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Jangid P, Rai U, Sharma RS, Singh R. The role of non-ionizing electromagnetic radiation on female fertility: A review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:358-373. [PMID: 35132884 DOI: 10.1080/09603123.2022.2030676] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 01/13/2022] [Indexed: 06/14/2023]
Abstract
With increasing technological developments, exposure to non-ionizing radiations has become unavoidable as people cannot escape from electromagnetic field sources, such as Wi-Fi, electric wires, microwave oven, radio, telecommunication, bluetooth devices, etc. These radiations can be associated with increased health problems of the users. This review aims to determine the effects of non-ionizing electromagnetic radiations on female fertility. To date, several in vitro and in vivo studies unveiled that exposure to non-ionizing radiations brings about harmful effects on oocytes, ovarian follicles, endometrial tissue, estrous cycle, reproductive endocrine hormones, developing embryo, and fetal development in animal models. Non-ionizing radiation also upsurges the free radical load in the uterus and ovary, which leads to inhibition of cell growth and DNA disruptions. In conclusion, non-ionizing electromagnetic radiations can cause alterations in both germ cells as well as in their nourishing environment and also affect other female reproductive parameters that might lead to infertility.
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Affiliation(s)
- Pooja Jangid
- Department of Environmental Studies, Satyawati College, University of Delhi, Delhi, India
| | - Umesh Rai
- Department of Zoology, University of Delhi, Delhi, India
| | - Radhey Shyam Sharma
- Department of RBMH & CH, Indian Council of Medical Research, New Delhi, India
| | - Rajeev Singh
- Department of Environmental Studies, Satyawati College, University of Delhi, Delhi, India
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Guarnotta V, Amodei R, Frasca F, Aversa A, Giordano C. Impact of Chemical Endocrine Disruptors and Hormone Modulators on the Endocrine System. Int J Mol Sci 2022; 23:ijms23105710. [PMID: 35628520 PMCID: PMC9145289 DOI: 10.3390/ijms23105710] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/14/2022] [Accepted: 05/17/2022] [Indexed: 11/16/2022] Open
Abstract
There is growing concern regarding the health and safety issues of endocrine-disrupting chemicals (EDCs). Long-term exposure to EDCs has alarming adverse health effects through both hormone-direct and hormone-indirect pathways. Non-chemical agents, including physical agents such as artificial light, radiation, temperature, and stress exposure, are currently poorly investigated, even though they can seriously affect the endocrine system, by modulation of hormonal action. Several mechanisms have been suggested to explain the interference of EDCs with hormonal activity. However, difficulty in quantifying the exposure, low standardization of studies, and the presence of confounding factors do not allow the establishment of a causal relationship between endocrine disorders and exposure to specific toxic agents. In this review, we focus on recent findings on the effects of EDCs and hormone system modulators on the endocrine system, including the thyroid, parathyroid glands, adrenal steroidogenesis, beta-cell function, and male and female reproductive function.
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Affiliation(s)
- Valentina Guarnotta
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), Section of Endocrinology, University of Palermo, Piazza delle Cliniche 2, 90127 Palermo, Italy; (V.G.); (R.A.)
| | - Roberta Amodei
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), Section of Endocrinology, University of Palermo, Piazza delle Cliniche 2, 90127 Palermo, Italy; (V.G.); (R.A.)
| | - Francesco Frasca
- Endocrinology Section, Department of Clinical and Experimental Medicine, Garibaldi Nesima Hospital, University of Catania, 95122 Catania, Italy;
| | - Antonio Aversa
- Department of Experimental and Clinical Medicine, Section of Endocrinology, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy;
| | - Carla Giordano
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), Section of Endocrinology, University of Palermo, Piazza delle Cliniche 2, 90127 Palermo, Italy; (V.G.); (R.A.)
- Correspondence: ; Tel.: +39-0916552110
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Mohammed S, Sundaram V, Adidam Venkata CR, Zyuzikov N. Polycystic ovary rat model exposure to 150 kHz intermediate frequency: hypothalamic-pituitary-ovarian axis at the receptor, cellular, tissue, and hormone levels. J Ovarian Res 2021; 14:173. [PMID: 34895279 PMCID: PMC8665544 DOI: 10.1186/s13048-021-00914-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/27/2021] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION The hypothalamic-pituitary-ovarian (HPO) axis is the principal regulator of the reproductive system. The neurons in the arcuate nucleus of the hypothalamus signal the basophilic cells of the anterior pituitary to release luteinizing hormone (LH) and follicle stimulating hormone (FSH), which bind to the granulosa and theca cells of a follicle in the ovary to promote healthy follicular development. Disruption of this process at any time can lead to polycystic ovaries and, if left untreated, can lead to Polycystic Ovarian Syndrome (PCOS), one of the leading causes of infertility. A novel treatment option using 150 kHz Intermediate Frequency (IF) Electromagnetic Radiation (EMR) has been proposed to monitor the effect of this frequency during cystic development. METHODS To prove this, an experiment was conducted to study the effect of whole-body exposure to 150 kHz EMR for 8 weeks at receptor, cellular, tissue and hormonal levels on the HPO axis of 25 young cyclic female rats. RESULTS The results showed that 150 kHz EMR did not affect the histoarchitecture of neurons of arcuate nucleus of the hypothalamus of PCO-induced rats. It was also found that the number of basophilic cells of the pituitary gland was increased and the immunoreactivity of LH and FSH secretion increased. This EMR field also decreased the development of follicular cysts in the ovary and possibly increased the immunoreactivity of the LH and FSH receptors as well on the theca and granulosa cells of follicles in the ovary. CONCLUSION There are still many limitations to this study. If properly evaluated, the results of this experiment could help develop a new non-invasive treatment option for women with PCOS in the near future.
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Affiliation(s)
- Stephanie Mohammed
- Department of Physics, Faculty of Science and Technology, The University of the West Indies, St. Augustine, West Indies, Trinidad and Tobago.
| | - Venkatesan Sundaram
- Department of Basic Veterinary Sciences, School of Veterinary Medicine, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, West Indies, Trinidad and Tobago.
| | - Chalapathi R Adidam Venkata
- Department of Clinical Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, West Indies, Trinidad and Tobago
| | - Nikolay Zyuzikov
- Department of Physics, Faculty of Science and Technology, The University of the West Indies, St. Augustine, West Indies, Trinidad and Tobago
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Mohammed S, Sundaram V, Zyuzikov N. Effect of 150 kHz electromagnetic radiation on the development of polycystic ovaries induced by estradiol Valerate in Sprague Dawley rats. J Ovarian Res 2021; 14:26. [PMID: 33546719 PMCID: PMC7866699 DOI: 10.1186/s13048-021-00774-4] [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: 12/08/2020] [Accepted: 01/25/2021] [Indexed: 11/23/2022] Open
Abstract
Background Polycystic ovary syndrome (PCOS) is the most common complex endocrine disorder affecting approximately 2–20% of reproductive aged females. Tumour Treating Fields (100–300 kHz) is a recent innovative, non-invasive therapeutic approach to cancer therapy. This frequency as an alternative therapy for the management of polycystic ovaries has not yet been explored. Objectives To explore the effect of full-body exposure of 150 kHz Electromagnetic Radiation (EMR), on the development of polycystic ovaries in an estradiol valerate-induced PCO rat model. Method Twenty-one female adult rats were divided into three groups (n = 7 each): control, Estradiol Valerate (EV) and EV + EMR groups. The EV + EMR group was subjected to full body exposure at 150 kHz EMR continuously for eight consecutive weeks. Estradiol valerate was administered orally to induce polycystic ovaries in EV and EV + EMR groups. Body and ovarian weights were recorded and analysed. The regularity of the estrous cycle was assessed in all three groups. The histological study of ovarian tissue was carried out by haematoxylin and eosin staining. The serum concentration levels of Luteinizing Hormone (LH), Follicle-Stimulating Hormone (FSH) and testosterone were measured using the ELISA method. Results The body and ovary weights did not differ significantly between the EV and EV + EMR groups. The estrous cycle was found to be irregular in both the EV and EV + EMR groups. Ovarian histology revealed near normal morphology with little or no degenerative and morphological changes in developing follicles in the exposed group. Histometrical analysis showed an increased number of developing follicles and a significant reduction in the number and size of follicular cysts (p < 0.05) in the EV + EMR group. Hormonal analysis revealed no significant difference in the testosterone and FSH levels between the EV + EMR and EV groups. However, the LH, LH/FSH ratio decreased significantly in the EV + EMR group compares to the EV group. Conclusion The 150 kHz EMR appear to have little or no degenerative and morphological changes in the developing follicles, an increased number of typical developing follicles and a significant reduction in the number and size of the follicular cysts (p < 0.05).
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Affiliation(s)
- Stephanie Mohammed
- Department of Physics, Faculty of Science and Technology, The University of the West Indies, St. Augustine, Trinidad and Tobago.
| | - Venkatesan Sundaram
- Department of Basic Veterinary Sciences, School of Veterinary Medicine, Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Nikolay Zyuzikov
- Department of Physics, Faculty of Science and Technology, The University of the West Indies, St. Augustine, Trinidad and Tobago
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Zhao D, Guo L, Zhang R, Zhu Q, Wang H, Liu R, Yan H, Dang S. Risk of congenital heart disease due to exposure to common electrical appliances during early pregnancy: a case-control study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:4739-4748. [PMID: 32949363 DOI: 10.1007/s11356-020-10852-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 09/14/2020] [Indexed: 06/11/2023]
Abstract
To examine the association between exposure to common electrical appliances in early pregnancy and congenital heart disease (CHD). A case-control study of 2339 participants was conducted in six hospitals in Xi'an, Shaanxi Province, Northwest China from 2014 to 2016. All infants with CHD were diagnosed according to ICD-10 classification. Selected controls consisted of newborns from the same hospital, without any birth defects, and 1:3 matched by birthdate. We conducted personal interviews with the mothers to gather information on any exposure to electrical appliances during pregnancy. Multivariate logistic regression was used to estimate the effects of exposure to common electrical appliances on CHD. We observed that the mothers exposed to computers (OR: 1.33, 95% CI: 1.03, 1.71), induction cookers (OR: 2.79, 95% CI: 2.19, 3.55), and microwave ovens (OR: 1.53, 95% CI: 1.01, 2.31) during early pregnancy were more likely to give birth to infants with CHD. Mothers who wore radiation protection suits (OR: 0.67, 95% CI: 0.52, 0.87) during early pregnancy decreased the risk of CHD in their neonate. There was an interaction for induction cooker exposure with wore radiation protection suits on CHD (RERI: - 1.44, 95% CI: - 2.48, - 0.39; S: 0.37, 95% CI: 0.16, 0.84; AP: - 0.79, 95% CI: - 1.53, - 0.05). Our study confirmed that exposure to some electrical appliances was associated with a higher risk of CHD, and wearing a radiation protection suit was associated with a lower risk of CHD. Women should therefore reduce the usage of electrical appliances before and during pregnancy.
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Affiliation(s)
- Doudou Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
- Department of Translational Medicine Center, Northwest Women's and Children's Hospital, Xi'an, 710061, Shaanxi, China
| | - Leqian Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
- Department of Obstetrics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
| | - Ruo Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
- Department of Endocrinology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
| | - Qixia Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
| | - Hongli Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
| | - Rong Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China
| | - Hong Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China.
| | - Shaonong Dang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China.
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Esmailzadeh S, Delavar MA, Aleyassin A, Gholamian SA, Ahmadi A. Exposure to Electromagnetic Fields of High Voltage Overhead Power Lines and Female Infertility. THE INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE 2019; 10:11-16. [PMID: 30685773 PMCID: PMC6522214 DOI: 10.15171/ijoem.2019.1429] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Accepted: 11/28/2018] [Indexed: 12/02/2022]
Abstract
Background: Living in the vicinity of high voltage power lines has brought about a range of health woes, but the effect of residential exposure to electromagnetic fields from the power lines on female fertility has not been explored yet. Objective: To test the hypothesis if residential proximity to high voltage power lines could be associated with the increased risk of female infertility. Methods: In a case-control study, 462 women with confirmed diagnosis of unexplained infertility or behavioral and environmental factors were assessed between February 2014 and December 2016. Control group comprised of 471 persons with no history of infertility selected using randomized-digit dialing from the numbers registered in a birth registry between 2014 and 2016. The nearest linear distance from high voltage power lines to the participants' residence of cases and controls was measured using a Geographical Information System (GIS) and Google Earth aerial evaluation for high voltage power lines (240–400 kV). Results: 112 (14.1%) houses were within 500 meters from a high voltage power line. Women living within 500 meters of the lines (OR 4.14, 95% CI 2.61 to 6.57) and 500–1000 meters of the line (OR 1.61, 95% CI 1.05 to 2.47) carried a significantly higher risk of infertility than those women living more than 1000 meters away from the power lines. After adjusting for confounding factors, women living within 500 meters of the lines carried a higher risk (aOR 4.44, 95% CI 2.77 to 7.11) of infertility compared with women living more than 1000 meters of the lines. Conclusion: The current safety guidelines for electromagnetic fields exposure seems to be not adequate for protecting people from the hazardous effects of the field.
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Affiliation(s)
- Sedigheh Esmailzadeh
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mouloud Agajani Delavar
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ashraf Aleyassin
- Department of Obstetrics and Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sayyed Asghar Gholamian
- Faculty of Electrical and Computer Engineering, Department of Electrical Engineering, Babol Noushirvani University of Technology, Babol, Iran
| | - Amirmasoud Ahmadi
- Biomedical Engineering, Biomedical Engineering Department, Faculty of Electrical Engineering, Iran University of Science and Technology (IUST), Tehran, Iran.
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Alekperov SI, Suetov AA, Efremov VI, Kimstach AN, Lavrenenok LV. The Effect of Electromagnetic Fields of Extremely Low Frequency 30 Hz on Rat Ovaries. Bull Exp Biol Med 2019; 166:704-707. [PMID: 30904973 DOI: 10.1007/s10517-019-04422-2] [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] [Received: 05/08/2018] [Indexed: 10/27/2022]
Abstract
We studied the effects of extremely low-frequency electromagnetic field on the ovaries in rats. The female rats were exposed to a 30 Hz sinusoidal magnetic field of 4 kA/m for 2 h per day for a period of 10 weeks, including the period of embryonic development. After the exposure, the duration of the estrous cycle and serum levels of luteinizing hormone, follicle stimulating hormone, progesterone, and estradiol E2 were measured in different phases of the estrous cycle and morphological changes in the ovaries were evaluated. Lower levels of follicle stimulating hormone in the proestrus and progesterone in the estrus phase were found; in the ovaries, the content of primordial follicles was lower than in the control. The exposure to electromagnetic field in the selected mode caused no significant defects in the structure and function of rat ovaries.
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Affiliation(s)
- S I Alekperov
- State Scientific Research Test Institute of Military Medicine, St. Petersburg, Russia
| | - A A Suetov
- State Scientific Research Test Institute of Military Medicine, St. Petersburg, Russia.
| | - V I Efremov
- State Scientific Research Test Institute of Military Medicine, St. Petersburg, Russia
| | - A N Kimstach
- State Scientific Research Test Institute of Military Medicine, St. Petersburg, Russia
| | - L V Lavrenenok
- State Scientific Research Test Institute of Military Medicine, St. Petersburg, Russia
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Role of Mitochondria in the Oxidative Stress Induced by Electromagnetic Fields: Focus on Reproductive Systems. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:5076271. [PMID: 30533171 PMCID: PMC6250044 DOI: 10.1155/2018/5076271] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 10/15/2018] [Indexed: 12/15/2022]
Abstract
Modern technologies relying on wireless communication systems have brought increasing levels of electromagnetic field (EMF) exposure. This increased research interest in the effects of these radiations on human health. There is compelling evidence that EMFs affect cell physiology by altering redox-related processes. Considering the importance of redox milieu in the biological competence of oocyte and sperm, we reviewed the existing literature regarding the effects of EMFs on reproductive systems. Given the role of mitochondria as the main source of reactive oxygen species (ROS), we focused on the hypothesis of a mitochondrial basis of EMF-induced reproductive toxicity. MEDLINE, Web of Science, and Scopus database were examined for peer-reviewed original articles by searching for the following keywords: “extremely low frequency electromagnetic fields (ELF-EMFs),” “radiofrequency (RF),” “microwaves,” “Wi-Fi,” “mobile phone,” “oxidative stress,” “mitochondria,” “fertility,” “sperm,” “testis,” “oocyte,” “ovarian follicle,” and “embryo.” These keywords were combined with other search phrases relevant to the topic. Although we reported contradictory data due to lack of uniformity in the experimental designs, a growing body of evidence suggests that EMF exposure during spermatogenesis induces increased ROS production associated with decreased ROS scavenging activity. Numerous studies revealed the detrimental effects of EMFs from mobile phones, laptops, and other electric devices on sperm quality and provide evidence for extensive electron leakage from the mitochondrial electron transport chain as the main cause of EMF damage. In female reproductive systems, the contribution of oxidative stress to EMF-induced damages and the evidence of mitochondrial origin of ROS overproduction are reported, as well. In conclusion, mitochondria seem to play an important role as source of ROS in both male and female reproductive systems under EMF exposure. Future and more standardized studies are required for a better understanding of molecular mechanisms underlying EMF potential challenge to our reproductive system in order to improve preventive strategies.
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Saygin M, Ozmen O, Erol O, Ellidag HY, Ilhan I, Aslankoc R. The impact of electromagnetic radiation (2.45 GHz, Wi-Fi) on the female reproductive system: The role of vitamin C. Toxicol Ind Health 2018; 34:620-630. [PMID: 29848237 DOI: 10.1177/0748233718775540] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The present study investigated the effects of applied continuous 2.45 GHz electromagnetic radiation (EMR), which might cause physiopathological or morphological changes in the ovarian, fallopian tubal, and uterine tissues of rats. We proposed that the addition of vitamin C (Vit C) may reduce these severe effects. Eighteen female Sprague Dawley rats were randomly divided into three groups with six animals in each: Sham, EMR (EMR, 1 h/day for 30 days), and EMR + Vit C (EMR, 1 h/day for 30 days 250 mg/kg/daily). Total oxidant status (TOS) and oxidative stress index (OSI) levels increased ( p = 0.011 and p = 0.002, respectively) in the EMR-only group in ovarian tissues. In all tissues, TOS and OSI levels significantly decreased in the Vit C-treated group in ovarian, fallopian tubal, and uterine tissues ( p < 0.05). Anti-müllerian hormone levels significantly increased in the EMR group ( p < 0.05) and decreased in the Vit C-treated groups. Estrogen (E2) levels were unchanged in the EMR group, as the differences were not statistically significant. Immunohistochemical examination of the ovaries revealed significant increases in Caspase-3 expressions in the epithelial cells of the EMR group ( p < 0.05). In the EMR group, hyperemia was observed in uterine tissues. Also, Caspase-3 and Caspase-8 were significantly increased in the EMR group ( p < 0.001). Caspase-3 was significantly diminished with Vit C application in the ovarian and uterine tissues ( p < 0.05). Caspase-8 was significantly diminished only in uterine tissues ( p < 0.05). These results indicate that prolonged EMR exposure induced physiopathological changes in the ovarian, fallopian tubal, and uterine tissues due to oxidative damage. Under the conditions of this study, Vit C may have protective effects on female reproductive system against oxidative damage.
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Affiliation(s)
- Mustafa Saygin
- 1 Department of Physiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Ozlem Ozmen
- 2 Department of Pathology, Faculty of Veterinary Medicine, Mehmet Akif Ersoy University, Burdur, Turkey
| | - Onur Erol
- 3 Department of Gynecology and Obstetrics, Antalya Education and Research Hospital, Antalya, Turkey
| | - Hamit Yasar Ellidag
- 4 Department of Medical Biochemistry, Antalya Education and Research Hospital, Antalya, Turkey
| | - Ilter Ilhan
- 5 Department of Medical Biochemistry, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Rahime Aslankoc
- 1 Department of Physiology, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
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