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Mohsin R, Fujimoto VY, Galusha AL, Parsons PJ, Krall JR, Butts-Jackson CD, Mok-Lin E, Bloom MS. Associations between follicular fluid trace elements and ovarian response during in vitro fertilization. ENVIRONMENTAL RESEARCH 2024; 252:118801. [PMID: 38555083 PMCID: PMC11156565 DOI: 10.1016/j.envres.2024.118801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 03/04/2024] [Accepted: 03/25/2024] [Indexed: 04/02/2024]
Abstract
INTRODUCTION Exposure to trace elements has been associated with ovarian response in experimental studies. We conducted a hypothesis-generating study of associations between ovarian follicular fluid (FF) trace elements and measures of ovarian response among women using in vitro fertilization (IVF). METHODS We collected ovarian FF specimens from 56 women. We determined concentrations (μg/L) of 11 trace elements using inductively coupled plasma-tandem mass spectrometry. We estimated associations between women's FF trace elements per interquartile range difference, and measures of ovarian response using linear (peak estradiol (E2), baseline anti-mullerian hormone (AMH), and follicle stimulating hormone (FSH)) and negative binomial (baseline antral follicle count (AFC) and oocyte count) regression, adjusting for confounding factors. We used principal component analysis (PCA) to estimate the associations of the FF trace elements mixture. We also explored FF oxidative stress enzymes as causal mediators of the associations. RESULTS Higher FF cobalt was associated with greater peak E2 (mean difference = 351.48 pg/mL; 95%CI: 21.76, 724.71) and AFC (rate ratio = 1.14; 95%CI: 1.01, 1.28), and higher FF copper was associated with greater peak E2 (mean difference = 335.66 pg/mL; 95%CI: 81.77, 753.08) and oocyte count (rate ratio = 1.19; 95%CI: 1.02, 1.43). Higher FF mercury was also associated with greater peak E2 (mean difference = 410.70 pg/mL; 95%CI: 61.90, 883.39). Higher FF lead was associated with lesser AFC (rate ratio = 0.85; 95%CI: 0.73, 0.98). Using PCA, the mixture of Sr, Hg, and As was associated with higher peak estradiol, AFC, and oocyte count. FF glutathione peroxidase, paraoxonase, and arylesterase activities were inconsistent mediators of the associations, but the effect estimates were imprecise. CONCLUSION Our results suggest that essential and non-essential trace elements in FF were associated with ovarian response during IVF.
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Affiliation(s)
- Rooshna Mohsin
- Department of Global and Community Health, George Mason University, Fairfax, VA, 22030, United States
| | - Victor Y Fujimoto
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Francisco, San Francisco, CA, 94158, United States
| | - Aubrey L Galusha
- Laboratory of Inorganic & Nuclear Chemistry, Wadsworth Center, New York State Department of Health, Albany, NY, 12237, United States; Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, 12144, United States
| | - Patrick J Parsons
- Laboratory of Inorganic & Nuclear Chemistry, Wadsworth Center, New York State Department of Health, Albany, NY, 12237, United States; Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, 12144, United States
| | - Jenna R Krall
- Department of Global and Community Health, George Mason University, Fairfax, VA, 22030, United States
| | - Celeste D Butts-Jackson
- Department of Health Services Management, North Carolina Agricultural and Technical State University, Greensboro, NC, 27411, United States; Department of Epidemiology, University of North Carolina, Chapel Hill, NC, 27599, United States
| | - Evelyn Mok-Lin
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Francisco, San Francisco, CA, 94158, United States
| | - Michael S Bloom
- Department of Global and Community Health, George Mason University, Fairfax, VA, 22030, United States.
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Tian T, Wang Z, Liu F, Fu Y, Kong F, Wang Y, Li Q, Long X, Qiao J. Exposure to heavy metallic and trace essential elements and risk of diminished ovarian reserve in reproductive age women: A case-control study. JOURNAL OF HAZARDOUS MATERIALS 2024; 470:134206. [PMID: 38583203 DOI: 10.1016/j.jhazmat.2024.134206] [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: 01/15/2024] [Revised: 04/01/2024] [Accepted: 04/02/2024] [Indexed: 04/09/2024]
Abstract
The associations between metallic elements and ovarian reserve function have remained uncertain yet. In this case-control study, we involved 149 women with diminished ovarian reserve (DOR) and 151 women with normal ovarian reserve, and assessed the levels of six heavy metallic (Cr, Cd, As, Hg, Pb, and Mn) and seven trace essential (Se, Fe, Zn, Co, Mo, Cu, I) elements in their follicular fluid with inductively coupled plasma mass spectrometry. Associations were examined with logistic regressions and Bayesian kernel machine regression (BKMR). As a result, we found that the medium and the highest tertiles of Pb were significantly associated with an increased likelihood of DOR compared to the lowest tertile, while the medium or/an the highest tertiles of Cu, I, and Fe showed significantly lower likelihoods of DOR compared to the lowest tertiles. Cu and Pb showed significantly non-linear associations with ovarian reserve markers such as follicle-stimulating, anti-mullerian hormone levels, and antral follicle count. With the rising overall concentrations of heavy metals, the likelihood of DOR increased although not significant. There was a trend of a "U-shaped" association across the whole concentration range of trace essential elements and the likelihood of DOR. Our study revealed that avoiding heavy metallic elements and properly supplementing trace essential elements are conducive to ovarian function.
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Affiliation(s)
- Tian Tian
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), China
| | - Zheng Wang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), China
| | - Fang Liu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), China
| | - Yu Fu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), China
| | - Fei Kong
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), China
| | - Yuanyuan Wang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), China
| | - Qin Li
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), China; Department of Maternal and Child Health, School of Public Health, Peking University, China.
| | - Xiaoyu Long
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), China.
| | - Jie Qiao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), China; Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), China; Beijing Advanced Innovation Center for Genomics, China; Peking-Tsinghua Center for Life Sciences, Peking University, China.
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Kapper C, Oppelt P, Ganhör C, Gyunesh AA, Arbeithuber B, Stelzl P, Rezk-Füreder M. Minerals and the Menstrual Cycle: Impacts on Ovulation and Endometrial Health. Nutrients 2024; 16:1008. [PMID: 38613041 PMCID: PMC11013220 DOI: 10.3390/nu16071008] [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: 02/26/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
The role of minerals in female fertility, particularly in relation to the menstrual cycle, presents a complex area of study that underscores the interplay between nutrition and reproductive health. This narrative review aims to elucidate the impacts of minerals on key aspects of the reproductive system: hormonal regulation, ovarian function and ovulation, endometrial health, and oxidative stress. Despite the attention given to specific micronutrients in relation to reproductive disorders, there is a noticeable absence of a comprehensive review focusing on the impact of minerals throughout the menstrual cycle on female fertility. This narrative review aims to address this gap by examining the influence of minerals on reproductive health. Each mineral's contribution is explored in detail to provide a clearer picture of its importance in supporting female fertility. This comprehensive analysis not only enhances our knowledge of reproductive health but also offers clinicians valuable insights into potential therapeutic strategies and the recommended intake of minerals to promote female reproductive well-being, considering the menstrual cycle. This review stands as the first to offer such a detailed examination of minerals in the context of the menstrual cycle, aiming to elevate the understanding of their critical role in female fertility and reproductive health.
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Affiliation(s)
- Celine Kapper
- Experimental Gynaecology, Obstetrics and Gynaecological Endocrinology, Johannes Kepler University Linz, Altenberger Strasse 69, 4040 Linz, Austria; (C.K.); (P.O.); (B.A.)
| | - Peter Oppelt
- Experimental Gynaecology, Obstetrics and Gynaecological Endocrinology, Johannes Kepler University Linz, Altenberger Strasse 69, 4040 Linz, Austria; (C.K.); (P.O.); (B.A.)
- Department for Gynaecology, Obstetrics and Gynaecological Endocrinology, Kepler University Hospital, Johannes Kepler University Linz, 4020 Linz, Austria
| | - Clara Ganhör
- Division of Pathophysiology, Institute of Physiology and Pathophysiology, Medical Faculty, Johannes Kepler University Linz, 4020 Linz, Austria
- Clinical Research Institute for Cardiovascular and Metabolic Diseases, Medical Faculty, Johannes Kepler University Linz, 4020 Linz, Austria
| | - Ayberk Alp Gyunesh
- Experimental Gynaecology, Obstetrics and Gynaecological Endocrinology, Johannes Kepler University Linz, Altenberger Strasse 69, 4040 Linz, Austria; (C.K.); (P.O.); (B.A.)
| | - Barbara Arbeithuber
- Experimental Gynaecology, Obstetrics and Gynaecological Endocrinology, Johannes Kepler University Linz, Altenberger Strasse 69, 4040 Linz, Austria; (C.K.); (P.O.); (B.A.)
| | - Patrick Stelzl
- Department for Gynaecology, Obstetrics and Gynaecological Endocrinology, Kepler University Hospital, Johannes Kepler University Linz, 4020 Linz, Austria
| | - Marlene Rezk-Füreder
- Experimental Gynaecology, Obstetrics and Gynaecological Endocrinology, Johannes Kepler University Linz, Altenberger Strasse 69, 4040 Linz, Austria; (C.K.); (P.O.); (B.A.)
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Arefnezhad R, Roghani-Shahraki H, Motedayyen H, Rezaei Tazangi F. Function of MicroRNAs in Normal and Abnormal Ovarian Activities: A Review Focus on MicroRNA-21. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2024; 18:94-99. [PMID: 38368510 PMCID: PMC10875309 DOI: 10.22074/ijfs.2023.1985792.1415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 01/28/2023] [Accepted: 07/22/2023] [Indexed: 02/19/2024]
Abstract
Some failures in ovary function, like folliculogenesis and oogenesis, can give rise to various infertility-associated problems, including polycystic ovary syndrome (PCOS) and premature ovarian insufficiency (POI). PCOS influences 8 to 20% of women; while POI occurs in at least 1% of all women. Regrettably, the current therapies for these diseases have not sufficiently been effective, and finding a suitable strategy is still a puzzle. One of the helpful strategies for managing and treating these disorders is understanding the contributing pathogenesis and mechanisms. Recently, it has been declared that abnormal expression of microRNAs (miRNAs), as a subset of non-coding RNAs, is involved in the pathogenesis of reproductive diseases. Among the miRNAs, the roles of miRNA-21 in the pathogenesis of PCOS and POI have been highlighted in some documents; hence, the purpose of this mini-review was to summarize the evidences in conjunction with the functions of this miRNA and other effective microRNAs in the normal or abnormal functions of the ovary (i.e., PCOS and POI) with a mechanistic insight.
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Affiliation(s)
- Reza Arefnezhad
- Coenzyme R Research Institute, Tehran, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Hossein Motedayyen
- Autoimmune Diseases Research Center, Shahid Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran.
| | - Fatemeh Rezaei Tazangi
- Department of Anatomy, Faculty of Medicine, Fasa University of Medical Sciences, Fasa, Iran
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Abramiuk M, Mertowska P, Frankowska K, Świechowska-Starek P, Satora M, Polak G, Dymanowska-Dyjak I, Grywalska E. How Can Selected Dietary Ingredients Influence the Development and Progression of Endometriosis? Nutrients 2024; 16:154. [PMID: 38201982 PMCID: PMC10781184 DOI: 10.3390/nu16010154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/30/2023] [Accepted: 12/31/2023] [Indexed: 01/12/2024] Open
Abstract
Endometriosis is a chronic, hormone-dependent disease characterized by the presence of endometrial tissue in ectopic locations. Since the treatment options for this disease are still limited, and the cure rate is unsatisfactory, the search for ways to treat symptoms and modify the course of the disease is of key importance in improving the quality of life of patients with endometriosis. So far, the literature has shown that nutrition can influence endometriosis through hormonal modification and altering the inflammatory or oxidative response. Since the importance of nutrition in this disease is still a subject of scientific research, we aimed to summarize the current knowledge on the role of dietary modifications in endometriosis. Our review showed that nutrients with anti-inflammatory and antioxidant properties, including most vitamins and several trace elements, may influence the pathogenesis of endometriosis and can be considered as the nutrients preventing the development of endometriosis. However, despite the many discoveries described in this review, further interdisciplinary research on this topic seems to be extremely important, as in the future, it may result in the development of personalized therapies supporting the treatment of endometriosis.
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Affiliation(s)
- Monika Abramiuk
- Independent Laboratory of Minimally Invasive Gynaecology and Gynaecological Endocrinology, Medical University of Lublin, Staszica 16 St., 20-081 Lublin, Poland; (G.P.); (I.D.-D.)
| | - Paulina Mertowska
- Department of Experimental Immunology, Medical University of Lublin, Chodźki 4a St., 20-093 Lublin, Poland; (P.M.); (E.G.)
| | - Karolina Frankowska
- 1st Chair and Department of Oncological Gynecology and Gynecology, Students’ Scientific Association, Medical University of Lublin, Staszica 16 St., 20-081 Lublin, Poland; (K.F.); (M.S.)
| | - Paulina Świechowska-Starek
- 1st Chair and Department of Oncological Gynaecology and Gynaecology, Medical University of Lublin, Staszica 16 St., 20-081 Lublin, Poland;
| | - Małgorzata Satora
- 1st Chair and Department of Oncological Gynecology and Gynecology, Students’ Scientific Association, Medical University of Lublin, Staszica 16 St., 20-081 Lublin, Poland; (K.F.); (M.S.)
| | - Grzegorz Polak
- Independent Laboratory of Minimally Invasive Gynaecology and Gynaecological Endocrinology, Medical University of Lublin, Staszica 16 St., 20-081 Lublin, Poland; (G.P.); (I.D.-D.)
| | - Izabela Dymanowska-Dyjak
- Independent Laboratory of Minimally Invasive Gynaecology and Gynaecological Endocrinology, Medical University of Lublin, Staszica 16 St., 20-081 Lublin, Poland; (G.P.); (I.D.-D.)
| | - Ewelina Grywalska
- Department of Experimental Immunology, Medical University of Lublin, Chodźki 4a St., 20-093 Lublin, Poland; (P.M.); (E.G.)
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Rabajdová M, Špaková I, Smolko L, Abrahamovská M, Baranovičová B, Birková A, Vašková J, Mareková M. Serum trace element levels and activity of enzymes associated with oxidative stress in endometriosis and endometrial cancer. FEBS Open Bio 2024; 14:148-157. [PMID: 37968795 PMCID: PMC10761925 DOI: 10.1002/2211-5463.13738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/23/2023] [Accepted: 11/13/2023] [Indexed: 11/17/2023] Open
Abstract
Endometriosis and endometrial cancer are closely related to oxidative stress. However, the direct relationship between copper and zinc levels and oxidative stress in the extracellular and intracellular space remains unclear. The presented study is focused on the determination of serum Zn and Cu levels, glutathione concentration and enzyme activity in three groups: patients diagnosed with endometrial cancer (EC), patients diagnosed with endometriosis (EM), and a healthy control group. Spectrophotometric determination of trace elements revealed that levels of zinc and copper were lower in blood plasma of patients with endometriosis as compared with the other groups; however, there were no significant differences in the Cu/Zn ratio. Furthermore, significantly increased blood serum glutathione levels were detected in both EM and EC groups compared with the control group. While the activity of superoxide dismutase (SOD) was similar across the studied groups, we observed differences in the activity of other enzymes associated with oxidative stress, including glutathione peroxidase (GPx), glutathione reductase (GR) and glutathione S-transferase (GST), between the control group and the EM and EC patients. Additionally, analysis of gene expression based on free circulating mRNA indicated significant differences in the expression of SOD isoenzymes between the patient groups and the control group; expression of GPx isoenzymes was also altered. Obtained results may have potential application in diagnostics as well as monitoring of endometriosis and endometrial cancer.
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Affiliation(s)
- Miroslava Rabajdová
- Department of Medical and Clinical Biochemistry, Faculty of MedicineP. J. Šafárik University in KošiceSlovakia
| | - Ivana Špaková
- Department of Medical and Clinical Biochemistry, Faculty of MedicineP. J. Šafárik University in KošiceSlovakia
| | - Lukáš Smolko
- Department of Medical and Clinical Biochemistry, Faculty of MedicineP. J. Šafárik University in KošiceSlovakia
| | - Michaela Abrahamovská
- Department of Medical and Clinical Biochemistry, Faculty of MedicineP. J. Šafárik University in KošiceSlovakia
| | - Barbora Baranovičová
- Department of Gynaecology and Obstetrics, Faculty of MedicineP. J. Šafárik University in KošiceSlovakia
| | - Anna Birková
- Department of Medical and Clinical Biochemistry, Faculty of MedicineP. J. Šafárik University in KošiceSlovakia
| | - Janka Vašková
- Department of Medical and Clinical Biochemistry, Faculty of MedicineP. J. Šafárik University in KošiceSlovakia
| | - Mária Mareková
- Department of Medical and Clinical Biochemistry, Faculty of MedicineP. J. Šafárik University in KošiceSlovakia
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Shen Z, Yang M, Wang H, Liu Y, Gao Y. Changes in the urinary proteome of rats after short-term intake of magnesium L-threonate(MgT). Front Nutr 2023; 10:1305738. [PMID: 38188875 PMCID: PMC10768015 DOI: 10.3389/fnut.2023.1305738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/08/2023] [Indexed: 01/09/2024] Open
Abstract
Introduction Magnesium (Mg) is an important mineral in living organisms. Magnesium has multiple functions in the human body, wherein it plays an important therapeutic and preventive role in a variety of diseases. Methods Urine samples of rats before and after gavage of magnesium L-threonate (MgT) were collected, and the urinary proteome was identified using the LC-MS/MS technique and analyzed using various databases. Results and discussion The results illustrated that the urinary proteome of rats was significantly altered after short-term intake of magnesium supplements and that the differential proteins and the biological functions were related to magnesium. This study innovatively establishes a method to study nutrients from the perspective of urine proteomics. This work demonstrates that the urinary proteome is capable of reflecting the effects of nutrient intake on the organism in a more systematic and comprehensive manner and has the potential to provide clues for clinical nutrition research and practice.
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Affiliation(s)
| | | | | | | | - Youhe Gao
- Beijing Key Laboratory of Gene Engineering Drug and Biotechnology, College of Life Sciences, Beijing Normal University, Beijing, China
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López-Botella A, Gómez-Torres MJ, Sánchez R, Todolí-Torró JL, Velasco I, Acién M. Elevated Lead, Nickel, and Bismuth Levels in the Peritoneal Fluid of a Peritoneal Endometriosis Patient without Toxic Habits or Occupational Exposure following a Vegetarian Diet. TOXICS 2023; 11:1009. [PMID: 38133409 PMCID: PMC10747131 DOI: 10.3390/toxics11121009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/30/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023]
Abstract
Potentially toxic elements (PTEs), found as environmental contaminants, have been related to endometriosis disease. In this context, the peritoneal fluid (PF) matrix has been poorly studied despite its importance. PF is the environment in which endometriotic lesions reside and communicate with surrounding tissues including tissues and nerve cells. In this work, our investigation group reports the special case of a peritoneal endometriosis patient presenting elevated lead, nickel, and bismuth levels in PF. This patient reported following a vegetarian diet and no toxic habits or occupational exposure. In conclusion, the elevated levels of PTEs found may result from a vegetarian diet or an unidentified environmental exposure source. This report provides new insights regarding the possible etiology of endometriosis disease and potential biomarkers for its diagnosis in early stages, although additional research is needed.
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Affiliation(s)
- Andrea López-Botella
- Service of Obstetrics and Gynecology, Unit of Human Reproduction, FISABIO—San Juan University Hospital, Carretera Alicante-Valencia s/n, 03550 Sant Joan d’Alacant, Alicante, Spain; (A.L.-B.); (M.A.)
- Biotechnology Department, Faculty of Sciences, University of Alicante, Carretera San Vicente del Raspeig s/n, 03690 San Vicente del Raspeig, Alicante, Spain;
- Department of Analytical Chemistry, Nutrition and Food Sciences, University of Alicante, Carretera San Vicente del Raspeig s/n, 03690 San Vicente del Raspeig, Alicante, Spain; (R.S.); (J.-L.T.-T.)
| | - María José Gómez-Torres
- Biotechnology Department, Faculty of Sciences, University of Alicante, Carretera San Vicente del Raspeig s/n, 03690 San Vicente del Raspeig, Alicante, Spain;
| | - Raquel Sánchez
- Department of Analytical Chemistry, Nutrition and Food Sciences, University of Alicante, Carretera San Vicente del Raspeig s/n, 03690 San Vicente del Raspeig, Alicante, Spain; (R.S.); (J.-L.T.-T.)
| | - José-Luis Todolí-Torró
- Department of Analytical Chemistry, Nutrition and Food Sciences, University of Alicante, Carretera San Vicente del Raspeig s/n, 03690 San Vicente del Raspeig, Alicante, Spain; (R.S.); (J.-L.T.-T.)
| | - Irene Velasco
- Service of Obstetrics and Gynecology, Unit of Human Reproduction, FISABIO—San Juan University Hospital, Carretera Alicante-Valencia s/n, 03550 Sant Joan d’Alacant, Alicante, Spain; (A.L.-B.); (M.A.)
- Biotechnology Department, Faculty of Sciences, University of Alicante, Carretera San Vicente del Raspeig s/n, 03690 San Vicente del Raspeig, Alicante, Spain;
| | - Maribel Acién
- Service of Obstetrics and Gynecology, Unit of Human Reproduction, FISABIO—San Juan University Hospital, Carretera Alicante-Valencia s/n, 03550 Sant Joan d’Alacant, Alicante, Spain; (A.L.-B.); (M.A.)
- Gynecology Division, Faculty of Medicine, Miguel Hernández University, Carretera Alicante-Valencia s/n, 03202 Elche, Alicante, Spain
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9
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Liu Y, Wang T, Ge Y, Shen H, Li J, Qiao C. Individual and combined association between nutritional trace metals and the risk of preterm birth in a recurrent pregnancy loss cohort. Front Nutr 2023; 10:1205748. [PMID: 38099181 PMCID: PMC10720726 DOI: 10.3389/fnut.2023.1205748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 10/30/2023] [Indexed: 12/17/2023] Open
Abstract
Background Recurrent pregnancy loss (RPL) was associated with an elevated risk of pregnancy complications, particularly preterm birth (PTB). However, the risk factors associated with PTB in RPL remained unclear. Emerging evidence indicated that maternal exposure to metals played a crucial role in the development of PTB. The objective of our study was to investigate the individual and combined associations of nutritional trace metals (NTMs) during pregnancy with PTB in RPL. Methods Using data from a recurrent pregnancy loss cohort (n = 459), propensity score matching (1:3) was performed to control for covariates. Multiple logistic regression and multiple linear regression were employed to identify the individual effects, while elastic-net regularization (ENET) and Bayesian kernel machine regression (BKMR) were used to examine the combined effects on PTB in RPL. Results The logistic regression model found that maternal exposure to copper (Cu) (quantile 4 [Q4] vs. quantile 1 [Q1], odds ratio [OR]: 0.21, 95% confidence interval [CI]: 0.05, 0.74) and zinc (Zn) (Q4 vs. Q1, OR: 0.19, 95%CI: 0.04, 0.77) was inversely associated with total PTB risk. We further constructed environmental risk scores (ERSs) using principal components and interaction terms derived from the ENET model to predict PTB accurately (p < 0.001). In the BKMR model, we confirmed that Cu was the most significant component (PIP = 0.85). When other metals were fixed at the 25th and 50th percentiles, Cu was inversely associated with PTB. In addition, we demonstrated the non-linear relationships of Zn with PTB and the potential interaction between Cu and other metals, including Zn, Ca, and Fe. Conclusion In conclusion, our study highlighted the significance of maternal exposure to NTMs in RPL and its association with PTB risk. Cu and Zn were inversely associated with PTB risk, with Cu identified as a crucial factor. Potential interactions between Cu and other metals (Zn, Ca, and Fe) further contributed to the understanding of PTB etiology in RPL. These findings suggest opportunities for personalized care and preventive interventions to optimize maternal and infant health outcomes.
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Affiliation(s)
- Yilin Liu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Reproductive and Genetic Medicine, National Health Commission, Shenyang, China
- Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
| | - Tingting Wang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Reproductive and Genetic Medicine, National Health Commission, Shenyang, China
- Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
| | - Yunpeng Ge
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Reproductive and Genetic Medicine, National Health Commission, Shenyang, China
- Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
| | - Hongfei Shen
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Reproductive and Genetic Medicine, National Health Commission, Shenyang, China
- Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
| | - Jiapo Li
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Reproductive and Genetic Medicine, National Health Commission, Shenyang, China
- Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
| | - Chong Qiao
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Reproductive and Genetic Medicine, National Health Commission, Shenyang, China
- Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Shenyang, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, China
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10
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Baj J, Flieger W, Barbachowska A, Kowalska B, Flieger M, Forma A, Teresiński G, Portincasa P, Buszewicz G, Radzikowska-Büchner E, Flieger J. Consequences of Disturbing Manganese Homeostasis. Int J Mol Sci 2023; 24:14959. [PMID: 37834407 PMCID: PMC10573482 DOI: 10.3390/ijms241914959] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/01/2023] [Accepted: 10/04/2023] [Indexed: 10/15/2023] Open
Abstract
Manganese (Mn) is an essential trace element with unique functions in the body; it acts as a cofactor for many enzymes involved in energy metabolism, the endogenous antioxidant enzyme systems, neurotransmitter production, and the regulation of reproductive hormones. However, overexposure to Mn is toxic, particularly to the central nervous system (CNS) due to it causing the progressive destruction of nerve cells. Exposure to manganese is widespread and occurs by inhalation, ingestion, or dermal contact. Associations have been observed between Mn accumulation and neurodegenerative diseases such as manganism, Alzheimer's disease, Parkinson's disease, Huntington's disease, and amyotrophic lateral sclerosis. People with genetic diseases associated with a mutation in the gene associated with impaired Mn excretion, kidney disease, iron deficiency, or a vegetarian diet are at particular risk of excessive exposure to Mn. This review has collected data on the current knowledge of the source of Mn exposure, the experimental data supporting the dispersive accumulation of Mn in the brain, the controversies surrounding the reference values of biomarkers related to Mn status in different matrices, and the competitiveness of Mn with other metals, such as iron (Fe), magnesium (Mg), zinc (Zn), copper (Cu), lead (Pb), calcium (Ca). The disturbed homeostasis of Mn in the body has been connected with susceptibility to neurodegenerative diseases, fertility, and infectious diseases. The current evidence on the involvement of Mn in metabolic diseases, such as type 2 diabetes mellitus/insulin resistance, osteoporosis, obesity, atherosclerosis, and non-alcoholic fatty liver disease, was collected and discussed.
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Affiliation(s)
- Jacek Baj
- Chair and Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland; (W.F.); (A.F.)
| | - Wojciech Flieger
- Chair and Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland; (W.F.); (A.F.)
| | - Aleksandra Barbachowska
- Department of Plastic, Reconstructive and Burn Surgery, Medical University of Lublin, 21-010 Łęczna, Poland;
| | - Beata Kowalska
- Department of Water Supply and Wastewater Disposal, Lublin University of Technology, 20-618 Lublin, Poland;
| | - Michał Flieger
- Chair and Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; (M.F.); (G.T.); (G.B.)
| | - Alicja Forma
- Chair and Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland; (W.F.); (A.F.)
| | - Grzegorz Teresiński
- Chair and Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; (M.F.); (G.T.); (G.B.)
| | - Piero Portincasa
- Clinica Medica A. Murri, Department of Biomedical Sciences & Human Oncology, Medical School, University of Bari, 70124 Bari, Italy;
| | - Grzegorz Buszewicz
- Chair and Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; (M.F.); (G.T.); (G.B.)
| | | | - Jolanta Flieger
- Department of Analytical Chemistry, Medical University of Lublin, 20-093 Lublin, Poland
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11
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Gök F, Ekin S, Karaman E, Erten R, Yıldız D, Bakır A. Total Sialic Acid, Antioxidant Enzyme Activities, Trace Elements, and Vitamin Status Before and After Surgery in Women with Uterine Myoma and Endometrial Cancer. Reprod Sci 2023; 30:2743-2757. [PMID: 37069473 DOI: 10.1007/s43032-023-01241-9] [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: 01/18/2023] [Accepted: 04/06/2023] [Indexed: 04/19/2023]
Abstract
The objective of present study was to examine endometrial tissue Be, As, Cr, Mo, Sr, Ti, Tl, Cu, Co, Se, Zn, Mn, Fe, Cd, Pb, Mg, P, erythrocytes CAT, SOD, GSH-Px, GSH, MDA, serum retinol, cholecalciferol, phylloquinone, TSA, LSA, TOS, and TAS status and to evaluate the relationships between the variables. The study had 110 participants; of these, 50 were women with uterine myoma (UM), 10 were women with endometrial cancer (EC), and 50 were healthy female subjects. In the study, vitamin analyses by HPLC and element analyses were determined using ICP-OES method. It was observed that EC group was significantly lower than healthy group in terms of levels of cholecalciferol (p < 0.05), phylloquinone (p < 0.01), GSH (p < 0.05), Fe (p < 0.05), and had a significant rise in Mg/Fe (p < 0.01) and Zn/Fe (p < 0.05) in preoperative period. UM group had significantly lower retinol (p < 0.05), phylloquinone (p < 0.001), GSH-Px (p < 0.01), GSH (p < 0.01), Cr (p < 0.01), Cu (p < 0.05), Mg (p < 0.01), and Zn (p < 0.01) levels than control group in preoperative period and significantly higher levels of MDA (p < 0.01), TSA (p < 0.01), and LSA (p < 0.01) than control group. It was found that significant associations were observed between Cu-CA 15-3 (r = 0.558, p = 0.016), Mn-CA 15-3 (r = 0.511, p = 0.030), P-CA 15-3(r = - 0.502, p = 0.034) and with UM, also between GSH-CA-125 (r = - 0.825, p = 0.022) and with EC group. The results of correlation analysis observed that concentrations of Cu, Mn, P, and GSH together with CA 15-3 and CA-125 levels might be important for monitoring patients with UM and EC before surgery.
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Affiliation(s)
- Fazilet Gök
- Department of Chemistry, Division of Biochemistry, Institute of Natural and Applied Sciences, Van Yuzuncu Yil University, Van, Turkey
| | - Suat Ekin
- Department of Chemistry, Division of Biochemistry, Science Faculty, Van Yuzuncu Yil University, Van, Turkey.
| | - Erbil Karaman
- Department of Gynecology and Obstetrics, Division of Gynecological Oncology, Van Yuzuncu Yil University, Van, Turkey
| | - Remzi Erten
- Department of Medical Pathology, Van Yuzuncu Yil University, Van, Turkey
| | - Damla Yıldız
- Department of Chemistry, Division of Biochemistry, Institute of Natural and Applied Sciences, Van Yuzuncu Yil University, Van, Turkey
| | - Ahmet Bakır
- Department of Chemistry, Division of Biochemistry, Institute of Natural and Applied Sciences, Van Yuzuncu Yil University, Van, Turkey
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12
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Brecht P, Dring JC, Yanez F, Styczeń A, Mertowska P, Mertowski S, Grywalska E. How Do Minerals, Vitamins, and Intestinal Microbiota Affect the Development and Progression of Heart Disease in Adult and Pediatric Patients? Nutrients 2023; 15:3264. [PMID: 37513682 PMCID: PMC10384570 DOI: 10.3390/nu15143264] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/21/2023] [Accepted: 07/22/2023] [Indexed: 07/30/2023] Open
Abstract
Cardiovascular diseases (CVDs) are the leading cause of death worldwide, far ahead of cancer. Epidemiological data emphasize the participation of many risk factors that increase the incidence of CVDs, including genetic factors, age, and sex, but also lifestyle, mainly nutritional irregularities and, connected with them, overweight and obesity, as well as metabolic diseases. Despite the importance of cardiovascular problems in the whole society, the principles of prevention of CVDs are not widely disseminated, especially among the youngest. As a result, nutritional neglect, growing from childhood and adolescence, translates into the occurrence of numerous disease entities, including CVDs, in adult life. This review aimed to draw attention to the role of selected minerals and vitamins in health and the development and progression of CVDs in adults and children. Particular attention was paid to the effects of deficiency and toxicity of the analyzed compounds in the context of the cardiovascular system and to the role of intestinal microorganisms, which by interacting with nutrients, may contribute to the development of cardiovascular disorders. We hope this article will draw the attention of society and the medical community to emphasize promoting healthy eating and proper eating habits in children and adults, translating into increased awareness and a reduced risk of CVD.
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Affiliation(s)
- Peet Brecht
- Department of Cardiology, Medical University of Lublin, Jaczewskiego 8, 20-093 Lublin, Poland
| | - James Curtis Dring
- Department of Cardiology, Medical University of Lublin, Jaczewskiego 8, 20-093 Lublin, Poland
| | - Felipe Yanez
- Department of Cardiology, Medical University of Lublin, Jaczewskiego 8, 20-093 Lublin, Poland
| | - Agnieszka Styczeń
- Department of Cardiology, Medical University of Lublin, Jaczewskiego 8, 20-093 Lublin, Poland
| | - Paulina Mertowska
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Sebastian Mertowski
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
| | - Ewelina Grywalska
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland
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13
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Vašková J, Klepcová Z, Špaková I, Urdzík P, Štofilová J, Bertková I, Kľoc M, Rabajdová M. The Importance of Natural Antioxidants in Female Reproduction. Antioxidants (Basel) 2023; 12:antiox12040907. [PMID: 37107282 PMCID: PMC10135990 DOI: 10.3390/antiox12040907] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/03/2023] [Accepted: 04/08/2023] [Indexed: 04/29/2023] Open
Abstract
Oxidative stress (OS) has an important role in female reproduction, whether it is ovulation, endometrium decidualization, menstruation, oocyte fertilization, or development andimplantation of an embryo in the uterus. The menstrual cycle is regulated by the physiological concentration of reactive forms of oxygen and nitrogen as redox signal molecules, which trigger and regulate the length of individual phases of the menstrual cycle. It has been suggested that the decline in female fertility is modulated by pathological OS. The pathological excess of OS compared to antioxidants triggers many disorders of female reproduction which could lead to gynecological diseases and to infertility. Therefore, antioxidants are crucial for proper female reproductive function. They play a part in the metabolism of oocytes; in endometrium maturation via the activation of antioxidant signaling pathways Nrf2 and NF-κB; and in the hormonal regulation of vascular action. Antioxidants can directly scavenge radicals and act as a cofactor of highly valuable enzymes of cell differentiation and development, or enhance the activity of antioxidant enzymes. Compensation for low levels of antioxidants through their supplementation can improve fertility. This review considers the role of selected vitamins, flavonoids, peptides, and trace elements with antioxidant effects in female reproduction mechanisms.
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Affiliation(s)
- Janka Vašková
- Department of Medical and Clinical Biochemistry, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Trieda SNP 1, 040 11 Košice, Slovakia
| | - Zuzana Klepcová
- Department of Medical and Clinical Biochemistry, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Trieda SNP 1, 040 11 Košice, Slovakia
- Medirex, a.s., Holubyho 35, 902 01 Pezinok, Slovakia
| | - Ivana Špaková
- Department of Medical and Clinical Biochemistry, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Trieda SNP 1, 040 11 Košice, Slovakia
| | - Peter Urdzík
- Department of Gynaecology and Obstetrics, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Trieda SNP 1, 040 11 Košice, Slovakia
| | - Jana Štofilová
- Center for Clinical and Preclinical Research MEDIPARK, Department of Experimental Medicine, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Trieda SNP 1, 040 11 Košice, Slovakia
| | - Izabela Bertková
- Center for Clinical and Preclinical Research MEDIPARK, Department of Experimental Medicine, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Trieda SNP 1, 040 11 Košice, Slovakia
| | - Marek Kľoc
- Medirex, a.s., Holubyho 35, 902 01 Pezinok, Slovakia
| | - Miroslava Rabajdová
- Department of Medical and Clinical Biochemistry, Faculty of Medicine, Pavol Jozef Šafárik University in Košice, Trieda SNP 1, 040 11 Košice, Slovakia
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14
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Wang PH, Yang ST, Liu CH, Chang WH, Lee FK, Lee WL. Endometrial cancer: Part I. Basic concept. Taiwan J Obstet Gynecol 2022; 61:951-959. [DOI: 10.1016/j.tjog.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2022] [Indexed: 11/24/2022] Open
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15
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Yao X, Zuo N, Guan W, Fu L, Jiang S, Jiao J, Wang X. Association of Gut Microbiota Enterotypes with Blood Trace Elements in Women with Infertility. Nutrients 2022; 14:nu14153195. [PMID: 35956371 PMCID: PMC9370633 DOI: 10.3390/nu14153195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/30/2022] [Accepted: 08/02/2022] [Indexed: 02/04/2023] Open
Abstract
Infertility is defined as failure to achieve pregnancy within 12 months of unprotected intercourse in women. Trace elements, a kind of micronutrient that is very important to female reproductive function, are affected by intestinal absorption, which is regulated by gut microbiota. Enterotype is the classification of an intestinal microbiome based on its characteristics. Whether or not Prevotella-enterotype and Bacteroides-enterotype are associated with blood trace elements among infertile women remains unclear. The study aimed to explore the relationship between five main whole blood trace elements and these two enterotypes in women with infertility. This retrospective cross-sectional study recruited 651 Chinese women. Whole blood copper, zinc, calcium, magnesium, and iron levels were measured. Quantitative real-time PCR was performed on all fecal samples. Patients were categorized according to whole blood trace elements (low levels group, <5th percentile; normal levels group, 5th‒95th percentile; high levels group, >95th percentile). There were no significant differences in trace elements between the two enterotypes within the control population, while in infertile participants, copper (P = 0.033), zinc (P < 0.001), magnesium (P < 0.001), and iron (P < 0.001) in Prevotella-enterotype was significantly lower than in Bacteroides-enterotype. The Chi-square test showed that only the iron group had a significant difference in the two enterotypes (P = 0.001). Among infertile patients, Prevotella-enterotype (Log(P/B) > −0.27) predicted the low levels of whole blood iron in the obesity population (AUC = 0.894; P = 0.042). For the high levels of iron, Bacteroides-enterotype (Log(P/B) <−2.76) had a predictive power in the lean/normal group (AUC = 0.648; P = 0.041) and Log(P/B) <−3.99 in the overweight group (AUC = 0.863; P = 0.013). We can infer that these two enterotypes may have an effect on the iron metabolism in patients with infertility, highlighting the importance of further research into the interaction between enterotypes and trace elements in reproductive function.
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Affiliation(s)
- Xinrui Yao
- Center of Reproductive Medicine, Shengjing Hospital of China Medical University, 39 Huaxiang Road, Shenyang 110004, China
- Shenyang Reproductive Health Clinical Medicine Research Center, Shenyang 110004, China
| | - Na Zuo
- Center of Reproductive Medicine, Shengjing Hospital of China Medical University, 39 Huaxiang Road, Shenyang 110004, China
- Shenyang Reproductive Health Clinical Medicine Research Center, Shenyang 110004, China
| | - Wenzheng Guan
- Center of Reproductive Medicine, Shengjing Hospital of China Medical University, 39 Huaxiang Road, Shenyang 110004, China
- Shenyang Reproductive Health Clinical Medicine Research Center, Shenyang 110004, China
| | - Lingjie Fu
- Center of Reproductive Medicine, Shengjing Hospital of China Medical University, 39 Huaxiang Road, Shenyang 110004, China
- Shenyang Reproductive Health Clinical Medicine Research Center, Shenyang 110004, China
| | - Shuyi Jiang
- Center of Reproductive Medicine, Shengjing Hospital of China Medical University, 39 Huaxiang Road, Shenyang 110004, China
- Shenyang Reproductive Health Clinical Medicine Research Center, Shenyang 110004, China
| | - Jiao Jiao
- Center of Reproductive Medicine, Shengjing Hospital of China Medical University, 39 Huaxiang Road, Shenyang 110004, China
- Shenyang Reproductive Health Clinical Medicine Research Center, Shenyang 110004, China
- Correspondence: (J.J.); (X.W.)
| | - Xiuxia Wang
- Center of Reproductive Medicine, Shengjing Hospital of China Medical University, 39 Huaxiang Road, Shenyang 110004, China
- Shenyang Reproductive Health Clinical Medicine Research Center, Shenyang 110004, China
- Correspondence: (J.J.); (X.W.)
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