Spermatozoa have a highly complex RNA profile.Several of these transcripts are suggested as biomarkers for male infertility and contribute to early development.To analyze the differences between sperm RNA quantity and...Spermatozoa have a highly complex RNA profile.Several of these transcripts are suggested as biomarkers for male infertility and contribute to early development.To analyze the differences between sperm RNA quantity and expression of protamine(PRM1 and PRM2)and testis-specific histone 2B(TH2B)genes,spermatozoa from 33 patients who enrolled in assisted reproduction treatment(ART)program were analyzed.Sperm RNA of teratozoospermic(T),oligoteratozoospermic(OT),and normozoospermic(N)samples was extracted,and the differences in transcript levels among the study groups were analyzed by quantitative real-time polymerase chain reaction(qRT-PCR).The correlations of total RNA per spermatozoon and the expression of the transcripts were evaluated in relation to sperm characteristics and preimplantation embryo development.The mean(±standard deviation)RNA amount per spermatozoon was 28.48(±23.03)femtogram in the overall group and was significantly higher in the OT group than that in N and T groups.Total sperm RNA and gene expression of PRM1 and PRM2 genes were related to preimplantation embryo development and developmental arrest.Specific sperm characteristics were correlated with the expressions of PRM1,PRM2,or TH2B genes.We conclude that the sperm RNA amount and composition are important factors and might influence early embryonic development and also differ in different cases of male infertility.展开更多
Mitophagy is activated by a number of stimuli, including hypoxia, energy stress, and increased oxidative phosphorylation activity. Mitophagy is associated with oxidative stress conditions and central neurodegenerative...Mitophagy is activated by a number of stimuli, including hypoxia, energy stress, and increased oxidative phosphorylation activity. Mitophagy is associated with oxidative stress conditions and central neurodegenerative diseases. Proper regulation of mitophagy is crucial for maintaining homeostasis; conversely, inadequate removal of mitochondria through mitophagy leads to the generation of oxidative species, including reactive oxygen species and reactive nitrogen species, resulting in various neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease, Huntington's disease, and amyotrophic lateral sclerosis. These diseases are most prevalent in older adults whose bodies fail to maintain proper mitophagic functions to combat oxidative species. As mitophagy is essential for normal body function, by targeting mitophagic pathways we can improve these disease conditions. The search for effective remedies to treat these disease conditions is an ongoing process, which is why more studies are needed. Additionally, more relevant studies could help establish therapeutic conditions, which are currently in high demand. In this review, we discuss how mitophagy plays a significant role in homeostasis and how its dysregulation causes neurodegeneration. We also discuss how combating oxidative species and targeting mitophagy can help treat these neurodegenerative diseases.展开更多
Obesity has a negative effect on male reproductive function. It is associated with low testosterone levels and alteration in gonadotropin secretion. Male obesity has been linked to reduced male fertility. Data regardi...Obesity has a negative effect on male reproductive function. It is associated with low testosterone levels and alteration in gonadotropin secretion. Male obesity has been linked to reduced male fertility. Data regarding the relation of obesity to sperm parameters are conflicting in terms of the nature and magnitude of the effect. New areas of interest are emerging that can help explain the variation in study results, such as genetic polymorphism and sleep apnea. Sleep disorders have been linked to altered testosterone production and hypogonadism in men. It was also correlated to erectile dysfunction. The relation of sleep disorders to male fertility and sperm parameters remains to be investigated. Men with hypogonadism and infertility should be screened for sleep apnea. Treatment of obesity and sleep apnea improves testosterone levels and erectile function.展开更多
Implantation of the embryo into the endometrium is the first step in the establishment of pregnancy. This process is complex, and depends on many factors. Recurrent implantation failure is a source of distress to pati...Implantation of the embryo into the endometrium is the first step in the establishment of pregnancy. This process is complex, and depends on many factors. Recurrent implantation failure is a source of distress to patients and specialists. It is defined as failure to achieve a viable pregnancy, following “>3 embryo transfers with high quality embryos or the transfer of ≥ 10 embryos in multiple transfers”. Thrombophilic conditions that contribute to recurrent implantation failure are the main concern in this review. The mechanism of implantation failure is believed to be due to decreased blood flow to the endometrium and placenta which can hinder normal endometrial receptivity leading to miscarriage. Defects in early placentation resulting in pregnancy failure, have focused attention on the therapeutic potential of low molecular weight heparin in the implantation process. Heparin has a role at all stages of implantation to improve pregnancy outcomes. There are controversies in literature regarding the association between thrombophilia and recurrent implantation failure and available literature regarding this issue is very heterogeneous. Various investigators, have shown that women with RIF are more likely to have a thrombophilia disorder, yet a clear cause cannot be acknowledged from these studies. Heparin treatment has been evaluated in several studies, showing conflicting evidence. However, several studies have pointed out that it may play a role in a subset of patients who presents a thrombophilia mutation, thus the group of patients that might benefit is needed to be identified. This review is dedicated to evaluate the published literature about the role of low molecular weight heparin in case of recurrent implantation failure with or without the presence of thrombophilia.展开更多
This is a retrospective cohort study comparing blastocyst transfer outcomes following intracytoplasmic sperm injection utilizing epididymal versus testicular sperm for men with obstructive azoospermia.All cases at a s...This is a retrospective cohort study comparing blastocyst transfer outcomes following intracytoplasmic sperm injection utilizing epididymal versus testicular sperm for men with obstructive azoospermia.All cases at a single center between 2012 and 2016 were included.Operative approach was selected at the surgeon’s discretion and included microepididymal sperm aspiration or testicular sperm extraction.Blastocyst culture was exclusively utilized prior to transfer.The primary outcome was live birth rate.Secondary outcomes included fertilization rate,blastulation rate,euploidy rate,and implantation rate.A mixed effects model was performed.Seventy-six microepididymal sperm aspiration cases and 93 testicular sperm extraction cases were analyzed.The live birth rate was equivalent(48.6%vs 50.5%,P=0.77).However,on mixed effects model,epididymal sperm resulted in a greater likelihood of fertilization(adjusted OR:1.37,95%CI:1.05–1.81,P=0.02)and produced a higher blastulation rate(adjusted OR:1.41,95%CI:1.1–1.85,P=0.01).As a result,the epididymal sperm group had more supernumerary blastocysts available(4.3 vs 3,P<0.05).The euploidy rate was no different.Pregnancy rates were no different through the first transfer cycle.However,intracytoplasmic sperm injection following microepididymal sperm aspiration resulted in a greater number of usable blastocysts per patient.Thus,the true benefit of epididymal sperm may only be demonstrated via a comparison of cumulative pregnancy rates after multiple transfers from one cohort.展开更多
Objective: To determine the effect of luteal-phase acupuncture on the outcome of IVF/intracytoplasmic sperm injection (ICSI). Design: Randomized, prospective, controlled clinical study. Setting: University IVF center....Objective: To determine the effect of luteal-phase acupuncture on the outcome of IVF/intracytoplasmic sperm injection (ICSI). Design: Randomized, prospective, controlled clinical study. Setting: University IVF center. Patient(s): Two hundred twenty-five infertile patients undergoing IVF/ICSI. Intervention( s): In group I, 116 patients received luteal-phase acupuncture according to the principles of traditional Chinese medicine. In group II, 109 patients received placebo acupuncture. Main Outcome Measure(s): Clinical and ongoing pregnancy rates. Result(s): In group I, the clinical pregnancy rate and ongoing pregnancy rate (33.6% and 28.4% , respectively) were significantly higher than in group II (15.6% and 13.8% ). Conclusion(s): Luteal-phase acupuncture has a positive effect on the outcome of 5 IVF/ICSI. .展开更多
Preeclampsia complicates 3%-5% of pregnancies and is one of the major causes of maternal morbidity and mortality. The pathologic mechanisms are well described but despite decades of research, the exact etiology of pre...Preeclampsia complicates 3%-5% of pregnancies and is one of the major causes of maternal morbidity and mortality. The pathologic mechanisms are well described but despite decades of research, the exact etiology of preeclampsia remains poorly understood. For years it was believed that the etiology of preeclampsia was the result of maternal factors, but recent evidence suggests that preeclampsia may be a couple specific disease where the interplay between both female and male factors plays an important role. Recent studies have suggested a complex etiologic mechanism that includes genetic imprinting, immune maladaptation, placental ischemia and generalized endothelial dysfunction. The immunological hypothesis suggests exaggerated maternal response against fetal antigens. While the role of maternal exposure to new paternal antigens in the development of preeclampsia was the initial focus of research in this area, studies examining pregnancy outcomes in pregnancies from donor oocytes provide intriguingly similar findings. The pregnancies that resulted from male or female donor gametes or donor embryos bring new insight into the role of immune response to new antigens in pathogenesis ofpreeclampsia. The primary goal of the current review is the role of exposure to new gametes on the development of preeclampsia. The objective was therefore to provide a review of current literature on the role of cohabitation length, semen exposure and gamete source in development of preeclampsia.展开更多
This was a cohort study of in vitro fertilization(IVF)subjects at the University of Utah,Salt Lake City(UT,USA)utilizing partner sperm.Cycles where both the hamster egg penetration test(HEPT)and semen analysis were pe...This was a cohort study of in vitro fertilization(IVF)subjects at the University of Utah,Salt Lake City(UT,USA)utilizing partner sperm.Cycles where both the hamster egg penetration test(HEPT)and semen analysis were performed within 2 years prior to IVF cycles were stratified into four groups based on a normal or an abnormal HEPT and morphology.The mean conventional and intracytoplasmic sperm injection(ICSI)fertilization rates were calculated in each group.We performed a univariate analysis on the primary outcome comparing clinically interesting subjects.We performed a cost-effectiveness analysis of a policy of HEPT versus universal ICSI in couples with an abnormal morphology.Among patients with a normal HEPT,there was no difference in the mean conventional fertilization rates between those with a normal and an abnormal morphology.There was no difference in the mean conventional fertilization rates between subjects with a normal morphology without a hamster test and those with a normal HEPT without a morphology assessment.In 1000 simulated cycles with an abnormal morphology,a policy of HEPT was cost saving compared to universal ICSI,yet produced similar fertilization rates.The HEPT is similar to the World Health Organization edition 5(WHO-5)morphology in predicting successful conventional fertilization while allowing decreased utilization of ICSI.A policy of HEPT for males with abnormal morphology saves cost in selecting couples for a fertilization method.展开更多
Dominant intermediate Charcot-Marie-Tooth disease type C（DI-CMTC） is a dominantly inherited neuropathy that has been classified primarily based on motor conduction velocity tests but is now known to involve axonal a...Dominant intermediate Charcot-Marie-Tooth disease type C（DI-CMTC） is a dominantly inherited neuropathy that has been classified primarily based on motor conduction velocity tests but is now known to involve axonal and demyelination features.DI-CMTC is linked to tyrosyl-t RNA synthetase（YARS）-associated neuropathies,which are caused by E196 K and G41 R missense mutations and a single de novo deletion（153-156 del VKQV）.It is well-established that these YARS mutations induce neuronal dysfunction,morphological symptoms involving axonal degeneration,and impaired motor performance.The present study is the first to describe a novel mouse model of YARS-mutation-induced neuropathy involving a neuron-specific promoter with a deleted mitochondrial targeting sequence that inhibits the expression of YARS protein in the mitochondria.An adenovirus vector system and in vivo techniques were utilized to express YARS fusion proteins with a Flag-tag in the spinal cord,peripheral axons,and dorsal root ganglia.Following transfection of YARS-expressing viruses,the distributions of wild-type（WT） YARS and E196 K mutant proteins were compared in all expressed regions; G41 R was not expressed.The proportion of Flag/green fluorescent protein（GFP） double-positive signaling in the E196 K mutant-type mice did not significantly differ from that of WT mice in dorsal root ganglion neurons.All adenovirus genes,and even the empty vector without the YARS gene,exhibited GFP-positive signaling in the ventral horn of the spinal cord because GFP in an adenovirus vector is driven by a cytomegalovirus promoter.The present study demonstrated that anatomical differences in tissue can lead to dissimilar expressions of YARS genes.Thus,use of this novel animal model will provide data regarding distributional defects between mutant and WT genes in neurons,the DICMTC phenotype,and potential treatment approaches for this disease.展开更多
<abstract>Aim: To describe the reproductive outcome following intracytoplasmic sperm injection (ICSI) for male factor infertility associated with Crohn's disease and 6-mercap-topurine (6-MP) chemotherapy. Me...<abstract>Aim: To describe the reproductive outcome following intracytoplasmic sperm injection (ICSI) for male factor infertility associated with Crohn's disease and 6-mercap-topurine (6-MP) chemotherapy. Methods: The male partner of a couple suffered from severe Crohn's disease and received a 3-month course of 6-MP for this condition. Two spontaneous conceptions were established before 6-MP, although post-chemotherapy semen analysis found the sperm concentration to be 8,000/mL. In vitro fertilization (IVF) with ICSI and embryo transfer was performed. Results: The woman underwent an uncomplicated controlled ovarian hyperstimulation sequence using a combined rec-FSH+hMG protocol, following late luteal phase pituitary downregulation. This culminated in the retrieval of 18 oocytes, 11 of which were fertilized with ICSI. She later delivered a normal male infant without urogenital anomaly. Four nontransferred blastocysts were cryopreserved. Conclusion: This report describes the first successful birth after ICSI for severe oligozoospermia associated with Crohn's disease and 6-MP therapy. We outline salient features of Crohn's disease, 6-MP pharmacology, and their relevance to human fertility.展开更多
Glycodelin modulates vascular endothelial growth factor (VEGF) production in cumulus cells in vitro. Patients with normal gonadotropin responses who were undergoing IVF demonstrated increased VEGF production to glycod...Glycodelin modulates vascular endothelial growth factor (VEGF) production in cumulus cells in vitro. Patients with normal gonadotropin responses who were undergoing IVF demonstrated increased VEGF production to glycodelin, whereas poor responders had a decreased response to glycodelin.展开更多
Purpose: Endometriosis can be managed effectively by medication, surgery, or a combination of both. Numerous studies have been conducted on surgical and medication treatment options, but their results are still under ...Purpose: Endometriosis can be managed effectively by medication, surgery, or a combination of both. Numerous studies have been conducted on surgical and medication treatment options, but their results are still under discussion. Therefore, we performed a study to develop a combinational treatment for various stages of endometriosis. Methods: Over a 3-year period, 218 documented endometriosis patients were classified in 4 stages. After first laparoscopy (with electrocoagulation and adhesion removal for stages I to III), the patients were treated with GnRH analogs (Gonadotropin Releasing Hormone Agonist-375 mg of Decapeptyl) for 3, 6 & 6 months, respectively. The second and third laparoscopy procedures were performed after 3 and 6 months, with add-back therapy. The treatment was evaluated by direct observation based on laparoscopic view and the pain relief was measured by the VAS (Visual Analogue Scale) after the first step of medication for patients of stages I-III. Results: After 3 months, 70/76 patients (91.9%) with stage-I endometriosis showed complete recovery (six cases after 6 months) while 65/72 and 32/43 cases with stage-II and -III (90.3 and 74.4%), respectively, showed complete recovery after 6 months of treatment. The remaining patients had GnRH treatment for another 3 months, and all showed a complete recovery after 9 months. Furthermore, 12 of the patients with stage-IV symptoms were candidates for laparoscopy or laparotomy, and their treatment response rate was 55.6%. The pain relief was significant after the combinational treatment in patients with stages I-III (P = 0.0001). Conclusion: Our study showed efficacy of the developed protocol for the endometriosis management.展开更多
No studies have evaluated the ultrasound features of the male sex accessory glands in infertile patients with bacterial male accessory gland infection （MAGI） according to the microbiological outcomes of bacterial cu...No studies have evaluated the ultrasound features of the male sex accessory glands in infertile patients with bacterial male accessory gland infection （MAGI） according to the microbiological outcomes of bacterial cultures （absent, partial or complete） following antibiotic therapy administration. Therefore, the aim of this study was to evaluate the ultrasound characteristics of the prostate, seminal vesicles, and epididymal tracts after treatment with levofloxacin （a common quinolone antibiotic）, in patients with infections caused by Escherichia coil （a Gram-negative bacterium） according to the Naber＇s classification, which includes the following categories： eradication, eradication with superinfection, persistence and persistence with superinfection. The study was conducted in 100 patients aged 25±8 years （range： 20-40 years） with bacterial MAGI and bacterial cultures positive only for E. coil（colony forming units ≥ 106 per ml）. Retrospective analysis was conducted only on patients treated with oral levofloxacin （500 mg） administered once daily for 28 days who were recruited over the last 5 years. Following antibiotic treatment, patients with microbiological persistence or persistence with superinfection had a significantly higher percentage of ultrasound abnormalities suggestive of prostato-vesiculitis （PV） （30.2% and 36.0%, respectively） or prostato-vesiculo-epididymitis （PVE） （60.2% and 70.0%, respectively） compared with patients with microbiological eradication （PV= 10.2% and PVE=8.2%, respectively） or eradication with superinfection （PV= 18.8% and PVE=21.2%, respectively）. In conclusion, patients with microbiological persistence or persistence plus superinfection showed the highest prevalence of complicated forms of MAGI （PV and PVE）, compared with patients with microbiological eradication or eradication with superinfection.展开更多
Purpose: Premature ovarian failure (POF) includes cessation of normal ovarian function before age 40, causing amenorrhea, menopausal symptoms and general health problems. Hormone replacement therapy (HRT) can be admin...Purpose: Premature ovarian failure (POF) includes cessation of normal ovarian function before age 40, causing amenorrhea, menopausal symptoms and general health problems. Hormone replacement therapy (HRT) can be administered in order to prevent menopausal symptoms, osteoporosis and vascular complications. Due to the contraindications and side effects of HRT and the increasing demand for alternative therapeutic modalities, we used Mentha longifolia, which is known in the Iranian traditional medicine (ITM), as being able to cause menstrual bleeding in women with early amenorrhea and decreased FSH serum. Methods: In this pilot study, we report twenty seven amenorrheic women with POF who were referred to the Iranian traditional medicine clinic in Tehran and treated by Mentha longifolia. All those patients had high FSH levels and amenorrhea. They were in their fertility age, between 30 to 40 years old. They were asked to take a cup of herbal tea which was steeped with Mentha longifolia tea three times a day for 2 weeks in 3 menstural cycles. If the patients developed menstruation, the FSH serum level was measured immediately;otherwise they had an FSH measurement one month after the beginning of therapy. Results: Mean age of patients was 36.44 ± 1.5 years. Mean FSH level before treatment was 79.13 ± 19.17 mIU/ml, and after treatment was 27.83 ± 16.14 mIU/ml. In four patients who did not have any response, mean range of FSH was 82.37 ± 19.75 mIU/ml before treatment and afterwards it was 81.97 ± 21.52 mIU/ml. After treatment with herbal teas, there was a significant decrease in FSH (79.39 ± 19.17 to 27.83 ± 16.14 mIU/ml, p value < 0.001). All patient except four (14.81%) had mensturation after taking the herbal medicine. Those four patients showed no decrease in FSH level. More of the patients who used medicinal tea achieved regular monthly bleeding when followed for three cycles.展开更多
We present a rare case of a congenital isolated missing segment of the fallopian tube, including hysterosalpingographic and laparoscopic images. We conclude that when this occurs without concomitant mllerian anomali...We present a rare case of a congenital isolated missing segment of the fallopian tube, including hysterosalpingographic and laparoscopic images. We conclude that when this occurs without concomitant mllerian anomalies, the mechanism of development would not be expected to be associated with an increase in renal abnormalities.展开更多
Objective: To investigate the expression of interleukin- 8 (IL- 8) receptors CXCR1 and CXCR2 in adenomyosis. Design: Comparative immunohistochemical study. Setting: Academic medical center. Patient(s): Thirty women wh...Objective: To investigate the expression of interleukin- 8 (IL- 8) receptors CXCR1 and CXCR2 in adenomyosis. Design: Comparative immunohistochemical study. Setting: Academic medical center. Patient(s): Thirty women who had undergone hysterectomy and were proved histopathologically to have adenomyosis, and 27 women without adenomyosis who had a hysterectomy for nonendometrial pathology such as leiomyomata or benign ovarian cysts. Intervention(s): Tissue sections were immunostained with murine monoclonal anti- human CXCR1 and CXCR2 antibodies. Main Outcome Measure(s): Microscopic evaluation to assess the presence and localization of CXCR1 and CXCR2 throughout the menstrual cycle in both eutopic endometrial and adenomyotic tissues of women with adenomyosis and compare it with normal endometrium. Result(s): In eutopic endometrium of women with adenomyosis, proliferative phase samples showed higher epithelial CXCR1 and CXCR2 staining intensity compared with proliferative phase samples of normal endometrium. Adenomyosis foci expressed higher epithelial CXCR1 compared with the homologous eutopic endometrium and normal endometrium. On the other hand, adenomyosis foci and the homologous eutopic endometrium showed similar epithelial CXCR2 staining intensity, and this expression was higher than the normal controls. Conclusion(s): Intrinsic abnormalities concerning IL- 8 and its receptor system may be present in the eutopic endometrium of women affected by adenomyosis. These findings suggest that IL- 8 receptors may be involved in the pathogenesis and/or pathophysiology of adenomyosis.展开更多
A prospective study of 210 infertile patients, investigating the role of chlamydia serology as a screening test for tubal infertility with comparison of resultswith hysterosalpingographyand laparoscopy, showed that Ch...A prospective study of 210 infertile patients, investigating the role of chlamydia serology as a screening test for tubal infertility with comparison of resultswith hysterosalpingographyand laparoscopy, showed that Chlamydia serology is an inexpensive, noninvasive test that matches or surpasses the predictive value of most standard infertility tests.展开更多
Acupuncture has been used to treat infertility extensively, including ovulatory dysfunction, in vitro fertilization and embryo transfer （IVF-ET）, and male infertility. This review summarizes the recent studies which...Acupuncture has been used to treat infertility extensively, including ovulatory dysfunction, in vitro fertilization and embryo transfer （IVF-ET）, and male infertility. This review summarizes the recent studies which investigated the role of acupuncture in infertility. In conclusion, most of the existing studies suggest a positive effect of acupuncture in infertility treatment. Firstly, acupuncture may improve ovulation by modulating the central and peripheral nervous systems, the neuroendocrine and endocrine systems, the ovarian blood flow, and metabolism. Secondly, acupuncture can improve the outcome of IVF-ET, and the mechanisms may be related to the increased uterine blood flow, inhibited uterine motility, and the anesis of depression, anxiety and stress. Its effect on modulating immune function also suggests helpfulness in improving the outcome of IVF-ET. Finally, the studies suggest that acupuncture plays a positive role in male infertility, the mechanism of which is not yet clear. Even though a positive effect of acupuncture in infertility has been found, well-designed multi-center, prospective randomized controlled studies are still needed to provide more reliable and valid scientific evidence. Furthermore, it is urgent and necessary to clarify the mechanism of acupuncture for infertility.展开更多
Few large-scale studies have systematically examined the effects of maternal exposure to fine particulate matter(PM_(2.5))on live birth in women undergoing in vitro fertilization(IVF).This study aimed to investigate t...Few large-scale studies have systematically examined the effects of maternal exposure to fine particulate matter(PM_(2.5))on live birth in women undergoing in vitro fertilization(IVF).This study aimed to investigate the associations between ambient PM_(2.5)exposure and live birth in women treated with IVF,and determine critical periods,key failure events,and vulnerable populations affected by such exposure.We included 58,637 patients from six reproductive centers in China between 2016 and 2021.We defined six exposure windows and adopted logistic regression with random-effect models to investigate the associations between PM_(2.5)exposure and live birth.We further categorized live birth failure as implantation failure,biochemical pregnancy loss,and miscarriage,to determine at which stage PM_(2.5)exposure caused the live birth failure.Subgroup analyses were conducted by female age,ovarian response,embryo quality,and transplantation protocol.For each 10μg/m^(3)increase in PM_(2.5)concentration during follicle growth phase,preantral-antral follicle phase,and antral-mature follicle phase,the odds ratios for live birth were 0.966[95%confidence interval(CI):0.938,0.995],0.967(0.939,0.996),and 0.978(0.958,0.998),respectively.PM_(2.5)during these stages was significantly associated only with an increased likelihood of implantation failure,highlighting adverse impact of ambient PM_(2.5)on early pregnancy outcome.In addition,we observed relatively stronger associations in women with poor ovarian response,compromised embryo quality,and those undergoing fresh or double embryo transfers.This large-scale population-based study demonstrated the detrimental effects of high PM_(2.5)exposure for IVF women,shedding light on clinical and public health practices.展开更多
Endometriosis is a chronic gynecological disorder that affects approximately 10%of women of reproductive age.Most medical treatments used today for endometriosis pain are hormonal therapies,which are not an option for...Endometriosis is a chronic gynecological disorder that affects approximately 10%of women of reproductive age.Most medical treatments used today for endometriosis pain are hormonal therapies,which are not an option for those trying to conceive and are not tolerated by a subset of patients due to side effects.In this article,we offer a comprehensive review of current and investigational medical therapeutic options used to treat endometriosis pain,as well as a symptom-based systematic approach for patients with painful endometriosis.We have also included recommendations for research to enhance the evolution of novel therapeutic options.A thorough literature search was carried out,and the data were synthesized using a synthesis matrix that classifies and categorizes various arguments.展开更多
基金supported by the Scientific Research Projects Coordination Unit of Istanbul University(No.13930).
文摘Spermatozoa have a highly complex RNA profile.Several of these transcripts are suggested as biomarkers for male infertility and contribute to early development.To analyze the differences between sperm RNA quantity and expression of protamine(PRM1 and PRM2)and testis-specific histone 2B(TH2B)genes,spermatozoa from 33 patients who enrolled in assisted reproduction treatment(ART)program were analyzed.Sperm RNA of teratozoospermic(T),oligoteratozoospermic(OT),and normozoospermic(N)samples was extracted,and the differences in transcript levels among the study groups were analyzed by quantitative real-time polymerase chain reaction(qRT-PCR).The correlations of total RNA per spermatozoon and the expression of the transcripts were evaluated in relation to sperm characteristics and preimplantation embryo development.The mean(±standard deviation)RNA amount per spermatozoon was 28.48(±23.03)femtogram in the overall group and was significantly higher in the OT group than that in N and T groups.Total sperm RNA and gene expression of PRM1 and PRM2 genes were related to preimplantation embryo development and developmental arrest.Specific sperm characteristics were correlated with the expressions of PRM1,PRM2,or TH2B genes.We conclude that the sperm RNA amount and composition are important factors and might influence early embryonic development and also differ in different cases of male infertility.
基金supported by Basic Science Research Program through the National Research Foundation of Korea(NRF) funded by the Ministry of Science,ICT and Future Planning,No.2018R1C1B5029745(to HJC),2011-0030072(to YH),2018R1D1A1B07040282(to JJ),2018R1A2B6001123(to NYJ)
文摘Mitophagy is activated by a number of stimuli, including hypoxia, energy stress, and increased oxidative phosphorylation activity. Mitophagy is associated with oxidative stress conditions and central neurodegenerative diseases. Proper regulation of mitophagy is crucial for maintaining homeostasis; conversely, inadequate removal of mitochondria through mitophagy leads to the generation of oxidative species, including reactive oxygen species and reactive nitrogen species, resulting in various neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease, Huntington's disease, and amyotrophic lateral sclerosis. These diseases are most prevalent in older adults whose bodies fail to maintain proper mitophagic functions to combat oxidative species. As mitophagy is essential for normal body function, by targeting mitophagic pathways we can improve these disease conditions. The search for effective remedies to treat these disease conditions is an ongoing process, which is why more studies are needed. Additionally, more relevant studies could help establish therapeutic conditions, which are currently in high demand. In this review, we discuss how mitophagy plays a significant role in homeostasis and how its dysregulation causes neurodegeneration. We also discuss how combating oxidative species and targeting mitophagy can help treat these neurodegenerative diseases.
文摘Obesity has a negative effect on male reproductive function. It is associated with low testosterone levels and alteration in gonadotropin secretion. Male obesity has been linked to reduced male fertility. Data regarding the relation of obesity to sperm parameters are conflicting in terms of the nature and magnitude of the effect. New areas of interest are emerging that can help explain the variation in study results, such as genetic polymorphism and sleep apnea. Sleep disorders have been linked to altered testosterone production and hypogonadism in men. It was also correlated to erectile dysfunction. The relation of sleep disorders to male fertility and sperm parameters remains to be investigated. Men with hypogonadism and infertility should be screened for sleep apnea. Treatment of obesity and sleep apnea improves testosterone levels and erectile function.
文摘Implantation of the embryo into the endometrium is the first step in the establishment of pregnancy. This process is complex, and depends on many factors. Recurrent implantation failure is a source of distress to patients and specialists. It is defined as failure to achieve a viable pregnancy, following “>3 embryo transfers with high quality embryos or the transfer of ≥ 10 embryos in multiple transfers”. Thrombophilic conditions that contribute to recurrent implantation failure are the main concern in this review. The mechanism of implantation failure is believed to be due to decreased blood flow to the endometrium and placenta which can hinder normal endometrial receptivity leading to miscarriage. Defects in early placentation resulting in pregnancy failure, have focused attention on the therapeutic potential of low molecular weight heparin in the implantation process. Heparin has a role at all stages of implantation to improve pregnancy outcomes. There are controversies in literature regarding the association between thrombophilia and recurrent implantation failure and available literature regarding this issue is very heterogeneous. Various investigators, have shown that women with RIF are more likely to have a thrombophilia disorder, yet a clear cause cannot be acknowledged from these studies. Heparin treatment has been evaluated in several studies, showing conflicting evidence. However, several studies have pointed out that it may play a role in a subset of patients who presents a thrombophilia mutation, thus the group of patients that might benefit is needed to be identified. This review is dedicated to evaluate the published literature about the role of low molecular weight heparin in case of recurrent implantation failure with or without the presence of thrombophilia.
文摘This is a retrospective cohort study comparing blastocyst transfer outcomes following intracytoplasmic sperm injection utilizing epididymal versus testicular sperm for men with obstructive azoospermia.All cases at a single center between 2012 and 2016 were included.Operative approach was selected at the surgeon’s discretion and included microepididymal sperm aspiration or testicular sperm extraction.Blastocyst culture was exclusively utilized prior to transfer.The primary outcome was live birth rate.Secondary outcomes included fertilization rate,blastulation rate,euploidy rate,and implantation rate.A mixed effects model was performed.Seventy-six microepididymal sperm aspiration cases and 93 testicular sperm extraction cases were analyzed.The live birth rate was equivalent(48.6%vs 50.5%,P=0.77).However,on mixed effects model,epididymal sperm resulted in a greater likelihood of fertilization(adjusted OR:1.37,95%CI:1.05–1.81,P=0.02)and produced a higher blastulation rate(adjusted OR:1.41,95%CI:1.1–1.85,P=0.01).As a result,the epididymal sperm group had more supernumerary blastocysts available(4.3 vs 3,P<0.05).The euploidy rate was no different.Pregnancy rates were no different through the first transfer cycle.However,intracytoplasmic sperm injection following microepididymal sperm aspiration resulted in a greater number of usable blastocysts per patient.Thus,the true benefit of epididymal sperm may only be demonstrated via a comparison of cumulative pregnancy rates after multiple transfers from one cohort.
文摘Objective: To determine the effect of luteal-phase acupuncture on the outcome of IVF/intracytoplasmic sperm injection (ICSI). Design: Randomized, prospective, controlled clinical study. Setting: University IVF center. Patient(s): Two hundred twenty-five infertile patients undergoing IVF/ICSI. Intervention( s): In group I, 116 patients received luteal-phase acupuncture according to the principles of traditional Chinese medicine. In group II, 109 patients received placebo acupuncture. Main Outcome Measure(s): Clinical and ongoing pregnancy rates. Result(s): In group I, the clinical pregnancy rate and ongoing pregnancy rate (33.6% and 28.4% , respectively) were significantly higher than in group II (15.6% and 13.8% ). Conclusion(s): Luteal-phase acupuncture has a positive effect on the outcome of 5 IVF/ICSI. .
文摘Preeclampsia complicates 3%-5% of pregnancies and is one of the major causes of maternal morbidity and mortality. The pathologic mechanisms are well described but despite decades of research, the exact etiology of preeclampsia remains poorly understood. For years it was believed that the etiology of preeclampsia was the result of maternal factors, but recent evidence suggests that preeclampsia may be a couple specific disease where the interplay between both female and male factors plays an important role. Recent studies have suggested a complex etiologic mechanism that includes genetic imprinting, immune maladaptation, placental ischemia and generalized endothelial dysfunction. The immunological hypothesis suggests exaggerated maternal response against fetal antigens. While the role of maternal exposure to new paternal antigens in the development of preeclampsia was the initial focus of research in this area, studies examining pregnancy outcomes in pregnancies from donor oocytes provide intriguingly similar findings. The pregnancies that resulted from male or female donor gametes or donor embryos bring new insight into the role of immune response to new antigens in pathogenesis ofpreeclampsia. The primary goal of the current review is the role of exposure to new gametes on the development of preeclampsia. The objective was therefore to provide a review of current literature on the role of cohabitation length, semen exposure and gamete source in development of preeclampsia.
文摘This was a cohort study of in vitro fertilization(IVF)subjects at the University of Utah,Salt Lake City(UT,USA)utilizing partner sperm.Cycles where both the hamster egg penetration test(HEPT)and semen analysis were performed within 2 years prior to IVF cycles were stratified into four groups based on a normal or an abnormal HEPT and morphology.The mean conventional and intracytoplasmic sperm injection(ICSI)fertilization rates were calculated in each group.We performed a univariate analysis on the primary outcome comparing clinically interesting subjects.We performed a cost-effectiveness analysis of a policy of HEPT versus universal ICSI in couples with an abnormal morphology.Among patients with a normal HEPT,there was no difference in the mean conventional fertilization rates between those with a normal and an abnormal morphology.There was no difference in the mean conventional fertilization rates between subjects with a normal morphology without a hamster test and those with a normal HEPT without a morphology assessment.In 1000 simulated cycles with an abnormal morphology,a policy of HEPT was cost saving compared to universal ICSI,yet produced similar fertilization rates.The HEPT is similar to the World Health Organization edition 5(WHO-5)morphology in predicting successful conventional fertilization while allowing decreased utilization of ICSI.A policy of HEPT for males with abnormal morphology saves cost in selecting couples for a fertilization method.
基金supported by the National Research Foundation(NRF)of Korea grant funded by Korean Government(MEST)(No.2011-0030072)
文摘Dominant intermediate Charcot-Marie-Tooth disease type C（DI-CMTC） is a dominantly inherited neuropathy that has been classified primarily based on motor conduction velocity tests but is now known to involve axonal and demyelination features.DI-CMTC is linked to tyrosyl-t RNA synthetase（YARS）-associated neuropathies,which are caused by E196 K and G41 R missense mutations and a single de novo deletion（153-156 del VKQV）.It is well-established that these YARS mutations induce neuronal dysfunction,morphological symptoms involving axonal degeneration,and impaired motor performance.The present study is the first to describe a novel mouse model of YARS-mutation-induced neuropathy involving a neuron-specific promoter with a deleted mitochondrial targeting sequence that inhibits the expression of YARS protein in the mitochondria.An adenovirus vector system and in vivo techniques were utilized to express YARS fusion proteins with a Flag-tag in the spinal cord,peripheral axons,and dorsal root ganglia.Following transfection of YARS-expressing viruses,the distributions of wild-type（WT） YARS and E196 K mutant proteins were compared in all expressed regions; G41 R was not expressed.The proportion of Flag/green fluorescent protein（GFP） double-positive signaling in the E196 K mutant-type mice did not significantly differ from that of WT mice in dorsal root ganglion neurons.All adenovirus genes,and even the empty vector without the YARS gene,exhibited GFP-positive signaling in the ventral horn of the spinal cord because GFP in an adenovirus vector is driven by a cytomegalovirus promoter.The present study demonstrated that anatomical differences in tissue can lead to dissimilar expressions of YARS genes.Thus,use of this novel animal model will provide data regarding distributional defects between mutant and WT genes in neurons,the DICMTC phenotype,and potential treatment approaches for this disease.
文摘<abstract>Aim: To describe the reproductive outcome following intracytoplasmic sperm injection (ICSI) for male factor infertility associated with Crohn's disease and 6-mercap-topurine (6-MP) chemotherapy. Methods: The male partner of a couple suffered from severe Crohn's disease and received a 3-month course of 6-MP for this condition. Two spontaneous conceptions were established before 6-MP, although post-chemotherapy semen analysis found the sperm concentration to be 8,000/mL. In vitro fertilization (IVF) with ICSI and embryo transfer was performed. Results: The woman underwent an uncomplicated controlled ovarian hyperstimulation sequence using a combined rec-FSH+hMG protocol, following late luteal phase pituitary downregulation. This culminated in the retrieval of 18 oocytes, 11 of which were fertilized with ICSI. She later delivered a normal male infant without urogenital anomaly. Four nontransferred blastocysts were cryopreserved. Conclusion: This report describes the first successful birth after ICSI for severe oligozoospermia associated with Crohn's disease and 6-MP therapy. We outline salient features of Crohn's disease, 6-MP pharmacology, and their relevance to human fertility.
文摘Glycodelin modulates vascular endothelial growth factor (VEGF) production in cumulus cells in vitro. Patients with normal gonadotropin responses who were undergoing IVF demonstrated increased VEGF production to glycodelin, whereas poor responders had a decreased response to glycodelin.
文摘Purpose: Endometriosis can be managed effectively by medication, surgery, or a combination of both. Numerous studies have been conducted on surgical and medication treatment options, but their results are still under discussion. Therefore, we performed a study to develop a combinational treatment for various stages of endometriosis. Methods: Over a 3-year period, 218 documented endometriosis patients were classified in 4 stages. After first laparoscopy (with electrocoagulation and adhesion removal for stages I to III), the patients were treated with GnRH analogs (Gonadotropin Releasing Hormone Agonist-375 mg of Decapeptyl) for 3, 6 & 6 months, respectively. The second and third laparoscopy procedures were performed after 3 and 6 months, with add-back therapy. The treatment was evaluated by direct observation based on laparoscopic view and the pain relief was measured by the VAS (Visual Analogue Scale) after the first step of medication for patients of stages I-III. Results: After 3 months, 70/76 patients (91.9%) with stage-I endometriosis showed complete recovery (six cases after 6 months) while 65/72 and 32/43 cases with stage-II and -III (90.3 and 74.4%), respectively, showed complete recovery after 6 months of treatment. The remaining patients had GnRH treatment for another 3 months, and all showed a complete recovery after 9 months. Furthermore, 12 of the patients with stage-IV symptoms were candidates for laparoscopy or laparotomy, and their treatment response rate was 55.6%. The pain relief was significant after the combinational treatment in patients with stages I-III (P = 0.0001). Conclusion: Our study showed efficacy of the developed protocol for the endometriosis management.
文摘No studies have evaluated the ultrasound features of the male sex accessory glands in infertile patients with bacterial male accessory gland infection （MAGI） according to the microbiological outcomes of bacterial cultures （absent, partial or complete） following antibiotic therapy administration. Therefore, the aim of this study was to evaluate the ultrasound characteristics of the prostate, seminal vesicles, and epididymal tracts after treatment with levofloxacin （a common quinolone antibiotic）, in patients with infections caused by Escherichia coil （a Gram-negative bacterium） according to the Naber＇s classification, which includes the following categories： eradication, eradication with superinfection, persistence and persistence with superinfection. The study was conducted in 100 patients aged 25±8 years （range： 20-40 years） with bacterial MAGI and bacterial cultures positive only for E. coil（colony forming units ≥ 106 per ml）. Retrospective analysis was conducted only on patients treated with oral levofloxacin （500 mg） administered once daily for 28 days who were recruited over the last 5 years. Following antibiotic treatment, patients with microbiological persistence or persistence with superinfection had a significantly higher percentage of ultrasound abnormalities suggestive of prostato-vesiculitis （PV） （30.2% and 36.0%, respectively） or prostato-vesiculo-epididymitis （PVE） （60.2% and 70.0%, respectively） compared with patients with microbiological eradication （PV= 10.2% and PVE=8.2%, respectively） or eradication with superinfection （PV= 18.8% and PVE=21.2%, respectively）. In conclusion, patients with microbiological persistence or persistence plus superinfection showed the highest prevalence of complicated forms of MAGI （PV and PVE）, compared with patients with microbiological eradication or eradication with superinfection.
文摘Purpose: Premature ovarian failure (POF) includes cessation of normal ovarian function before age 40, causing amenorrhea, menopausal symptoms and general health problems. Hormone replacement therapy (HRT) can be administered in order to prevent menopausal symptoms, osteoporosis and vascular complications. Due to the contraindications and side effects of HRT and the increasing demand for alternative therapeutic modalities, we used Mentha longifolia, which is known in the Iranian traditional medicine (ITM), as being able to cause menstrual bleeding in women with early amenorrhea and decreased FSH serum. Methods: In this pilot study, we report twenty seven amenorrheic women with POF who were referred to the Iranian traditional medicine clinic in Tehran and treated by Mentha longifolia. All those patients had high FSH levels and amenorrhea. They were in their fertility age, between 30 to 40 years old. They were asked to take a cup of herbal tea which was steeped with Mentha longifolia tea three times a day for 2 weeks in 3 menstural cycles. If the patients developed menstruation, the FSH serum level was measured immediately;otherwise they had an FSH measurement one month after the beginning of therapy. Results: Mean age of patients was 36.44 ± 1.5 years. Mean FSH level before treatment was 79.13 ± 19.17 mIU/ml, and after treatment was 27.83 ± 16.14 mIU/ml. In four patients who did not have any response, mean range of FSH was 82.37 ± 19.75 mIU/ml before treatment and afterwards it was 81.97 ± 21.52 mIU/ml. After treatment with herbal teas, there was a significant decrease in FSH (79.39 ± 19.17 to 27.83 ± 16.14 mIU/ml, p value < 0.001). All patient except four (14.81%) had mensturation after taking the herbal medicine. Those four patients showed no decrease in FSH level. More of the patients who used medicinal tea achieved regular monthly bleeding when followed for three cycles.
文摘We present a rare case of a congenital isolated missing segment of the fallopian tube, including hysterosalpingographic and laparoscopic images. We conclude that when this occurs without concomitant mllerian anomalies, the mechanism of development would not be expected to be associated with an increase in renal abnormalities.
文摘Objective: To investigate the expression of interleukin- 8 (IL- 8) receptors CXCR1 and CXCR2 in adenomyosis. Design: Comparative immunohistochemical study. Setting: Academic medical center. Patient(s): Thirty women who had undergone hysterectomy and were proved histopathologically to have adenomyosis, and 27 women without adenomyosis who had a hysterectomy for nonendometrial pathology such as leiomyomata or benign ovarian cysts. Intervention(s): Tissue sections were immunostained with murine monoclonal anti- human CXCR1 and CXCR2 antibodies. Main Outcome Measure(s): Microscopic evaluation to assess the presence and localization of CXCR1 and CXCR2 throughout the menstrual cycle in both eutopic endometrial and adenomyotic tissues of women with adenomyosis and compare it with normal endometrium. Result(s): In eutopic endometrium of women with adenomyosis, proliferative phase samples showed higher epithelial CXCR1 and CXCR2 staining intensity compared with proliferative phase samples of normal endometrium. Adenomyosis foci expressed higher epithelial CXCR1 compared with the homologous eutopic endometrium and normal endometrium. On the other hand, adenomyosis foci and the homologous eutopic endometrium showed similar epithelial CXCR2 staining intensity, and this expression was higher than the normal controls. Conclusion(s): Intrinsic abnormalities concerning IL- 8 and its receptor system may be present in the eutopic endometrium of women affected by adenomyosis. These findings suggest that IL- 8 receptors may be involved in the pathogenesis and/or pathophysiology of adenomyosis.
文摘A prospective study of 210 infertile patients, investigating the role of chlamydia serology as a screening test for tubal infertility with comparison of resultswith hysterosalpingographyand laparoscopy, showed that Chlamydia serology is an inexpensive, noninvasive test that matches or surpasses the predictive value of most standard infertility tests.
基金Supported by the National Nature Science Foundation of China (No.30600838)
文摘Acupuncture has been used to treat infertility extensively, including ovulatory dysfunction, in vitro fertilization and embryo transfer （IVF-ET）, and male infertility. This review summarizes the recent studies which investigated the role of acupuncture in infertility. In conclusion, most of the existing studies suggest a positive effect of acupuncture in infertility treatment. Firstly, acupuncture may improve ovulation by modulating the central and peripheral nervous systems, the neuroendocrine and endocrine systems, the ovarian blood flow, and metabolism. Secondly, acupuncture can improve the outcome of IVF-ET, and the mechanisms may be related to the increased uterine blood flow, inhibited uterine motility, and the anesis of depression, anxiety and stress. Its effect on modulating immune function also suggests helpfulness in improving the outcome of IVF-ET. Finally, the studies suggest that acupuncture plays a positive role in male infertility, the mechanism of which is not yet clear. Even though a positive effect of acupuncture in infertility has been found, well-designed multi-center, prospective randomized controlled studies are still needed to provide more reliable and valid scientific evidence. Furthermore, it is urgent and necessary to clarify the mechanism of acupuncture for infertility.
基金supported by Science and Technology Commission of Shanghai Municipality(23Y11909600)Clinical Research Plan of Shanghai Hospital Development Center(SHDC2020CR4080)National Natural Science Foundation of China(81871213,81671468).
文摘Few large-scale studies have systematically examined the effects of maternal exposure to fine particulate matter(PM_(2.5))on live birth in women undergoing in vitro fertilization(IVF).This study aimed to investigate the associations between ambient PM_(2.5)exposure and live birth in women treated with IVF,and determine critical periods,key failure events,and vulnerable populations affected by such exposure.We included 58,637 patients from six reproductive centers in China between 2016 and 2021.We defined six exposure windows and adopted logistic regression with random-effect models to investigate the associations between PM_(2.5)exposure and live birth.We further categorized live birth failure as implantation failure,biochemical pregnancy loss,and miscarriage,to determine at which stage PM_(2.5)exposure caused the live birth failure.Subgroup analyses were conducted by female age,ovarian response,embryo quality,and transplantation protocol.For each 10μg/m^(3)increase in PM_(2.5)concentration during follicle growth phase,preantral-antral follicle phase,and antral-mature follicle phase,the odds ratios for live birth were 0.966[95%confidence interval(CI):0.938,0.995],0.967(0.939,0.996),and 0.978(0.958,0.998),respectively.PM_(2.5)during these stages was significantly associated only with an increased likelihood of implantation failure,highlighting adverse impact of ambient PM_(2.5)on early pregnancy outcome.In addition,we observed relatively stronger associations in women with poor ovarian response,compromised embryo quality,and those undergoing fresh or double embryo transfers.This large-scale population-based study demonstrated the detrimental effects of high PM_(2.5)exposure for IVF women,shedding light on clinical and public health practices.
文摘Endometriosis is a chronic gynecological disorder that affects approximately 10%of women of reproductive age.Most medical treatments used today for endometriosis pain are hormonal therapies,which are not an option for those trying to conceive and are not tolerated by a subset of patients due to side effects.In this article,we offer a comprehensive review of current and investigational medical therapeutic options used to treat endometriosis pain,as well as a symptom-based systematic approach for patients with painful endometriosis.We have also included recommendations for research to enhance the evolution of novel therapeutic options.A thorough literature search was carried out,and the data were synthesized using a synthesis matrix that classifies and categorizes various arguments.
