1
|
Wu J, Feng S, Luo Y, Ning Y, Qiu P, Lin Y, Ma F, Zhuo Y. Transcriptomic profile of premature ovarian insufficiency with RNA-sequencing. Front Cell Dev Biol 2024; 12:1370772. [PMID: 38655066 PMCID: PMC11035783 DOI: 10.3389/fcell.2024.1370772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/27/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction This study aimed to explore the transcriptomic profile of premature ovarian insufficiency (POI) by investigating alterations in gene expression. Methods A total of sixty-one women, comprising 31 individuals with POI in the POI group and 30 healthy women in the control group (HC group), aged between 24 and 40 years, were recruited for this study. The transcriptomic profiles of peripheral blood samples from all study subjects were analyzed using RNA-sequencing. Results The results revealed 39 differentially expressed genes in individuals with POI compared to healthy controls, with 10 upregulated and 29 downregulated genes. Correlation analysis highlighted the relationship between the expression of SLC25A39, CNIH3, and PDZK1IP1 and hormone levels. Additionally, an effective classification model was developed using SLC25A39, CNIH3, PDZK1IP1, SHISA4, and LOC389834. Functional enrichment analysis demonstrated the involvement of these differentially expressed genes in the "haptoglobin-hemoglobin complex," while KEGG pathway analysis indicated their participation in the "Proteoglycans in cancer" pathway. Conclusion The identified genes could play a crucial role in characterizing the genetic foundation of POI, potentially serving as valuable biomarkers for enhancing disease classification accuracy.
Collapse
Affiliation(s)
- Jiaman Wu
- Department of Chinese Medicine, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, China
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shiyu Feng
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yan Luo
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yan Ning
- Department of Chinese Medicine, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, China
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Pingping Qiu
- Department of Chinese Medicine, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Yanting Lin
- Department of Chinese Medicine, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, China
| | - Fei Ma
- Department of Chinese Medicine, Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, China
- Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yuanyuan Zhuo
- Department of Acupuncture and Moxibustion, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, China
| |
Collapse
|
2
|
Horowitz E, Mizrachi Y, Barber E, Shimshy M, Levitas-Djerbi T, Finkelstein M, Shalev A, Farhi J, Raziel A, Esteves SC, Weissman A. High prevalence of low prognosis by the POSEIDON criteria in women undergoing planned oocyte cryopreservation. Eur J Obstet Gynecol Reprod Biol 2024; 295:42-47. [PMID: 38335583 DOI: 10.1016/j.ejogrb.2024.01.025] [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: 10/28/2023] [Revised: 01/13/2024] [Accepted: 01/18/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVE Planned oocyte cryopreservation (OC) is being increasingly utilized worldwide. However, some women cannot accumulate sufficient oocytes because of poor response to stimulation. The POSEIDON classification is a novel system to classify patients with 'expected' or 'unexpected' inappropriate ovarian response to exogenous gonadotropins. Our study aimed to examine the prevalence of POSEIDON patients among women undergoing planned OC. STUDY DESIGN We retrospectively reviewed the first cycles of 160 consecutive patients undergoing planned OC. Patients were classified into the four POSEIDON groups or as 'non-POSEIDON' based on age, AMH level and the number of oocytes retrieved. The primary outcome measure was the prevalence of POSEIDON patients. RESULTS Overall, 63 patients (39.4 %) were classified as POSEIDON patients, 12 in group 1, 12 in group 2, 8 in group 3, and 31 in group 4. Compared to non-POSEIDON patients, POSEIDON patients had increased basal FSH levels and reduced serum AMH levels and antral follicle counts, required higher FSH starting doses and increased gonadotropin requirements and reached lower peak serum estradiol levels. Additionally, POSEIDON patients had a lower number of oocytes retrieved (7.6 ± 3.1 vs.20.2 ± 9.9, p < 0.001) and vitrified (5.8 ± 2.9 vs.14.7 ± 6.8, p < 0.001) than non-POSEIDON counterparts, respectively. CONCLUSION We found a high prevalence of patients being classified as low prognosis according to the POSEIDON criteria among patients seeking planned OC. POSEIDON patients had increased gonadotropin requirements and a significantly lower number of oocytes retrieved and vitrified. This novel, unexpected finding adds clinically relevant information for counselling and management of patients undergoing planned OC.
Collapse
Affiliation(s)
- Eran Horowitz
- In Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, and Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Yossi Mizrachi
- In Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, and Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Elad Barber
- In Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, and Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Miriam Shimshy
- In Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, and Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Talia Levitas-Djerbi
- In Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, and Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Maya Finkelstein
- In Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, and Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Amir Shalev
- In Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, and Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Jacob Farhi
- In Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, and Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Arieh Raziel
- In Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, and Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Campinas, Brazil.
| | - Ariel Weissman
- In Vitro Fertilization Unit, Department of Obstetrics and Gynecology, Edith Wolfson Medical Center, Holon, and Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| |
Collapse
|
3
|
Chang CL. Facilitation of Ovarian Response by Mechanical Force-Latest Insight on Fertility Improvement in Women with Poor Ovarian Response or Primary Ovarian Insufficiency. Int J Mol Sci 2023; 24:14751. [PMID: 37834198 PMCID: PMC10573075 DOI: 10.3390/ijms241914751] [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: 07/21/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
The decline in fertility in aging women, especially those with poor ovarian response (POR) or primary ovarian insufficiency (POI), is a major concern for modern IVF centers. Fertility treatments have traditionally relied on gonadotropin- and steroid-hormone-based IVF practices, but these methods have limitations, especially for women with aging ovaries. Researchers have been motivated to explore alternative approaches. Ovarian aging is a complicated process, and the deterioration of oocytes, follicular cells, the extracellular matrix (ECM), and the stromal compartment can all contribute to declining fertility. Adjunct interventions that involve the use of hormones, steroids, and cofactors and gamete engineering are two major research areas aimed to improve fertility in aging women. Additionally, mechanical procedures including the In Vitro Activation (IVA) procedure, which combines pharmacological activators and fragmentation of ovarian strips, and the Whole Ovary Laparoscopic Incision (WOLI) procedure that solely relies on mechanical manipulation in vivo have shown promising results in improving follicle growth and fertility in women with POR and POI. Advances in the use of mechanical procedures have brought exciting opportunities to improve fertility outcomes in aging women with POR or POI. While the lack of a comprehensive understanding of the molecular mechanisms that lead to fertility decline in aging women remains a major challenge for further improvement of mechanical-manipulation-based approaches, recent progress has provided a better view of how these procedures promote folliculogenesis in the fibrotic and avascular aging ovaries. In this review, we first provide a brief overview of the potential mechanisms that contribute to ovarian aging in POI and POR patients, followed by a discussion of measures that aim to improve ovarian folliculogenesis in aging women. At last, we discuss the likely mechanisms that contribute to the outcomes of IVA and WOLI procedures and potential future directions.
Collapse
Affiliation(s)
- Chia Lin Chang
- Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital Linkou Medical Center, Chang Gung University, Guishan, Taoyuan 33305, Taiwan
| |
Collapse
|
4
|
Fiorentino G, Cimadomo D, Innocenti F, Soscia D, Vaiarelli A, Ubaldi FM, Gennarelli G, Garagna S, Rienzi L, Zuccotti M. Biomechanical forces and signals operating in the ovary during folliculogenesis and their dysregulation: implications for fertility. Hum Reprod Update 2023; 29:1-23. [PMID: 35856663 DOI: 10.1093/humupd/dmac031] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 05/12/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Folliculogenesis occurs in the highly dynamic environment of the ovary. Follicle cyclic recruitment, neo-angiogenesis, spatial displacement, follicle atresia and ovulation stand out as major events resulting from the interplay between mechanical forces and molecular signals. Morphological and functional changes to the growing follicle and to the surrounding tissue are required to produce oocytes capable of supporting preimplantation development to the blastocyst stage. OBJECTIVE AND RATIONALE This review will summarize the ovarian morphological and functional context that contributes to follicle recruitment, growth and ovulation, as well as to the acquisition of oocyte developmental competence. We will describe the changes occurring during folliculogenesis to the ovarian extracellular matrix (ECM) and to the vasculature, their influence on the mechanical properties of the ovarian tissue, and, in turn, their influence on the regulation of signal transduction. Also, we will outline how their dysregulation might be associated with pathologies such as polycystic ovary syndrome (PCOS), endometriosis or premature ovarian insufficiency (POI). Finally, for each of these three pathologies, we will highlight therapeutic strategies attempting to correct the altered biomechanical context in order to restore fertility. SEARCH METHODS For each area discussed, a systematic bibliographical search was performed, without temporal limits, using PubMed Central, Web of Science and Scopus search engines employing the keywords extracellular matrix, mechanobiology, biomechanics, vasculature, angiogenesis or signalling pathway in combination with: ovary, oogenesis, oocyte, folliculogenesis, ovarian follicle, theca, granulosa, cumulus, follicular fluid, corpus luteum, meiosis, oocyte developmental competence, preimplantation, polycystic ovary syndrome, premature ovarian insufficiency or endometriosis. OUTCOMES Through search engines queries, we yielded a total of 37 368 papers that were further selected based on our focus on mammals and, specifically, on rodents, bovine, equine, ovine, primates and human, and also were trimmed around each specific topic of the review. After the elimination of duplicates, this selection process resulted in 628 papers, of which 287 were cited in the manuscript. Among these, 89.2% were published in the past 22 years, while the remaining 8.0%, 2.4% or 0.3% were published during the 1990s, 1980s or before, respectively. During folliculogenesis, changes occur to the ovarian ECM composition and organization that, together with vasculature modelling around the growing follicle, are aimed to sustain its recruitment and growth, and the maturation of the enclosed oocyte. These events define the scenario in which mechanical forces are key to the regulation of cascades of molecular signals. Alterations to this context determine impaired folliculogenesis and decreased oocyte developmental potential, as observed in pathological conditions which are causes of infertility, such as PCOS, endometriosis or POI. WIDER IMPLICATIONS The knowledge of these mechanisms and the rules that govern them lay a sound basis to explain how follicles recruitment and growth are modulated, and stimulate insights to develop, in clinical practice, strategies to improve follicular recruitment and oocyte competence, particularly for pathologies like PCOS, endometriosis and POI.
Collapse
Affiliation(s)
- Giulia Fiorentino
- Laboratory of Developmental Biology, Department of Biology and Biotechnology "Lazzaro Spallanzani", University of Pavia, Pavia, Italy.,Center for Health Technologies, University of Pavia, Pavia, Italy
| | | | | | - Daria Soscia
- Clinica Valle Giulia, GeneraLife IVF, Rome, Italy
| | | | | | - Gianluca Gennarelli
- Obstetrics and Gynecology, Physiopathology of Reproduction and IVF Unit, Department of Surgical Sciences, Sant'Anna Hospital, University of Torino, Turin, Italy.,Livet, GeneraLife IVF, Turin, Italy
| | - Silvia Garagna
- Laboratory of Developmental Biology, Department of Biology and Biotechnology "Lazzaro Spallanzani", University of Pavia, Pavia, Italy.,Center for Health Technologies, University of Pavia, Pavia, Italy
| | - Laura Rienzi
- Clinica Valle Giulia, GeneraLife IVF, Rome, Italy.,Department of Biomolecular Sciences, University of Urbino "Carlo Bo", Urbino, Italy
| | - Maurizio Zuccotti
- Laboratory of Developmental Biology, Department of Biology and Biotechnology "Lazzaro Spallanzani", University of Pavia, Pavia, Italy.,Center for Health Technologies, University of Pavia, Pavia, Italy
| |
Collapse
|
5
|
Dovom MR, Noroozzadeh M, Mosaffa N, Zadeh‐Vakili A, Piryaei A, Rahmati M, Azar MF, Tehrani FR. Continued exposure to D‐galactose in postnatal period may inhibit excessive primordial follicle reduction in rats exposed prenatally to D‐galactose. Birth Defects Res 2022; 114:1112-1122. [DOI: 10.1002/bdr2.2083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 08/03/2022] [Accepted: 08/12/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Marzieh Rostami Dovom
- Reproductive Endocrinology Research Center Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Mahsa Noroozzadeh
- Reproductive Endocrinology Research Center Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Nariman Mosaffa
- Department of Immunology, School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Azita Zadeh‐Vakili
- Endocrine Research Center Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Abbas Piryaei
- Department of Biology and Anatomical Sciences, School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran
- Department of Stem Cells and Developmental Biology, Cell Science Research Center Royan Institute for Stem Cell Biology and Technology, ACECR Tehran Iran
| | - Maryam Rahmati
- Reproductive Endocrinology Research Center Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Mahbanoo Farhadi Azar
- Reproductive Endocrinology Research Center Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences Tehran Iran
| |
Collapse
|
6
|
Tugrul Ersak D, Yilmaz N, Cavkaytar S, Ersak B, Ustun Y. Investigation of the role of serum telomerase levels in patients with occult primary ovarian insufficiency: a prospective cross-sectional study. J OBSTET GYNAECOL 2021; 42:485-489. [PMID: 34219577 DOI: 10.1080/01443615.2021.1916807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study was designed to investigate serum telomerase levels of occult primary ovarian insufficiency (POI) and the relationship between in vitro fertilisation (IVF) results of these patients and serum telomerase levels. A cross-sectional case-control study was conducted between May and October 2017 including 78 patients at University of Health Science, Turkey. Occult POI was defined as women with a history of follicle-stimulating hormone (FSH) elevation between 12 and 25 IU/L and low ovarian reserve before initiation of IVF (n = 39). The control group were patients attending the hospital for contraception, with no history of infertility, having at least one healthy child (n = 39). Telomerase levels in serum samples were determined using enzyme-linked immunosorbent assay method. There was no statistically significant difference in serum telomerase levels in occult POI patients when compared with the control group.Impact statementWhat is already known on this subject? Clinical studies investigating the role of telomerase on reproductive function and in vitro fertilisation (IVF) outcomes in occult primary ovarian insufficiency (POI) patients are limited with no clear consensus and in all these studies polymerase chain reaction technique was used to evaluate telomere length. Regarding our knowledge, this is the first study in the literature investigating the role of serum telomerase levels in occult POI patients.What do the results of this study add? In contrast to the previous studies, in this study no statistically significant difference was found in serum telomerase levels in occult POI patients when compared with the fertile control patients.What are the implications of these findings for clinical practice and/or further research? The occult POI patients examined in this study are overlooked until they apply with infertility. Serum telomerase measurement is not useful to support the diagnosis of occult POI. Nevertheless, in order to confirm these findings, further studies in larger populations are needed.
Collapse
Affiliation(s)
| | - Nafiye Yilmaz
- Department of IVF, University of Health Science, Ankara, Turkey, Turkey
| | - Sabri Cavkaytar
- Department of Reproductive Endocrinology and IVF Center, Bahceci Health Group, Istanbul, Turkey
| | - Burak Ersak
- Department of Oncology, University of Health Science, Ankara, Turkey
| | - Yaprak Ustun
- Department of IVF, University of Health Science, Ankara, Turkey, Turkey
| |
Collapse
|
7
|
Henarejos-Castillo I, Aleman A, Martinez-Montoro B, Gracia-Aznárez FJ, Sebastian-Leon P, Romeu M, Remohi J, Patiño-Garcia A, Royo P, Alkorta-Aranburu G, Diaz-Gimeno P. Machine Learning-Based Approach Highlights the Use of a Genomic Variant Profile for Precision Medicine in Ovarian Failure. J Pers Med 2021; 11:609. [PMID: 34199109 PMCID: PMC8305607 DOI: 10.3390/jpm11070609] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/16/2021] [Accepted: 06/22/2021] [Indexed: 12/27/2022] Open
Abstract
Ovarian failure (OF) is a common cause of infertility usually diagnosed as idiopathic, with genetic causes accounting for 10-25% of cases. Whole-exome sequencing (WES) may enable identifying contributing genes and variant profiles to stratify the population into subtypes of OF. This study sought to identify a blood-based gene variant profile using accumulation of rare variants to promote precision medicine in fertility preservation programs. A case-control (n = 118, n = 32, respectively) WES study was performed in which only non-synonymous rare variants <5% minor allele frequency (MAF; in the IGSR) and coverage ≥ 100× were considered. A profile of 66 variants of uncertain significance was used for training an unsupervised machine learning model to separate cases from controls (97.2% sensitivity, 99.2% specificity) and stratify the population into two subtypes of OF (A and B) (93.31% sensitivity, 96.67% specificity). Model testing within the IGSR female population predicted 0.5% of women as subtype A and 2.4% as subtype B. This is the first study linking OF to the accumulation of rare variants and generates a new potential taxonomy supporting application of this approach for precision medicine in fertility preservation.
Collapse
Affiliation(s)
- Ismael Henarejos-Castillo
- IVI Foundation-Instituto de Investigación Sanitaria La Fe, Av. Fernando Abril Martorell 106, Torre A, Planta 1ª, 46026 Valencia, Spain; (I.H.-C.); (A.A.); (P.S.-L.)
- Department of Paediatrics, Obstetrics and Gynaecology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain;
| | - Alejandro Aleman
- IVI Foundation-Instituto de Investigación Sanitaria La Fe, Av. Fernando Abril Martorell 106, Torre A, Planta 1ª, 46026 Valencia, Spain; (I.H.-C.); (A.A.); (P.S.-L.)
| | - Begoña Martinez-Montoro
- IVI-RMA Pamplona, Reproductive Medicine, C/Sangüesa, Número 15-Planta Baja, 31003 Pamplona, Spain; (B.M.-M.); (P.R.)
| | - Francisco Javier Gracia-Aznárez
- CIMA Lab Diagnostics, University of Navarra, IdiSNA, Avda Pio XII, 55, 31008 Pamplona, Spain; (F.J.G.-A.); (A.P.-G.); (G.A.-A.)
| | - Patricia Sebastian-Leon
- IVI Foundation-Instituto de Investigación Sanitaria La Fe, Av. Fernando Abril Martorell 106, Torre A, Planta 1ª, 46026 Valencia, Spain; (I.H.-C.); (A.A.); (P.S.-L.)
- IVI-RMA Pamplona, Reproductive Medicine, C/Sangüesa, Número 15-Planta Baja, 31003 Pamplona, Spain; (B.M.-M.); (P.R.)
| | - Monica Romeu
- Hospital Universitario y Politécnico La Fe, Av. Fernando Abril Martorell 106, 46026 Valencia, Spain;
| | - Jose Remohi
- Department of Paediatrics, Obstetrics and Gynaecology, University of Valencia, Av. Blasco Ibáñez 15, 46010 Valencia, Spain;
- IVI-RMA Valencia, Reproductive Medicine, Plaça de la Policia Local, 3, 46015 Valencia, Spain
| | - Ana Patiño-Garcia
- CIMA Lab Diagnostics, University of Navarra, IdiSNA, Avda Pio XII, 55, 31008 Pamplona, Spain; (F.J.G.-A.); (A.P.-G.); (G.A.-A.)
- Laboratorio de Pediatría-Unidad de Genética Clínica, Clínica Universidad de Navarra, Avda Pio XII, 55, 31008 Pamplona, Spain
| | - Pedro Royo
- IVI-RMA Pamplona, Reproductive Medicine, C/Sangüesa, Número 15-Planta Baja, 31003 Pamplona, Spain; (B.M.-M.); (P.R.)
| | - Gorka Alkorta-Aranburu
- CIMA Lab Diagnostics, University of Navarra, IdiSNA, Avda Pio XII, 55, 31008 Pamplona, Spain; (F.J.G.-A.); (A.P.-G.); (G.A.-A.)
| | - Patricia Diaz-Gimeno
- IVI Foundation-Instituto de Investigación Sanitaria La Fe, Av. Fernando Abril Martorell 106, Torre A, Planta 1ª, 46026 Valencia, Spain; (I.H.-C.); (A.A.); (P.S.-L.)
- IVI-RMA Pamplona, Reproductive Medicine, C/Sangüesa, Número 15-Planta Baja, 31003 Pamplona, Spain; (B.M.-M.); (P.R.)
| |
Collapse
|
8
|
MERTK-Mediated LC3-Associated Phagocytosis (LAP) of Apoptotic Substrates in Blood-Separated Tissues: Retina, Testis, Ovarian Follicles. Cells 2021; 10:cells10061443. [PMID: 34207717 PMCID: PMC8229618 DOI: 10.3390/cells10061443] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 06/05/2021] [Accepted: 06/07/2021] [Indexed: 01/22/2023] Open
Abstract
Timely and efficient elimination of apoptotic substrates, continuously produced during one’s lifespan, is a vital need for all tissues of the body. This task is achieved by cells endowed with phagocytic activity. In blood-separated tissues such as the retina, the testis and the ovaries, the resident cells of epithelial origin as retinal pigmented epithelial cells (RPE), testis Sertoli cells and ovarian granulosa cells (GC) provide phagocytic cleaning of apoptotic cells and cell membranes. Disruption of this process leads to functional ablation as blindness in the retina and compromised fertility in males and females. To ensure the efficient elimination of apoptotic substrates, RPE, Sertoli cells and GC combine various mechanisms allowing maintenance of tissue homeostasis and avoiding acute inflammation, tissue disorganization and functional ablation. In tight cooperation with other phagocytosis receptors, MERTK—a member of the TAM family of receptor tyrosine kinases (RTK)—plays a pivotal role in apoptotic substrate cleaning from the retina, the testis and the ovaries through unconventional autophagy-assisted phagocytosis process LAP (LC3-associated phagocytosis). In this review, we focus on the interplay between TAM RTKs, autophagy-related proteins, LAP, and Toll-like receptors (TLR), as well as the regulatory mechanisms allowing these components to sustain tissue homeostasis and prevent functional ablation of the retina, the testis and the ovaries.
Collapse
|
9
|
Yefimova MG, Lefevre C, Bashamboo A, Eozenou C, Burel A, Lavault MT, Meunier AC, Pimentel C, Veau S, Neyroud AS, Jaillard S, Jégou B, Bourmeyster N, Ravel C. Granulosa cells provide elimination of apoptotic oocytes through unconventional autophagy-assisted phagocytosis. Hum Reprod 2021; 35:1346-1362. [PMID: 32531067 DOI: 10.1093/humrep/deaa097] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 03/14/2020] [Indexed: 12/30/2022] Open
Abstract
STUDY QUESTION Do human granulosa cells (GCs) ingest and destroy apoptotic oocytes? SUMMARY ANSWER Somatic GCs ingest and destroy apoptotic oocytes and other apoptotic substrates through unconventional autophagy-assisted phagocytosis. WHAT IS KNOWN ALREADY Most (99%) ovarian germ cells undergo apoptosis through follicular atresia. The mode of cleaning of atretic follicles from the ovary is unclear. Ovarian GCs share striking similarities with testicular Sertoli cells with respect to their origin and function. Somatic Sertoli cells are responsible for the elimination of apoptotic spermatogenic cells through unconventional autophagy-assisted phagocytosis. STUDY DESIGN, SIZE, DURATION Human GCs were tested for the ability to ingest and destroy the apoptotic oocytes and other apoptotic substrates. A systemic study of the main phagocytosis steps has been performed at different time points after loading of apoptotic substrates into the GC. PARTICIPANTS/MATERIALS, SETTING, METHODS Primary cultures of GC retrieved following controlled ovarian stimulation of five women for IVF/ICSI and a human granulosa KGN cell line were incubated with different apoptotic substrates: oocytes which underwent spontaneous apoptosis during the cultivation of immature germ cells for IVF/ICSI; apoptotic KGN cells; and apoptotic membranes from rat retinas. Cultured GC were analyzed for the presence of specific molecular markers characteristic of different steps of phagocytic and autophagy machineries by immunocytochemistry, confocal microscopy, transmission electron microscopy and western blotting, before and after loading with apoptotic substrates. MAIN RESULTS AND THE ROLE OF CHANCE Incubation of human GC with apoptotic substrates resulted in their translocation in cell cytoplasm, concomitant with activation of the phagocytosis receptor c-mer proto-oncogene tyrosine kinase MERTK (P < 0.001), clumping of motor molecule myosin II, recruitment of autophagy proteins: autophagy-related protein 5 (ATG5), autophagy-related protein 6 (Beclin1) and the rise of a membrane form of microtubule-associated protein 1 light chain 3 (LC3-II) protein. Ingestion of apoptotic substrates was accompanied by increased expression of the lysosomal protease Cathepsin D (P < 0.001), and a rise of lysosomes in the GCs, as assessed by different techniques. The level of autophagy adaptor, sequestosome 1/p62 (p62) protein remained unchanged. LARGE SCALE DATA N/A. LIMITATIONS, REASONS FOR CAUTION The number of patients described here is limited. Also the dependence of phagocytosis on reproductive hormone status of patients should be analyzed. WIDER IMPLICATIONS OF THE FINDINGS Removal of apoptotic oocytes by surrounding GC seems likely to be a physiological mechanism involved in follicular atresia. Proper functioning of this mechanism may be a new strategy for the treatment of ovarian dysfunctions associated with an imbalance in content of germ cells in the ovaries, such as premature ovarian failure and polycystic ovary syndrome. STUDY FUNDING/COMPETING INTEREST(S) The study was funded by Rennes Metropole (AIS 2015) and Agence de BioMédecine. This work was supported by funding from Université de Rennes1, Institut National de la Santé et de la Recherche Médicale (INSERM) and CHU de Rennes. A.B. is funded in part by the program Actions Concertées Interpasteuriennes (ACIP) and a research grant from the European Society of Pediatric Endocrinology. This work is supported by the Agence Nationale de la Recherche Grants ANR-17-CE14-0038 and ANR-10-LABX-73. The authors declare no competing interests.
Collapse
Affiliation(s)
- M G Yefimova
- CHU RENNES, Département de Gynécologie Obstétrique et Reproduction Humaine - CECOS, F-35000 Rennes, France.,Sechenov Institute of Evolutionary Physiology and Biochemistry, Russian Academy of Sciences, St-Petersburg 194223, Russia
| | - C Lefevre
- Université Rennes, INSERM, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)-UMR_S 1085, F-35000 Rennes, France
| | - A Bashamboo
- Human Developmental Genetics, Institut Pasteur, 75724, Paris, France
| | - C Eozenou
- Human Developmental Genetics, Institut Pasteur, 75724, Paris, France
| | - A Burel
- MRic TEM Plateform, BIOSIT, Université Rennes 1, 35000 Rennes, France
| | - M T Lavault
- MRic TEM Plateform, BIOSIT, Université Rennes 1, 35000 Rennes, France
| | - A C Meunier
- Laboratoire STIM, Université de Poitiers, 86022 Poitiers Cedex, France
| | - C Pimentel
- CHU RENNES, Département de Gynécologie Obstétrique et Reproduction Humaine - CECOS, F-35000 Rennes, France
| | - S Veau
- CHU RENNES, Département de Gynécologie Obstétrique et Reproduction Humaine - CECOS, F-35000 Rennes, France
| | - A S Neyroud
- CHU RENNES, Département de Gynécologie Obstétrique et Reproduction Humaine - CECOS, F-35000 Rennes, France
| | - S Jaillard
- CHU RENNES, Département de Gynécologie Obstétrique et Reproduction Humaine - CECOS, F-35000 Rennes, France
| | - B Jégou
- Université Rennes, INSERM, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)-UMR_S 1085, F-35000 Rennes, France
| | - N Bourmeyster
- Laboratoire STIM, Université de Poitiers, 86022 Poitiers Cedex, France.,CHU POITIERS, Pôle Biospharm, secteur Biochimie, 86022 Poitiers Cedex, France
| | - C Ravel
- CHU RENNES, Département de Gynécologie Obstétrique et Reproduction Humaine - CECOS, F-35000 Rennes, France.,Université Rennes, INSERM, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail)-UMR_S 1085, F-35000 Rennes, France
| |
Collapse
|
10
|
Zhang XJ, Gu Y, Fu W. A novel PPRC1 point mutation in a Chinese family with premature ovarian failure: A case study. J Gene Med 2021; 23:e3335. [PMID: 33818872 DOI: 10.1002/jgm.3335] [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: 07/16/2020] [Revised: 03/25/2021] [Accepted: 03/30/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Patients with premature ovarian failure (POF) have an at least 6-month history of amenorrhea and elevated follicle-stimulating hormone levels in plasma. Most of the POF causes are idiopathic and hereditary, and chromosomal abnormalities have been associated with POF development. A pedigree study was performed on a family with idiopathic POF to observe the possible link between gene mutation and POF development. METHODS In total, eight women were diagnosed with POF and seven POF patients and five non-POF members from the same family were evaluated by whole exome sequencing and Sanger sequencing. An apoptotic assay, senescence staining, real-time polymerase chain reaction (qPCR) and overexpression of the peroxisome proliferator-activated receptor gamma coactivator-related 1 (PPRC1) gene were performed to examine the association of POF in vitro. RESULTS Through whole exome sequencing and Sanger sequencing, a novel point mutation (NM_015062: c.2902C>T:p.Thr958Ile) was identified and verified in the PPRC1 gene on chromosome 10 (10q24.32). The point mutation only presented in all the seven POF cases and not in non-POF cases or public databases. Subsequent expression of PPRC1 in COV434 granulosa cells showed that PPRC1 might be involved in regulating granulosa cell apoptosis but not senescence-associated POF development. CONCLUSIONS A novel point mutation in the PPRC1 gene was identified by the pedigree study and by sequence analysis of the case series with idiopathic POF in the present study. The subsequent PPRC1 expression analysis showed that PPRC1 was not involved in senescence-associated POF development. Further studies will be needed to confirm the link between PPRC1 gene mutation and POF.
Collapse
Affiliation(s)
- Xiao-Jin Zhang
- Obstertric and Gynecologic Hospital, Fudan University, Shanghai, China
| | - Yu Gu
- Obstertric and Gynecologic Hospital, Fudan University, Shanghai, China
| | - Wei Fu
- Obstertric and Gynecologic Hospital, Fudan University, Shanghai, China
- Shanghai Ji Ai Genetics and IVF Institute, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| |
Collapse
|
11
|
Safiyeh FD, Mojgan M, Parviz S, Sakineh MA, Behnaz SO. The effect of selenium and vitamin E supplementation on anti-Mullerian hormone and antral follicle count in infertile women with occult premature ovarian insufficiency: A randomized controlled clinical trial. Complement Ther Med 2020; 56:102533. [PMID: 33197657 DOI: 10.1016/j.ctim.2020.102533] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Increased accumulation of reactive oxygen species (ROS) in the process of oogenesis is one of the most well known causes of ovarian insufficiency and decreased ovarian reserve. Selenium and vitamin E as cofactors of glutathione peroxidase plays an important role in the removal of ROS in the ovary. We evaluated the effects of selenium and vitamin E supplementation on anti-Mullerian hormone (AMH) index and antral follicle count (AFC) (primary outcomes) and mean ovarian volume (MOV) and side effects of these supplements (secondary outcome) in infertile women with occult premature ovarian insufficiency (OPOI). METHODS 70 patients were allocated into the control and treatment groups through block randomization method. 35 women in the treatment group received 200 ng selenium and 400IU vitamin E and 35 women in the control group received placebo for a total of 90 days. AMH index, AFC and mean ovarian volume (MOV) were investigated in both groups after 12 months of study. RESULT There was no significant difference between groups before intervention in AMH (Mean difference: -0.08; 95% CI: -0.20 to.08; p=0.33), AFC (-0.71; 95%CI: -1.44 to -0.01; p=0.05) and MOV (-0.55; 95% CI: -0.85 to -0.24; p=0.001). There was a significant increase in AMH (mean difference: 0.59; 95% CI: 0.48 to 0.71; p<0.001), AFC (5.08; 95% CI: 4.36 to 5.08; p<0.001) and MOV (2.17; 95% CI: 1.87 to 2.47; p<0.001) in selenium + vitamin E group compared to placebo group 12 months after intervention. These supplements had no side effects. CONCLUSION Supplementation with selenium and vitamin E can increase AMH, AFC and MOV in women with OPOI.
Collapse
Affiliation(s)
- Farhadi Dizaji Safiyeh
- Department of midwifery, nursing and midwifery Faculty, Tabriz University of Medical sciences, Tabriz, Iran
| | - Mirghafourvand Mojgan
- Social Determinants of Health Research Center, Midwifery Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahabi Parviz
- Department of Physiology, Faculty of Medicine, Tabriz University of Medical sciences, Tabriz, Iran
| | - Mohammad Alizadeh Sakineh
- Department of midwifery, nursing and midwifery Faculty, Tabriz University of Medical sciences, Tabriz, Iran
| | - Sadeghzadeh Oskouei Behnaz
- Department of midwifery, nursing and midwifery Faculty, Tabriz University of Medical sciences, Tabriz, Iran.
| |
Collapse
|
12
|
Lin D, Quan H, Chen K, Lin L, Lin L, Ji Q. An adolescent girl with premature ovarian failure, Graves' disease, and chronic urticaria: a case report. J Med Case Rep 2020; 14:184. [PMID: 33038927 PMCID: PMC7548041 DOI: 10.1186/s13256-020-02491-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/07/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Premature ovarian failure is characterized by amenorrhea, hypoestrogenism, and hypergonadotropinism, and occurs in women under 40 years of age. The prevalence of premature ovarian failure in women younger than 20 years of age is only 0.01%. Immune disorders are one of the causes of premature ovarian failure. Graves' disease and chronic urticaria are also associated with immune disorders. CASE PRESENTATION We report a case of a 15-year-old Han Chinese girl with premature ovarian failure complicated by Graves' disease and chronic urticaria. She experienced menarche at 13 years of age and presented with amenorrhea after 7 months of irregular menstruation. Laboratory examinations indicated hypoestrogenism and hypergonadotropinism. Ultrasound imaging revealed that her uterus and ovaries were small in size. Gene and antibody tests related to premature ovarian failure returned negative results. Both thyroid peroxidase autoantibody and thyrotropin receptor antibody were positive. After reviewing the literature on the relationship between these three diseases and immune disorders, our patient was diagnosed as having atypical autoimmune polyglandular syndrome. After taking small doses of estrogen for 6 months, the size of her uterus increased, and her psychological anxiety was relieved. CONCLUSIONS We report a case of an unusual association of premature ovarian failure, Graves' disease, and chronic urticaria. This case presents an atypical combination of adolescent autoimmune polyglandular syndrome, which is worthy of the attention of clinicians and presents an important lesson for them. Our case highlights that premature ovarian failure in adolescents requires long-term follow-up and medical treatment as well as psychological counselling.
Collapse
Affiliation(s)
- Danhong Lin
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, No. 19, Xiuhua Road, Xiuying District, Haikou City, Hainan Province, China
| | - Huibiao Quan
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, No. 19, Xiuhua Road, Xiuying District, Haikou City, Hainan Province, China.
| | - Kaining Chen
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, No. 19, Xiuhua Road, Xiuying District, Haikou City, Hainan Province, China
| | - Lu Lin
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, No. 19, Xiuhua Road, Xiuying District, Haikou City, Hainan Province, China
| | - Leweihua Lin
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, No. 19, Xiuhua Road, Xiuying District, Haikou City, Hainan Province, China
| | - Qun Ji
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, No. 19, Xiuhua Road, Xiuying District, Haikou City, Hainan Province, China
| |
Collapse
|
13
|
Grootenhuis A, van den Hoogen A, Broekmans F, Torrance H, van Os-Medendorp H, Ockhuijsen H. Young women's opinions on the use of a blood test to predict the possibility of premature ovarian failure: a qualitative study. HUM FERTIL 2019; 24:304-314. [PMID: 31530237 DOI: 10.1080/14647273.2019.1665198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The anti-Müllerian hormone (AMH) test is increasingly being used to predict the age when women will enter menopause, signalling the end of their reproductive life. However, the accuracy of the AMH test varies widely. In this qualitative study, we asked young women of three differing education levels about the possibility of predicting premature ovarian failure (POF), defined as menopause that occurs before the age of 40. A total of 15 face-to-face semi-structured interviews were conducted. The overarching theme was 'considering the possibility of predicting POF', and the three interpretive themes were (i) limited fertility knowledge, (ii) preconditions for pregnancy and (iii) desire to have children. The interview was their first awareness of the concept of POF. All the women who participated in this study wished to have children at some point later in life and tended to think more about fulfilling preconditions before getting pregnant than about their actual fertility. Most participants (n = 8) were interested in the AMH test regardless of their education level. Five participants wanted to take the test in the future. This research provides some insight into young women's current thoughts about the possibility of predicting POF with an AMH test.
Collapse
Affiliation(s)
- Anouk Grootenhuis
- Clinical Health Sciences at the University Utrecht, Utrecht, The Netherlands
| | - Agnes van den Hoogen
- Department Women and Baby, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Frank Broekmans
- Department Women and Baby, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Helen Torrance
- Department Women and Baby, University Medical Centre Utrecht, Utrecht, The Netherlands
| | | | - Henrietta Ockhuijsen
- Department Women and Baby, University Medical Centre Utrecht, Utrecht, The Netherlands
| |
Collapse
|
14
|
Premature ovarian insufficiency (POI) and autoimmunity-an update appraisal. J Assist Reprod Genet 2019; 36:2207-2215. [PMID: 31440958 DOI: 10.1007/s10815-019-01572-0] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 08/16/2019] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Primary ovarian insufficiency (POI) represents ovarian dysfunction related to very early aging of the ovaries. While the cause of POI in a majority of clinical cases remains undefined, autoimmunity is responsible for approximately 4-30% of POI cases. In the present paper, we aim to provide a critical appraisal and update review on the role of autoimmunity in POI patients. METHODS A literature review was conducted for all relevant articles reporting on POI and autoimmunity. PubMed/MEDLINE and the Cochrane library were searched for the best available evidence on this topic. RESULTS Patients with POI and coexisting autoimmunity are indistinguishable from those with negative autoimmune screen with regard to age of onset, prevalence of primary amenorrhea, or their endocrine profiles. A specific noninvasive reliable diagnostic test for the diagnosis of an autoimmune etiology is lacking; therefore, patients should be screened for the most common autoantibodies, i.e., steroid cell antibodies, anti-ovarian antibodies, and anti-thyroid antibodies. Moreover, treatment strategies to POI infertility are lacking and controversial. CONCLUSIONS Nowadays, guidelines for the treatment of autoimmune POI are not available. Moreover, since diagnostic and treatment strategies to POI infertility are still lacking and controversial, further large clinical studies are needed to investigate the true impact of autoimmunity on POI and to identify the selected groups of patients who are most likely to benefit from immunossuprresive treatment.
Collapse
|
15
|
Domniz N, Meirow D. Premature ovarian insufficiency and autoimmune diseases. Best Pract Res Clin Obstet Gynaecol 2019; 60:42-55. [PMID: 31495598 DOI: 10.1016/j.bpobgyn.2019.07.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 07/23/2019] [Indexed: 01/13/2023]
Abstract
Premature ovarian insufficiency (POI) is a clinical syndrome defined by loss of ovarian activity before the age of 40 years and has a potentially devastating effect upon women's health, both physically and psychologically. An underlying autoimmune disease has been identified in approximately 20% of patients with POI, the most common of which are disorders of the thyroid and adrenal glands. Nevertheless, in the majority of cases, the etiology is unknown. The damage mechanism to the ovary is usually caused by antibodies, and autoimmune POI is usually characterized by cellular infiltration of the theca cells of growing follicles by various inflammatory cells. Yet, other various factors and proteins of unknown clinical significance are present. The major diagnostic tool for otherwise idiopathic POI is the presence of autoantibodies against various ovarian components that strongly support the option of autoimmune etiology of POI. Treatment of the underlying cause of POI is the main strategy, although immunosuppressive therapy should be considered in a selected population of well-defined autoimmune POI and, as in idiopathic POI, in whom the resumption of ovarian activity is possible.
Collapse
Affiliation(s)
- Noam Domniz
- Dept. Obstetrics and Gynecology, Sheba Medical Center, Tel Aviv University, Tel Hashomer, 52651, Israel.
| | - Dror Meirow
- Dept. Obstetrics and Gynecology, Sheba Medical Center, Tel Aviv University, Tel Hashomer, 52651, Israel
| |
Collapse
|
16
|
Condorelli M, Demeestere I. Challenges of fertility preservation in non-oncological diseases. Acta Obstet Gynecol Scand 2019; 98:638-646. [PMID: 30771251 DOI: 10.1111/aogs.13577] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 02/11/2019] [Indexed: 12/15/2022]
Abstract
Clinicians should provide fertility counseling to all patients receiving gonadotoxic treatment. International scientific societies have mainly focused on oncological patients, and fewer efforts have been made to apply these recommendations to women diagnosed with benign disease (eg benign hematological diseases, autoimmune diseases, and gynecological or genetic disorders). However, these indications account for 8%-13% of the demand for fertility preservation. The risk of premature ovarian failure due to treatment, or to the disease itself, can be considered fairly high for many young women. Counseling and adequate management of these women require particular attention due to the severe health conditions that are associated with some of these diseases. In this review, we address specific issues related to providing adequate fertility counseling and management for women who have been diagnosed with the major non-oncological indications, based on the literature and on our clinical experience.
Collapse
Affiliation(s)
- Margherita Condorelli
- Research Laboratory on Human Reproduction and Fertility Clinic, CUB-Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Isabelle Demeestere
- Research Laboratory on Human Reproduction and Fertility Clinic, CUB-Erasme, Université Libre de Bruxelles, Brussels, Belgium
| |
Collapse
|
17
|
Hossein-Rashidi B, Nemati M. Effects of Vitex agnus-castus extract on the secretory function of pituitary-gonadal axis and pregnancy rate in patients with premature ovarian aging (POA). J Herb Med 2017. [DOI: 10.1016/j.hermed.2017.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
18
|
Autoimmune premature ovarian failure. MENOPAUSE REVIEW 2017; 15:210-214. [PMID: 28250725 PMCID: PMC5327623 DOI: 10.5114/pm.2016.65666] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Accepted: 12/29/2016] [Indexed: 11/17/2022]
Abstract
Premature ovarian failure (POF), also termed as primary ovarian insufficiency (POI), is a highly heterogenous condition affecting 0.5-3.0% of women in childbearing age. These young women comprise quite a formidable group with unique physical and psychological needs that require special attention. Premature ovarian senescence (POS) in all of its forms evolves insidiously as a basically asymptomatic process, leading to complete loss of ovarian function, and POI/POF diagnoses are currently made at relatively late stages. Well-known and well-documented risk factors exist, and the presence or suspicion of autoimmune disorder should be regarded as an important one. Premature ovarian failure is to some degree predictable in its occurrence and should be considered while encountering young women with loss of menstrual regularity, especially when there is a concomitant dysfunction in the immune system.
Collapse
|
19
|
Izhar R, Husain S, Tahir S, Husain S. Occult Form of Premature Ovarian Insufficiency in Women with Infertility and Oligomenorrhea as Assessed by Poor Ovarian Response Criteria. J Reprod Infertil 2017; 18:361-367. [PMID: 29201666 PMCID: PMC5691252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the ability of poor ovarian response criteria to classify women presenting with infertility and oligomenorrhea as having "occult" premature ovarian insufficiency. METHODS This was a cross sectional study conducted at Aziz Medical Center, Karachi, Pakistan from 1st August 2015 to 31st July 2016. Women with infertility and oligomenorrhea were included. All eligible women underwent day 2 FSH level and an early follicular phase transvaginal ultrasound to assess the antral follicular count (AFC). All women then underwent the confirmatory test, of Anti-Mullerian Hormone (AMH) level. The main outcome measure was assignment to occult premature ovarian insufficiency (POI) after screening that used the criteria set out in fertility guideline for predicting the likely ovarian response to gonadotrophin stimulation. Another measure was to compare the sensitivity and specificity of the two index criteria, of FSH and AFC, relative to the emerging reference standard, of the AMH criterion. RESULTS The three criteria together classified 59 (34.91%) women as occult POI in those with oligomenorrhea. The sensitivity, specificity, negative predictive value and positive predictive value of FSH relative to AMH for these women were 77.8%, 95.7%, 90.2% and 89.4%, respectively whereas the same values of AFC relative to AMH were 92.6%, 99.1 %, 96.6% and 98%, respectively. CONCLUSION Women with menstrual irregularity and infertility are at a higher risk for satisfying criteria of poor ovarian response irrespective of age. A policy incorporating these surrogate markers can be used to screen these women for occult premature ovarian insufficiency.
Collapse
Affiliation(s)
- Rubina Izhar
- Department of Gynaecology and Obstetrics, Abbasi Shaheed Hospital and Karachi Medical and Dental College, Karachi, Pakistan,Aziz Medical Center, Karachi, Pakistan
| | - Samia Husain
- Department of Gynaecology and Obstetrics, Abbasi Shaheed Hospital and Karachi Medical and Dental College, Karachi, Pakistan,Corresponding Author: Samia Husain, Department of Gynaecology and Obstetrics, Abbasi Shaheed Hospital and Karachi Medical and Dental College, Karachi, Pakistan E-mail:
| | | | - Sonia Husain
- Department of Gynaecology and Obstetrics, Abbasi Shaheed Hospital and Karachi Medical and Dental College, Karachi, Pakistan
| |
Collapse
|
20
|
Abstract
Premature ovarian insufficiency (POI) is a life-changing diagnosis, with profound physical and psychological consequences. Despite the description of different genetic, immune and iatrogenic factors of POI, the etiology of most cases of this disease are unexplained, and optimal management strategies are still unclear. Recent data showed that POI may have a long period of oligomenorrhea before the fully developed form (complete ovarian failure stage), with the occurrence of amenorrhea and climacteric symptoms. The main problem in the recognition of early stages of POI is the lack of proper diagnostic criteria. Patients with an undiagnosed occult form of POI may present with menstrual irregularities, unexplained infertility or repeated IVF failures. We evaluated 23 patients with unexplained oligomenorrhea and/or infertility. After a proper evaluation of these patients, a low ovarian reserve was identified, and an occult form of POI was diagnosed.
Collapse
Affiliation(s)
- I G Shestakova
- a Department of Obstetrics and Gynecology with Course of Perinatology of the Russian University of Peoples' Friendship , Moscow , Russia
| | - V E Radzinsky
- a Department of Obstetrics and Gynecology with Course of Perinatology of the Russian University of Peoples' Friendship , Moscow , Russia
| | - M B Khamoshina
- a Department of Obstetrics and Gynecology with Course of Perinatology of the Russian University of Peoples' Friendship , Moscow , Russia
| |
Collapse
|
21
|
Ruth KS, Bennett CE, Schoemaker MJ, Weedon MN, Swerdlow AJ, Murray A. Length of FMR1 repeat alleles within the normal range does not substantially affect the risk of early menopause. Hum Reprod 2016; 31:2396-403. [PMID: 27614355 PMCID: PMC5027929 DOI: 10.1093/humrep/dew204] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 07/22/2016] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Is the length of FMR1 repeat alleles within the normal range associated with the risk of early menopause? SUMMARY ANSWER The length of repeat alleles within the normal range does not substantially affect risk of early menopause. WHAT IS KNOWN ALREADY There is a strong, well-established relationship between length of premutation FMR1 alleles and age at menopause, suggesting that this relationship could continue into the normal range. Within the normal range, there is conflicting evidence; differences in ovarian reserve have been identified with FMR1 repeat allele length, but a recent population-based study did not find any association with age at menopause as a quantitative trait. STUDY DESIGN, SIZE, DURATION We analysed cross-sectional baseline survey data collected at recruitment from 2004 to 2010 from a population-based, prospective epidemiological cohort study of >110 000 women to investigate whether repeat allele length was associated with early menopause. PARTICIPANTS/MATERIALS, SETTING, METHOD We included 4333 women from the Breakthrough Generations Study (BGS), of whom 2118 were early menopause cases (menopause under 46 years) and 2215 were controls. We analysed the relationship between length of FMR1 alleles and early menopause using logistic regression with allele length as continuous and categorical variables. We also conducted analyses with the outcome age at menopause as a quantitative trait as well as appropriate sensitivity and exploratory analyses. MAIN RESULTS AND THE ROLE OF CHANCE There was no association of the shorter or longer FMR1 allele or their combined genotype with the clinically relevant end point of early menopause in our main analysis. Likewise, there were no associations with age at menopause as a quantitative trait in our secondary analysis. LIMITATIONS, REASONS FOR CAUTION Women with homozygous alleles in the normal range may have undetected FMR1 premutation alleles, although there was no evidence to suggest this. We estimate minor dilution of risk of early menopause from the likely inclusion of some women with menopause at over 45 years in the early menopause cases due to age-rounding bias in self-reports. WIDER IMPLICATIONS OF THE FINDINGS There is no robust evidence in this large study that variation within the normal range of FMR1 repeat alleles influences timing of menopause in the general population, which contradicts findings from some earlier, mainly smaller studies. The FMR1 CGG repeat polymorphism in the normal range is unlikely to contribute to genetic susceptibility to early menopause. STUDY FUNDING/COMPETING INTERESTS We thank Breast Cancer Now and The Institute of Cancer Research for funding the BGS. The Institute of Cancer Research acknowledges NHS funding to the NIHR Biomedical Research Centre. The study was funded by the Wellcome Trust (grant number 085943). There are no competing interests. TRIAL REGISTRATION NUMBER Not applicable.
Collapse
Affiliation(s)
- Katherine S Ruth
- Genetics of Complex Traits, University of Exeter Medical School, RILD Level 3, Royal Devon & Exeter Hospital, Barrack Road, Exeter, EX2 5DW, UK
| | - Claire E Bennett
- Genetics of Complex Traits, University of Exeter Medical School, RILD Level 3, Royal Devon & Exeter Hospital, Barrack Road, Exeter, EX2 5DW, UK
| | - Minouk J Schoemaker
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK
| | - Michael N Weedon
- Genetics of Complex Traits, University of Exeter Medical School, RILD Level 3, Royal Devon & Exeter Hospital, Barrack Road, Exeter, EX2 5DW, UK
| | - Anthony J Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London, UK Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
| | - Anna Murray
- Genetics of Complex Traits, University of Exeter Medical School, RILD Level 3, Royal Devon & Exeter Hospital, Barrack Road, Exeter, EX2 5DW, UK
| |
Collapse
|
22
|
Maslow BSL, Davis S, Engmann L, Nulsen JC, Benadiva CA. Correlation of normal-range FMR1 repeat length or genotypes and reproductive parameters. J Assist Reprod Genet 2016; 33:1149-55. [PMID: 27189053 DOI: 10.1007/s10815-016-0732-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 05/06/2016] [Indexed: 12/15/2022] Open
Abstract
PURPOSE This study aims to ascertain whether the length of normal-ranged CGG repeats on the FMR1 gene correlates with abnormal reproductive parameters. METHODS We performed a retrospective, cross-sectional study of all FMR1 carrier screening performed as part of routine care at a large university-based fertility center from January 2011 to March 2014. Correlations were performed between normal-range FMR1 length and baseline serum anti-Müllerian hormone (AMH), cycle day 3 follicle stimulating hormone (FSH), ovarian volumes (OV), antral follicle counts (AFC), and incidence of diminished ovarian reserve (DOR), while controlling for the effect of age. RESULTS Six hundred three FMR1 screening results were collected. One subject was found to be a pre-mutation carrier and was excluded from the study. Baseline serum AMH, cycle day 3 FSH, OV, and AFC data were collected for the 602 subjects with normal-ranged CGG repeats. No significant difference in median age was noted amongst any of the FMR1 repeat genotypes. No significant correlation or association was found between any allele length or genotype, with any of the reproductive parameters or with incidence of DOR at any age (p > 0.05). However, subjects who were less than 35 years old with low/low genotype were significantly more likely to have below average AMH levels compared to those with normal/normal genotype (RR 3.82; 95 % CI 1.38-10.56). CONCLUSIONS This large study did not demonstrate any substantial association between normal-range FMR1 repeat lengths and reproductive parameters.
Collapse
Affiliation(s)
- Bat-Sheva L Maslow
- Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, 2 Batterson Park Rd, Farmington, CT, 06032, USA
| | - Stephanie Davis
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA
| | - Lawrence Engmann
- Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, 2 Batterson Park Rd, Farmington, CT, 06032, USA
| | - John C Nulsen
- Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, 2 Batterson Park Rd, Farmington, CT, 06032, USA
| | - Claudio A Benadiva
- Division of Reproductive Endocrinology and Infertility, University of Connecticut School of Medicine, 2 Batterson Park Rd, Farmington, CT, 06032, USA.
| |
Collapse
|
23
|
Banks N, Patounakis G, Devine K, DeCherney AH, Widra E, Levens ED, Whitcomb BW, Hill MJ. Is FMR1 CGG repeat length a predictor of in vitro fertilization stimulation response or outcome? Fertil Steril 2016; 105:1537-1546.e8. [PMID: 26940792 DOI: 10.1016/j.fertnstert.2016.02.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 02/03/2016] [Accepted: 02/04/2016] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To study a broad range of FMR1 CGG repeat lengths and assisted reproduction technology (ART) outcomes. DESIGN Retrospective cohort study. SETTING Private ART practice. PATIENT(S) Fresh autologous ART stimulation cycles. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Oocyte yield, live birth. RESULT(S) We screened 14,088 fresh autologous ART cycles from 2012 to 2015, of which 4,690 cycles in 3,290 patients met the inclusion criteria. The FMR1 repeat length was statistically significantly but weakly associated with oocyte yield and other markers of ovarian response. The receiver operating characteristic curve analysis suggested extremely limited predictive ability. Moreover, the FMR1 repeat length was not statistically significantly associated with outcomes in multivariable models, including other markers of ovarian reserve. The FMR1 repeat length was not associated with embryo quality or live birth. Only patient age had a strong ability to predict live birth. CONCLUSION(S) The FMR1 repeat length is associated with ART response, but only weakly. It provides no incremental predictive ability beyond the conventionally used predictors, including patient age, antimüllerian hormone concentration, antral follicle count, and follicle-stimulating hormone level. These data suggest a possible role of the FMR1 repeat length within the normal range in ovarian response but demonstrate no clinically relevant indication for testing FMR1 as a predictor of ART outcomes.
Collapse
Affiliation(s)
- Nicole Banks
- Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - George Patounakis
- Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Kate Devine
- Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Shady Grove Fertility Science Center, Rockville, Maryland
| | - Alan H DeCherney
- Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - Eric Widra
- Shady Grove Fertility Science Center, Rockville, Maryland
| | - Eric D Levens
- Shady Grove Fertility Science Center, Rockville, Maryland
| | - Brian W Whitcomb
- Division of Biostatistics and Epidemiology, University of Massachusetts School of Public Health and Health Sciences, Amherst, Massachusetts
| | - Micah J Hill
- Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland.
| |
Collapse
|
24
|
Fu C, Begum K, Overbeek PA. Primary Ovarian Insufficiency Induced by Fanconi Anemia E Mutation in a Mouse Model. PLoS One 2016; 11:e0144285. [PMID: 26939056 PMCID: PMC4777492 DOI: 10.1371/journal.pone.0144285] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Accepted: 01/18/2016] [Indexed: 01/18/2023] Open
Abstract
In most cases of primary ovarian insufficiency (POI), the cause of the depletion of ovarian follicles is unknown. Fanconi anemia (FA) proteins are known to play important roles in follicular development. Using random insertional mutagenesis with a lentiviral transgene, we identified a family with reduced fertility in the homozygous transgenic mice. We identified the integration site and found that the lentivirus had integrated into intron 8 of the Fanconi E gene (Fance). By RT-PCR and in situ hybridization, we found that Fance transcript levels were significantly reduced. The Fance homozygous mutant mice were assayed for changes in ovarian development, follicle numbers and estrous cycle. Ovarian dysplasias and a severe lack of follicles were seen in the mutant mice. In addition, the estrous cycle was disrupted in adult females. Our results suggest that POI has been induced by the Fance mutation in this new mouse model.
Collapse
Affiliation(s)
- Chun Fu
- Department of Obstetrics and Gynecology, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas, United States of America
- * E-mail:
| | - Khurshida Begum
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas, United States of America
| | - Paul A. Overbeek
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas, United States of America
| |
Collapse
|
25
|
Gleicher N, Yu Y, Himaya E, Barad DH, Weghofer A, Wu YG, Albertini DF, Wang VQ, Kushnir VA. Early decline in functional ovarian reserve in young women with low (CGGn < 26) FMR1 gene alleles. Transl Res 2015. [PMID: 26209748 DOI: 10.1016/j.trsl.2015.06.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Mouse fmr1 models, and recent cross-sectional human data, suggest that different triple CGGn ranges of the fragile X mental retardation 1 (FMR1) gene are associated with variations in ovarian aging and infertility treatment outcomes. The FMR1 mutation affecting reproductive function most negatively in humans is the so-called low mutation, characterized by CGGn < 26. We here present a first longitudinal study of selected young women with normal functional ovarian reserve (FOR). In a prospective cohort study, we selected among 233 young oocyte donors (mean age 24.8 ± 3.3 years) as study population of 66 who had more than 1 anti-Müllerian hormone (AMH) level drawn over a 4-year period. AMH curves, as reflection of FOR, were then statistically compared between women with and without low FMR1 alleles. Biallelic low FMR1 (hom-low/low) donors already at initial presentation demonstrated significantly lower FOR than donors with biallelic normal (norm) FMR1 (CGGn = 26-34; P = 0.001). Although monoallelic low FMR1 at initial presentation was not yet associated with decreased FOR, it over 4 years did demonstrate significantly enhanced declines in FOR (P = 0.046). Including repeat measurements, low/low (P = 0.006) and high/high (CGGn > 34) alleles (P < 0.001) demonstrated lower FOR by AMH than norm donors. Even monoallelic low FMR1 alleles are, thus, already at young female ages associated with accelerated declines in FOR. Low FMR1 alleles, therefore, potentially represent a screening tool for women at genetic risk toward premature ovarian senescence, representing in all races circa 10% of the female population.
Collapse
Affiliation(s)
- Norbert Gleicher
- Center for Human Reproduction, New York, NY; Foundation for Reproductive Medicine, New York, NY; Stem Cell Biology and Molecular Embryology Laboratory, The Rockefeller University, New York, NY.
| | - Yao Yu
- Center for Human Reproduction, New York, NY
| | - Erik Himaya
- Gatineau Hospital, McGill University, Montréal, Quebec, Canada
| | - David H Barad
- Center for Human Reproduction, New York, NY; Foundation for Reproductive Medicine, New York, NY; Department of Obstetrics and Gynecology, Albert Einstein College of Medicine, Bronx, NY
| | - Andrea Weghofer
- Center for Human Reproduction, New York, NY; Department of Obstetrics and Gynecology, University of Vienna School of Medicine, Vienna, Austria
| | | | - David F Albertini
- Center for Human Reproduction, New York, NY; Department of Molecular and Integrative Physiology, University of Kansas School of Medicine, Wichita, KS
| | | | - Vitaly A Kushnir
- Center for Human Reproduction, New York, NY; Department of Obstetrics and Gynecology, Wake Forest School of Medicine, Winston-Salem, NC
| |
Collapse
|
26
|
[Does the serum AMH assay allow predicting reliably female fertility?]. ACTA ACUST UNITED AC 2015; 43:670-5. [PMID: 26388252 DOI: 10.1016/j.gyobfe.2015.08.004] [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: 07/22/2015] [Accepted: 08/19/2015] [Indexed: 11/22/2022]
Abstract
In women, the anti-Müllerian hormone (AMH) is secreted by the granulosa cells of growing follicles. Its measurement is strongly correlated with antral follicle count and represents a reliable marker of ovarian reserve. It also has the advantage of being highly reproducible since it has little variation within and between cycles. However, although it seems to be a good quantitative reflection of the ovarian reserve, it does not assess the oocyte quality. This drawback precludes any good prediction of female fertility in the general population. However, the AMH assay can become an indirect marker of female fertility in some situations at risk for premature ovarian failure or in the polycystic ovary syndrome. Its interest is no more to be proven in assisted reproductive technology where it is a valuable aid to the choice of the proposed techniques, ovarian stimulation protocols and gonadotropin doses. AMH is finally very informative in monitoring cancer patients having received ovariotoxic drugs or having undergone mutilating ovarian surgeries. In conclusion, although it cannot be considered itself as a reliable predictor of pregnancy in women, AMH is now a must in the management and treatment of female infertility.
Collapse
|