Background: Unsafe abortion (USA) is defined as the termination of a non-desired pregnancy, performed by an unqualified person or in an environment without minimum medical standards, or both. It can impact negatively ...Background: Unsafe abortion (USA) is defined as the termination of a non-desired pregnancy, performed by an unqualified person or in an environment without minimum medical standards, or both. It can impact negatively the fertility in the future by tubo-peritoneal lesions. The current study aimed to highlight the infertility factors associated with USA. Material and Methods: From January 1st 2000 to December 31st 2021, a total of 3876 patients that sought care for infertility in the University Clinic of Kinshasa and the Edith Medical Center were enrolled. The socio-demographic, clinical and paraclinical variables were recorded and analyzed in relation to USA history. Results: The patients’ average age was 33.4 ± 5.7 years. Half of them were housewives;about sixty percent of the patients were nulliparous (59.31%). Seventy percent had a secondary infertility with 43.33% having a history of unsafe abortion. The main diagnosis was genital infections and uterus myoma. The chronic endometritis, bilateral tubal occlusion and Uterine synechiae were more associated with USA group. The spermogram anomalies and other partners’ lesions seemed of infectious origin. Conclusion: The USA remains a more frequent phenomenon in our setting. The chronic endometritis, bilateral tubal occlusion, uterine synechiae and indirectly uterus myoma were the infertility factors related to USA. The genital infection of any origin seems to be the main denominator underlying the female and the male infertility in our setting.展开更多
Background Antibiotic therapy in infertility management is one of the most frequent and useful practices in sub-Saharan setting. Infertility of tubal origin and secondary to infections are the most prevalent. The curr...Background Antibiotic therapy in infertility management is one of the most frequent and useful practices in sub-Saharan setting. Infertility of tubal origin and secondary to infections are the most prevalent. The current study aimed to take stock of antibiotic therapy in infertility management without in Vitro Fertilization (IVF). Material and Methods A cross-sectional analytical study undertaken in University Clinics of Kinshasa and the Edith Medical Center, from January 2001 to December 2021. It involved 3754 patients who sought care for infertility and received antibiotics during the treatment. Results The mean age of the patients was 33.3 ± 5.7 years and ranged from 16 to 49 years. Most of them were nulliparous with secondary infertility. The average duration of infertility was 4.5 ± 3.6 years and ranged from 1 to 20 years. Most had a history of unsafe abortion and tubal obstruction. The pelvic infections were the main diagnosis. After antibiotic therapy, especially made of Doxycycline alone or in association 442 (8.8%) patients conceived. Conclusion In the low-income sub-Saharan setting, infection remained the common cause of infertility and doxycycline was found to be the most used and efficient antibiotics.展开更多
Objective:To investigate the levels of seminal plasma exosomes and the expression of the SRD5A2 gene in Iraqi men with different types of male infertility(asthenozoospermia,oligozoospermia,and azoospermia),and to expl...Objective:To investigate the levels of seminal plasma exosomes and the expression of the SRD5A2 gene in Iraqi men with different types of male infertility(asthenozoospermia,oligozoospermia,and azoospermia),and to explore the regulatory role of selected microRNAs(miRNAs)in the modulation of SRD5A2 gene expression.Methods:A total of 90 male participants were categorized into four groups:asthenozoospermia(n=24),oligozoospermia(n=24),azoospermia(n=18),and normozoospermia(n=24).Seminal plasma exosome levels were quantified using ELISA.RNA,including miRNAs,was extracted,followed by cDNA synthesis.The expression of SRD5A2 mRNA and five selected miRNAs(miR-6090,hsa-miR-5189-5p,miR-23a-5p,miR-1914-3p,and miR-4540)was evaluated using qRT-PCR.Correlation analyses were conducted between exosome levels,miRNA expression,and SRD5A2 expression.Results:Infertile men exhibited significantly lower seminal exosome levels than normozoospermic men(P<0.01).The expression of SRD5A2 mRNA was decreased in asthenozoospermic and oligozoospermic men but elevated in azoospermic men.Elevated levels of hsa-miR-5189-5p,miR-6090,and miR-23a-5p were observed in infertile groups.Correlation analysis revealed a significant negative relationship between these miRNAs and SRD5A2 expression in asthenozoospermic and oligozoospermic men,but a positive correlation in azoospermic men.Exosome levels were also significantly correlated with the expression of these miRNAs,suggesting their role as molecular carriers in regulating gene expression.Conclusions:This study highlights the potential role of seminal exosomes and specific miRNAs in regulating SRD5A2 gene expression among infertile men.The altered levels of exosomes and dysregulated miRNA expression,particularly hsa-miR-5189-5p and miR-6090,may serve as novel biomarkers for the diagnosis and management of male infertility.Further research is warranted to validate these findings and explore their therapeutic implications.展开更多
Background: Infertility is a global health issue, and it is a multidimensional problem with social, economic, and cultural influences. Objectives: The study aimed to determine types of infertility and their contributi...Background: Infertility is a global health issue, and it is a multidimensional problem with social, economic, and cultural influences. Objectives: The study aimed to determine types of infertility and their contributing factors among the respondent infertile women. Methods: This prospective cross-sectional study was conducted among infertile women visiting Sir Salimullah Medical College and Hospital, Dhaka. From January to December 2020, 111 infertile women were included and evaluated for infertility types and their contributing factors. Data were collected by face-to-face interviewing, and data were analyzed statistically. Results: Primary infertility was found among 90 (81%) and secondary infertility among 21 (18.9%). Among the direct risk factors of female infertility, ovulation failure was the majority of the cases, 74 (35.1%), and its mainly observed in primarily infertile women 58 (33.9%). These observations were statistically significant. Conclusions: Infertility should be treated as a public health problem, government and non-government organizations should develop a basic policy to create effective fertility centers.展开更多
This study primarily aimed to investigate the prevalence of human papillomavirus(HPV)and other common pathogens of sexually transmitted infections(STIs)in spermatozoa of infertile men and their effects on semen parame...This study primarily aimed to investigate the prevalence of human papillomavirus(HPV)and other common pathogens of sexually transmitted infections(STIs)in spermatozoa of infertile men and their effects on semen parameters.These pathogens included Ureaplasma urealyticum,Ureaplasma parvum,Chlamydia trachomatis,Mycoplasma genitalium,herpes simplex virus 2,Neisseria gonorrhoeae,Enterococcus faecalis,Streptococcus agalactiae,Pseudomonas aeruginosa,and Staphylococcus aureus.A total of 1951 men of infertile couples were recruited between 23 March 2023,and 17 May 2023,at the Department of Reproductive Medicine of The First People’s Hospital of Yunnan Province(Kunming,China).Multiplex polymerase chain reaction and capillary electrophoresis were used for HPV genotyping.Polymerase chain reaction and electrophoresis were also used to detect the presence of other STIs.The overall prevalence of HPV infection was 12.4%.The top five prevalent HPV subtypes were types 56,52,43,16,and 53 among those tested positive for HPV.Other common infections with high prevalence rates were Ureaplasma urealyticum(28.3%),Ureaplasma parvum(20.4%),and Enterococcus faecalis(9.5%).The prevalence rates of HPV coinfection with Ureaplasma urealyticum,Ureaplasma parvum,Chlamydia trachomatis,Mycoplasma genitalium,herpes simplex virus 2,Neisseria gonorrhoeae,Enterococcus faecalis,Streptococcus agalactiae,and Staphylococcus aureus were 24.8%,25.4%,10.6%,6.4%,2.4%,7.9%,5.9%,0.9%,and 1.3%,respectively.The semen volume and total sperm count were greatly decreased by HPV infection alone.Coinfection with HPV and Ureaplasma urealyticum significantly reduced sperm motility and viability.Our study shows that coinfection with STIs is highly prevalent in the semen of infertile men and that coinfection with pathogens can seriously affect semen parameters,emphasizing the necessity of semen screening for STIs.展开更多
Primary ciliary dyskinesia(PCD)is a clinically rare,genetically and phenotypically heterogeneous condition characterized by chronic respiratory tract infections,male infertility,tympanitis,and laterality abnormalities...Primary ciliary dyskinesia(PCD)is a clinically rare,genetically and phenotypically heterogeneous condition characterized by chronic respiratory tract infections,male infertility,tympanitis,and laterality abnormalities.PCD is typically resulted from variants in genes encoding assembly or structural proteins that are indispensable for the movement of motile cilia.Here,we identified a novel nonsense mutation,c.466G>T,in cilia-and flagella-associated protein 300(CFAP300)resulting in a stop codon(p.Glu156*)through whole-exome sequencing(WES).The proband had a PCD phenotype with laterality defects and immotile sperm flagella displaying a combined loss of the inner dynein arm(IDA)and outer dynein arm(ODA).Bioinformatic programs predicted that the mutation is deleterious.Successful pregnancy was achieved through intracytoplasmic sperm injection(ICSI).Our results expand the spectrum of CFAP300 variants in PCD and provide reproductive guidance for infertile couples suffering from PCD caused by them.展开更多
Male infertility can result from impaired sperm motility caused by multiple morphological abnormalities of the flagella(MMAF).Distinct projections encircling the central microtubules of the spermatozoal axoneme play p...Male infertility can result from impaired sperm motility caused by multiple morphological abnormalities of the flagella(MMAF).Distinct projections encircling the central microtubules of the spermatozoal axoneme play pivotal roles in flagellar bending and spermatozoal movement.Mammalian sperm-associated antigen 17(SPAG17)encodes a conserved axonemal protein of cilia and flagella,forming part of the C1a projection of the central apparatus,with functions related to ciliary/flagellar motility,skeletal growth,and male fertility.This study investigated two novel homozygous SPAG17 mutations(M1:NM_206996.2,c.829+1G>T,p.Asp212_Glu276del;and M2:c.2120del,p.Leu707*)identified in four infertile patients from two consanguineous Pakistani families.These patients displayed the MMAF phenotype confirmed by Papanicolaou staining and scanning electron microscopy assays of spermatozoa.Quantitative real-time polymerase chain reaction(PCR)of patients’spermatozoa also revealed a significant decrease in SPAG17 mRNA expression,and immunofluorescence staining showed the absence of SPAG17 protein signals along the flagella.However,no apparent ciliary-related symptoms or skeletal malformations were observed in the chest X-rays of any of the patients.Transmission electron microscopy of axoneme cross-sections from the patients showed incomplete C1a projection and a higher frequency of missing microtubule doublets 1 and 9 compared with those from fertile controls.Immunofluorescence staining and Western blot analyses of spermatogenesis-associated protein 17(SPATA17),a component of the C1a projection,and sperm-associated antigen 6(SPAG6),a marker of the spring layer,revealed disrupted expression of both proteins in the patients’spermatozoa.Altogether,these findings demonstrated that SPAG17 maintains the integrity of spermatozoal flagellar axoneme,expanding the phenotypic spectrum of SPAG17 mutations in humans.展开更多
In Burkina Faso, as in other African countries, infertility has become a social burden for the population and a public health problem. Male infertility accounts for 30% to 40% of all infertility cases. The diagnosis o...In Burkina Faso, as in other African countries, infertility has become a social burden for the population and a public health problem. Male infertility accounts for 30% to 40% of all infertility cases. The diagnosis of male infertility or hypofertility is often made by a simple laboratory analysis of sperm to explore sperm parameters. In most African countries, such as Burkina Faso, microbiological analysis in the context of sperm analysis is still not developed, and is carried out solely based on microscopy and traditional culture, which does not allow the growth of fragile and demanding bacteria. Our study investigated the microorganisms of sperm that may be involved in male infertility, using conventional bacteriology techniques and real-time PCR. However, it did not intend to perform a multivariate statistical association analysis to estimate the association of microorganisms with abnormal semen parameters. This prospective cross-sectional pilot study was carried out on patients who visited the bacteriology laboratory of Centre MURAZ, a research Institute in Burkina Faso, for male infertility diagnosis between 2 August and 31 August 2021. Bacteria were isolated and identified using standard bacteriology techniques. In parallel, common pathogenic microorganisms known to be associated with male infertility were targeted and detected in the sperm using a multiplex real-time PCR assay. A total of 38 sperm samples were analyzed by bacteriological culture and bacteria isolated were Staphylococcus aureus (S. aureus) 5.55%, Klebsiella pneumoniae (K. pneumoniae), Enterococcus faecalis (E. faecalis), Streptococcus agalactiae (S. agalactiae) and Staphylococcus hoemalyticus (S. hoemalyticus) respectively 2.70%. Real-time PCR targeted and detected Chlamydia trachomatis (C. trachomatis) at 7.89%, Ureaplasma urealyticum (U. urealyticum) at 21.05%, Ureaplasma parvum (U. parvum) at 18.42%, Mycoplasma hominis (M. hominis) at 15.79%, Mycoplasma genitalium (M. genitalium) at 10.53% and Trichomonas vaginalis (T. vaginalis) at 2.63%. Neisseria gonorrhoeae (N. gonorrhoeae) was targeted by the real-time PCR assay and was not detected (0%) in the tested semen samples. Our study highlights critical limitations of culture performance (low sensitivity), particularly in Burkina Faso, which has a total inability to detect microorganisms (fragile and demanding microorganisms) detected by PCR-based assays. There is therefore an urgent need to at least optimize culture, procedures and algorithms for detection of microorganisms associated with male infertility in clinical laboratories of Burkina Faso. The most effective solution is the routine implementation of molecular diagnostic methods.展开更多
Objective:To analyze the application effect of hysterosalpingography in infertility and provide a reference for the clinical diagnosis of infertility.Methods:A total of 80 infertile patients admitted to Guangdong Wome...Objective:To analyze the application effect of hysterosalpingography in infertility and provide a reference for the clinical diagnosis of infertility.Methods:A total of 80 infertile patients admitted to Guangdong Women and Children’s Hospital from March 2023 to March 2024 were selected as the research objects.They were randomly divided into two groups:the control group and the observation group,with 40 patients in each group,and 80 fallopian tubes were observed in each group.The control group underwent traditional gynecological examinations,while the observation group underwent X-ray hysterosalpingography[1].Four indicators,namely diagnostic accuracy,specificity,sensitivity,and excellent/good rate of image quality,were compared between the two groups to evaluate the diagnostic effect on the fallopian tubes.Results:The values of the above four indicators in the observation group were 95.00%,93.33%,95.38%,and 97.50%respectively,while those in the control group were 76.25%,73.33%,70.77%,and 80.00%respectively.There were statistically significant differences in the four indicators between the two groups(P<0.05).The incidence of adverse reactions in the observation group was 5.00%,and that in the control group was 25.00%,showing a significant difference with statistical significance(χ^(2)=6.275,P<0.05).Conclusion:Modified hysterosalpingography for infertile patients can significantly improve the diagnostic effect of infertility and reduce the incidence of adverse reactions,which has high clinical promotion value.展开更多
Varicocele(VC)is a common cause of male infertility,yet there is a lack of molecular information for VC-associated male infertility.This study investigated alterations in the seminal plasma metabolomic and lipidomic p...Varicocele(VC)is a common cause of male infertility,yet there is a lack of molecular information for VC-associated male infertility.This study investigated alterations in the seminal plasma metabolomic and lipidomic profiles of infertile male VC patients.Twenty infertile males with VC and twenty-three age-matched healthy controls(HCs)were recruited from Peking Union Medical College Hospital(Beijing,China)between October 2019 and April 2021.Untargeted metabolite and lipid profiles from seminal plasma were analyzed using mass spectrometry.Four hundred and seventy-six metabolites and seventeen lipids were significantly different in infertile male VC patients compared to HCs.The top enriched pathways among these significantly different metabolites are protein digestion and absorption,aminoacyl-transfer RNA(tRNA)biosynthesis,and biosynthesis of amino acids.Different key lipid species,including triglyceride(TG),diacylglycerol(DG),ceramides(Cer),and phosphatidylserine(PS),varied betweenVC and HC groups.The distinct metabolites and lipids were moderately correlated.DL-3-phenyllactic acid is a potential diagnostic biomarker for VC-related male infertility(area under the curve[AUC]=0.893),positively correlating with sperm count,concentration,and motility.Furthermore,DL-3-phenyllactic acid is the only metabolite shared by all four comparisons(VC vs HC,VC-induced oligoasthenospermia[OAS]vs VC-induced asthenospermia[AS],OAS vs HC,and AS vs HC).DL-3-phenyllactic acid significantly decreased in OAS than AS.Metabolite-targeting gene analysis revealed carbonic anhydrase 9(CA9)might be the strongest candidate associated with the onset and severity of VC.The seminal plasma metabolite and lipid profiles of infertile males with VC differ significantly from those of HCs.DL-3-phenyllactic acid could be a promising biomarker.展开更多
Objective To evaluate the impact of endometrial polyps(EP)on postoperative pregnancy outcomes in infertile women with endometriosis(EMs).Methods PubMed,Embase,The Cochrane Library,CNKI,VIP,SinoMed,and WanFang Data dat...Objective To evaluate the impact of endometrial polyps(EP)on postoperative pregnancy outcomes in infertile women with endometriosis(EMs).Methods PubMed,Embase,The Cochrane Library,CNKI,VIP,SinoMed,and WanFang Data databases were searched to include clinical studies on the effect of EP on pregnancy outcomes in patients with EMs,published before August 31,2020.A meta-analysis was performed using Rev Man 5.3 software after two investigators independently screened the literature,extracted information,and evaluated the risk of bias of the included studies.Results The meta-analysis included ten studies(651 and 1,040 in the combined EP and uncomplicated EP groups,respectively).The spontaneous pregnancy rate,clinical pregnancy rate,and live birth rate were significantly lower in the group with combined EPs than in the group without combined EPs[Odd’s ratio(OR)=0.63,95%confidence interval(CI):0.50–0.80,P=0.0001;OR=0.63,95%CI:0.48–0.84,P=0.001;OR=0.63,95%CI:0.42–0.96,P=0.03],and the rate of embryonic abortion was significantly higher than that in the uncomplicated EP group[OR=3.10,95%CI:1.52–6.32,P=0.002].Conclusion EP may adversely affect pregnancy outcomes in patients with infertility and EMs.Even after surgical treatment,EP can still reduce natural pregnancy,clinical pregnancy,and live birth rates in infertile women with EMs and increase the risk of embryo arrest in these women.展开更多
Investigating the correlation between micronucleus formation and male infertility has the potential to improve clinical diagnosis and deepen our understanding of pathological progression. Our study enrolled 2252 male ...Investigating the correlation between micronucleus formation and male infertility has the potential to improve clinical diagnosis and deepen our understanding of pathological progression. Our study enrolled 2252 male patients whose semen was analyzed from March 2023 to July 2023. Their clinical data, including semen parameters and age, were also collected. Genetic analysis was used to determine whether the sex chromosome involved in male infertility was abnormal (including the increase, deletion, and translocation of the X and Y chromosomes), and subsequent semen analysis was conducted for clinical grouping purposes. The participants were categorized into five groups: normozoospermia, asthenozoospermia, oligozoospermia, oligoasthenozoospermia, and azoospermia. Patients were randomly selected for further study;41 patients with normozoospermia were included in the control group and 117 patients with non-normozoospermia were included in the study group according to the proportions of all enrolled patients. Cytokinesis-block micronucleus (CBMN) screening was conducted through peripheral blood. Statistical analysis was used to determine the differences in micronuclei (MNi) among the groups and the relationships between MNi and clinical data. There was a significant increase in MNi in infertile men, including those with azoospermia, compared with normozoospermic patients, but there was no significant difference between the genetic and nongenetic groups in azoospermic men. The presence of MNi was associated with sperm concentration, progressive sperm motility, immotile spermatozoa, malformed spermatozoa, total sperm count, and total sperm motility. This study underscores the potential utility of MNi as a diagnostic tool and highlights the need for further research to elucidate the underlying mechanisms of male infertility.展开更多
Male infertility has been regarded as a significant public health concern,with a cumulative total of 55 million men affected across the globe[1].A wide range of causes,including hormonal imbalance,physical abnormaliti...Male infertility has been regarded as a significant public health concern,with a cumulative total of 55 million men affected across the globe[1].A wide range of causes,including hormonal imbalance,physical abnormalities,lifestyle parameters,chromosomal defects,psychological concerns,etc.,cumulatively account for 30%of male infertility cases[1].These estimates emphasize the urgent need to raise awareness,conduct thorough evaluations,and implement targeted measures to address male infertility effectively[1].展开更多
Infertility has been regarded as a global public health concern,affecting both men and women irrespective of geographical region,race,ethnicity,and socioeconomic class[1].The available global estimates suggest that al...Infertility has been regarded as a global public health concern,affecting both men and women irrespective of geographical region,race,ethnicity,and socioeconomic class[1].The available global estimates suggest that almost 17%of people of reproductive age experience infertility during their lives[1],with 55 million men and 110 million women living with infertility worldwide and varying estimates across different global regions[2].The consequences of infertility go beyond just medical suffering,and result in huge social and psychological consequences,including marital strains,stigma,and mental health problems[1].The current paper explores infertility in cultural context,enlists herbal remedies and traditional healers for infertility,and proposes targeted public health interventions to minimize the utilization of herbal treatment in dealing with cases of infertility.展开更多
Background: According to the World Health Organization, the worldwide prevalence of infertility is 17.5%. The male share of responsibility is undeniable. Several factors, such as smoking, alcoholism, obesity and envir...Background: According to the World Health Organization, the worldwide prevalence of infertility is 17.5%. The male share of responsibility is undeniable. Several factors, such as smoking, alcoholism, obesity and environmental pollution are sources of infertility in men. The aim of this study was to determine the spermological profile of infertile men and the factors associated with sperm parameter abnormalities. Methods: This retrospective study analysed 1000 sperm samples over an 11-year period, from January 2010 to December 2021. Results: The average age was 37.52 ± 8.66 years. Surgical history of varicocele and teratozoospermia were associated (p-value = 0.0001). Candida albicans was associated with a 2.27-fold risk of necrozoospermia and a 3.14-fold risk of oligozoospermia. The link between the reason for requesting a spermogram and the age range between 38 and 47 was significant (p-value Conclusion: Today, lifestyle and environmental pollution play a major role in sperm parameter abnormalities.展开更多
BACKGROUND Although limited clinical evidence exists,such as case reports of azoospermia treatment in humans using bone marrow aspirate concentrate(BMAC)injection,these findings provide a compelling foundation for exp...BACKGROUND Although limited clinical evidence exists,such as case reports of azoospermia treatment in humans using bone marrow aspirate concentrate(BMAC)injection,these findings provide a compelling foundation for exploring mesenchymal stem cell therapy in male infertility.AIM To evaluate the safety and efficacy of autologous BMAC injection into human testis for men with severe oligospermia or azoospermia over the existing standard of care pharmacotherapy and lifestyle modifications.METHODS We included patients diagnosed with male infertility of the age group between 35–45 years in this trial comparing BMAC injection therapy with pharmacotherapy and lifestyle modifications over a 6-month follow-up period.Semen analysis was used to evaluate the efficacy of the interventions analyzed.RESULTS We enrolled 30 patients in the trial with 10 patients in each arm of the trial.Compared to the baseline,neither the BMAC group(P=0.139)or pharmacotherapy group(P=0.056)nor the lifestyle modification group(P=0.112)demonstrated a statistically significant increase in sperm count at 6 months.However,the BMAC group demonstrated a significant increase in sperm count(mean 19.2 million;P=0.001)compared to the pharmacotherapy group(mean 3.5 million)and lifestyle modification group(mean 2.2 million)at 6 months.Significant improvement was noted in the motility grade(P<0.001)only in the BMAC group while no changes were noted in the other groups.CONCLUSION This trial highlights the potential of autologous BMAC as a promising therapeutic option for male infertility.Despite the absence of significant changes within individual treatment arms,BMAC therapy demonstrated superior efficacy in improving both sperm count and motility compared to standard pharmacotherapy and lifestyle modifications.These findings underscore the potential role of regenerative medicine in addressing severe oligospermia and azoospermia,warranting further research to solidify its clinical applicability.展开更多
Varicocele,the most common and treatable cause of male infertility,significantly impacts fertility.The pathophysiological mechanisms of varicocele have not been fully understood yet.Recent studies have focused on the ...Varicocele,the most common and treatable cause of male infertility,significantly impacts fertility.The pathophysiological mechanisms of varicocele have not been fully understood yet.Recent studies have focused on the pathophysiology of varicocele-induced infertility,highlighting inflammation and oxidative stress as key contributing factors.We reviewed recent research on the roles of inflammation and oxidative stress in the pathophysiology of varicocele and found that they negatively impact semen parameters,spermatogenesis,and testicular and epididymal function.In addition,this article summarizes the related factors of inflammation and oxidative stress caused by varicocele.Finally,a brief consideration on the treatments to address inflammation and oxidative stress is proposed.This review may provide treatment options and targets for varicocele-induced infertility.However,the relationship between inflammation and oxidative stress in varicocele still needs further study.展开更多
Selecting the embryo with the highest implantation potential is a top priority in in-vitro fertilization(IVF)centers.Few studies have explored the relationship between day 5 blastocyst morphokinetics and implantation ...Selecting the embryo with the highest implantation potential is a top priority in in-vitro fertilization(IVF)centers.Few studies have explored the relationship between day 5 blastocyst morphokinetics and implantation outcomes[1].Despite numerous time-lapse studies,the findings often conflict due to differences in patient demographics,lab conditions,and protocols,such as oxygen concentration[2].Thus,there is ongoing debate regarding which parameters are most predictive of implantation.展开更多
Objective:To analyze the diagnostic value of transvaginal three-dimensional ultrasound(3D-TVS)in evaluating endometrial receptivity(ER)for ovulation disorder infertility(ODI),and to investigate the impact of subendome...Objective:To analyze the diagnostic value of transvaginal three-dimensional ultrasound(3D-TVS)in evaluating endometrial receptivity(ER)for ovulation disorder infertility(ODI),and to investigate the impact of subendometrial endometrial vascular index(VI)and endometrial vascular flow index(VFI)levels on ODI.Methods:A total of 110 patients diagnosed with ODI admitted between January 2023 and June 2024 were selected.All patients underwent ovulation induction therapy,3D-TVS examination,and sex hormone testing.Based on pregnancy outcomes,patients were divided into a successful pregnancy group(73 cases)and an unsuccessful pregnancy group(37 cases).ER parameters,sex hormone levels,and endometrial blood flow patterns were compared between the two groups.Receiver operating characteristic(ROC)curves were plotted to evaluate the predictive value of ER for ODI.Results:The spiral artery peak systolic velocity(PSV),endometrial volume(EMV),endometrial flow index(FI),and VFI in the successful pregnancy group were significantly higher than those in the unsuccessful pregnancy group(p<0.05).No significant differences were observed in other ER parameters between the two groups(p>0.05).There was no significant difference in sex hormone levels between the two groups on the day of human chorionic gonadotropin(hCG)treatment(p>0.05).Among the endometrial blood flow classifications in the pregnant group,the proportion of Type II was lower than that in the nonpregnant group(p<0.05).The Receiver Operating Characteristic(ROC)curve demonstrated that the area under the curve(AUC)for Endometrial Volume(EMV)in predicting pregnancy after Ovarian Dysfunction Infertility(ODI)treatment was 0.854,with a sensitivity of 92.61%and a specificity of 71.75%.The AUC for Vascularization Index(VI)was 0.771,with a sensitivity of 52.18%and a specificity of 88.70%.The AUC for Vascularization Flow Index(VFI)of the endometrium was 0.887,with a sensitivity of 80.01%and a specificity of 69.20%.Conclusion:Three-dimensional transvaginal sonography(3D-TVS)assessment of endometrial receptivity(ER)can effectively detect ODI,and the levels of subendometrial VI and VFI demonstrate superior predictive performance for pregnancy outcomes in this condition,serving as commonly used predictive indicators for the disease.展开更多
OBJECTIVE:To evaluate the effectiveness and safety of the sequential therapy in treating infertility with polycystic ovary syndrome(PCOS)and luteal phase defects(LPD)by Yangxin Dianji decoction(养心奠基方,YXDJ-D)and N...OBJECTIVE:To evaluate the effectiveness and safety of the sequential therapy in treating infertility with polycystic ovary syndrome(PCOS)and luteal phase defects(LPD)by Yangxin Dianji decoction(养心奠基方,YXDJ-D)and Nuangong Tiaojing decoction(暖宫调经方,NGTJ-D).METHODS:This study was undertaken in the Jiangsu Province Hospital of Chinese Medicine.Altogether 90 eligible patients with PCOS and LPD were assigned to exposed group A(Chinese Medicine therapy,YXDJ-D and NGTJ-D),exposed group B(Chinese Medicine plus Western Medicine therapy),control group(Western Medicine therapy).The exposed group A adopted the sequential therapy that YXDJ-D is taken in the postmenstrual period(follicular phase)and NGTJ-D is taken in premenstrual period(luteal phase).Control group took letrozole,dydrogesterone and was given intramuscular injection of human menopausal gonadotropin,human chorionic gonadotropin.The exposed group B was treated with the above-mentioned therapy project of integrated Chinese Medicine and Western Medicine.This study lasted for 2 courses for 6 months.The primary outcomes were pregnancy rate and early abortion rate.The secondary outcomes were the Traditional Chinese Medicine(TCM)syndrome scores,estrogen(E2)and progesterone(P),endometrial volume(EV),vascularity index(VI),flow index(FI)and vascularization flow index(VFI).These outcomes will be assessed at baseline and post-intervention.RESULTS:The pregnancy rates of the exposed group A and B were higher than the control group(60.00%vs 60.00%vs 53.33%),while early abortion rates of exposed groups A and B were lower than the control group(33.33%vs 16.67%vs 43.75%,P>0.05).Total efficacy rates in exposed group A and B were better than the control group(93.30%vs 93.30%vs 53.30%,P<0.01).TCM symptom scores and endometrial receptivity indexes(EV,FI,VFI)were significantly lower in exposed groups compared to the control group(P<0.05).P increase in exposed group B was superior to the other two groups(P<0.01).No noticeable abnormalities in safety indicators in the three groups.CONCLUSION:The sequential therapy of YXDJ-D and NGTJ-D can effectively increase pregnancy rate,reduce the early abortion rate and alleviate the clinical symptoms of infertility in patients with PCOS and LPD by improving luteal function and promoting the endometrial receptivity.展开更多
文摘Background: Unsafe abortion (USA) is defined as the termination of a non-desired pregnancy, performed by an unqualified person or in an environment without minimum medical standards, or both. It can impact negatively the fertility in the future by tubo-peritoneal lesions. The current study aimed to highlight the infertility factors associated with USA. Material and Methods: From January 1st 2000 to December 31st 2021, a total of 3876 patients that sought care for infertility in the University Clinic of Kinshasa and the Edith Medical Center were enrolled. The socio-demographic, clinical and paraclinical variables were recorded and analyzed in relation to USA history. Results: The patients’ average age was 33.4 ± 5.7 years. Half of them were housewives;about sixty percent of the patients were nulliparous (59.31%). Seventy percent had a secondary infertility with 43.33% having a history of unsafe abortion. The main diagnosis was genital infections and uterus myoma. The chronic endometritis, bilateral tubal occlusion and Uterine synechiae were more associated with USA group. The spermogram anomalies and other partners’ lesions seemed of infectious origin. Conclusion: The USA remains a more frequent phenomenon in our setting. The chronic endometritis, bilateral tubal occlusion, uterine synechiae and indirectly uterus myoma were the infertility factors related to USA. The genital infection of any origin seems to be the main denominator underlying the female and the male infertility in our setting.
文摘Background Antibiotic therapy in infertility management is one of the most frequent and useful practices in sub-Saharan setting. Infertility of tubal origin and secondary to infections are the most prevalent. The current study aimed to take stock of antibiotic therapy in infertility management without in Vitro Fertilization (IVF). Material and Methods A cross-sectional analytical study undertaken in University Clinics of Kinshasa and the Edith Medical Center, from January 2001 to December 2021. It involved 3754 patients who sought care for infertility and received antibiotics during the treatment. Results The mean age of the patients was 33.3 ± 5.7 years and ranged from 16 to 49 years. Most of them were nulliparous with secondary infertility. The average duration of infertility was 4.5 ± 3.6 years and ranged from 1 to 20 years. Most had a history of unsafe abortion and tubal obstruction. The pelvic infections were the main diagnosis. After antibiotic therapy, especially made of Doxycycline alone or in association 442 (8.8%) patients conceived. Conclusion In the low-income sub-Saharan setting, infection remained the common cause of infertility and doxycycline was found to be the most used and efficient antibiotics.
文摘Objective:To investigate the levels of seminal plasma exosomes and the expression of the SRD5A2 gene in Iraqi men with different types of male infertility(asthenozoospermia,oligozoospermia,and azoospermia),and to explore the regulatory role of selected microRNAs(miRNAs)in the modulation of SRD5A2 gene expression.Methods:A total of 90 male participants were categorized into four groups:asthenozoospermia(n=24),oligozoospermia(n=24),azoospermia(n=18),and normozoospermia(n=24).Seminal plasma exosome levels were quantified using ELISA.RNA,including miRNAs,was extracted,followed by cDNA synthesis.The expression of SRD5A2 mRNA and five selected miRNAs(miR-6090,hsa-miR-5189-5p,miR-23a-5p,miR-1914-3p,and miR-4540)was evaluated using qRT-PCR.Correlation analyses were conducted between exosome levels,miRNA expression,and SRD5A2 expression.Results:Infertile men exhibited significantly lower seminal exosome levels than normozoospermic men(P<0.01).The expression of SRD5A2 mRNA was decreased in asthenozoospermic and oligozoospermic men but elevated in azoospermic men.Elevated levels of hsa-miR-5189-5p,miR-6090,and miR-23a-5p were observed in infertile groups.Correlation analysis revealed a significant negative relationship between these miRNAs and SRD5A2 expression in asthenozoospermic and oligozoospermic men,but a positive correlation in azoospermic men.Exosome levels were also significantly correlated with the expression of these miRNAs,suggesting their role as molecular carriers in regulating gene expression.Conclusions:This study highlights the potential role of seminal exosomes and specific miRNAs in regulating SRD5A2 gene expression among infertile men.The altered levels of exosomes and dysregulated miRNA expression,particularly hsa-miR-5189-5p and miR-6090,may serve as novel biomarkers for the diagnosis and management of male infertility.Further research is warranted to validate these findings and explore their therapeutic implications.
文摘Background: Infertility is a global health issue, and it is a multidimensional problem with social, economic, and cultural influences. Objectives: The study aimed to determine types of infertility and their contributing factors among the respondent infertile women. Methods: This prospective cross-sectional study was conducted among infertile women visiting Sir Salimullah Medical College and Hospital, Dhaka. From January to December 2020, 111 infertile women were included and evaluated for infertility types and their contributing factors. Data were collected by face-to-face interviewing, and data were analyzed statistically. Results: Primary infertility was found among 90 (81%) and secondary infertility among 21 (18.9%). Among the direct risk factors of female infertility, ovulation failure was the majority of the cases, 74 (35.1%), and its mainly observed in primarily infertile women 58 (33.9%). These observations were statistically significant. Conclusions: Infertility should be treated as a public health problem, government and non-government organizations should develop a basic policy to create effective fertility centers.
基金supported by the Yunnan Provincial Key Laboratory of Clinical Virology(No.202002AG070062)the Key Projects of Yunnan Province Science and Technology Department(No.202302AA310044)the National Natural Science Foundation of China(No.82060664).
文摘This study primarily aimed to investigate the prevalence of human papillomavirus(HPV)and other common pathogens of sexually transmitted infections(STIs)in spermatozoa of infertile men and their effects on semen parameters.These pathogens included Ureaplasma urealyticum,Ureaplasma parvum,Chlamydia trachomatis,Mycoplasma genitalium,herpes simplex virus 2,Neisseria gonorrhoeae,Enterococcus faecalis,Streptococcus agalactiae,Pseudomonas aeruginosa,and Staphylococcus aureus.A total of 1951 men of infertile couples were recruited between 23 March 2023,and 17 May 2023,at the Department of Reproductive Medicine of The First People’s Hospital of Yunnan Province(Kunming,China).Multiplex polymerase chain reaction and capillary electrophoresis were used for HPV genotyping.Polymerase chain reaction and electrophoresis were also used to detect the presence of other STIs.The overall prevalence of HPV infection was 12.4%.The top five prevalent HPV subtypes were types 56,52,43,16,and 53 among those tested positive for HPV.Other common infections with high prevalence rates were Ureaplasma urealyticum(28.3%),Ureaplasma parvum(20.4%),and Enterococcus faecalis(9.5%).The prevalence rates of HPV coinfection with Ureaplasma urealyticum,Ureaplasma parvum,Chlamydia trachomatis,Mycoplasma genitalium,herpes simplex virus 2,Neisseria gonorrhoeae,Enterococcus faecalis,Streptococcus agalactiae,and Staphylococcus aureus were 24.8%,25.4%,10.6%,6.4%,2.4%,7.9%,5.9%,0.9%,and 1.3%,respectively.The semen volume and total sperm count were greatly decreased by HPV infection alone.Coinfection with HPV and Ureaplasma urealyticum significantly reduced sperm motility and viability.Our study shows that coinfection with STIs is highly prevalent in the semen of infertile men and that coinfection with pathogens can seriously affect semen parameters,emphasizing the necessity of semen screening for STIs.
基金supported by the China Postdoctoral Science Foundation Grant(2023M734294)Jiangsu Provincial Medical Key Discipline Cultivation Unit(JSDW202215)the National Natural Science Foundation of China(No.82001618).
文摘Primary ciliary dyskinesia(PCD)is a clinically rare,genetically and phenotypically heterogeneous condition characterized by chronic respiratory tract infections,male infertility,tympanitis,and laterality abnormalities.PCD is typically resulted from variants in genes encoding assembly or structural proteins that are indispensable for the movement of motile cilia.Here,we identified a novel nonsense mutation,c.466G>T,in cilia-and flagella-associated protein 300(CFAP300)resulting in a stop codon(p.Glu156*)through whole-exome sequencing(WES).The proband had a PCD phenotype with laterality defects and immotile sperm flagella displaying a combined loss of the inner dynein arm(IDA)and outer dynein arm(ODA).Bioinformatic programs predicted that the mutation is deleterious.Successful pregnancy was achieved through intracytoplasmic sperm injection(ICSI).Our results expand the spectrum of CFAP300 variants in PCD and provide reproductive guidance for infertile couples suffering from PCD caused by them.
基金supported by the National Natural Science Foundation of China(No.82171599 and No.32270901)the National Key Research and Developmental Program of China(2022YFC2702601 and 2022YFA0806303)the Global Select Project(DJKLX-2022010)of the Institute of Health and Medicine,Hefei Comprehensive National Science Center.
文摘Male infertility can result from impaired sperm motility caused by multiple morphological abnormalities of the flagella(MMAF).Distinct projections encircling the central microtubules of the spermatozoal axoneme play pivotal roles in flagellar bending and spermatozoal movement.Mammalian sperm-associated antigen 17(SPAG17)encodes a conserved axonemal protein of cilia and flagella,forming part of the C1a projection of the central apparatus,with functions related to ciliary/flagellar motility,skeletal growth,and male fertility.This study investigated two novel homozygous SPAG17 mutations(M1:NM_206996.2,c.829+1G>T,p.Asp212_Glu276del;and M2:c.2120del,p.Leu707*)identified in four infertile patients from two consanguineous Pakistani families.These patients displayed the MMAF phenotype confirmed by Papanicolaou staining and scanning electron microscopy assays of spermatozoa.Quantitative real-time polymerase chain reaction(PCR)of patients’spermatozoa also revealed a significant decrease in SPAG17 mRNA expression,and immunofluorescence staining showed the absence of SPAG17 protein signals along the flagella.However,no apparent ciliary-related symptoms or skeletal malformations were observed in the chest X-rays of any of the patients.Transmission electron microscopy of axoneme cross-sections from the patients showed incomplete C1a projection and a higher frequency of missing microtubule doublets 1 and 9 compared with those from fertile controls.Immunofluorescence staining and Western blot analyses of spermatogenesis-associated protein 17(SPATA17),a component of the C1a projection,and sperm-associated antigen 6(SPAG6),a marker of the spring layer,revealed disrupted expression of both proteins in the patients’spermatozoa.Altogether,these findings demonstrated that SPAG17 maintains the integrity of spermatozoal flagellar axoneme,expanding the phenotypic spectrum of SPAG17 mutations in humans.
文摘In Burkina Faso, as in other African countries, infertility has become a social burden for the population and a public health problem. Male infertility accounts for 30% to 40% of all infertility cases. The diagnosis of male infertility or hypofertility is often made by a simple laboratory analysis of sperm to explore sperm parameters. In most African countries, such as Burkina Faso, microbiological analysis in the context of sperm analysis is still not developed, and is carried out solely based on microscopy and traditional culture, which does not allow the growth of fragile and demanding bacteria. Our study investigated the microorganisms of sperm that may be involved in male infertility, using conventional bacteriology techniques and real-time PCR. However, it did not intend to perform a multivariate statistical association analysis to estimate the association of microorganisms with abnormal semen parameters. This prospective cross-sectional pilot study was carried out on patients who visited the bacteriology laboratory of Centre MURAZ, a research Institute in Burkina Faso, for male infertility diagnosis between 2 August and 31 August 2021. Bacteria were isolated and identified using standard bacteriology techniques. In parallel, common pathogenic microorganisms known to be associated with male infertility were targeted and detected in the sperm using a multiplex real-time PCR assay. A total of 38 sperm samples were analyzed by bacteriological culture and bacteria isolated were Staphylococcus aureus (S. aureus) 5.55%, Klebsiella pneumoniae (K. pneumoniae), Enterococcus faecalis (E. faecalis), Streptococcus agalactiae (S. agalactiae) and Staphylococcus hoemalyticus (S. hoemalyticus) respectively 2.70%. Real-time PCR targeted and detected Chlamydia trachomatis (C. trachomatis) at 7.89%, Ureaplasma urealyticum (U. urealyticum) at 21.05%, Ureaplasma parvum (U. parvum) at 18.42%, Mycoplasma hominis (M. hominis) at 15.79%, Mycoplasma genitalium (M. genitalium) at 10.53% and Trichomonas vaginalis (T. vaginalis) at 2.63%. Neisseria gonorrhoeae (N. gonorrhoeae) was targeted by the real-time PCR assay and was not detected (0%) in the tested semen samples. Our study highlights critical limitations of culture performance (low sensitivity), particularly in Burkina Faso, which has a total inability to detect microorganisms (fragile and demanding microorganisms) detected by PCR-based assays. There is therefore an urgent need to at least optimize culture, procedures and algorithms for detection of microorganisms associated with male infertility in clinical laboratories of Burkina Faso. The most effective solution is the routine implementation of molecular diagnostic methods.
文摘Objective:To analyze the application effect of hysterosalpingography in infertility and provide a reference for the clinical diagnosis of infertility.Methods:A total of 80 infertile patients admitted to Guangdong Women and Children’s Hospital from March 2023 to March 2024 were selected as the research objects.They were randomly divided into two groups:the control group and the observation group,with 40 patients in each group,and 80 fallopian tubes were observed in each group.The control group underwent traditional gynecological examinations,while the observation group underwent X-ray hysterosalpingography[1].Four indicators,namely diagnostic accuracy,specificity,sensitivity,and excellent/good rate of image quality,were compared between the two groups to evaluate the diagnostic effect on the fallopian tubes.Results:The values of the above four indicators in the observation group were 95.00%,93.33%,95.38%,and 97.50%respectively,while those in the control group were 76.25%,73.33%,70.77%,and 80.00%respectively.There were statistically significant differences in the four indicators between the two groups(P<0.05).The incidence of adverse reactions in the observation group was 5.00%,and that in the control group was 25.00%,showing a significant difference with statistical significance(χ^(2)=6.275,P<0.05).Conclusion:Modified hysterosalpingography for infertile patients can significantly improve the diagnostic effect of infertility and reduce the incidence of adverse reactions,which has high clinical promotion value.
基金supported by the National Key Research and Development Program of China(No.2018YFE0207300)Beijing Natural Science Foundation(No.M23008)+1 种基金the National High Level Hospital Clinical Research Funding(No.2022-PUMCH-B-124)the National High Level Hospital Clinical Research Funding(No.2022-PUMCH-A-057)。
文摘Varicocele(VC)is a common cause of male infertility,yet there is a lack of molecular information for VC-associated male infertility.This study investigated alterations in the seminal plasma metabolomic and lipidomic profiles of infertile male VC patients.Twenty infertile males with VC and twenty-three age-matched healthy controls(HCs)were recruited from Peking Union Medical College Hospital(Beijing,China)between October 2019 and April 2021.Untargeted metabolite and lipid profiles from seminal plasma were analyzed using mass spectrometry.Four hundred and seventy-six metabolites and seventeen lipids were significantly different in infertile male VC patients compared to HCs.The top enriched pathways among these significantly different metabolites are protein digestion and absorption,aminoacyl-transfer RNA(tRNA)biosynthesis,and biosynthesis of amino acids.Different key lipid species,including triglyceride(TG),diacylglycerol(DG),ceramides(Cer),and phosphatidylserine(PS),varied betweenVC and HC groups.The distinct metabolites and lipids were moderately correlated.DL-3-phenyllactic acid is a potential diagnostic biomarker for VC-related male infertility(area under the curve[AUC]=0.893),positively correlating with sperm count,concentration,and motility.Furthermore,DL-3-phenyllactic acid is the only metabolite shared by all four comparisons(VC vs HC,VC-induced oligoasthenospermia[OAS]vs VC-induced asthenospermia[AS],OAS vs HC,and AS vs HC).DL-3-phenyllactic acid significantly decreased in OAS than AS.Metabolite-targeting gene analysis revealed carbonic anhydrase 9(CA9)might be the strongest candidate associated with the onset and severity of VC.The seminal plasma metabolite and lipid profiles of infertile males with VC differ significantly from those of HCs.DL-3-phenyllactic acid could be a promising biomarker.
文摘Objective To evaluate the impact of endometrial polyps(EP)on postoperative pregnancy outcomes in infertile women with endometriosis(EMs).Methods PubMed,Embase,The Cochrane Library,CNKI,VIP,SinoMed,and WanFang Data databases were searched to include clinical studies on the effect of EP on pregnancy outcomes in patients with EMs,published before August 31,2020.A meta-analysis was performed using Rev Man 5.3 software after two investigators independently screened the literature,extracted information,and evaluated the risk of bias of the included studies.Results The meta-analysis included ten studies(651 and 1,040 in the combined EP and uncomplicated EP groups,respectively).The spontaneous pregnancy rate,clinical pregnancy rate,and live birth rate were significantly lower in the group with combined EPs than in the group without combined EPs[Odd’s ratio(OR)=0.63,95%confidence interval(CI):0.50–0.80,P=0.0001;OR=0.63,95%CI:0.48–0.84,P=0.001;OR=0.63,95%CI:0.42–0.96,P=0.03],and the rate of embryonic abortion was significantly higher than that in the uncomplicated EP group[OR=3.10,95%CI:1.52–6.32,P=0.002].Conclusion EP may adversely affect pregnancy outcomes in patients with infertility and EMs.Even after surgical treatment,EP can still reduce natural pregnancy,clinical pregnancy,and live birth rates in infertile women with EMs and increase the risk of embryo arrest in these women.
基金supported by the National Natural Science Foundation of China(No.32070582)the Joint Foundation of He Lin Academical Workstation of the Third Affiliated Hospital of Guangzhou Medical University(2023HLLH01)the Plan on enhancing scientific research in GMU(2024SRP125).
文摘Investigating the correlation between micronucleus formation and male infertility has the potential to improve clinical diagnosis and deepen our understanding of pathological progression. Our study enrolled 2252 male patients whose semen was analyzed from March 2023 to July 2023. Their clinical data, including semen parameters and age, were also collected. Genetic analysis was used to determine whether the sex chromosome involved in male infertility was abnormal (including the increase, deletion, and translocation of the X and Y chromosomes), and subsequent semen analysis was conducted for clinical grouping purposes. The participants were categorized into five groups: normozoospermia, asthenozoospermia, oligozoospermia, oligoasthenozoospermia, and azoospermia. Patients were randomly selected for further study;41 patients with normozoospermia were included in the control group and 117 patients with non-normozoospermia were included in the study group according to the proportions of all enrolled patients. Cytokinesis-block micronucleus (CBMN) screening was conducted through peripheral blood. Statistical analysis was used to determine the differences in micronuclei (MNi) among the groups and the relationships between MNi and clinical data. There was a significant increase in MNi in infertile men, including those with azoospermia, compared with normozoospermic patients, but there was no significant difference between the genetic and nongenetic groups in azoospermic men. The presence of MNi was associated with sperm concentration, progressive sperm motility, immotile spermatozoa, malformed spermatozoa, total sperm count, and total sperm motility. This study underscores the potential utility of MNi as a diagnostic tool and highlights the need for further research to elucidate the underlying mechanisms of male infertility.
文摘Male infertility has been regarded as a significant public health concern,with a cumulative total of 55 million men affected across the globe[1].A wide range of causes,including hormonal imbalance,physical abnormalities,lifestyle parameters,chromosomal defects,psychological concerns,etc.,cumulatively account for 30%of male infertility cases[1].These estimates emphasize the urgent need to raise awareness,conduct thorough evaluations,and implement targeted measures to address male infertility effectively[1].
文摘Infertility has been regarded as a global public health concern,affecting both men and women irrespective of geographical region,race,ethnicity,and socioeconomic class[1].The available global estimates suggest that almost 17%of people of reproductive age experience infertility during their lives[1],with 55 million men and 110 million women living with infertility worldwide and varying estimates across different global regions[2].The consequences of infertility go beyond just medical suffering,and result in huge social and psychological consequences,including marital strains,stigma,and mental health problems[1].The current paper explores infertility in cultural context,enlists herbal remedies and traditional healers for infertility,and proposes targeted public health interventions to minimize the utilization of herbal treatment in dealing with cases of infertility.
文摘Background: According to the World Health Organization, the worldwide prevalence of infertility is 17.5%. The male share of responsibility is undeniable. Several factors, such as smoking, alcoholism, obesity and environmental pollution are sources of infertility in men. The aim of this study was to determine the spermological profile of infertile men and the factors associated with sperm parameter abnormalities. Methods: This retrospective study analysed 1000 sperm samples over an 11-year period, from January 2010 to December 2021. Results: The average age was 37.52 ± 8.66 years. Surgical history of varicocele and teratozoospermia were associated (p-value = 0.0001). Candida albicans was associated with a 2.27-fold risk of necrozoospermia and a 3.14-fold risk of oligozoospermia. The link between the reason for requesting a spermogram and the age range between 38 and 47 was significant (p-value Conclusion: Today, lifestyle and environmental pollution play a major role in sperm parameter abnormalities.
文摘BACKGROUND Although limited clinical evidence exists,such as case reports of azoospermia treatment in humans using bone marrow aspirate concentrate(BMAC)injection,these findings provide a compelling foundation for exploring mesenchymal stem cell therapy in male infertility.AIM To evaluate the safety and efficacy of autologous BMAC injection into human testis for men with severe oligospermia or azoospermia over the existing standard of care pharmacotherapy and lifestyle modifications.METHODS We included patients diagnosed with male infertility of the age group between 35–45 years in this trial comparing BMAC injection therapy with pharmacotherapy and lifestyle modifications over a 6-month follow-up period.Semen analysis was used to evaluate the efficacy of the interventions analyzed.RESULTS We enrolled 30 patients in the trial with 10 patients in each arm of the trial.Compared to the baseline,neither the BMAC group(P=0.139)or pharmacotherapy group(P=0.056)nor the lifestyle modification group(P=0.112)demonstrated a statistically significant increase in sperm count at 6 months.However,the BMAC group demonstrated a significant increase in sperm count(mean 19.2 million;P=0.001)compared to the pharmacotherapy group(mean 3.5 million)and lifestyle modification group(mean 2.2 million)at 6 months.Significant improvement was noted in the motility grade(P<0.001)only in the BMAC group while no changes were noted in the other groups.CONCLUSION This trial highlights the potential of autologous BMAC as a promising therapeutic option for male infertility.Despite the absence of significant changes within individual treatment arms,BMAC therapy demonstrated superior efficacy in improving both sperm count and motility compared to standard pharmacotherapy and lifestyle modifications.These findings underscore the potential role of regenerative medicine in addressing severe oligospermia and azoospermia,warranting further research to solidify its clinical applicability.
文摘Varicocele,the most common and treatable cause of male infertility,significantly impacts fertility.The pathophysiological mechanisms of varicocele have not been fully understood yet.Recent studies have focused on the pathophysiology of varicocele-induced infertility,highlighting inflammation and oxidative stress as key contributing factors.We reviewed recent research on the roles of inflammation and oxidative stress in the pathophysiology of varicocele and found that they negatively impact semen parameters,spermatogenesis,and testicular and epididymal function.In addition,this article summarizes the related factors of inflammation and oxidative stress caused by varicocele.Finally,a brief consideration on the treatments to address inflammation and oxidative stress is proposed.This review may provide treatment options and targets for varicocele-induced infertility.However,the relationship between inflammation and oxidative stress in varicocele still needs further study.
文摘Selecting the embryo with the highest implantation potential is a top priority in in-vitro fertilization(IVF)centers.Few studies have explored the relationship between day 5 blastocyst morphokinetics and implantation outcomes[1].Despite numerous time-lapse studies,the findings often conflict due to differences in patient demographics,lab conditions,and protocols,such as oxygen concentration[2].Thus,there is ongoing debate regarding which parameters are most predictive of implantation.
文摘Objective:To analyze the diagnostic value of transvaginal three-dimensional ultrasound(3D-TVS)in evaluating endometrial receptivity(ER)for ovulation disorder infertility(ODI),and to investigate the impact of subendometrial endometrial vascular index(VI)and endometrial vascular flow index(VFI)levels on ODI.Methods:A total of 110 patients diagnosed with ODI admitted between January 2023 and June 2024 were selected.All patients underwent ovulation induction therapy,3D-TVS examination,and sex hormone testing.Based on pregnancy outcomes,patients were divided into a successful pregnancy group(73 cases)and an unsuccessful pregnancy group(37 cases).ER parameters,sex hormone levels,and endometrial blood flow patterns were compared between the two groups.Receiver operating characteristic(ROC)curves were plotted to evaluate the predictive value of ER for ODI.Results:The spiral artery peak systolic velocity(PSV),endometrial volume(EMV),endometrial flow index(FI),and VFI in the successful pregnancy group were significantly higher than those in the unsuccessful pregnancy group(p<0.05).No significant differences were observed in other ER parameters between the two groups(p>0.05).There was no significant difference in sex hormone levels between the two groups on the day of human chorionic gonadotropin(hCG)treatment(p>0.05).Among the endometrial blood flow classifications in the pregnant group,the proportion of Type II was lower than that in the nonpregnant group(p<0.05).The Receiver Operating Characteristic(ROC)curve demonstrated that the area under the curve(AUC)for Endometrial Volume(EMV)in predicting pregnancy after Ovarian Dysfunction Infertility(ODI)treatment was 0.854,with a sensitivity of 92.61%and a specificity of 71.75%.The AUC for Vascularization Index(VI)was 0.771,with a sensitivity of 52.18%and a specificity of 88.70%.The AUC for Vascularization Flow Index(VFI)of the endometrium was 0.887,with a sensitivity of 80.01%and a specificity of 69.20%.Conclusion:Three-dimensional transvaginal sonography(3D-TVS)assessment of endometrial receptivity(ER)can effectively detect ODI,and the levels of subendometrial VI and VFI demonstrate superior predictive performance for pregnancy outcomes in this condition,serving as commonly used predictive indicators for the disease.
基金Supported by National Natural Science Foundation of China:Elucidation of a New Mechanism of the Prescription for Reinforcing Kidney and Promoting Pregnancy (Bushen Zhuyun Decoction) in Treating Luteal Phase Defects Infertility based on Coenzyme Q10/Ubiquinol Mediated New Ferroptosis Pathway in Endometrium During Implantation (No. 82474567)Jiangsu Province Key Research and Development Plan (Society Development) Project:a Multicenter Real-world Study of Sequential Treatment of Luteal Phase Defects Infertility with “Improving Endometrial Receptivity” as the Effect Point (No. BE2021726)Project of Clinical Innovation Center of Traditional Chinese Medicine in Jiangsu Province:Clinical And Basic Research on the Treatment of Luteal Phase Defects Infertility with “Improving Endometrial Receptivity” as the Effect Point (No. k2021j18-1)
文摘OBJECTIVE:To evaluate the effectiveness and safety of the sequential therapy in treating infertility with polycystic ovary syndrome(PCOS)and luteal phase defects(LPD)by Yangxin Dianji decoction(养心奠基方,YXDJ-D)and Nuangong Tiaojing decoction(暖宫调经方,NGTJ-D).METHODS:This study was undertaken in the Jiangsu Province Hospital of Chinese Medicine.Altogether 90 eligible patients with PCOS and LPD were assigned to exposed group A(Chinese Medicine therapy,YXDJ-D and NGTJ-D),exposed group B(Chinese Medicine plus Western Medicine therapy),control group(Western Medicine therapy).The exposed group A adopted the sequential therapy that YXDJ-D is taken in the postmenstrual period(follicular phase)and NGTJ-D is taken in premenstrual period(luteal phase).Control group took letrozole,dydrogesterone and was given intramuscular injection of human menopausal gonadotropin,human chorionic gonadotropin.The exposed group B was treated with the above-mentioned therapy project of integrated Chinese Medicine and Western Medicine.This study lasted for 2 courses for 6 months.The primary outcomes were pregnancy rate and early abortion rate.The secondary outcomes were the Traditional Chinese Medicine(TCM)syndrome scores,estrogen(E2)and progesterone(P),endometrial volume(EV),vascularity index(VI),flow index(FI)and vascularization flow index(VFI).These outcomes will be assessed at baseline and post-intervention.RESULTS:The pregnancy rates of the exposed group A and B were higher than the control group(60.00%vs 60.00%vs 53.33%),while early abortion rates of exposed groups A and B were lower than the control group(33.33%vs 16.67%vs 43.75%,P>0.05).Total efficacy rates in exposed group A and B were better than the control group(93.30%vs 93.30%vs 53.30%,P<0.01).TCM symptom scores and endometrial receptivity indexes(EV,FI,VFI)were significantly lower in exposed groups compared to the control group(P<0.05).P increase in exposed group B was superior to the other two groups(P<0.01).No noticeable abnormalities in safety indicators in the three groups.CONCLUSION:The sequential therapy of YXDJ-D and NGTJ-D can effectively increase pregnancy rate,reduce the early abortion rate and alleviate the clinical symptoms of infertility in patients with PCOS and LPD by improving luteal function and promoting the endometrial receptivity.
