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Dang L, Dong Y, Zhang C, Su B, Ning N, Zhou S, Zhang M, Huang Q, Li Y, Wang S. Zishen Yutai pills restore fertility in premature ovarian failure through regulating arachidonic acid metabolism and the ATK pathway. JOURNAL OF ETHNOPHARMACOLOGY 2024; 324:117782. [PMID: 38272104 DOI: 10.1016/j.jep.2024.117782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/08/2024] [Accepted: 01/15/2024] [Indexed: 01/27/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The Zishen Yutai pills (ZYP), a Chinese medicinal formulation derived from the Qing Dynasty prescription "Shou Tai pills", have been documented to exhibit beneficial effects in clinical observations treating premature ovarian failure (POF). However, the anti-POF effects and its comprehensive systemic mechanism have not yet been clarified. AIM OF THE REVIEW Therapeutic effects and systemic mechanism of ZYP in POF were evaluated. MATERIALS AND METHODS After pulverization, sieving, and stirring, ZYP was administered intragastrically to cisplatin-induced POF mice at a dose of 1.95 mg/kg/d for 14 days. The anti-POF effects of ZYP were investigated by assessing the number of ovarian follicles at different developmental stages, as well as measuring serum estradiol (E2) levels and ovarian-expressed anti-Müllerian hormone (AMH). Reproductive performance and offspring health were evaluated to predict fertility restoration. Furthermore, a combination of proteomic and metabolomic profiling was employed to elucidate the underlying molecular mechanism of ZYP in treating POF. Western blot (WB) analyses and real-time quantitative polymerase chain reaction (RT-qPCR) were conducted to explore the mechanisms through which ZYP exerted its anti-POF effects. RESULTS We have demonstrated that oral administration of ZYP reversed the reduction in follicles at different developmental stages and stimulated the expressions of serum E2 and ovarian-expressed AMH in a cisplatin-induced POF model. Additionally, ZYP ameliorated follicle apoptosis in ovaries affected by cisplatin-induced POF. Furthermore, treatment with ZYP restored the quantity and quality of oocytes, as well as enhanced fertility. Our results revealed 62 differentially expressed proteins (DEPs) through proteomic analyses and identified 26 differentially expressed metabolites (DEMs) through metabolomic analyses. Both DEPs and DEMs were highly enriched in the arachidonic acid (AA) metabolism pathway. ZYP treatment effectively upregulated the protein and mRNA expression of critical targets in AA metabolism and the AKT pathway, including CYP17α1, HSD3β1, LHR, STAR, and AKT, in cisplatin-induced POF mice. CONCLUSIONS These results indicated that ZYP exerted protective effects against POF and restored fertility from cisplatin-induced apoptosis. ZYP could be a satisfying alternative treating POF.
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Affiliation(s)
- Lei Dang
- Department of Obstetrics and Gynaecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Guangzhou Baiyunshan Zhongyi Pharmaceutical Co. Ltd, Guangzhou, Guangdong, China; Postdoctoral Research Center of Guangzhou Pharmaceutical Holdings Ltd., Guangzhou, China
| | - Yingying Dong
- Department of Obstetrics and Gynaecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chunbo Zhang
- Guangzhou Baiyunshan Zhongyi Pharmaceutical Co. Ltd, Guangzhou, Guangdong, China; Postdoctoral Research Center of Guangzhou Pharmaceutical Holdings Ltd., Guangzhou, China
| | - Biru Su
- Guangzhou Baiyunshan Zhongyi Pharmaceutical Co. Ltd, Guangzhou, Guangdong, China
| | - Na Ning
- Guangzhou Baiyunshan Zhongyi Pharmaceutical Co. Ltd, Guangzhou, Guangdong, China
| | - Su Zhou
- Department of Obstetrics and Gynaecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Minli Zhang
- Department of Obstetrics and Gynaecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qiuling Huang
- Guangzhou Baiyunshan Zhongyi Pharmaceutical Co. Ltd, Guangzhou, Guangdong, China
| | - Yan Li
- Department of Obstetrics and Gynaecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
| | - Shixuan Wang
- Department of Obstetrics and Gynaecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Nash Z, Davies M. Premature ovarian insufficiency. BMJ 2024; 384:e077469. [PMID: 38508679 DOI: 10.1136/bmj-2023-077469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Affiliation(s)
- Zachary Nash
- University College London Hospitals, London, UK
- EGA Institute for Women's Health, University College London
| | - Melanie Davies
- University College London Hospitals, London, UK
- EGA Institute for Women's Health, University College London
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Kim HK, Kim TJ. Current Status and Future Prospects of Stem Cell Therapy for Infertile Patients with Premature Ovarian Insufficiency. Biomolecules 2024; 14:242. [PMID: 38397479 PMCID: PMC10887045 DOI: 10.3390/biom14020242] [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: 12/29/2023] [Revised: 02/08/2024] [Accepted: 02/17/2024] [Indexed: 02/25/2024] Open
Abstract
Premature ovarian insufficiency (POI), also known as premature menopause or premature ovarian failure, signifies the partial or complete loss of ovarian endocrine function and fertility before 40 years of age. This condition affects approximately 1% of women of childbearing age. Although 5-10% of patients may conceive naturally, conventional infertility treatments, including assisted reproductive technology, often prove ineffective for the majority. For infertile patients with POI, oocyte donation or adoption exist, although a prevalent desire persists among them to have biological children. Stem cells, which are characterized by their undifferentiated nature, self-renewal capability, and potential to differentiate into various cell types, have emerged as promising avenues for treating POI. Stem cell therapy can potentially reverse the diminished ovarian endocrine function and restore fertility. Beyond direct POI therapy, stem cells show promise in supplementary applications such as ovarian tissue cryopreservation and tissue engineering. However, technological and ethical challenges hinder the widespread clinical application of stem cells. This review examines the current landscape of stem cell therapy for POI, underscoring the importance of comprehensive assessments that acknowledge the diversity of cell types and functions. Additionally, this review scrutinizes the limitations and prospects associated with the clinical implementation of stem cell treatments for POI.
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Affiliation(s)
- Hye Kyeong Kim
- Department of Obstetrics & Gynecology, Infertility Center, CHA University Ilsan Medical Center, Goyang 10414, Republic of Korea;
| | - Tae Jin Kim
- Department of Urology, CHA University Ilsan Medical Center, CHA University School of Medicine, Goyang 10414, Republic of Korea
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Huang Y, Qin T, Yang M, Liu Z. Impact of ovary-sparing treatment planning on plan quality, treatment time and gamma passing rates in intensity-modulated radiotherapy for stage I/II cervical cancer. Medicine (Baltimore) 2023; 102:e36373. [PMID: 38115303 PMCID: PMC10727547 DOI: 10.1097/md.0000000000036373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND This study aimed to investigate the impact of ovary-sparing intensity-modulated radiotherapy (IMRT) on plan quality, treatment time, and gamma passing rates for stage I/II cervical cancer patients. METHODS Fifteen stage I/II cervical cancer patients were retrospectively enrolled, and a pair of clinically suitable IMRT plans were designed for each patient, with (Group A) and without (Group B) ovary-sparing. Plan factors affecting plan quality, treatment time, and gamma passing rates, including the number of segments, monitor units, percentage of small-area segments (field area < 20 cm2), and percentage of small-MU segments (MU < 10), were compared and statistically analyzed. Key plan quality indicators, including ovarian dose, target dose coverage (D98%, D95%, D50%, D2%), conformity index, and homogeneity index, were evaluated and statistically assessed. Treatment time and gamma passing rates collected by IBA MatriXX were also compared. RESULTS The median ovarian dose in Group A and Group B was 7.61 Gy (range 6.71-8.51 Gy) and 38.52 Gy (range 29.84-43.82 Gy), respectively. Except for monitor units, all other plan factors were significantly lower in Group A than in Group B (all P < .05). Correlation coefficients between plan factors, treatment time, and gamma passing rates that were statistically different were all negative. Both Groups of plans met the prescription requirement (D95% ≥ 45.00 Gy) for clinical treatment. D98% was smaller for Group A than for Group B (P < .05); D50% and D2% were larger for Group A than for Group B (P < .05, P < .05). Group A plans had worse conformity index and homogeneity index than Group B plans (P < .05, P < .05). Treatment time did not differ significantly (P > .05). Gamma passing rates in Group A were higher than in Group B with the criteria of 2%/3 mm (P < .05) and 3%/2 mm (P < .05). CONCLUSION Despite the slightly decreased quality of the treatment plans, the ovary-sparing IMRT plans exhibited several advantages including lower ovarian dose and plan complexity, improved gamma passing rates, and a negligible impact on treatment time.
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Affiliation(s)
- Yangyang Huang
- Department of Radiotherapy, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Tingting Qin
- Department of Radiotherapy, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Menglin Yang
- Department of Radiotherapy, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Zongwen Liu
- Department of Radiotherapy, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
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Chen Z, Zhang Y, Kwak-Kim J, Wang W. Memory regulatory T cells in pregnancy. Front Immunol 2023; 14:1209706. [PMID: 37954599 PMCID: PMC10637476 DOI: 10.3389/fimmu.2023.1209706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 10/16/2023] [Indexed: 11/14/2023] Open
Abstract
Pregnancy requires the process of maternal immune tolerance to semi-allogeneic embryos. In contrast, an overreactive maternal immune system to embryo-specific antigens is likely to result in the rejection of embryos while damaging the invading placenta, such that the likelihood of adverse pregnancy outcomes can be increased. Regulatory T cells (Tregs) are capable of suppressing excessive immune responses and regulating immune homeostasis. When stimulating Tregs, specific antigens will differentiate into memory Tregs with long-term survival and rapid and powerful immune regulatory ability. Immunomodulatory effects mediated by memory Tregs at the maternal-fetal interface take on critical significance in a successful pregnancy. The impaired function of memory Tregs shows a correlation with various pregnancy complications (e.g., preeclampsia, gestational diabetes mellitus, and recurrent pregnancy losses). However, the differentiation process and characteristics of memory Tregs, especially their role in pregnancy, remain unclear. In this study, a review is presented in terms of memory Tregs differentiation and activation, the characteristics of memory Tregs and their role in pregnancy, and the correlation between memory Tregs and pregnancy complications. Furthermore, several potential therapeutic methods are investigated to restore the function of memory Tregs in accordance with immunopathologies arising from memory Tregs abnormalities and provide novel targets for diagnosing and treating pregnancy-associated diseases.
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Affiliation(s)
- Zeyang Chen
- School of Medicine, Qingdao University, Qingdao, China
- Reproduction Medical Center, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yanan Zhang
- School of Integrated Chinese and Western Medicine, Hunan University of Chinese Medicine, Changsha, China
| | - Joanne Kwak-Kim
- Reproductive Medicine and Immunology, Obstetrics and Gynecology, Clinical Sciences Department, Chicago Medical School, Rosalind Franklin University of Medicine and Science, Vernon Hills, IL, United States
- Center for Cancer Cell Biology, Immunology and Infection, Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States
| | - Wenjuan Wang
- Reproduction Medical Center, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
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Li M, Zhu Y, Wei J, Chen L, Chen S, Lai D. The global prevalence of premature ovarian insufficiency: a systematic review and meta-analysis. Climacteric 2023; 26:95-102. [PMID: 36519275 DOI: 10.1080/13697137.2022.2153033] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The objective of this review was to answer the global prevalence of premature ovarian insufficiency (POI), and explore the associated factors including etiopathology and regions with POI. METHODS The search was conducted on reports from a total of eight databases that comprised Chinese National Knowledge Infrastructure (CNKI), Wanfang, China BioMedical Literature Database (CBM), PubMed, the Cochrane Library, Embase, Web of Science and Ovid MEDLINE® between 1946 and 2021. To analyze the source of heterogeneity, we performed subgroup analysis based on different etiologies and regions. Meta-analysis was carried out by Stata14.0 software. RESULTS The results showed that the global overall prevalence of POI among women was 3.5%. By subgroup analysis, the prevalence of POI among women with iatrogenic etiology was 11.2%, followed by autoimmunity (10.5%); the prevalence of POI by region was 11.3% at the highest in North America followed by South America (5.4%); and the prevalence of POI was 5.3% in a developing country, higher than 3.1% in a developed country. The trend of prevalence of POI over the past 20 years was on the rise (although p > 0.05). CONCLUSION We recommend that health and medical institutions strengthen public health awareness, achieve health-education goals related to POI and increase women's awareness of and attention to POI.
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Affiliation(s)
- M Li
- Department of Nosocomial Infection, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - Y Zhu
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, P.R. China
- Department of Scientific Research, Children's Hospital of Fudan University, Shanghai, P.R. China
| | - J Wei
- Department of Pharmacy, Shanghai Chest Hospital, Shanghai, P.R. China
| | - L Chen
- Department of Nosocomial Infection, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - S Chen
- Department of Nosocomial Infection, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - D Lai
- Department of Nosocomial Infection, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
- Shanghai Key Laboratory of Embryo Original Diseases, The International Peace Maternity & Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
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Du R, Cheng X, Ji J, Lu Y, Xie Y, Wang W, Xu Y, Zhang Y. Mechanism of ferroptosis in a rat model of premature ovarian insufficiency induced by cisplatin. Sci Rep 2023; 13:4463. [PMID: 36932163 PMCID: PMC10023701 DOI: 10.1038/s41598-023-31712-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 03/16/2023] [Indexed: 03/19/2023] Open
Abstract
Ferroptosis is widely present in fibrosis-related diseases. The basic pathology of premature ovarian insufficiency (POI) involves ovarian tissue fibrosis, and there are currently fewer relevant studies addressing the association between ferroptosis and POI. This study aimed to demonstrate that ferroptosis induced by cisplatin (CDDP) caused ovarian tissue fibrosis, leading to POI. Vitamin E (VE), a ferroptosis inhibitor, could repair damaged ovarian function. CDDP was used to establish a rat model of POI, and VE was administered to reverse the reproductive toxicity of CDDP. Ovarian function was assessed by histological section staining, follicle counts, sex hormone levels, as well as fertility assays. The extent of ferroptosis was assessed by transmission electron microscopy (TEM), malondialdehyde (MDA), Perls staining. CCK-8, Ethynyl-2-Deoxyuridine (EdU), and scratch assays were used to determine the effect of CDDP and VE on ovarian granulosa cell (GC) viability. Western blot, quantitative reverse-transcription polymerase chain reaction (qRT-PCR) and immunohistochemistry were performed to evaluate ferroptosis-related molecular changes. Our results showed that CDDP caused follicle development disorders and ovarian tissue fibrosis, the levels of sex hormones suggested impaired ovarian function, and VE could reverse the reproductive toxicity of CDDP. The results of TEM, MDA and Perls staining suggested that the typical mitochondrial signature of ferroptosis was altered in ovarian GCs from the CDDP group, with significantly higher levels of lipid peroxidation and significant iron deposition in ovarian tissue, whereas VE mitigated the extent of ferroptosis. Molecular experiments then confirmed that the ferroptosis-related molecules acetyl CoA synthetase long chain family member 4 (ACSl4), 15-lipoxygenase-1 (ALOX15), solute carrier family 7 member 11 (SLC7A11), and glutathione peroxidase 4 (GPX4) were differentially expressed in each group. In summary, our study preliminarily demonstrated that CDDP may promote GCs to undergo ferroptosis, cause follicle development disorders, ovarian tissue fibrosis, and induce POI by regulating the expression of ACSl4, ALOX15, SLC7A11, and GPX4, while VE improved impaired ovarian function.
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Grants
- MS12021003, KYCX20_2799, KYCX21_3118 XiCheng
- MS12021003, KYCX20_2799, KYCX21_3118 XiCheng
- MS12021003, KYCX20_2799, KYCX21_3118 XiCheng
- MS12021003, KYCX20_2799, KYCX21_3118 XiCheng
- MS12021003, KYCX20_2799, KYCX21_3118 XiCheng
- MS12021003, KYCX20_2799, KYCX21_3118 XiCheng
- MS12021003, KYCX20_2799, KYCX21_3118 XiCheng
- BE2018672 Yuquan Zhang
- BE2018672 Yuquan Zhang
- BE2018672 Yuquan Zhang
- BE2018672 Yuquan Zhang
- BE2018672 Yuquan Zhang
- BE2018672 Yuquan Zhang
- BE2018672 Yuquan Zhang
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Affiliation(s)
- Rong Du
- Department of Obstetrics and Gynecology, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, Jiangsu Province, 226001, China
| | - Xi Cheng
- Department of Obstetrics and Gynecology, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, Jiangsu Province, 226001, China
| | - Jingjing Ji
- Department of Obstetrics and Gynecology, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, Jiangsu Province, 226001, China
| | - Yang Lu
- Department of Orthopedics, Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, 226001, China
| | - Yuanyuan Xie
- Department of Obstetrics and Gynecology, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, Jiangsu Province, 226001, China
| | - Weina Wang
- Department of Obstetrics and Gynecology, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, Jiangsu Province, 226001, China
| | - Yanhua Xu
- Department of Obstetrics and Gynecology, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong, Jiangsu Province, 226001, China
| | - Yuquan Zhang
- Department of Obstetrics and Gynecology, Affiliated Hospital of Nantong University, No.20, Xisi Road, Nantong, Jiangsu Province, 226001, China.
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Luo X, Liu W, Zhao M, Wang J, Gao X, Feng F. The evaluation of sea cucumber ( Acaudina leucoprocta) peptide on sex hormone regulation in normal and premature ovarian failure female mice. Food Funct 2023; 14:1430-1445. [PMID: 36645395 DOI: 10.1039/d2fo01707e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Sea cucumber peptides (SCPs) have various functional activities. However, studies to evaluate the efficacy and safety of SCPs from the perspective of sex hormones are still lacking. In this study, normal and premature ovarian failure (POF) female mice were used to assess the effect of SCPs on the sex hormones. The ovarian and uterine indices were not influenced by SCP both in normal and POF mice. In normal mice, SCP showed no significant impact on the estrous cycle, ovarian, uterine morphology, sex hormone levels, and sex hormone synthesis-related genes of the ovary. However, 0.6 mg per g bw dosage of SCP (SCPH) statistically increased mapk1 expression on normal mice hypothalamus. In POF mice, SCPH played a more positive role than a low dosage of SCP (0.2 mg per g bw). SCP ameliorated POF-induced estrous cycle disturbances and significantly increased serum estradiol, testosterone, and AMH levels. Moreover, SCP increased the synthesis of the sex hormone by upregulating the expression of StAR, Fshr, and Cyp19a1 in the ovary, which might be due to the activation of the cAMP-related signaling pathways. The upregulation of mapk1, Esr1, and Gnrh was also observed in the hypothalamus. Together, SCP is safe for normal female mice and seems to have positive effects on POF mice from sex hormone regulation. However, the risk of excessive supplementation of sex hormones induced by the SCP intake in POF mice needs to be further explored.
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Affiliation(s)
- Xianliang Luo
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China.
| | - Wangxin Liu
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China.
| | - Minjie Zhao
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China.
| | - Jing Wang
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China.
| | - Xinchang Gao
- Department of Chemistry, Tsinghua University, Beijing 100084, China
| | - Fengqin Feng
- College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China.
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Ryu KJ, Park H, Jeong Y, Nam S, Jeong HG, Kim T. Age at Menopause and Suicidal Ideation in Menopausal Women: A Study of Korea National Health and Nutrition Examination Survey Data. J Korean Med Sci 2022; 37:e330. [PMID: 36413799 PMCID: PMC9678656 DOI: 10.3346/jkms.2022.37.e330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 09/14/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Although menopause is considered a risk factor for depression, no association has been established between the risk of suicidal ideation and age at menopause. This study aimed to evaluate the association between age at menopause and suicidal ideation in middle-aged menopausal Korean women. METHODS This cross-sectional study used data from the Korea National Health and Nutrition Examination Survey (2013-2018). Women aged 40-65 years were divided into the following three categories: primary ovarian insufficiency (POI), early menopause, and menopause, according to age at natural menopause (< 40, 40-45, and > 45 years, respectively). Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). RESULTS Among 2,232 menopausal women, 25 (1.1%) experienced POI and 114 (5.1%) experienced early menopause. The PHQ-9 items that pertained to low self-esteem and suicidal ideation scored higher in women with POI than in those who experienced menopause after 45 years of age. The prevalence of suicidal ideation differed significantly according to age at menopause (POI, 30.0%; early menopause, 12.7%; menopause, 8.0%; P = 0.016). Logistic regression analysis revealed that POI was significantly associated with suicidal ideation after the adjustment for age, body mass index, and education, household income, and walking levels (odds ratio, 4.2; 95% confidence interval, 1.0-17.7). CONCLUSION Korean middle-aged women with POI were more likely to have suicidal ideation than those who experienced menopause at 45 years or above, despite not being diagnosed with major depressive disorder.
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Affiliation(s)
- Ki-Jin Ryu
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Hyuntae Park
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.
| | - Yujin Jeong
- Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
| | - Seunghyun Nam
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Hye Gyeong Jeong
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Tak Kim
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
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Jiang XL, Tai H, Kuang JS, Zhang JY, Cui SC, Lu YX, Qi SB, Zhang SY, Li SM, Chen JP, Meng XS. Jian-Pi-Yi-Shen decoction inhibits mitochondria-dependent granulosa cell apoptosis in a rat model of POF. Aging (Albany NY) 2022; 14:8321-8345. [PMID: 36309912 PMCID: PMC9648799 DOI: 10.18632/aging.204320] [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: 07/12/2022] [Accepted: 09/23/2022] [Indexed: 11/25/2022]
Abstract
As a widely applied traditional Chinese medicine (TCM), Jian-Pi-Yi-Shen (JPYS) decoction maybe applied in curing premature ovarian failure (POF) besides chronic kidney disease (CKD). In vivo experiments, 40 female SD (8-week-old) rats were randomized into four groups, namely, control group (negative control), POF model group, JPYS treatment group, and triptorelin treatment group (positive control). JPYS group was treated with JPYS decoction (oral, 11 g/kg) for 60 days, and the triptorelin group was treated with triptorelin (injection, 1.5 mg/kg) for 10 days before the administration of cyclophosphamide (CTX) (50 mg/kg body weight) to establish POF model. We examined apoptosis, mitochondrial function, and target gene (ASK1/JNK pathway and mitochondrial fusion/fission) expression. In vitro experiments, the KGN human granulosa cell line was used. Cells were pretreated with CTX (20, 40, and 60 μg/mL) for 24 h, followed by JPYS-containing serum (2, 4, and 8 %) for 24 h. Thereafter, these cells were employed to assess apoptosis, mitochondrial function, and target gene levels of protein and mRNA. In vivo, JPYS alleviated injury and suppressed apoptosis in POF rats. In addition, JPYS improved ovarian function. JPYS inhibit apoptosis of granulosa cells through improving mitochondrial function by activating ASK1/JNK pathway. In vitro, JPYS inhibited KGN cell apoptosis through inhibited ASK1/JNK pathway and improved mitochondrial function. The effects of GS-49977 were similar to those of JPYS. During POF, mitochondrial dysfunction occurs in the ovary and leads to granulosa cell apoptosis. JPYS decoction improves mitochondrial function and alleviates apoptosis through ASK1/JNK pathway.
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Affiliation(s)
- Xiao-Lin Jiang
- Department of Nephrology, The Fourth of Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine (Shenzhen Traditional Chinese Medicine Hospital), Guangzhou University of Traditional Chinese Medicine, Shenzhen, China
- Key Laboratory of Ministry of Education for Traditional Chinese Medicine Viscera-State Theory and Applications, Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - He Tai
- College of Pharmacy, Liaoning University of Traditional Chinese Medicine, Dalian, China
- Department of Internal Medicine, Liaoning Provincial Corps Hospital of Chinese People’s Armed Police Forces, Shenyang, China
| | - Jin-Song Kuang
- Department of Endocrinology and Metabolism, The Fourth People’s Hospital of Shenyang, Shenyang, China
| | - Jing-Yi Zhang
- Department of Pharmacy, General Hospital of Northern Theater Command, Shenyang, China
| | - Shi-Chao Cui
- NHC Key Laboratory of Male Reproduction and Genetics, Guangdong Provincial Reproductive Science Institute (Guangdong Provincial Fertility Hospital), Guangzhou, China
| | - Yu-Xuan Lu
- College of Basic Medical Science, Chinese Capital Medical University, Beijing, China
| | - Shu-Bo Qi
- Key Laboratory of Ministry of Education for Traditional Chinese Medicine Viscera-State Theory and Applications, Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Shi-Yu Zhang
- Key Laboratory of Ministry of Education for Traditional Chinese Medicine Viscera-State Theory and Applications, Liaoning University of Traditional Chinese Medicine, Shenyang, China
| | - Shun-Min Li
- Department of Nephrology, The Fourth of Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine (Shenzhen Traditional Chinese Medicine Hospital), Guangzhou University of Traditional Chinese Medicine, Shenzhen, China
| | - Jian-Ping Chen
- Department of Internal Medicine, Liaoning Provincial Corps Hospital of Chinese People’s Armed Police Forces, Shenyang, China
| | - Xian-Sheng Meng
- College of Pharmacy, Liaoning University of Traditional Chinese Medicine, Dalian, China
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Craciunas L, Zdoukopoulos N, Vinayagam S, Mohiyiddeen L. Hormone therapy for uterine and endometrial development in women with premature ovarian insufficiency. Cochrane Database Syst Rev 2022; 10:CD008209. [PMID: 36200708 PMCID: PMC9536017 DOI: 10.1002/14651858.cd008209.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Premature ovarian insufficiency (POI) is a clinical syndrome resulting from loss of ovarian function before the age of 40. It is a state of hypergonadotropic hypogonadism, characterised by amenorrhoea or oligomenorrhoea, with low ovarian sex hormones (oestrogen deficiency) and elevated pituitary gonadotrophins. POI with primary amenorrhoea may occur as a result of chromosomal and genetic abnormalities, such as Turner syndrome, Fragile X, or autosomal gene defects; secondary amenorrhoea may be iatrogenic after the surgical removal of the ovaries, radiotherapy, or chemotherapy. Other causes include autoimmune diseases, viral infections, and environmental factors; in most cases, POI is idiopathic. Appropriate replacement of sex hormones in women with POI may facilitate the achievement of near normal uterine development. However, the optimal effective hormone therapy (HT) regimen to maximise the reproductive potential for women with POI remains unclear. OBJECTIVES To investigate the effectiveness and safety of different hormonal regimens on uterine and endometrial development in women with POI. SEARCH METHODS We searched the Cochrane Gynaecology and Fertility (CGF) Group trials register, CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, and two trials registers in September 2021. We also checked references of included studies, and contacted study authors to identify additional studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) investigating the effect of various hormonal preparations on the uterine development of women diagnosed with POI. DATA COLLECTION AND ANALYSIS We used standard methodological procedures recommended by Cochrane. The primary review outcome was uterine volume; secondary outcomes were endometrial thickness, endometrial histology, uterine perfusion, reproductive outcomes, and any reported adverse events. MAIN RESULTS We included three studies (52 participants analysed in total) investigating the role of various hormonal preparations in three different contexts, which deemed meta-analysis unfeasible. We found very low-certainty evidence; the main limitation was very serious imprecision due to small sample size. Conjugated oral oestrogens versus transdermal 17ß-oestradiol We are uncertain of the effect of conjugated oral oestrogens compared to transdermal 17ß-oestradiol (mean difference (MD) -18.2 (mL), 95% confidence interval (CI) -23.18 to -13.22; 1 RCT, N = 12; very low-certainty evidence) on uterine volume, measured after 12 months of treatment. The study reported no other relevant outcomes (including adverse events). Low versus high 17ß-oestradiol dose We are uncertain of the effect of a lower dose of 17ß-oestradiol compared to a higher dose of 17ß-oestradiol on uterine volume after three or five years of treatment, or adverse events (1 RCT, N = 20; very low-certainty evidence). The study reported no other relevant outcomes. Oral versus vaginal administration of oestradiol and dydrogesterone We are uncertain of the effect of an oral or vaginal administration route on uterine volume and endometrial thickness after 14 or 21 days of administration (1 RCT, N = 20; very low-certainty evidence). The study reported no other relevant outcomes (including adverse events). AUTHORS' CONCLUSIONS No clear conclusions can be drawn in this systematic review, due to the very low-certainty of the evidence. There is a need for pragmatic, well designed, randomised controlled trials, with adequate power to detect differences between various HT regimens on uterine growth, endometrial development, and pregnancy outcomes following the transfer of donated gametes or embryos in women diagnosed with POI.
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Affiliation(s)
| | | | - Suganthi Vinayagam
- Obstetrics and Gynaecology, St Helens and Knowsley Teaching Hospitals NHS Trust, Prescot, UK
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12
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Yuan Y, Xia Q, Cui W, Cao W, Zhou Z, Peng J, Huang H, Song Z, Xie S, Geng R, Li R, Yu X, Zhang J. Study on the Mechanism of Action of Different Acupuncture Regimens on Premature Ovarian Failure Model Rats. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:5254628. [PMID: 36388162 PMCID: PMC9643065 DOI: 10.1155/2022/5254628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/15/2022] [Indexed: 12/30/2023]
Abstract
OBJECTIVE To study the mechanism of acupuncture on premature ovarian failure (POF) through the apoptosis pathway mediated by Bcl-2/Bax. METHODS POF rats were successfully obtained by cyclophosphamide. They were divided into five groups. After that, acupuncture was performed. The blank group and model group were not treated. The routine acupuncture group was acupuncture at Guanyuan, Sanyinjiao, Zhongji, and Guilai four points. The Neck-seven-acupuncture group was selected from Fengchi, Fengfu, Tianzhu, and Wangu four acupoints; the three-viscera simultaneous treatment group selected Guanyuan, Shenshu, Sanyinjiao, Taichong, and Baihui five points; and the data mining group selected Guanyuan and Sanyinjiao two points for 14 days of treatment. During the treatment, some rats were shed one after another due to the side effects of bone marrow suppression caused by mold-making. After treatment, serum estradiol (E2), follicle forming hormone (FSH), and luteinizing hormone (LH) were detected by radioimmunoassay, Bcl-2 and Bax proteins were analyzed by Western blot method, and Bcl-2 and Bax RNA were analyzed by PCR method. RESULTS Bcl-2 increased and Bax decreased in rats with premature ovarian failure treated with acupuncture. It shows that acupuncture can affect the secretion of ovarian-related hormones and the expression of apoptosis-related proteins, which is more significant in the conventional acupuncture point group. CONCLUSION Acupuncture can inhibit the apoptosis of granulosa cells in ovarian tissue of rats with premature ovarian failure and improve ovarian function. The mechanism of its effect is to promote Bcl-2 gene expression and protein synthesis and inhibit Bax gene expression and protein synthesis. The conventional treatment group works best. This provides an experimental basis for the clinical use of acupuncture to intervene in the treatment of premature ovarian failure.
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Affiliation(s)
- Yonghao Yuan
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250355, China
| | - Qingchang Xia
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250355, China
| | - Wenzhe Cui
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250355, China
| | - Wen Cao
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250355, China
| | - Ziyang Zhou
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250355, China
| | - Jian Peng
- School of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250355, China
| | - Hailiang Huang
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250355, China
| | - Zhifei Song
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250355, China
| | - Shuying Xie
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250355, China
| | - Runjie Geng
- School of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250355, China
| | - Ran Li
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250355, China
| | - Xiaohua Yu
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250355, China
| | - Jing Zhang
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250355, China
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Liu X, Wu F, Jin F, Sun F, Li Q, Guo M, Zhao X, Guo Q. Dosimetric comparison of complete block in ovarian protection between helical tomotherapy and volumetric-modulated arc therapy for cervical cancer. JOURNAL OF RADIATION RESEARCH AND APPLIED SCIENCES 2022. [DOI: 10.1016/j.jrras.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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14
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Yu Y, Zhang Q, Sun K, Xiu Y, Wang X, Wang K, Yan L. Long non-coding RNA BBOX1 antisense RNA 1 increases the apoptosis of granulosa cells in premature ovarian failure by sponging miR-146b. Bioengineered 2022; 13:6092-6099. [PMID: 35188872 PMCID: PMC8973711 DOI: 10.1080/21655979.2022.2031675] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Long non-coding RNA (lncRNA) BBOX1 antisense RNA 1 (BBOX1-AS1) was reported to participate in ovarian cancer, while its role in other ovarian disorders is unclear. We speculated that BBOX1-AS1 could interact with microRNA(miR)-146b, which is involved in premature ovarian failure (POF). This study was therefore carried out to explore its role in POF. In this study, 60 patients with POF and 60 controls were enrolled. The expression of BBOX1-AS1 and miR-146b were analyzed by RT-qPCRs. The direct interaction between miR-146b and the wild type BBOX1-AS1 (BBOX1-AS1-WT) or mutant BBOX1-AS1 (BBOX1-AS1-mut) was explored with RNA-RNA pulldown assay. Subcellular location of BBOX1-AS1 in COV434 granulosa cells was detected by subcellular fractionation. The role of BBOX1-AS1 and miR-146b in the apoptosis of COV434 cells was evaluated by cell apoptosis assay. Overexpression assay was applied to explore the relationship between BBOX1-AS1 and miR-146b. We found that the expression levels of BBOX1-AS1 were increased, while the expression levels of miR-146b were decreased in POF patients. BBOX1-AS1-WT, but not BBOX1-AS1-mut, directly interacted with miR-146b. BBOX1-AS1 was detected in both nucleus and cytoplasm, while they did not affect the expression of each other. BBOX1-AS1 suppressed the role of miR-146b in cell apoptosis. Therefore, BBOX1-AS1 may increase the apoptosis of granulosa cells in POF by sponging miR-146b.
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Affiliation(s)
- Yuexin Yu
- Department of Reproductive Medicine, General Hospital of Northern Theater Command, Shenyang, Liaoning province, PR. China
| | - Qian Zhang
- Department of Reproductive Medicine, General Hospital of Northern Theater Command, Shenyang, Liaoning province, PR. China
| | - Kaixuan Sun
- Department of Reproductive Medicine, General Hospital of Northern Theater Command, Shenyang, Liaoning province, PR. China
| | - Yinling Xiu
- Department of Reproductive Medicine, General Hospital of Northern Theater Command, Shenyang, Liaoning province, PR. China
| | - Xiliang Wang
- Department of Reproductive Medicine, General Hospital of Northern Theater Command, Shenyang, Liaoning province, PR. China
| | - Kaiyue Wang
- Department of Reproductive Medicine, General Hospital of Northern Theater Command, Shenyang, Liaoning province, PR. China
| | - Li Yan
- Department of Reproductive Medicine, General Hospital of Northern Theater Command, Shenyang, Liaoning province, PR. China
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Zhang L, Mao B, Zhao X, Yuan Y, Wang W, Lin S. Translation regulatory long non-coding RNA 1 (TRERNA1) sponges microRNA-23a to suppress granulosa cell apoptosis in premature ovarian failure. Bioengineered 2022; 13:2173-2180. [PMID: 35034562 PMCID: PMC8973726 DOI: 10.1080/21655979.2021.2023802] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Translation regulatory long non-coding RNA 1 (TRERNA1) plays critical roles in cancer biology. We predicted the direct interaction of TRERNA1 with microRNA (miR)-23a, which promotes granulosa apoptosis. Granulosa apoptosis is involved in premature ovarian failure (POF). This study was therefore carried out to explore the involvement of TRERNA1 and miR-23a in POF. The expression of TRERNA1 and miR-23a in POF and control groups were detected by RT-qPCRs. The subcellular locations of TRERNA1 in granulosa cell line COV434 was detected by subcellular fractionation assay. The interaction between TRERNA1 and miR-23a was predicted using IntaRNA2.0. The direct interaction between COV434 and miR-23a was explored with RNA pull-down assay. In granulosa cells, the direct interaction between TRERNA1 and miR-23a was verified by overexpression assay. Cell apoptosis assay was performed to evaluate cell apoptosis. Both TRERNA1 and miR-23a were downregulated in POF. In addition, TRERNA1 was detected in both cytoplasm and nuclear samples of granulosa cells, and directly interacted with miR-23a. TRERNA1 did not affect the expression of miR-23a in granulosa cells, while TRERNA1 suppressed the role of miR-23a in enhancing cell apoptosis. In conclusion, TRERNA1 may sponge miR-23a to suppress granulosa cell apoptosis in POF.
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Affiliation(s)
- Lili Zhang
- Key Laboratory of Reproductive Medicine and Embryo, The Reproductive Medicine Center of the First Hospital of Lanzhou University, Lanzhou City, Gansu Province, China
| | - Bin Mao
- Key Laboratory of Reproductive Medicine and Embryo, The Reproductive Medicine Center of the First Hospital of Lanzhou University, Lanzhou City, Gansu Province, China
| | - Xiaodong Zhao
- Key Laboratory of Reproductive Medicine and Embryo, The Reproductive Medicine Center of the First Hospital of Lanzhou University, Lanzhou City, Gansu Province, China
| | - Yue Yuan
- Key Laboratory of Reproductive Medicine and Embryo, The Reproductive Medicine Center of the First Hospital of Lanzhou University, Lanzhou City, Gansu Province, China
| | - Wei Wang
- Key Laboratory of Reproductive Medicine and Embryo, The Reproductive Medicine Center of the First Hospital of Lanzhou University, Lanzhou City, Gansu Province, China
| | - Shaohua Lin
- Reproductive Department of Guangxi International Zhuang Medical Hospital, Nanning City, Guangxi Province, China
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Liu Y, Zhu X, Wu C, Lang Y, Zhao W, Li Y. Melatonin protects against ovarian damage by inhibiting autophagy in granulosa cells in rats. Clinics (Sao Paulo) 2022; 77:100119. [PMID: 36194922 PMCID: PMC9531038 DOI: 10.1016/j.clinsp.2022.100119] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 09/06/2022] [Accepted: 09/13/2022] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES This study sought to further verify the protective mechanism of Melatonin (MT) against ovarian damage through animal model experiments and to lay a theoretical and experimental foundation for exploring new approaches for ovarian damage treatment. METHOD The wet weight and ovarian index of rat ovaries were weighted, and the morphology of ovarian tissues and the number of follicles in the pathological sections of collected ovarian tissues were recorded. And the serum sex hormone levels, the key proteins of the autophagy pathway (PI3K, AKT, mTOR, LC3II, LC3I, and Agt5) in rat ovarian tissues, as well as the viability and mortality of ovarian granulosa cells in each group were measured by ELISA, western blotting, CCK8 kit and LDH kit, respectively. RESULTS The results showed that MT increased ovarian weight and improved the ovarian index in ovarian damage rats. Also, MT could improve autophagy-induced ovarian tissue injury, increase the number of primordial follicles, primary follicles, and sinus follicles, and decrease the number of atretic follicles. Furthermore, MT upregulated serum AMH, INH-B, and E2 levels downregulated serum FSH and LH levels in ovarian damage rats and activated the PI3K/AKT/mTOR signaling pathway. Besides, MT inhibited autophagic apoptosis of ovarian granulosa cells and repressed the expression of key proteins in the autophagic pathway and reduced the expression levels of Agt5 and LC3II/I. CONCLUSIONS MT inhibits granulosa cell autophagy by activating the PI3K/Akt/mTOR signaling pathway, thereby exerting a protective effect against ovarian damage.
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Affiliation(s)
- Yan Liu
- Department of Gynecology, Weifang People's Hospital, Weifang, Shandong, China
| | - Xiaohe Zhu
- Department of Obstetrics, Weifang People's Hospital, Weifang, Shandong, China
| | - Chunli Wu
- Department of Obstetrics, Weifang People's Hospital, Weifang, Shandong, China
| | - Yan Lang
- Department of Obstetrics, Weifang People's Hospital, Weifang, Shandong, China
| | - Wenjie Zhao
- Department of Reproductive Medicine, Weifang People's Hospital, Weifang, Shandong, China
| | - Yanmin Li
- Department of Reproductive Medicine, Weifang People's Hospital, Weifang, Shandong, China.
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Effects of Transcutaneous Electrical Acupoint Stimulation on Ovarian Responses and Pregnancy Outcomes in Patients Undergoing IVF-ET: A Randomized Controlled Trial. Chin J Integr Med 2021; 28:434-439. [PMID: 34762233 DOI: 10.1007/s11655-021-3457-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To evaluate the influence of different transcutaneous electrical acupoint stimulation (TEAS) modes on ovarian responses and pregnancy outcomes in patients with infertility undergoing in vitro fertilization and embryo transfer (IVF-ET). METHODS Two hundred infertility patients undergoing IVF-ET were divided randomly into experimental groups (TEAS groups: E-I, E-II, E-III, and E-IV, 40 cases each group) and a control group (mock TEAS group, 40 patients) using the random number method. The patients in the experimental groups received TEAS treatment of 20, 30, 40 and 50 mA for the E-I, E-II, E-III and E-IV groups, respectively. The control group received a treatment of 5 mA. TEAS was applied at acupoints of Guanyuan (RN 4), Zhongji (RN 3), Sanyinjiao (SP 6), Zigong (EX-CA 1), and Taixi (KI 13), once a day for 30 min each time for a treatment period of 10-13 d. Treatment effect was assessed using the following indicators: endometrial thickness on the 6th day of gonadotropin treatment (GN6 day), endometrial thickness on the day on chorionic gonadotropin administration (HCG day), number of ovarian follicles on HCG day, number of ova captured, amount of estrogen required for each harvested ova, number of mature ova divided by the total number of ova, percentage of high-quality embryos, and clinical pregnancy. RESULTS Endometrial thickness in the experimental groups on the HCG day was significantly better than that of the control group after TEAS stimulation (P=0.01). TEAS exhibited a greater impact on the number of ova captured (P=0.003). However, the effect of TEAS stimulation on the high-quality embryo rate and clinical pregnancy in patients was not statistically significant (P>0.05). CONCLUSIONS TEAS is an effective method in improving the ovarian state. When the stimulus intensity was at 40 mA and above, it could be helpful to improve the patient's endometrial condition and endometrial receptivity and to retrieve more oocytes. (Trial registration No. ChiCTR-TRC-11001780).
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Li Z, Zhang M, Tian Y, Li Q, Huang X. Mesenchymal Stem Cells in Premature Ovarian Insufficiency: Mechanisms and Prospects. Front Cell Dev Biol 2021; 9:718192. [PMID: 34414193 PMCID: PMC8369507 DOI: 10.3389/fcell.2021.718192] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 07/14/2021] [Indexed: 01/01/2023] Open
Abstract
Premature ovarian insufficiency (POI) is a complex endocrine disease that severely affects the physiological and reproductive functions of females. The current conventional clinical treatment methods for POI are characterized by several side effects, and most do not effectively restore the physiological functions of the ovaries. Transplantation of mesenchymal stem cells (MSCs) is a promising regenerative medicine approach, which has received significant attention in the management of POI with high efficacy. Associated pre-clinical and clinical trials are also proceeding orderly. However, the therapeutic mechanisms underlying the MSCs-based treatment are complex and have not been fully elucidated. In brief, proliferation, apoptosis, immunization, autophagy, oxidative stress, and fibrosis of ovarian cells are modulated through paracrine effects after migration of MSCs to the injured ovary. This review summarizes therapeutic mechanisms of MSCs-based treatments in POI and explores their therapeutic potential in clinical practice. Therefore, this review will provide a theoretical basis for further research and clinical application of MSCs in POI.
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Affiliation(s)
- Zhongkang Li
- Department of Obstetrics and Gynecology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Mingle Zhang
- Department of Obstetrics and Gynecology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yanpeng Tian
- Department of Obstetrics and Gynecology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Qian Li
- Department of Obstetrics and Gynecology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xianghua Huang
- Department of Obstetrics and Gynecology, The Second Hospital of Hebei Medical University, Shijiazhuang, China
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Lodde V, Luciano AM, Musmeci G, Miclea I, Tessaro I, Aru M, Albertini DF, Franciosi F. A Nuclear and Cytoplasmic Characterization of Bovine Oocytes Reveals That Cysteamine Partially Rescues the Embryo Development in a Model of Low Ovarian Reserve. Animals (Basel) 2021; 11:ani11071936. [PMID: 34209664 PMCID: PMC8300191 DOI: 10.3390/ani11071936] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/16/2021] [Accepted: 06/21/2021] [Indexed: 11/30/2022] Open
Abstract
Simple Summary Women’s reproductive performance starts declining in the mid-30s, and by age 40–45, the possibility of becoming pregnant becomes very small. Reproductive aging is a physiological process of fertility decline characterized by a decrease in quality and stockpile of eggs (also called ovarian reserve) in most mammals. However, young individuals too can show an accelerated reproductive aging that similarly results in a low ovarian reserve and hypofertility. This syndrome, called premature ovarian failure (POF), is becoming a relevant problem due to the general tendency to postpone the first pregnancy. In this study, we used bovine ovaries that were classified in two categories, according to the number of follicles visible on the ovarian surface, and analyzed some parameters of egg maturation. We observed that eggs from the ‘aging-like’ ovaries carry several defects that impair maturation. However, one of the parameters was improved upon supplementation with a scavenger of free radicals, providing a proof of concept that in-depth knowledge of the cellular mechanisms is essential to find solutions to everyday-life problems. Abstract Decreased oocyte quality is a major determinant of age-associated fertility decline. Similarly, individuals affected by early ovarian aging carry low-quality oocytes. Using an established bovine model of early ovarian aging, we investigated key features of ‘quality’ oocyte maturation, associated with the onset of egg aneuploidy and reproductive aging, such as histone modifications, mitochondria distribution and activity, reduced glutathione (GSH) content, and gap junction functionality. Bovine ovaries were classified according to the antral follicle count (AFC), and the retrieved oocytes were processed immediately or matured in vitro. We observed alterations in several cellular processes, suggesting a multifactorial etiology of the reduced oocyte quality. Furthermore, we performed a rescue experiment for one of the parameters considered. By adding cysteamine to the maturation medium, we experimentally increased the free radical scavenger ability of the ‘low competence’ oocytes and obtained a higher embryo development. Our findings show that adopting culture conditions that counteract the free radicals has a positive impact on the quality of ‘compromised’ oocytes. Specifically, cysteamine treatment seems to be a promising option for treating aging-related deficiencies in embryo development.
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Affiliation(s)
- Valentina Lodde
- Reproductive and Developmental Biology Lab., Dipartimento di Scienze Veterinarie per la Salute la Produzione Animale e la Sicurezza Alimentare ‘Carlo Cantoni’, Università degli Studi di Milano, 20133 Milano, Italy; (V.L.); (A.M.L.); (G.M.); (I.T.); (M.A.)
| | - Alberto Maria Luciano
- Reproductive and Developmental Biology Lab., Dipartimento di Scienze Veterinarie per la Salute la Produzione Animale e la Sicurezza Alimentare ‘Carlo Cantoni’, Università degli Studi di Milano, 20133 Milano, Italy; (V.L.); (A.M.L.); (G.M.); (I.T.); (M.A.)
| | - Giulia Musmeci
- Reproductive and Developmental Biology Lab., Dipartimento di Scienze Veterinarie per la Salute la Produzione Animale e la Sicurezza Alimentare ‘Carlo Cantoni’, Università degli Studi di Milano, 20133 Milano, Italy; (V.L.); (A.M.L.); (G.M.); (I.T.); (M.A.)
| | - Ileana Miclea
- Faculty of Animal Science and Biotechnologies, University of Agricultural Sciences and Veterinary Medicine, 400372 Cluj-Napoca, Romania;
| | - Irene Tessaro
- Reproductive and Developmental Biology Lab., Dipartimento di Scienze Veterinarie per la Salute la Produzione Animale e la Sicurezza Alimentare ‘Carlo Cantoni’, Università degli Studi di Milano, 20133 Milano, Italy; (V.L.); (A.M.L.); (G.M.); (I.T.); (M.A.)
| | - Mariella Aru
- Reproductive and Developmental Biology Lab., Dipartimento di Scienze Veterinarie per la Salute la Produzione Animale e la Sicurezza Alimentare ‘Carlo Cantoni’, Università degli Studi di Milano, 20133 Milano, Italy; (V.L.); (A.M.L.); (G.M.); (I.T.); (M.A.)
| | | | - Federica Franciosi
- Reproductive and Developmental Biology Lab., Dipartimento di Scienze Veterinarie per la Salute la Produzione Animale e la Sicurezza Alimentare ‘Carlo Cantoni’, Università degli Studi di Milano, 20133 Milano, Italy; (V.L.); (A.M.L.); (G.M.); (I.T.); (M.A.)
- Correspondence:
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Perniola R, Fierabracci A, Falorni A. Autoimmune Addison's Disease as Part of the Autoimmune Polyglandular Syndrome Type 1: Historical Overview and Current Evidence. Front Immunol 2021; 12:606860. [PMID: 33717087 PMCID: PMC7953157 DOI: 10.3389/fimmu.2021.606860] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/25/2021] [Indexed: 12/11/2022] Open
Abstract
The autoimmune polyglandular syndrome type 1 (APS1) is caused by pathogenic variants of the autoimmune regulator (AIRE) gene, located in the chromosomal region 21q22.3. The related protein, AIRE, enhances thymic self-representation and immune self-tolerance by localization to chromatin and anchorage to multimolecular complexes involved in the initiation and post-initiation events of tissue-specific antigen-encoding gene transcription. Once synthesized, the self-antigens are presented to, and cause deletion of, the self-reactive thymocyte clones. The clinical diagnosis of APS1 is based on the classic triad idiopathic hypoparathyroidism (HPT)—chronic mucocutaneous candidiasis—autoimmune Addison's disease (AAD), though new criteria based on early non-endocrine manifestations have been proposed. HPT is in most cases the first endocrine component of the syndrome; however, APS1-associated AAD has received the most accurate biochemical, clinical, and immunological characterization. Here is a comprehensive review of the studies on APS1-associated AAD from initial case reports to the most recent scientific findings.
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Affiliation(s)
- Roberto Perniola
- Department of Pediatrics-Neonatal Intensive Care, V. Fazzi Hospital, ASL LE, Lecce, Italy
| | - Alessandra Fierabracci
- Infectivology and Clinical Trials Research Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Alberto Falorni
- Section of Internal Medicine and Endocrinological and Metabolic Sciences, Department of Medicine, University of Perugia, Perugia, Italy
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Ameliorative effect of recombinant human lactoferrin on the premature ovarian failure in rats after cyclophosphamide treatments. J Ovarian Res 2021; 14:17. [PMID: 33478578 PMCID: PMC7821665 DOI: 10.1186/s13048-020-00763-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 12/27/2020] [Indexed: 12/27/2022] Open
Abstract
This study investigated the effect of recombinant human lactoferrin (rhLF) on the premature ovarian failure (POF) of rats. After cyclophosphamide treatments, the POF rats were divided into the following groups: normal control group (NC), low-dose group (LD), medium-dose group (MD) and high-dose group (HD) of rhLF. After drug administrations, the ovarian indexes and hormonal levels were detected. After follicle number count, the proliferation and apoptosis were analyzed with the expressions of genes related with oogenesis, reactive oxygen species (ROS) production and apoptosis detected, followed by the calculation of oxidative stress and protein expressions. After 4-hydroperoxy cyclophosphamide (4-HC) treatments, the effect of rhLF on the proliferation, ROS production and gene expressions of primary rat granulosa cells (GCs) cultured in vitro were detected. After mating, the fertilities of POF rats were recorded. The result showed that the rhLF administrations up-regulated the ovarian index with the number of developing follicles increased and the decreases of hormonal levels conferred. The Ki-67 intensities of the MD and HD groups were up-regulated with the Tunnel intensities decreased. The rhLF treatments significantly promoted the expression of oogenesis, antioxidant and anti-apoptosis related genes. The expression of Bax and Caspase 3 were decreased with the expression of Bcl-2 up-regulated after rhLF administrations. The in vitro treatments of rhLF effectively conferred the toxicity of 4-HC on primary rat GCs. The fertility assessment showed the rhLF treatments up-regulated the offspring’s’ folliculogenesis, which confirmed the ameliorative role of rhLF on the POF damages via the inhibition of ROS production in GCs.
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22
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Ishizuka B. Current Understanding of the Etiology, Symptomatology, and Treatment Options in Premature Ovarian Insufficiency (POI). Front Endocrinol (Lausanne) 2021; 12:626924. [PMID: 33716979 PMCID: PMC7949002 DOI: 10.3389/fendo.2021.626924] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 01/20/2021] [Indexed: 12/16/2022] Open
Abstract
Premature ovarian insufficiency (POI) occurs in at least 1% of all women and causes life-long health problems and psychological stress. Infertility caused by POI used to be considered absolute, with infertility treatment having little or no value. Generally, it has been thought that medicine can provide little service to these patients. The etiology of POI has been found to be genetic, chromosomal, and autoimmune. In addition, the increasing numbers of cancer survivors are candidates for iatrogenic POI, along with patients who have undergone ovarian surgery, especially laparoscopic surgery. Over 50 genes are known to be causally related to POI, and the disease course of some cases has been clarified, but in most cases, the genetic background remains unexplained, suggesting that more genes associated with the etiology of POI need to be discovered. Thus, in most cases, the genetic background of POI has not been clarified. Monosomy X is well known to manifest as Turner's syndrome and is associated with primary amenorrhea, but recent studies have shown that some women with numerical abnormalities of the X chromosome can have spontaneous menstruation up to their twenties and thirties, and some even conceive. Hormone replacement therapy (HRT) is recommended for women with POI from many perspectives. It alleviates vasomotor and genitourinary symptoms and prevents bone loss and cardiovascular disease. POI has been reported to reduce quality of life and life expectancy, and HRT may help improve both. Most of the problems that may occur with HRT in postmenopausal women do not apply to women with POI; thus, in POI, HRT should be considered physiological replacement of estrogen (+progesterone). This review describes some new approaches to infertility treatment in POI patients that may lead to new treatments for POI, along with the development of more sensitive markers of secondary/preantral follicles and genetic diagnosis.
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Affiliation(s)
- Bunpei Ishizuka
- Rose Ladies Clinic, Tokyo, Japan
- Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kanagawa, Japan
- *Correspondence: Bunpei Ishizuka,
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El Bakly W, Medhat M, Shafei M, Tash R, Elrefai M, Shoukry Y, Omar NN. Optimized platelet rich plasma releasate (O-rPRP) repairs galactosemia-induced ovarian follicular loss in rats by activating mTOR signaling and inhibiting apoptosis. Heliyon 2020; 6:e05006. [PMID: 33005806 PMCID: PMC7509792 DOI: 10.1016/j.heliyon.2020.e05006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 08/25/2020] [Accepted: 09/17/2020] [Indexed: 11/30/2022] Open
Abstract
Platelet rich plasma contains a collection of growth factors, and an optimal formulation, named O-rPRP, contains the highest possible concentration of growth factors. Purpose Challenging the healing power of O-rPRP in a high-galactose diet-induced premature ovarian insufficiency (POI) experimental rat model. Methods Rats were divided into four groups of ten rats each and treated for four week as follows; 1) the control group, fed with normal diet and received intraperitoneal (i.p.) injection of PBS once/week; 2) the POI group, fed with galactose diet (50%) and received PBS (i.p.) once/week; 3) the POI/O-rPRP group, fed a 50% galactose diet and received O-rPRP (i.p.) once/week; 4) the O-rPRP group (negative control), fed with a normal diet and received O-rPRP (i.p.) once/week. The levels of galactose, follicle stimulating hormone, 17 β-estradiol, anti-mullerian hormone and inhibin B were measured in serum samples. Western blotting and quantitative real-time PCR assays were employed to investigate the levels of miR-223, β1 integrin, p70S6k and MCL-1 in ovarian tissues. Results After O-rPRP treatment, β1 integrin expression was enhanced, and miR-223 expression was decreased. Unlike the untreated galactose group, in the group treated with O-rPRP, p70S6k and MCL-1 expression levels were increased, indicating that the mTOR growth signaling pathway was active and that apoptosis was inactive. After the introduction of O-rPRP, the number of follicles and the follicular maturation improved, which was consistent with the improvement of inhibin B levels and subsequent inhibition of FSH. Conclusion O-rPRP inhibited galactose-induced excessive atresia and provided an overall protective effect on the ovarian follicles.
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Affiliation(s)
- Wesam El Bakly
- Department of Pharmacology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Marwa Medhat
- Department of Pharmacology, National Center for Social & Criminological Research, Egypt
| | - Mohamed Shafei
- Obstetrician and Gynecologist at Sidnawy Health Insurance Hospital, Cairo, Egypt.,Dar Alshifa Hospital, Kuwait
| | - Reham Tash
- Department of Anatomy and Embryology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.,Department of Anatomy and Embryology, Faculty of Medicine in Rabigh, King Abdulaziz University, Saudi Arabia
| | - Mohamed Elrefai
- Department of Anatomy and Embryology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.,Basic Medical Science Department, Faculty of Medicine, Hashemite University, Alzarqa, Jordan
| | - Yousef Shoukry
- Department of Anatomy and Embryology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nesreen Nabil Omar
- Department of Biochemistry, Faculty of Pharmacy, Modern University for Technology and Information, 11 Saudia Buildings, Nozha Street, 11371, Cairo, Egypt
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Zhang J, Huang X, Liu Y, He Y, Yu H. A comparison of the effects of Chinese non-pharmaceutical therapies for premature ovarian failure: A PRISMA-compliant systematic review and network meta-analysis. Medicine (Baltimore) 2020; 99:e20958. [PMID: 32590807 PMCID: PMC7328983 DOI: 10.1097/md.0000000000020958] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 05/08/2020] [Accepted: 05/12/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Premature ovarian failure (POF) is commonly treated with hormone replacement therapy (HRT). Many patients with POF choose acupuncture as a complementary therapy over HRT, due to possible adverse reactions. This systematic review and network meta-analysis (NMA) compares the efficacy of different forms of acupuncture therapies for POF. METHODS Seven databases including PubMed, the Cochrane Library, Embase, Wanfang database, China National Knowledge Infrastructure database, VIP Chinese Science, and Chinese Biomedical Database were searched for randomized controlled trials (RCTs) of various acupuncture treatments for POF. This time spanned from the date of database inception to January 13, 2020. RevMan 5.3 was used to assess the bias risk of the studies. A NMA of the included studies was performed using Stata14.0. RESULTS A total of 408 items were searched in this study, and finally this NMA included 16 RCTS, involving 1,307 patients. It showed that acupuncture (OR:1.35,95%1.24 to 1.47) has the best effectiveness among the four acupuncture (standardized mean difference [SMD]-16.30,95% -31.33 to -1.28) is the most effective and the best in reducing follicle-stimulating hormone levels among the four acupuncture treatments. Acupuncture (SMD 26.67,95%5.95 to 47.40) and acupoint embedding (SMD41.14,95%11.90 to 70.37) were ranked in the top 2 positions, in improving estradiol, whereas acupuncture (SMD-4.90,95% -8.10 to -1.70) was than acupoint embedding and HRT, in reducing luteinizing hormone level. In addition, our conclusions have not changed significantly after the sensitivity analysis.Protocol registration number: CRD42020150508. CONCLUSION With clinical evidence summarized by NMA, it is observed that acupuncture is the most promising therapy for improving menopausal symptoms, decreasing serum follicle-stimulating hormone and luteinizing hormone level. Therefore, acupuncture could be effective for patients with POF, who are intolerant to the adverse effects of hormone replacement therapy or who would prefer non-drug therapies. Further multi-center and high-quality RCT studies should be conducted to make our conclusion more rigorous.
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Affiliation(s)
- Jinhuan Zhang
- The fourth Clinical Medical College of Guangzhou University of Chinese Medicine
| | - Xingxian Huang
- Department of Acupuncture, Shenzhen Traditional Chinese Medicine Hospital, Guangdong Province, China
| | - Yongfeng Liu
- Department of Acupuncture, Shenzhen Traditional Chinese Medicine Hospital, Guangdong Province, China
| | - Yuhai He
- Department of Acupuncture, Shenzhen Traditional Chinese Medicine Hospital, Guangdong Province, China
| | - Haibo Yu
- Department of Acupuncture, Shenzhen Traditional Chinese Medicine Hospital, Guangdong Province, China
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Ding C, Zhu L, Shen H, Lu J, Zou Q, Huang C, Li H, Huang B. Exosomal miRNA-17-5p derived from human umbilical cord mesenchymal stem cells improves ovarian function in premature ovarian insufficiency by regulating SIRT7. Stem Cells 2020; 38:1137-1148. [PMID: 32442343 DOI: 10.1002/stem.3204] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/24/2020] [Indexed: 12/13/2022]
Abstract
Premature ovarian insufficiency (POI) is clinically irreversible in women aged over 40 years. Although numerous studies have demonstrated satisfactory outcomes of mesenchymal stem cell therapy, the underlying therapeutic mechanism remains unclear. Exosomes were collected from the culture medium of human umbilical cord mesenchymal stem cells (hUMSCs) and assessed by electron microscopy and Western blot (WB) analysis. Then, exosomes were added to the culture medium of cyclophosphamide (CTX)-damaged human granulosa cells (hGCs), and the mixture was injected into the ovaries of CTX-induced POI model mice before detection of antiapoptotic and apoptotic gene expression. Next, the microRNA expression profiles of hUMSC-derived exosomes (hUMSC-Exos) were detected by small RNA sequencing. The ameliorative effect of exosomal microRNA-17-5P (miR-17-5P) was demonstrated by miR-17-5P knockdown before assessment of ovarian phenotype and function, reactive oxygen species (ROS) levels and SIRT7 expression. Finally, SIRT7 was inhibited or overexpressed by RNA interference or retrovirus transduction, and the protein expression of PARP1, γH2AX, and XRCC6 was analyzed. The ameliorative effect of hUMSC-Exos on POI was validated. Our results illustrated that hUMSC-Exos restored ovarian phenotype and function in a POI mouse model, promoted proliferation of CTX-damaged hGCs and ovarian cells, and alleviated ROS accumulation by delivering exosomal miR-17-5P and inhibiting SIRT7 expression. Moreover, our findings elucidated that miR-17-5P repressed PARP1, γH2AX, and XRCC6 by inhibiting SIRT7. Our findings suggest a critical role for exosomal miR-17-5P and its downstream target mRNA SIRT7 in hUMSC transplantation therapy. This study indicates the promise of exosome-based therapy for POI treatment.
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Affiliation(s)
- Chenyue Ding
- Center of Reproduction and Genetics, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, People's Republic of China
| | - Liping Zhu
- Department of Obstetrics and Gynecology, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou, People's Republic of China
| | - Han Shen
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, People's Republic of China
| | - Jiafeng Lu
- Center of Reproduction and Genetics, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, People's Republic of China
| | - Qinyan Zou
- Center of Reproduction and Genetics, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, People's Republic of China
| | - Chao Huang
- Center of Reproduction and Genetics, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, People's Republic of China
| | - Hong Li
- Center of Reproduction and Genetics, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, People's Republic of China
| | - Boxian Huang
- Center of Reproduction and Genetics, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, People's Republic of China.,State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, People's Republic of China
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Hou S, Ding C, Shen H, Qian C, Zou Q, Lu J, Huang B, Tan J, Li H. Vitamin C improves the therapeutic potential of human amniotic epithelial cells in premature ovarian insufficiency disease. Stem Cell Res Ther 2020; 11:159. [PMID: 32321569 PMCID: PMC7178972 DOI: 10.1186/s13287-020-01666-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/12/2020] [Accepted: 03/30/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Human amniotic epithelial cell (hAEC) transplantation holds great promise in treating premature ovarian insufficiency (POI). However, some deficient biological characteristics of hAECs restrict their application. METHODS Vitamin C (VC) was added to the culture media of hAECs for 2 weeks. Then, the proliferative ability, migration ability, pluripotency, and self-renewal of VC-treated hAECs (VC-hAECs) were determined. Next, hAECs and VC-hAECs were transplanted into the ovaries of cyclophosphamide (CTX)-induced POI model mice. The ovarian function of POI mice was evaluated after transplantation by counting follicle numbers and measuring the blood levels of AMH, E2, and FSH. The rescue effects of VC-hAECs and hAECs were unveiled by coculturing with CTX-damaged human ovarian granulosa cells (hGCs) and analyzing relative marker expression. Additionally, ovarian marker expression and transplant survival were detected in POI mice after transplantation to verify the beneficial effect of VC-hAECs. The cytokine profiles of VC-hAECs and hAECs were revealed by performing a cytokine array and an ELISA to show their paracrine function. RESULTS Our results indicated that VC promoted the proliferation, migration, pluripotency, and self-renewal of hAECs in vitro. The most effective concentration of VC was 50 μg/ml. After transplantation into the POI mouse model, VC-hAECs reversed ovarian function more powerfully than hAECs. Human granulosa cell marker expression in CTX-damaged hGCs was increased after coculture with VC-hAECs compared with hAECs. In the ovaries of the POI mice, ovarian marker expression was greater after VC-hAEC transplantation than after hAEC transplantation. VC-hAECs showed higher transplant survival than hAECs. Furthermore, VC-hAECs secreted more growth factors than hAECs. CONCLUSION Treatment with VC promoted the proliferation, migration, self-renewal, and paracrine functions of hAECs. Additionally, VC elevated the therapeutic potential of hAECs in treating POI.
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Affiliation(s)
- Shunyu Hou
- Department of Obstetrics and Gynecology, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, 215002, China
| | - Chenyue Ding
- Center of Reproduction and Genetics, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, 215002, China
| | - Han Shen
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 210029, China
| | - Chunfeng Qian
- Center of Reproduction and Genetics, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, 215002, China.,State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 210029, China
| | - Qinyan Zou
- Center of Reproduction and Genetics, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, 215002, China
| | - Jiafeng Lu
- Center of Reproduction and Genetics, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, 215002, China
| | - Boxian Huang
- Department of Obstetrics and Gynecology, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, 215002, China. .,Center of Reproduction and Genetics, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, 215002, China. .,State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 210029, China.
| | - Jichun Tan
- Reproductive Medical Center of Gynecology and Obstetrics Department, Shengjing Hospital of China Medical University, Shenyang, 110000, China. .,Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang, 110000, China.
| | - Hong Li
- Center of Reproduction and Genetics, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, 215002, China. .,State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, 210029, China.
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Park MJ, Ahn JW, Kim KH, Bang J, Kim SC, Jeong JY, Choi YE, Kim CW, Joo BS. Prediction of ovarian aging using ovarian expression of BMP15, GDF9, and C-KIT. Exp Biol Med (Maywood) 2020; 245:711-719. [PMID: 32223330 DOI: 10.1177/1535370220915826] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
IMPACT STATEMENT Ovarian aging is becoming a more important issue in terms of fertility preservation and infertility treatment. Serum anti-Mullerian hormone (AMH) level and antral follicle count (AFC) are being practically used as markers of ovarian aging as well as ovarian reserve in human. However, these factors have some drawbacks in assessing ovarian aging and reserve. Therefore, the identification of ovarian expressions of BMP15, GDF9, and C-KIT according to female could be applied as a potent predictor of ovarian aging. This work provides new information on the development of diagnosis and treatment strategy of age-related fertility decline and premature ovarian insufficiency.
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Affiliation(s)
- Min Jung Park
- Korea Institute for Public Sperm Bank, Busan 49241, Korea
| | - Jun-Woo Ahn
- Department of Obstetrics and Gynecology, College of Medicine, Ulsan University Hospital, Ulsan 44033, Korea
| | - Ki Hyung Kim
- Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Pusan National University Hospital, Busan 49241, Korea
| | - Junghee Bang
- Department of Cardiothoracic Surgery, Dong-A University Hospital, Busan 602-812, Korea
| | - Seung Chul Kim
- Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Pusan National University Hospital, Busan 49241, Korea
| | - Jae Yi Jeong
- Department of Obstetrics and Gynecology, Sungkyunkwan University School of Medicine, 51353 Changwon, Korea
| | - Ye Eun Choi
- Department of Obstetrics and Gynecology, Sungkyunkwan University School of Medicine, 51353 Changwon, Korea
| | - Chang-Woon Kim
- Department of Obstetrics and Gynecology, Sungkyunkwan University School of Medicine, 51353 Changwon, Korea
| | - Bo Sun Joo
- Korea Institute for Public Sperm Bank, Busan 49241, Korea.,Department of Cardiothoracic Surgery, Dong-A University Hospital, Busan 602-812, Korea
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Dragojević Dikić S, Vasiljević M, Jovanović A, Dikić S, Jurišić A, Srbinović L, Vujović S. Premature ovarian insufficiency - novel hormonal approaches in optimizing fertility. Gynecol Endocrinol 2020; 36:162-165. [PMID: 31311350 DOI: 10.1080/09513590.2019.1640203] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Premature ovarian insufficiency (POI) is a delicate medical problem in young women. This condition is not unchangeable and permanent but is associated with intermittent and unpredictable ovarian activity, resulting in low conception rate. Over the period of 8 years, the evaluation of secondary amenorrhea was conducted in 90 patients below the age of 40 who wished to restore fertility. Having confirmed the diagnosis and investigated the etiology of POI, hormone replacement therapy was applied (sequential administration of estradiol and norethisterone acetate) in the first 30 patients (group A). Estrogen-progestogen therapy with daily supplementation of 25 mg of micronized oral dehydroepiandrosterone (DHEA) was conducted in 44 patients (group B), whereas a combined regime (estrogen-progestogen therapy, DHEA supplementation in daily dose of 25 mg, and melatonin supplementation in daily dose of 3 mg) was conducted in 16 patients (group C). In the course of our study, 16 pregnancies were realized (18% of all cases: 17% in group A; 18% in group B; 19% in group C) 6 to 20 months after the initiation of hormone therapy, and there have been 13 completed term pregnancies so far with normal fetal growth and development. We concluded that estrogen-progestogen therapy combined with DHEA and melatonin could optimize fertility and lead to successful pregnancy in POI patients.
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Affiliation(s)
- Svetlana Dragojević Dikić
- Medical Faculty, University of Belgrade, Gynecology-Obstetrics Clinic "Narodni Front", Belgrade, Serbia
| | - Mladenko Vasiljević
- Medical Faculty, University of Belgrade, Gynecology-Obstetrics Clinic "Narodni Front", Belgrade, Serbia
| | - Ana Jovanović
- Medical Faculty, University of Belgrade, Gynecology-Obstetrics Clinic "Narodni Front", Belgrade, Serbia
| | - Srdjan Dikić
- University Medical Center "Bezanijska kosa", Belgrade, Serbia
| | - Aleksandar Jurišić
- Medical Faculty, University of Belgrade, Gynecology-Obstetrics Clinic "Narodni Front", Belgrade, Serbia
| | - Ljubomir Srbinović
- Medical Faculty, University of Belgrade, Gynecology-Obstetrics Clinic "Narodni Front", Belgrade, Serbia
| | - Svetlana Vujović
- Medical Faculty, University of Belgrade, Clinic of Endocrinology, Clinical Center of Serbia, Belgrade, Serbia
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Liu M, Qiu Y, Xue Z, Wu R, Li J, Niu X, Yuan J, Wang Y, Wu Q. Small extracellular vesicles derived from embryonic stem cells restore ovarian function of premature ovarian failure through PI3K/AKT signaling pathway. Stem Cell Res Ther 2020; 11:3. [PMID: 31900201 PMCID: PMC6942273 DOI: 10.1186/s13287-019-1508-2] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 11/18/2019] [Accepted: 11/22/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Premature ovarian failure (POF) has a great impact on reproductive endocrine function in females, and it is an important cause of infertility. Previous studies have demonstrated that small extracellular vesicles (sEVs) derived from stem cells play an important role in tissue regeneration. This study aimed to investigate the therapeutic effect of sEVs derived from embryonic stem cells (ESCs-sEVs) on damaged ovaries and explore the underlying molecular mechanisms. METHODS Mice POF models were established by injecting mice with cyclophosphamide and busulfan. Then, ESCs-sEVs were intravenously transplanted into POF mice. The plasma of mice was harvested at 1 and 2 weeks after treatment to analyze the levels of anti-Mullerian hormone (AMH), estradiol (E2), and follicle stimulating hormone (FSH) by ELISA. The morphology of ovaries and follicles was observed by H&E staining, and apoptosis of granulosa cells was detected by TUNEL. In vitro, EdU and CCK-8 tests were used to evaluate the proliferation of cultured granulosa cells stimulated by ESCs-sEVs. Western blotting was used to determine the expression of PI3K/AKT and apoptotic-related proteins. RESULTS After transplantation of ESCs-sEVs, the levels of serum sex hormones recovered to normal levels. In addition, the number of follicles was significantly increased, and the number of apoptotic cells was decreased. The results in vitro revealed that ESCs-sEVs could significantly improve the proliferation rate of granulosa cells and increase the expression of phosphorylated PI3K and AKT. Meanwhile, the positive effect on proliferation and the negative effect on apoptosis observed in granulosa cells were obviously decreased when the PI3K/AKT signaling pathway was inhibited. CONCLUSION Our findings suggested that ESCs-sEVs could improve ovarian function by regulating the PI3K/AKT signaling pathway, which could provide a promising clinical therapy for POF.
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Affiliation(s)
- Mengyu Liu
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No.600 Yishan Road, Shanghai, 200233, China
- Medical College of Soochow University, Suzhou, 215006, China
| | - Yu Qiu
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No.600 Yishan Road, Shanghai, 200233, China
| | - Zhuowei Xue
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No.600 Yishan Road, Shanghai, 200233, China
| | - Ruoyu Wu
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No.600 Yishan Road, Shanghai, 200233, China
| | - Jie Li
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No.600 Yishan Road, Shanghai, 200233, China
| | - Xin Niu
- Institute of Microsurgery on Extremities, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No.600 Yishan Road, Shanghai, 200233, China
| | - Ji Yuan
- Institute of Microsurgery on Extremities, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No.600 Yishan Road, Shanghai, 200233, China
| | - Yang Wang
- Institute of Microsurgery on Extremities, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No.600 Yishan Road, Shanghai, 200233, China.
| | - Qingkai Wu
- Department of Obstetrics and Gynecology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No.600 Yishan Road, Shanghai, 200233, China.
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Lv XJ, Cheng XL, Tu YQ, Yan DD, Tang Q. Association between the location of transposed ovary and ovarian dose in patients with cervical cancer treated with postoperative pelvic radiotherapy. Radiat Oncol 2019; 14:230. [PMID: 31842971 PMCID: PMC6916465 DOI: 10.1186/s13014-019-1437-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 12/06/2019] [Indexed: 12/24/2022] Open
Abstract
Background and purpose How to protect the ovarian function during radiotherapy is uncertain. The purpose of this study was to explore the association between the location of the transposed ovary and the ovarian dose in patients with cervical cancer received radical hysterectomy, ovarian transposition, and postoperative pelvic radiotherapy. Methods A retrospective analysis was conducted of 150 young patients with cervical cancer who received radical hysterectomy, intraoperative ovarian transposition, and postoperative adjuvant radiotherapy in Zhejiang Cancer Hospital. Association between location of the transposed ovaries and ovarian dose was evaluated. The transposed position of ovaries with a satisfactory dose was explored using a receiver operator characteristic curve (ROC) analysis. Patients’ ovarian function was followed up 3 months and 1 year after radiotherapy. Results A total of 32/214 (15%) transposed ovaries were higher than the upper boundary of the planning target volume (PTV). The optimum cutoff value of > 1.12 cm above the iliac crest plane was significantly associated with ovaries above the upper PTV boundary. When the ovaries were below the upper boundary of PTV, the optimum cutoff value of transverse distance > 3.265 cm between the ovary and PTV was significantly associated with ovarian max dose (Dmax) ≤ 4Gy, and the optimum cutoff value of transverse distance > 2.391 cm was significantly associated with ovarian Dmax≤5Gy. A total of 77 patients had received complete follow-up, and 56 patients (72.7%) showed preserved ovarian function 1 year after radiotherapy, which was significantly increased compared with 3 months (44.2%) after radiotherapy. Conclusions The location of transposed ovaries in patients with cervical cancer is significantly correlated with ovarian dose in adjuvant radiotherapy. We recommend transposition of ovaries > 1.12 cm higher than the iliac crest plane to obtain ovarian location above PTV. When the transposed ovary is below the upper boundary of PTV, ovarian Dmax ≤4Gy may be obtained when the transverse distance between the ovary and PTV was > 3.265 cm, and the ovarian Dmax≤5Gy may be obtained when the transverse distance was > 2.391 cm.
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Affiliation(s)
- Xiao-Juan Lv
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, China.,Department of Gynecologic Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences, Hangzhou, China.,Department of Gynecologic Radiation Oncology, Zhejiang Cancer Hospital, Bangshan East Road 1, Hangzhou, 310022, China
| | - Xiao-Long Cheng
- Department of Radiation Physics, Zhejiang Cancer Hospital, Hangzhou, China
| | - Ye-Qiang Tu
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, China.,Department of Gynecologic Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences, Hangzhou, China.,Department of Gynecologic Radiation Oncology, Zhejiang Cancer Hospital, Bangshan East Road 1, Hangzhou, 310022, China
| | - Ding-Ding Yan
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, China.,Department of Gynecologic Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences, Hangzhou, China.,Department of Gynecologic Radiation Oncology, Zhejiang Cancer Hospital, Bangshan East Road 1, Hangzhou, 310022, China
| | - Qiu Tang
- Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Hangzhou, China. .,Department of Gynecologic Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences, Hangzhou, China. .,Department of Gynecologic Radiation Oncology, Zhejiang Cancer Hospital, Bangshan East Road 1, Hangzhou, 310022, China.
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Kuntai Capsule plus Hormone Therapy vs. Hormone Therapy Alone in Patients with Premature Ovarian Failure: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:2085804. [PMID: 31346337 PMCID: PMC6617870 DOI: 10.1155/2019/2085804] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 06/12/2019] [Indexed: 12/11/2022]
Abstract
The aim of this study was to evaluate the efficacy and safety of Kuntai capsules (KTC) plus hormone therapy (HT) compared to HT alone for the treatment of premature ovarian failure (POF). Databases including PubMed, MEDLINE, Web of Science, China National Knowledge Infrastructure (CNKI), the Chinese BioMedical database (CBM), and the Wanfang database were searched up to October 2018 for randomized controlled trials (RCTs). After screening the studies, extracting the data, and assessing the study quality, Cochrane RevMan 5.3 software was used to conduct a meta-analysis. Twelve RCTs involving 1178 patients were included. Regarding the therapeutic effects, total effective treatment rate was higher for the KTC+HT groups compared to the HT-only groups. Furthermore, compared with HT, KTC+HR effectively altered endocrine indexes involving serum levels of luteinizing hormone (weighted mean difference [WMD]=-3.47, 95% CI [5.68, -1.26], P=0.002]), follicle-stimulating hormone [WMD=-8.15, 95% CI [-10.44, -5.86], P<0.00001], estrogen [WMD=17.21, 95% CI [10.16, 24.26], P<0.00001], and anti-Müllerian hormone [WMD=1.07, 95% CI [0.78, 1.36], P<0.00001]; blood lipid indexes involving serum levels of triglyceride (WMD=-0.55, 95% CI [-0.76, -0.43], P<0.00001), total cholesterol (WMD=-0.63, 95% CI [-0.74, -0.52], P<0.00001), and low-density lipoprotein cholesterol (WMD=-0.62, 95% CI [-0.75, -0.49], P<0.00001); and B-ultrasound results involving ovarian resistance index (WMD=-0.20, 95% CI [-0.35, -0.04], P=0.01), perfusion index (WMD=-0.41, 95% CI [-0.57, -0.24], P<0.00001), peak systolic velocity (WMD=2.43, 95% CI [1.52, 3.34], P<0.00001), antral follicle count (WMD=1.20, 95% CI [0.41, 2.00], P=0.003), and mean ovarian diameter in the plane containing the longest axis of the ovary (WMD=4.34, 95% CI [2.94, 5.74], P<0.00001). There were no serious adverse events in either group. There is evidence that KTC+HT is more effective and safer than HT alone for treating POF. However, the trials had low methodological quality and small samples, so further standardized research is required.
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Ghaleb RM, Fahmy KA. Premature ovarian failure in systemic lupus erythematosus patients: is it related to cyclophosphamide treatment? EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2019. [DOI: 10.4103/err.err_53_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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33
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Hatirnaz S, Basbug A, Akarsu S, Hatirnaz E, Demirci H, Dahan MH. Outcomes of random start versus clomiphene citrate and gonadotropin cycles in occult premature ovarian insufficiency patients, refusing oocyte donation: a retrospective cohort study. Gynecol Endocrinol 2018; 34:949-954. [PMID: 29847194 DOI: 10.1080/09513590.2018.1473361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
The aim of this study is to present the clinical outcomes of a random start, a spontaneous folliculogenesis protocol versus Clomiphene Citrate and Gonadotropin treatment in women with occult premature ovarian insufficiency. Women underwent treatment between 1 February 2009, and 30 May 2016. 41 women were treated with the random start protocol while 48 cases received ovarian stimulation with clomiphene and gonadotropins. All included cases met the criteria of 4 months of oligo-ovulation, follicular-stimulating hormone levels over 30 IU/L and anti-Mullerian hormone levels below 0.30 ng/mL. The random start protocol involved following the subjects for up to 6 months until spontaneous folliculogenesis occurred. The mean number of oocytes collected, mature oocytes, fertilized oocytes, and grade II embryos were significantly higher in the random start protocol (p < .05). The doses of gonadotropin administration and hCG were significantly lower in the random start protocol (p < .05). The clinical pregnancy and live birth rates were significantly higher in the random start protocol (p < .05). Likely stimulation is of little benefit in women with occult premature ovarian insufficiency. Observation while waiting for spontaneous folliculogenesis results in better outcomes, and less oocyte collections.
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Affiliation(s)
- Safak Hatirnaz
- a IVF Unit, Department of Obstetrics & Gynecology , Medicana Samsun International Hospital , Samsun , Turkey
| | - Alper Basbug
- b Gynecology and Obstetrics Department , Duzce University School of Medicine , Duzce , Turkey
| | - Suleyman Akarsu
- c Department of Obstetrics and Gynecology , Yüksek İhtisas University , Ankara , Turkey
| | - Ebru Hatirnaz
- a IVF Unit, Department of Obstetrics & Gynecology , Medicana Samsun International Hospital , Samsun , Turkey
| | - Hakan Demirci
- d Department of Family Medicine , Yüksek Ihtisas Training and Research Hospital,University of Health Sciences , Bursa , Turkey
| | - Michael H Dahan
- e Obstetrics and Gynecology Department , McGill University , Montreal , Canada
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Premature ovarian insufficiency - aetiopathology, epidemiology, and diagnostic evaluation. MENOPAUSE REVIEW 2018; 17:105-108. [PMID: 30357004 PMCID: PMC6196779 DOI: 10.5114/pm.2018.78550] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Accepted: 07/27/2018] [Indexed: 02/08/2023]
Abstract
Premature ovarian insufficiency (POI) is defined as a cessation of ovarian function before the age of 40 years. It is associated with hypoestrogenism and loss of residual follicles, both of which lead to menstrual abnormalities, pregnancy failures, and decreased health-related quality of life. The prevalence of POI is estimated at 1% in the general population. Current European Society of Human Reproduction and Embryology (ESHRE) diagnostic criteria include: amenorrhoea or oligomenorrhoea for at least four months and increased follicle-stimulating hormone (FSH) levels > 25 IU/l measured twice (with a four-week interval). The aetiopathogenesis of the disease in most cases remains unexplained. Nevertheless, in some patients with POI, genetic abnormalities, metabolic disorders, autoimmunity, iatrogenic procedures, infections, or environmental factors have been established as underlying causes of the syndrome.
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35
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Li J, Dalgleish R, Vujovic S, Dragojevic-Dikic S, Ivanisevic M, Ivovic M, Tancic M, Thompson J, Al-Azzawi F. Microsatellite variation of ESR1, ESR2, and AR in Serbian women with primary ovarian insufficiency. Climacteric 2018; 21:472-477. [PMID: 30156935 DOI: 10.1080/13697137.2018.1476967] [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: 10/28/2022]
Abstract
OBJECTIVE This study aimed to investigate the potential role of microsatellite polymorphisms of the estrogen receptor alpha gene (ESR1) TA repeat, estrogen receptor beta gene (ESR2) CA repeat, and androgen receptor gene (AR) CAG and GGN repeats among Serbian women with primary ovarian insufficiency (POI). These microsatellites have been reported to be associated with POI in different racial/ethnic populations. METHODS A cohort of 196 POI cases matched with 544 fertile controls was recruited by the Institute for Endocrinology, Diabetes and Metabolic Disorders of Serbia between 2007 and 2010. DNA was extracted from saliva. The four microsatellites were genotyped using a PCR-based assay to determine the repeat lengths. RESULTS POI patients carried shorter repeat lengths of ESR2 (CA)n than controls (P = 0.034), but the difference was small. ESR1 (TA)n was on the borderline of statistical differences between groups (P = 0.059). AR (CAG)n and (GGN)n showed no association with POI. CONCLUSIONS We cautiously conclude that microsatellite polymorphisms of gonadal steroid receptor genes might contribute to the genetic basis of POI in Serbian women, but a larger-scale study and family-based studies are warranted to validate our findings even though the sample size in this study is larger than any previously published in this field.
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Affiliation(s)
- J Li
- a Gynaecology Research Unit , University Hospitals of Leicester , Leicester , UK
| | - R Dalgleish
- b Department of Genetics and Genome Biology , University of Leicester , Leicester , UK
| | - S Vujovic
- c Faculty of Medicine, Clinic of Endocrinology , University of Belgrade, Clinical Centre of Serbia , Belgrade , Serbia
| | - S Dragojevic-Dikic
- c Faculty of Medicine, Clinic of Endocrinology , University of Belgrade, Clinical Centre of Serbia , Belgrade , Serbia
| | - M Ivanisevic
- c Faculty of Medicine, Clinic of Endocrinology , University of Belgrade, Clinical Centre of Serbia , Belgrade , Serbia
| | - M Ivovic
- c Faculty of Medicine, Clinic of Endocrinology , University of Belgrade, Clinical Centre of Serbia , Belgrade , Serbia
| | - M Tancic
- c Faculty of Medicine, Clinic of Endocrinology , University of Belgrade, Clinical Centre of Serbia , Belgrade , Serbia
| | - J Thompson
- d Department of Health Sciences , University of Leicester , Leicester , UK
| | - F Al-Azzawi
- a Gynaecology Research Unit , University Hospitals of Leicester , Leicester , UK
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Chen L, Guo S, Wei C, Li H, Wang H, Xu Y. Effect of stem cell transplantation of premature ovarian failure in animal models and patients: A meta-analysis and case report. Exp Ther Med 2018; 15:4105-4118. [PMID: 29755593 PMCID: PMC5943678 DOI: 10.3892/etm.2018.5970] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 06/06/2017] [Indexed: 12/15/2022] Open
Abstract
Stem cell transplantation has been considered a promising therapeutic approach for premature ovarian failure (POF). However, to date, no quantitative data analysis of stem cell therapy for POF has been performed. Therefore, the present study performed a meta-analysis to assess the efficacy of stem cell transplantation in improving ovarian function in animal models of POF. In addition, a case report of a patient with POF subjected to stem cell treatment was included to demonstrate that stem cell therapy also contributes to the recovery of ovarian function in patients. Published studies were identified by a systematic review of the PubMed, Embase, and Cochrane's library databases, and references cited in associated reviews were also considered. Data regarding follicle-stimulating hormone (FSH), estradiol (E2), ovarian weight, follicle count, the number of pregnancies and other parameters, including delivery route and cell type, were extracted. Pooled analysis, sensitivity analyses, subgroup analyses and meta-regression were performed. In the case of POF, transvaginal ultrasound (TVS), abdominal ultrasound (TAS) and color Doppler flow imaging (CDFI) were performed to observe the endometrial morphology and blood flow signals in the patient. Overall, pooled results from 16 pre-clinical studies demonstrated that stem cell-based therapy significantly improved FSH levels [standardized mean difference (SMD)=-1.330; 95% confidence interval (CI), -(2.095-0.565); P=0.001], E2 levels (SMD=2.334; 95% CI, 1.350-3.319; P<0.001), ovarian weight (SMD=1.310; 95% CI, 0.157-2.463; P=0.026), follicle count (SMD=1.871; 95% CI, 1.226-2.516; P<0.001), and the number of pregnancies (risk ratio=1.715, 95% CI, 1.213-2.424; P=0.002). The results of TVS and TAS demonstrated improved ovarian size and endometrial thickness in the patient with POF after MSC treatment. Of note, a rich blood flow signal in the endometrium was observed on CDFI. It appeared that stem cell-based therapy may be an effective method for the resumption of ovarian function in a patient and in animal models of POF; however, large-scale and high-quality future studies are required to confirm the present findings due to heterogeneity.
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Affiliation(s)
- Lei Chen
- R&D Department, Nanjing Regenerative Medicine Engineering and Technology Research Center, Nanjing, Jiangsu 210046, P.R. China
| | - Shilei Guo
- R&D Department, Nanjing Regenerative Medicine Engineering and Technology Research Center, Nanjing, Jiangsu 210046, P.R. China.,R&D Department, Regenerative Medicine Center, The Second Military Medical University, Shanghai 200433, P.R. China
| | - Cui Wei
- R&D Department, Nanjing Regenerative Medicine Engineering and Technology Research Center, Nanjing, Jiangsu 210046, P.R. China
| | - Honglan Li
- R&D Department, Nanjing Regenerative Medicine Engineering and Technology Research Center, Nanjing, Jiangsu 210046, P.R. China
| | - Haiya Wang
- R&D Department, Nanjing Regenerative Medicine Engineering and Technology Research Center, Nanjing, Jiangsu 210046, P.R. China
| | - Yan Xu
- R&D Department, Nanjing Regenerative Medicine Engineering and Technology Research Center, Nanjing, Jiangsu 210046, P.R. China.,R&D Department, Regenerative Medicine Center, The Second Military Medical University, Shanghai 200433, P.R. China
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Chen M, Han H, Chuai Y, Hao M, Shu M, Shang W. Effects of oral contraceptives on ovulation induction in in vitro fertilization patients with premature ovarian insufficiency. Climacteric 2018; 21:276-279. [PMID: 29488818 DOI: 10.1080/13697137.2018.1439912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To report a case series of in vitro fertilization patients with premature ovarian insufficiency, who were treated with oral contraceptives to reduce follicle stimulating hormone levels. METHOD This was a consecutive case series in a tertiary teaching hospital in China. Twenty-two women with refractory and idiopathic premature ovarian insufficiency were administered a drospirenone/ethinylestradiol oral contraceptive orally. The main outcome measures were the number of oocytes retrieved and the number of embryos frozen. RESULTS There were total 106 oral contraceptive treatment cycles and 53 oocyte retrieval cycles in 20 patients (91%, 20/22; 2.4 cycles per woman, 53/22). The total number of oocytes retrieved was 48 in 17 patients (77%, 17/22; 2.2 oocytes per woman, 48/22), and the total number of embryos frozen was 33 in 16 patients (73%, 16/22; 1.5 embryos per woman, 33/22). CONCLUSION Oral contraception may be an effective method to induce ovulation for some patients with premature ovarian insufficiency.
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Affiliation(s)
- M Chen
- a Navy Clinical Medical School , Anhui Medical University , Hefei , China.,b Reproductive Medicine Center, Department of Obstetrics and Gynecology , Navy General Hospital , Beijing , China
| | - H Han
- a Navy Clinical Medical School , Anhui Medical University , Hefei , China.,b Reproductive Medicine Center, Department of Obstetrics and Gynecology , Navy General Hospital , Beijing , China
| | - Y Chuai
- b Reproductive Medicine Center, Department of Obstetrics and Gynecology , Navy General Hospital , Beijing , China
| | - M Hao
- b Reproductive Medicine Center, Department of Obstetrics and Gynecology , Navy General Hospital , Beijing , China.,c Department of Histology and Embryology , Hebei Medical University , Shijiazhuang , China
| | - M Shu
- b Reproductive Medicine Center, Department of Obstetrics and Gynecology , Navy General Hospital , Beijing , China
| | - W Shang
- a Navy Clinical Medical School , Anhui Medical University , Hefei , China.,b Reproductive Medicine Center, Department of Obstetrics and Gynecology , Navy General Hospital , Beijing , China
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Arcos A, de Paola M, Gianetti D, Acuña D, Velásquez ZD, Miró MP, Toro G, Hinrichsen B, Muñoz RI, Lin Y, Mardones GA, Ehrenfeld P, Rivera FJ, Michaut MA, Batiz LF. α-SNAP is expressed in mouse ovarian granulosa cells and plays a key role in folliculogenesis and female fertility. Sci Rep 2017; 7:11765. [PMID: 28924180 PMCID: PMC5603506 DOI: 10.1038/s41598-017-12292-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 09/05/2017] [Indexed: 01/13/2023] Open
Abstract
The balance between ovarian folliculogenesis and follicular atresia is critical for female fertility and is strictly regulated by a complex network of neuroendocrine and intra-ovarian signals. Despite the numerous functions executed by granulosa cells (GCs) in ovarian physiology, the role of multifunctional proteins able to simultaneously coordinate/modulate several cellular pathways is unclear. Soluble N-ethylmaleimide-sensitive factor (NSF) attachment protein (α-SNAP) is a multifunctional protein that participates in SNARE-mediated membrane fusion events. In addition, it regulates cell-to-cell adhesion, AMPK signaling, autophagy and apoptosis in different cell types. In this study we examined the expression pattern of α-SNAP in ovarian tissue and the consequences of α-SNAP (M105I) mutation (hyh mutation) in folliculogenesis and female fertility. Our results showed that α-SNAP protein is highly expressed in GCs and its expression is modulated by gonadotropin stimuli. On the other hand, α-SNAP-mutant mice show a reduction in α-SNAP protein levels. Moreover, increased apoptosis of GCs and follicular atresia, reduced ovulation rate, and a dramatic decline in fertility is observed in α-SNAP-mutant females. In conclusion, α-SNAP plays a critical role in the balance between follicular development and atresia. Consequently, a reduction in its expression/function (M105I mutation) causes early depletion of ovarian follicles and female subfertility.
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Affiliation(s)
- Alexis Arcos
- Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Matilde de Paola
- Instituto de Histología y Embriología (IHEM), Universidad Nacional de Cuyo-CONICET, Mendoza, Argentina
| | - Diego Gianetti
- Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Diego Acuña
- Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Zahady D Velásquez
- Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - María Paz Miró
- Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Gabriela Toro
- Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Bryan Hinrichsen
- Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Rosa Iris Muñoz
- Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Yimo Lin
- Instituto de Fisiología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile.,Department of Neurosurgery, Oregon Health and Science University, Portland, Oregon, USA
| | - Gonzalo A Mardones
- Instituto de Fisiología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile.,Center for Interdisciplinary Studies on the Nervous System (CISNe), Universidad Austral de Chile, Valdivia, Chile
| | - Pamela Ehrenfeld
- Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile.,Center for Interdisciplinary Studies on the Nervous System (CISNe), Universidad Austral de Chile, Valdivia, Chile
| | - Francisco J Rivera
- Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile.,Center for Interdisciplinary Studies on the Nervous System (CISNe), Universidad Austral de Chile, Valdivia, Chile.,Institute of Molecular Regenerative Medicine, Paracelsus Medical University Salzburg, Salzburg, A-5020, Austria.,Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University Salzburg, Salzburg, A-5020, Austria
| | - Marcela A Michaut
- Instituto de Histología y Embriología (IHEM), Universidad Nacional de Cuyo-CONICET, Mendoza, Argentina. .,Facultad de Ciencias Exactas y Naturales, Universidad Nacional de Cuyo, Mendoza, Argentina.
| | - Luis Federico Batiz
- Instituto de Anatomía, Histología y Patología, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile. .,Center for Interdisciplinary Studies on the Nervous System (CISNe), Universidad Austral de Chile, Valdivia, Chile. .,Centro de Investigación Biomédica (CIB), Facultad de Medicina, Universidad de los Andes, Santiago, Chile.
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Xu X, Tan Y, Jiang G, Chen X, Lai R, Zhang L, Liang G. Effects of Bushen Tianjing Recipe in a rat model of tripterygium glycoside-induced premature ovarian failure. Chin Med 2017; 12:10. [PMID: 28439292 PMCID: PMC5402324 DOI: 10.1186/s13020-017-0131-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 04/10/2017] [Indexed: 12/13/2022] Open
Abstract
Background Bushen Tianjing Recipe (BTR) is a traditional Chinese herbal medicine that has been prescribed for premature ovarian failure (POF) for decades in China. Nevertheless, little is known regarding its underlying molecular mechanism. In the present study, we investigated the effects of BTR in a tripterygium glycoside (TG)-induced-POF rat model. Methods Three doses of BTR were administered via intragastric gavage to adult female Sprague–Dawley (SD) rats with TG-induced POF. After 15 days of treatment, the estrous cycle was examined by vaginal smear analysis. Serum levels of estradiol, follicle-stimulating hormone, progesterone, and testosterone were measured by radioimmunoassay. Histological analysis and assessment of apoptosis were performed after hematoxylin and eosin staining of ovarian tissue sections. The expression of vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor 2 (VEGFR2), anti-apoptotic factor Bcl-2, and pro-apoptotic factors Bax and caspase 3 in ovaries of animals was examined by an immunohistochemistry process. Results BTR not only reverted an abnormal estrous cycle and decreased the ovary index in POF rats but also improved the abnormal secretion of reproductive hormones associated with POF. In addition, treatment with BTR can protect ovaries from TG-induced damage, induce intraovarian expression of VEGF and VEGFR2, and regulate intraovarian expression of apoptosis-related proteins. Conclusions Our results show that BTR is effective in the treatment of TG-induced POF rats. Promotion of angiogenesis and anti-apoptosis are most likely to contribute to the effects of BTR against POF. Electronic supplementary material The online version of this article (doi:10.1186/s13020-017-0131-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Xiaofeng Xu
- Department of Gynecology, Suzhou Hospital Affiliated to Nanjing University of Chinese Medicine, No. 18 Yangsu Road, Gusu District, Suzhou, 215009 Jiangsu Province China
| | - Yong Tan
- Department of Gynecology, The No.1 Clinical Medical College, Nanjing University of Chinese Medicine, No. 138 Xianlin Avenue, Xianlin University City, Nanjing, 210046 Jiangsu Province China
| | - Guorong Jiang
- Institute of Traditional Chinese Medicine, Suzhou Hospital Affiliated to Nanjing University of Chinese Medicine, No. 18 Yangsu Road, Gusu District, Suzhou, 215009 Jiangsu Province China
| | - Xuanyi Chen
- Department of Gynecology, Suzhou Hospital Affiliated to Nanjing University of Chinese Medicine, No. 18 Yangsu Road, Gusu District, Suzhou, 215009 Jiangsu Province China
| | - Rensheng Lai
- Department of Pathology, Jiangsu Hospital of Traditional Chinese Medicine, No.155 Hanzhong Road, Qinhuai District, Nanjing, 210002 Jiangsu Province China
| | - Lurong Zhang
- Institute of Traditional Chinese Medicine, Suzhou Hospital Affiliated to Nanjing University of Chinese Medicine, No. 18 Yangsu Road, Gusu District, Suzhou, 215009 Jiangsu Province China
| | - Guoqiang Liang
- Institute of Traditional Chinese Medicine, Suzhou Hospital Affiliated to Nanjing University of Chinese Medicine, No. 18 Yangsu Road, Gusu District, Suzhou, 215009 Jiangsu Province China
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40
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ESHRE Guideline: management of women with premature ovarian insufficiency. Hum Reprod 2016; 31:926-37. [DOI: 10.1093/humrep/dew027] [Citation(s) in RCA: 612] [Impact Index Per Article: 76.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 01/11/2016] [Indexed: 11/13/2022] Open
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Abstract
A heterogeneous disorder, premature menopause is not an uncommon entity, affecting approximately 1% of women younger than 40 years. Multisystem implications are recognized as sequelae to the premature deprivation of ovarian steroids, posing unique health-related challenges in this population. An integrated management approach that addresses both the physical and psychological health concerns and the overall well-being of this relatively chronologically young population is paramount.
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Affiliation(s)
- Saioa Torrealday
- Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Womack Army Medical Center, 2817 Reilly Road, Fort Bragg, NC 28311, USA
| | - Lubna Pal
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA.
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Chen YP, Wu WH, Wu HM, Chen CK, Wang HS, Huang HY. Effects of anti-Müllerian hormone and follicle stimulating hormone levels on in vitro fertilization pregnancy rate. Taiwan J Obstet Gynecol 2015; 53:313-6. [PMID: 25286783 DOI: 10.1016/j.tjog.2013.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2013] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To analyze the relationship between in vitro fertilization (IVF) pregnancy rate and basal serum hormone levels before patients begin an IVF course. MATERIALS AND METHODS In this retrospective study, we analyzed patients with anti-Müllerian hormone (AMH) data and IVF data from January 2009 to October 2012. Pregnancy rates were calculated by AMH and follicle stimulating hormone quartiles and analyzed using the independent samples t test. Furthermore, patients were divided into three groups by age. The Chi-square test was used to assess the association between the parameters and IVF pregnancy rates. RESULTS From the 910 IVF treatment courses, 377 (41.4%) clinical pregnancies resulted. The pregnant and nonpregnant groups differed significantly in age and FSH and AMH levels. The pregnancy rate was 53.3% for patients aged <32 years and 22.1% for patients aged >38 years. The pregnancy rate was 53.4% for patients with FSH levels <5.6 mIU/mL and 25.8% for patients with FSH levels >8.9 mIU/mL. The pregnancy rate was 56.8% for patients with AMH levels >4.0 ng/mL and 20.0% for patients with AMH levels <1.1 ng/mL. Furthermore, among patients aged <40 years, AMH and FSH were significantly associated with pregnancy rate. Higher pregnancy rates were found among the groups with higher AMH levels than in groups with lower AMH levels. CONCLUSION For patients aged <40 years, basal serum AMH level and FSH level affected the IVF pregnancy rate, and patients with higher AMH levels had better pregnancy rates.
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Affiliation(s)
- Yi-Pin Chen
- Department of Gynecology, Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan County, Taiwan
| | - Wen-Hsiang Wu
- Department of Healthcare Management, Yuanpei University, Hsinchu, Taiwan
| | - Hsien-Ming Wu
- Department of Obstetrics and Gynecology, Chang Gung University College of Medicine, Linkou Medical Center, Taoyuan County, Taiwan
| | - Chun-Kai Chen
- Department of Obstetrics and Gynecology, Chang Gung University College of Medicine, Linkou Medical Center, Taoyuan County, Taiwan
| | - Hsin-Shih Wang
- Department of Obstetrics and Gynecology, Chang Gung University College of Medicine, Linkou Medical Center, Taoyuan County, Taiwan
| | - Hong-Yuan Huang
- Department of Obstetrics and Gynecology, Chang Gung University College of Medicine, Linkou Medical Center, Taoyuan County, Taiwan.
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Hyaluronic acid prevents immunosuppressive drug-induced ovarian damage via up-regulating PGRMC1 expression. Sci Rep 2015; 5:7647. [PMID: 25558795 PMCID: PMC4284510 DOI: 10.1038/srep07647] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 12/04/2014] [Indexed: 12/22/2022] Open
Abstract
Chemotherapy treatment in women can frequently cause damage to the ovaries, which may lead to primary ovarian insufficiency (POI). In this study, we assessed the preventative effects of hyaluronic acid (HA) in immunosuppressive drug-induced POI-like rat models and investigated the possible mechanisms. We found that HA, which was reduced in primary and immunosuppressant-induced POI patients, could protect the immunosuppressant-induced damage to granulosa cells (GCs) in vitro. Then we found that HA blocked the tripterygium glycosides (TG) induced POI-like presentations in rats, including delayed or irregular estrous cycles, reduced 17 beta-estradiol(E2) concentration, decreased number of follicles, destruction of follicle structure, and damage of reproductive ability. Furthermore, we investigated the mechanisms of HA prevention effects on POI, which was associated with promotion of GC proliferation and PGRMC1 expression. In conclusion, HA prevents chemotherapy-induced ovarian damage by promoting PGRMC1 in GCs. This study may provide a new strategy for prevention and treatment of POI.
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Modina SC, Tessaro I, Lodde V, Franciosi F, Corbani D, Luciano AM. Reductions in the number of mid-sized antral follicles are associated with markers of premature ovarian senescence in dairy cows. Reprod Fertil Dev 2014; 26:235-44. [PMID: 23327793 DOI: 10.1071/rd12295] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 11/26/2012] [Indexed: 01/31/2023] Open
Abstract
High-producing dairy cows are subfertile; however, the mechanisms responsible for the decreased fertility are unknown. The aim of the present study was to test the hypothesis that culled dairy cows (4-8 years old) characterised by 'Lo' ovaries (i.e. those with <10 mid-antral follicles) are affected by premature ovarian senescence. Cows in which both ovaries were 'Lo' ovaries represented 5% of the total population analysed, and exhibited reduced ovarian size (P<0.001) and increased perifollicular stroma (P<0.05) compared with age-matched controls (i.e. cows in which both ovaries had >10 mid-antral follicles; 'Hi' ovaries). The total number of follicles, including healthy and atretic primordial, primary, secondary and small antral follicles, was lower in Lo ovaries (P<0.01). Interestingly, the primordial follicle population in Lo ovaries was lower (P<0.05) than in the control. Finally, the follicular fluid of mid-antral follicles from Lo ovaries had reduced oestradiol and anti-Müllerian hormone levels (P<0.05), but increased progesterone concentrations (P<0.05). Together, these data account for the reduced fertility of cows with Lo ovaries and are in agreement with previous observations that oocytes isolated from Lo ovaries have reduced embryonic developmental competence. Cows with a specific Lo ovary condition may represent a suitable model to address the causes of low fertility in high-yielding dairy cows, as well as the condition of premature ovarian aging in single-ovulating species.
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Affiliation(s)
- Silvia C Modina
- Reproductive and Developmental Biology Laboratory, Department of Health, Animal Sciences and Food Safety, Università degli Studi di Milano, via G. Celoria 10, 20133, Milano, Italy
| | - Irene Tessaro
- Reproductive and Developmental Biology Laboratory, Department of Health, Animal Sciences and Food Safety, Università degli Studi di Milano, via G. Celoria 10, 20133, Milano, Italy
| | - Valentina Lodde
- Reproductive and Developmental Biology Laboratory, Department of Health, Animal Sciences and Food Safety, Università degli Studi di Milano, via G. Celoria 10, 20133, Milano, Italy
| | - Federica Franciosi
- Reproductive and Developmental Biology Laboratory, Department of Health, Animal Sciences and Food Safety, Università degli Studi di Milano, via G. Celoria 10, 20133, Milano, Italy
| | - Davide Corbani
- Reproductive and Developmental Biology Laboratory, Department of Health, Animal Sciences and Food Safety, Università degli Studi di Milano, via G. Celoria 10, 20133, Milano, Italy
| | - Alberto M Luciano
- Reproductive and Developmental Biology Laboratory, Department of Health, Animal Sciences and Food Safety, Università degli Studi di Milano, via G. Celoria 10, 20133, Milano, Italy
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Gaytan F, Garcia-Galiano D, Dorfman MD, Manfredi-Lozano M, Castellano JM, Dissen GA, Ojeda SR, Tena-Sempere M. Kisspeptin receptor haplo-insufficiency causes premature ovarian failure despite preserved gonadotropin secretion. Endocrinology 2014; 155:3088-97. [PMID: 24885574 PMCID: PMC4611053 DOI: 10.1210/en.2014-1110] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Premature ovarian failure (POF) affects 1% of women in reproductive age, but its etiology remains uncertain. Whereas kisspeptins, the products of Kiss1 that act via Kiss1r (aka, Gpr54), are known to operate at the hypothalamus to control GnRH/gonadotropin secretion, additional actions at other reproductive organs, including the ovary, have been proposed. Yet, their physiological relevance is still unclear. We present here a series of studies in Kiss1r haplo-insufficient and null mice suggesting a direct role of kisspeptin signaling in the ovary, the defect of which precipitates a state of primary POF. Kiss1r hypomorph mice displayed a premature decline in ovulatory rate, followed by progressive loss of antral follicles, oocyte loss, and a reduction in all categories of preantral follicles. These alterations were accompanied by reduced fertility. Because of this precocious ovarian ageing, mice more than 48 weeks of age showed atrophic ovaries, lacking growing follicles and corpora lutea. This phenomenon was associated with a drop in ovarian Kiss1r mRNA expression, but took place in the absence of a decrease in circulating gonadotropins. In fact, FSH levels increased in aged hypomorph animals, reflecting loss of follicular function. In turn, Kiss1r-null mice, which do not spontaneously ovulate and have arrested follicular development, failed to show normal ovulatory responses to standard gonadotropin priming and required GnRH prestimulation during 1 week in order to display gonadotropin-induced ovulation. Yet, the magnitude of such ovulatory responses was approximately half of that seen in control immature wild-type animals. Altogether, our data are the first to demonstrate that Kiss1r haplo-insufficiency induces a state of POF, which is not attributable to defective gonadotropin secretion. We also show that the failure of follicular development and ovulation linked to the absence of Kiss1r cannot be fully rescued by (even extended) gonadotropin replacement. These findings suggest a direct ovarian role of kisspeptin signaling, the perturbation of which may contribute to the pathogenesis of POF.
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Affiliation(s)
- Francisco Gaytan
- Department of Cell Biology, Physiology and Immunology (F.G., D.G-G., M.M-L., M.T-S.), University of Cordoba; CIBER Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III; and Instituto Maimónides de Investigación Biomédica (IMIBIC)/Hospital Universitario Reina Sofia (HURS), 14004 Cordoba, Spain; and Division of Neuroscience (M.D.D., J.M.C., G.A.D., S.R.O.) Oregon National Primate Research Center/Oregon Health and Science University, Beaverton, Oregon 97006
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Use of Titanium Spiral Tacks for Long-term Oophoropexy Before Pelvic Irradiation. Int J Gynecol Cancer 2014; 24:1133-6. [DOI: 10.1097/igc.0000000000000146] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BackgroundOvarian transposition before planned pelvic irradiation can preserve ovarian function in young patients with pelvic malignancies. The transposed ovaries are fixed to the posterolateral abdominal wall. We described the use of a titanium spiral tack as a fixation device and compared it with other methods of oophoropexy.MethodsMedical and surgical records of all consecutive patients who underwent oophoropexy in our institution between 2007 and 2013 were reviewed. Demographic and clinical data were summarized; follicle-stimulating hormone values, recorded; and imaging scans, reviewed.ResultsOophoropexy was performed in 30 patients: 28 with cervical carcinomas and 2 with pelvic sarcomas. The procedure was done through laparoscopy in 13 patients and through laparotomy in 17. Titanium spiral tack was used for ovarian fixation in 14 patients, Vicryl suturing in 14, and in 2 cases the ovaries were pulled up through a retroperitoneal tunnel and fixed to the peritoneum with sutures. Titanium spiral tack fixation took a few seconds to perform. There were no immediate intraoperative or postoperative complications. Ovarian function was preserved in 15 patients (7/14 with spiral tack, 6/14 with sutures, and in both patients with retroperitoneal tunneling). Postoperative imaging results showed that all ovaries retained their extrapelvic location for a median period of 11.6 months (range, 2.3–63 months).ConclusionsSpiral tack is a simple, reliable method for oophoropexy before pelvic irradiation. Its efficacy is comparable with that of suture fixation, with the added advantage of ultrashort operative time. It is therefore worth considering as an alternative to suturing.
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Park BW, Pan B, Toms D, Huynh E, Byun JH, Lee YM, Shen W, Rho GJ, Li J. Ovarian-cell-like cells from skin stem cells restored estradiol production and estrus cycling in ovariectomized mice. Stem Cells Dev 2014; 23:1647-58. [PMID: 24593690 DOI: 10.1089/scd.2014.0029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Reduction of estradiol production and high serum concentrations of follicular stimulating hormone (FSH) are endocrine disorders associated with premature ovarian failure. Here, we report that transplantation of ovarian-like cells differentiated from stem cells restored endogenous serum estradiol levels. Stem cells were isolated from postnatal mouse skin and differentiated into ovarian-cell-like cells that are consistent with female germ, and ovarian follicle somatic cells. The ovarian-cell-like cells were transplanted into ovariectomized mice (Cell Trans), whereas control mice were subjected to bilateral ovariectomies without cell transplantation (OVX). Using vaginal cytology analysis, it was revealed that in 13 out of 19 Cell Trans mice, estrus cycles were restored around 8 weeks after cell transplantation and were maintained until 16 weeks post-transplantation, whereas in the OVX group, all mice were arrested at metestrus/diestrus of the estrus cycle. The uterine weight in the Cell Trans group was similar to sham operation mice (Sham OP), while severe uterine atrophy and a decreased uterine weight were observed in the OVX group. Histologically, ectopic follicle-like structures and blood vessels were found within and around the transplants. At 12-14 weeks after cell transplantation, mean serum estradiol level in Cell Trans mice (178.0±35 pg/mL) was comparable to that of the Sham OP group (188.9±29 pg/mL), whereas it was lower in the OVX group (59.0±4 pg/mL). Serum FSH concentration increased in the OVX group (1.62±0.32 ng/mL) compared with the Sham OP group (0.39±0.34 ng/mL). Cell Trans mice had a similar FSH level (0.94±0.23 ng/mL; P<0.05) to Sham OP mice. Our results suggest that ovarian somatic cells differentiated from stem cells are functional in vivo. In addition to providing insights into the function of ovarian somatic cells derived from stem cells, our study may offer potential therapeutic means for patients with hypo-estradiol levels like those encountered in premature ovarian failure.
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Affiliation(s)
- Bong-Wook Park
- 1 Department of Animal and Poultry Science, University of Guelph , Guelph, Ontario, Canada
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Correlation between Abortion and Infertility among Nonsmoking Women with a History of Passive Smoking in Childhood and Adolescence. Int J Reprod Med 2014; 2014:678530. [PMID: 25763404 PMCID: PMC4334057 DOI: 10.1155/2014/678530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Revised: 07/09/2014] [Accepted: 07/30/2014] [Indexed: 11/30/2022] Open
Abstract
The aim of this study is to evaluate the correlation of exposing to the cigarette smoke in childhood and adolescence with infertility and abortion in women. This case-control study evaluated 178 women who had been attended to at the Amir-al-Momenin Hospital in Tehran in 2012-2013. Seventy-eight women with chief complaint of abortion, infertility, and missed abortion and 100 healthy women were considered as case and control groups, respectively. The tool was a questionnaire with two parts. In the first part demographic information was gathered and in the second part the information regarding the history of passive smoking in childhood and adolescence period, abortion, and infertility was gathered. The mean age in case and control groups was 26.24 ± 3.1 and 27.3 ± 4.2 years, respectively. The mean body mass index (BMI) was 25.74 ± 1.38 Kg/m2. Abortion rates among passive smoker and nonpassive smoker patients were statistically significant (P = 0.036). Based on findings of this study, the experience of being a passive smoker in childhood and adolescence in women will increase the risk of abortion and infertility in the future, which could be the reason to encourage the society to step back from smoking cigarettes.
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Naredi N, Sandeep K, Jamwal V. Can hormone replacement therapy prior to oocyte donation cycle in women with premature ovarian failure improve pregnancy rate? Med J Armed Forces India 2013; 69:357-60. [PMID: 24600143 PMCID: PMC3862755 DOI: 10.1016/j.mjafi.2013.06.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Accepted: 06/30/2013] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Infertility is an important issue in women with Premature Ovarian Failure (POF). With no conclusive treatment available to enhance fertility in these women, it is the use of donor eggs with In-Vitro Fertilization (IVF) which can fulfil their desire to become a mother in a novel way. Hormone replacement therapy (HRT) in POF apart from correcting the endocrine defect also helps in improving the milieu of the uterus by improving its vascularisation and the sub endometrial blood flow. We thus aimed to carry out a study to find out whether hormone replacement therapy if administered prior to the oocyte donation cycle in patients of premature ovarian failure improves the pregnancy rate. METHODS A comparative study was carried out incorporating 46 subjects with 23 in each group. Group A received HRT prior to their oocyte donation cycle while the second group entered into the oocyte donation programme directly after an artificially induced menstruation. RESULTS It was observed that, although the HRT group had a slightly higher pregnancy rate, with a better mean endometrial thickness as compared to the non HRT group it was not statistically significant. CONCLUSIONS Institution of hormone replacement therapy does improve the vascularisation of the uterus, corrects the histologic features of the uterine lining and makes the endometrium receptive but whether it enhances the pregnancy rate needs to be elucidated with further studies.
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Affiliation(s)
- Nikita Naredi
- Classified Specialist (Obstetrics & Gynaecology) & Trained in ART, ART Centre, Army Hospital (R&R), New Delhi 110 010, India
| | - K. Sandeep
- Classified Specialist (Obstetrics & Gynaecology) & Trained in ART, ART Centre, Army Hospital (R&R), New Delhi 110 010, India
| | - V.D.S. Jamwal
- Graded Specialist (Anatomy), ART Centre, Army Hospital (R&R), New Delhi 110 010, India
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