1
|
Mahdavinezhad F, Gharaei R, Farmani AR, Hashemi F, Kouhestani M, Amidi F. The Potential Relationship Between Different Human Female Reproductive Disorders and Sperm Quality in Female Genital Tract. Reprod Sci 2021; 29:695-710. [PMID: 33852138 DOI: 10.1007/s43032-021-00520-7] [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: 10/03/2020] [Accepted: 02/25/2021] [Indexed: 11/26/2022]
Abstract
Spermatozoa should travel throughout the female reproductive tract to reach its ultimate goal, fertilization of the oocyte. At the ejaculation moment, millions of sperm within a few milliliters of the ejaculate are deposited at the cranial segment of vagina and make their journey to the fertilization site. This is done by means of various factors, such as sperm motility, the uterine and fallopian tubes contractility, and the ciliary movement of the lining cells. During this migration, spermatozoa interact with the female microenvironment both physically and molecularly. In this regard, the quality of the environmental conditions may affect this interaction. Therefore, some alterations in women's genital tract microenvironment, such as conditions that occur in female reproductive disorders, may have detrimental effects on sperm reproductive function. In this review, human sperm migration through the female tract is described, and the potential effects of different reproductive disorders at reproductive organs, such as vagina, uterine cervix, uterus, fallopian tubes, and ovary on sperm survival and quality, are also argued. The understanding of those conditions that may impair sperm fertility in the female genital tract can provide a more accurate diagnosis of the causes of infertility in couples. This can ultimately lead to the discovery of effective treatment approaches.
Collapse
Affiliation(s)
- Forough Mahdavinezhad
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Roghaye Gharaei
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Farmani
- Department of Tissue Engineering, Faculty of Advanced Technologies, Tehran University of Medical Sciences, Tehran, Iran
| | - Farideh Hashemi
- Department of Molecular Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mahsa Kouhestani
- Department of Tissue Engineering, Faculty of Advanced Technologies, Tehran University of Medical Sciences, Tehran, Iran
| | - Fardin Amidi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Infertility, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
2
|
Tan Y, Zheng S, Lei W, Wang F, Jiang S, Zeng T, Zhou B, Hong F. Ethiodized poppyseed oil versus ioversol for image quality and adverse events in hysterosalpingography: a prospective cohort study. BMC Med Imaging 2019; 19:50. [PMID: 31234782 PMCID: PMC6591817 DOI: 10.1186/s12880-019-0346-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 05/29/2019] [Indexed: 11/25/2022] Open
Abstract
Background This study aimed to investigate the image quality and adverse events (AEs) of ethiodized poppyseed oil (EPO) compared with ioversol as contrast agents in hysterosalpingography (HSG). Methods Two hundred twenty-eight patients underwent HSG were consecutively recruited in this prospective cohort study, and were accordingly divided into EPO group (N = 165) and ioversol group (N = 63). The quality of image was assessed according to the European Guidelines on quality criteria for diagnostic radiographic images. AEs during, within 2 h and at 1-month post-HSG were recorded. Results EPO displayed elevated image quality compared with ioversol including the total image quality score (P < 0.001), the cervical canal display score (P < 0.001), shape and outline of uterus score (P < 0.01), cervical mucosa or folds score (P < 0.001), oviduct isthmus score (P < 0.001), ampulla and fimbriae of oviduct score (P < 0.001) and celiac diffuse image score (P < 0.001). Multivariate linear regression displayed that EPO (P < 0.001) was an independent predictive factor for increased total image quality score. AEs were similar between EPO group and ioversol group during and within 2 h post-HSG (all P > 0.05). However, at 1-month post-HSG, the number of patients had unchanged and faded menstrual blood color decreased but the proportion of patients with deepened menstrual color increased in EPO group compared with ioversol group (P = 0.007). In addition, the number of patients had iodine residue in uterine cavity was elevated in EPO group compared with ioversol group (P < 0.001). Conclusion EPO is more efficient in image quality and equally tolerant compared to ioversol as contrast agents in HSG. Electronic supplementary material The online version of this article (10.1186/s12880-019-0346-0) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Yiqing Tan
- Department of Radiology, Wuhan Third Hospital, Tongren Hospital of Wuhan University, 241 Liuyang Road, Wuhan, 430063, Hubei, China.
| | - Shilin Zheng
- Department of Radiology, Wuhan Third Hospital, Tongren Hospital of Wuhan University, 241 Liuyang Road, Wuhan, 430063, Hubei, China
| | - Wenfeng Lei
- Department of Radiology, Wuhan Third Hospital, Tongren Hospital of Wuhan University, 241 Liuyang Road, Wuhan, 430063, Hubei, China
| | - Fuhua Wang
- Department of Radiology, Wuhan Third Hospital, Tongren Hospital of Wuhan University, 241 Liuyang Road, Wuhan, 430063, Hubei, China
| | - Shengpan Jiang
- Department of Radiology, Wuhan Third Hospital, Tongren Hospital of Wuhan University, 241 Liuyang Road, Wuhan, 430063, Hubei, China
| | - Ting Zeng
- Department of Radiology, Wuhan Third Hospital, Tongren Hospital of Wuhan University, 241 Liuyang Road, Wuhan, 430063, Hubei, China
| | - Bei Zhou
- Department of Radiology, Wuhan Third Hospital, Tongren Hospital of Wuhan University, 241 Liuyang Road, Wuhan, 430063, Hubei, China
| | - Fan Hong
- Department of Radiology, Wuhan Third Hospital, Tongren Hospital of Wuhan University, 241 Liuyang Road, Wuhan, 430063, Hubei, China
| |
Collapse
|
4
|
Seyedoshohadaei F, Mohammadbeigi R, Tahmuri A, Ghaderi E. Frequency and related factors of tubal patency after methotrexate treatment in women with ectopic pregnancy. J Obstet Gynaecol Res 2015; 42:286-90. [PMID: 26694788 DOI: 10.1111/jog.12894] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 08/27/2015] [Accepted: 10/04/2015] [Indexed: 11/27/2022]
Abstract
AIM Ectopic pregnancy is a medical emergency. The classic treatment for this condition is surgery but early diagnosis allows for non-surgical treatment. In recent years, intramuscular methotrexate has been considered, due to easy administration, its less invasive nature and low complications, but there are arguments about its effects. The aim of this study was to evaluate tubal patency after treatment of ectopic pregnancy with methotrexate and related factors. METHODS This cross-sectional study was conducted on 80 women with ectopic pregnancy who were admitted to Sanandaj Be'sat Hospital in 2014. Patients who had successful treatment for ectopic pregnancy with single or multiple doses of methotrexate 50 mL/m(2) were enrolled. Three to 6 months after treatment, the patients were evaluated for tubal patency by hysterosalpingography. Data were analyzed using spss, t-tests, χ(2) -test and logistic regression. RESULTS The tubal patency rate after treatment of ectopic pregnancy with methotrexate was 75% in hysterosalpingography. The average size of the ectopic pregnancy mass of women with open fallopian tubes was 22.5 ± 7.0 mm and for women with closed fallopian tubes it was 34.7 ± 10.0 mm (P = 0.0001). β-human chorionic gonadotropin levels were 642.1 ± 850.5 in women with open fallopian tubes and 3816.3 ± 4487.3 for women with closed fallopian tubes (P = 0.0001). There was no significant correlation statistically between tubal patency with a history of stillbirth and number of pregnancies (P > 0.5). There was a statistically significant relation between tubal patency and the number of births and also methotrexate dose (P < 0.05). CONCLUSION Treatment of ectopic pregnancy with methotrexate is effective for saving tubal patency. Levels of human chorionic gonadotrophin-β < 1745, the treatment regimen of methotrexate (single or multiple doses) and ectopic pregnancy mass size smaller than 33.5 mm are significant predictors of tubal patency.
Collapse
Affiliation(s)
- Fariba Seyedoshohadaei
- Department of Obstetrics & Gynecology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | | | - Atefe Tahmuri
- Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ebrahim Ghaderi
- Research Center for Social Determinants of Health, Kurdistan University of Medical Sciences, Sanandaj, Iran
| |
Collapse
|
5
|
The Value of Hysterosalpingography following Medical Treatment with Methotrexate for Ectopic Pregnancy. Obstet Gynecol Int 2011; 2011:547946. [PMID: 21961008 PMCID: PMC3180780 DOI: 10.1155/2011/547946] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Revised: 07/21/2011] [Accepted: 07/26/2011] [Indexed: 11/18/2022] Open
Abstract
After an ectopic pregnancy (EP) fertility decreases, mostly due to tubal factor. Hysterosalpingography (HSG) is the most cost-effective tool for tubal patency assessment. Objective. To evaluate the usefulness of a HSG after a medical treatment for an EP, in order to counsel women on the most appropriate way to conceive future pregnancies. Methods. Between 1998 and 2008, 144 patients were submitted to medical treatment for an EP and performed HSG 3 months after the event. Results. 72.2% of normal HSG, 18.8% with unilateral obstruction, 6.3% tubal patency with defect, and 2.8% bilateral obstruction. Conclusion. Routine HSG following medical treatment for an EP does not seem necessary, as it does not change the initial management in 97.2% of the cases, but might be considered in selected risk cases, permitting timely referral of patients to in vitro fertilization.
Collapse
|
6
|
Helmy S, Sawyer E, Ofili-Yebovi D, Yazbek J, Ben Nagi J, Jurkovic D. Fertility outcomes following expectant management of tubal ectopic pregnancy. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2007; 30:988-993. [PMID: 18044813 DOI: 10.1002/uog.5186] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVES To evaluate fertility outcome after the expectant management of tubal ectopic pregnancy. METHODS Our dedicated early pregnancy database was searched for all women diagnosed with a tubal ectopic pregnancy between January 1999 and June 2003 who were either managed expectantly or underwent a salpingectomy. They were contacted to enquire about their ability to conceive following the ectopic pregnancy and about the outcomes of any subsequent pregnancies. RESULTS Four hundred and forty-four women had a diagnosis of tubal ectopic pregnancy, and 173 (39%) were successfully contacted. A total of 146/173 (84.4%; 95% CI, 79-89.8%) tried for another pregnancy: 49/59 (83.1%; 95% CI, 73.4-92.6%) in the expectant management and 97/114 (85.1%; 95% CI, 78.4-91.6%) in the salpingectomy group (P > 0.05). Spontaneous intrauterine pregnancy occurred in 41/49 (83.7%; 95% CI, 73.3-94.2%) women managed expectantly and in 62/97 (63.9%; 95% CI, 54.4-73.5%) women managed surgically (odds ratio 2.89; 95% CI, 1.22-6.86%). The risk of recurrent ectopic pregnancy was not significantly different between the two management groups. CONCLUSIONS Fertility outcomes following the expectant management of tubal ectopic pregnancy are comparable to those following salpingectomy.
Collapse
Affiliation(s)
- S Helmy
- Early Pregnancy and Gynaecology Assessment Unit, King's College Hospital, London, UK
| | | | | | | | | | | |
Collapse
|