adjustments is an attractive non-pharmacological treatment to prevent infertility, and a Mediterranean diet aimed at maintaining normal body mass may be effective in the preservation of ovarian health and physiology. Furthermore, in relation to the oxidative stress as a co-factor of defective oocyte maturation, an appropriate intake of proteins, antioxidants and methyl-donor supplements (1-Carbon Cycle) may decrease the bioavailability of toxic oxidants resulting in the protection of oocyte maturation.
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Agarwal A, Rana M, Qiu E, AlBunni H, Bui AD, Henkel R. Role of oxidative stress, infection and inflammation in male infertility. Andrologia 2018; 50:e13126. [DOI: 10.1111/and.13126] [Citation(s) in RCA: 144] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 06/08/2018] [Accepted: 07/18/2018] [Indexed: 02/06/2023] Open
Affiliation(s)
- Ashok Agarwal
- American Center for Reproductive Medicine; Cleveland Clinic; Cleveland Ohio
| | - Mohit Rana
- American Center for Reproductive Medicine; Cleveland Clinic; Cleveland Ohio
| | - Emily Qiu
- American Center for Reproductive Medicine; Cleveland Clinic; Cleveland Ohio
| | - Hashem AlBunni
- American Center for Reproductive Medicine; Cleveland Clinic; Cleveland Ohio
| | - Albert D. Bui
- American Center for Reproductive Medicine; Cleveland Clinic; Cleveland Ohio
- Ohio University Heritage College of Osteopathic Medicine; Athens Ohio
| | - Ralf Henkel
- American Center for Reproductive Medicine; Cleveland Clinic; Cleveland Ohio
- Department of Medical Biosciences; University of the Western Cape; Bellville South Africa
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The casual effect of lifestyle factors on outcomes of assisted reproductive techniques: a protocol study on Iranian infertile couples. Reprod Health 2018; 15:210. [PMID: 30558625 PMCID: PMC6296043 DOI: 10.1186/s12978-018-0655-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 12/05/2018] [Indexed: 12/02/2022] Open
Abstract
Background Attention to additional factors affecting the success of assisted reproduction techniques (ARTs) is very important and with appropriate interventions in some of these factors, success rate can be as high as improve a lot. There is a lot of evidence that lifestyle factors can influence on ARTs outcomes. Current knowledge of the effect of combined effect of several lifestyle factors on the outcomes of ARTs is low and contradictory. The importance of the causality of this phenomenon is felt by the pandemic of inappropriate lifestyle as well as the dramatic increase in infertility in the world. The aim of this cohort study is to scrutinize the casual effect of a specific range of contemporary lifestyle factors on ARTs outcomes. Methods A prospective cohort study will be conducted in Royan institute, Tehran, Iran. Each infertile couple will be monitored from the first visit to the end of treatment cycle. The data will be collected electronically and include the following: detailed interview about lifestyle and socioeconomic status, past medical history, general physical examination, assessment of menstrual and ovulatory status, assessment of tuboperitoneal, assessment of uterine, assessment of cervix, urogenital examination, semen analysis, anti-sperm antibodies, biochemical analysis, sperm-cervical mucus contact test, in vitro cervical mucus penetration test and sperm functional assays. To estimate the casual effect of lifestyle variables on clinical pregnancy and live birth, the obtained propensity score (PS) from generalized boosted models (GBM) will be matched between couple with and without live birth. Discussion This is the first study to prospectively obtain detailed information on causes of ARTs success. Determining the casual effect of lifestyle variables on ARTs success will be important to inform strategies most likely to increase the success rates in ARTs.
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