Resultados de las consultas municipales de atención a la pareja infértil 2017-2020 / Results of the Municipal Consultations for Infertile Couple Care 2017-2020

Introducción: La infertilidad afecta hasta un 15 por ciento de las parejas en edad reproductiva en el mundo y es uno de los factores que inciden en la baja natalidad de Cuba. Antes del 2016 no existían consultas de infertilidad en todos los municipios y era bajo el número de embarazos logrados, lo que motivó la decisión de extenderlas a todos los municipios del país. Objetivo: Describir los resultados de las consultas municipales de infertilidad en los primeros cuatro años de su implementación (2017-2020). Métodos: Estudio observacional transversal de casos, atendidos en las 82 consultas municipales de infertilidad existentes antes del 2016 y después de su generalización a todos los municipios del país. Resultados: En las consultas municipales han sido atendidas 81,3 por ciento de las parejas infértiles que lo demandan, se incrementó el número de consultas ofrecidas de 24 215 en el año 2016 a 140 183 en el 2020. En ese período se elevó en 10 por ciento los embarazos obtenidos, 63,5 por ciento de los logrados en todos los niveles de atención. Conclusiones: Las consultas municipales incrementaron sus resultados entre el año 2017 al 2020 y los nacimientos obtenidos pueden ser considerados como una contribución del sector salud a reducir la baja natalidad que experimenta el país(AU)

Introduction: Infertility affects up to 15percent of couples of reproductive age in the world and is one of the factors affecting the low birth rate in Cuba. Before 2016, infertility consultations did not exist in all municipalities and the number of pregnancies achieved was low, which motivated the decision to extend them to all municipalities in the country. Aim: To describe the results of municipal infertility consultations in the first four years of their implementation (2017-2020). Methods: Cross-sectional observational study of cases, attended in the 82 municipal infertility consultations existing before 2016 and after their generalization to all municipalities in the country. Results: 81.3percent of the infertile couples requesting treatment were attended in the municipal consultations. The number of consultations offered increased from 24 215 in 2016 to 140 183 in 2020. In that period, pregnancies obtained increased by 10 percent, 63.5 percent of those achieved at all levels of care. Conclusions: Municipal consultations increased their results from 2017 to 2020 and the births obtained can be considered as a contribution of the health sector to reduce the low birth rate experienced by the country(AU)

Correlation analysis of vitamin D level and anti-Müllerian hormone in infertile female and the role in predicting pregnancy outcome / 北京大学学报(医学版)

OBJECTIVE@#To investigate the relationship between serum 25(OH)D and anti-Müllerian hormone (AMH) among infertile females and their predictive impacts on in vitro fertilization and embryo transfer pregnancy outcome.@*METHODS@#Totally 756 infertile females treated with assisted reproductive technology were enrolled and divided into three groups according to their vitamin D levels (group A with serum 25(OH)D≤10 μg/L, group B with serum (10-20) μg/L, and group C with serum ≥20 μg/L). The serum AMH levels were detected. The differences among the groups were analyzed, as well as the correlation between vitamin D levels and serum AMH levels in various infertility types (fallopian tube/male factor, polycystic ovary syndrome (PCOS), ovulation disorders excluded PCOS, endometriosis, unexplained infertility, and others). Also, the predictive roles of vitamin D and AMH in pregnancy outcome in all the infertile females were discussed.@*RESULTS@#(1) 87.7% of the enrolled females were insufficient or deficient in vitamin D. (2) The serum AMH levels in the three groups with different vitamin D levels were 1.960 (1.155, 3.655) μg/L, 2.455 (1.370, 4.403) μg/L, 2.360 (1.430, 4.780) μg/L and there was no significant difference in serum AMH levels among the three groups (P>0.05). (3) Serum 25(OH)D and AMH levels presented seasonal variations (P < 0.05). (4) There was no prominent correlation between the serum AMH level and serum 25(OH)D level in females of various infertility types after adjusting potential confounding factors [age, body mass index (BMI), antral follicle count (AFC), vitamin D blood collection season, etc.] by multiple linear regression analysis (P>0.05). (5) After adjusting for confounding factors, such as age, BMI, number of transplanted embryos and AFC, the results of binary Logistics regression model showed that in all the infertile females, the serum AMH level was an independent predictor of biochemical pregnancy outcome (P < 0.05) while the serum 25(OH)D level might not act as a prediction factor alone (P>0.05). In the meanwhile, the serum 25(OH)D level and serum AMH level were synergistic predictors of biochemical or clinical pregnancy outcome (P < 0.05).@*CONCLUSION@#Based on the current diagnostic criteria, most infertile females had vitamin D insufficiency or deficiency, but there was not significant correlation between serum 25(OH)D and ovarian reserve. While vitamin D could not be used as an independent predictor of pregnancy outcome in infertile females, the serum AMH level could predict biochemical pregnancy outcome independently or jointly with vitamin D.

Estados emocionales y estrategias de afrontamiento frecuentes en consulta para parejas infértiles / Emotional states and frequent coping strategies in the medical consultation for infertile couples / Estados emocionais frequentes e estratégias de enfrentamento em consulta para casais inférteis

RESUMEN Introducción: La infertilidad se conoce como la imposibilidad de concebir un hijo de forma natural o de llevar un embarazo a término, luego de un año de vida sexual activa. Por cuanto la procreación es un acontecimiento vital, no lograrla puede generar algunos trastornos psicológicos. Objetivo: Identificar los estados emocionales negativos, así como el estilo de afrontamiento utilizados por ambos miembros de parejas infértiles durante su tratamiento, en la consulta municipal de infertilidad del Policlínico Comunitario "30 de Noviembre", de Santiago de Cuba, durante el periodo enero de 2020 a febrero de 2021. Método: Se realizó un estudio descriptivo con una muestra intencional de 85 parejas (n꓿85) que asistieron a dicha consulta. Se utilizó el método clínico, se revisaron las historias clínicas de los pacientes y se aplicaron técnicas psicológicas (Inventario de Ansiedad Rasgo-Estado de Ch. Spielberger, inventario de depresión de Beck y escala de afrontamiento de Lazarus). Resultados: Predominó el nivel alto de ansiedad como estado en el 61,18 % de los hombres y en el 68,24 % de las mujeres, no se encontró ningún miembro de las parejas infértiles que presentara niveles bajos de ansiedad, además, se constataron niveles severos de depresión en el 52,94 % de las mujeres y en el 44,71 % de los hombres. Predominó el modo de afrontamiento centrado en las emociones en el 90,59 % de la muestra estudiada. Conclusiones: La ansiedad y la depresión, así como la carencia de estrategias de afrontamiento eficaces son fenómenos psicológicos presentes en las parejas que asisten a la consulta municipal de infertilidad.

ABSTRACT Introduction: Infertility is define by the failure to conceive a child naturally or achieve a pregnancy after one year of a sexually active life. Therefore, procreation is a vital aspect in humans, and fail to achieve it may generate some psychological disorders. Objective: To identify the negative emotional states, as well as the coping style used by both members of infertile couples during their treatment in the municipal fertility department at the Policlínico Comunitario "30 de Noviembre", Santiago de Cuba, during the period January 2020 to February 2021. Method: A descriptive study was conducted with a purposive sample of 85 couples (n꓿85) who attended such consultation. Method: a descriptive study was conducted with a purposive sample of 85 couples (n꓿85) who attended such consultation. It was used the clinical method, clinical histories were reviewed and various psychological techniques were applied (Ch. Spielberger's Trait-State Anxiety Inventory, Beck's depression inventory and Lazarus' coping scale). Results: High level of anxiety predominated in both sex, in male (61.18%) and in female (68.24%), with no member of the infertile couples showing up low levels of anxiety. In addition, severe levels of depression were found in 52.94% of women and 44.71% of men. The emotion-focused coping mode predominated in 90.59% of the studied sample. Conclusions: Anxiety and depression, as well as lack of effective coping strategies are psychological phenomena shows in couples attending the municipal fertility department.

RESUMO Introdução: A infertilidade é conhecida como a incapacidade de conceber um filho naturalmente ou de levar uma gravidez a termo, após um ano de vida sexual ativa. Como a procriação é um evento vital, sua não realização pode gerar alguns transtornos psicológicos. Objetivo: Identificar os estados emocionais negativos, bem como o estilo de enfrentamento utilizado por ambos os membros de casais inférteis durante seu tratamento, na consulta municipal de infertilidade da Policlínica Comunitária "30 de Noviembre", em Santiago de Cuba, no período de janeiro 2020 a fevereiro de 2021. Método: Foi realizado um estudo descritivo com uma amostra intencional de 85 casais (n꓿85) que compareceram à referida consulta. O método clínico foi utilizado, os prontuários dos pacientes foram revisados e as técnicas psicológicas foram aplicadas (Inventário de Ansiedade Traço-Estado de Ch. Spielberger, inventário de depressão de Beck e escala de enfrentamento de Lazarus). Resultados: O alto nível de ansiedade prevaleceu como estado em 61,18% dos homens e em 68,24% das mulheres, nenhum membro dos casais inférteis apresentou níveis baixos de ansiedade, além disso, foram encontrados níveis graves de depressão em 52,94% das mulheres e 44,71% dos homens. O modo de enfrentamento focado na emoção prevaleceu em 90,59% da amostra estudada. Conclusões: A ansiedade e a depressão, bem como a falta de estratégias de enfrentamento eficazes, são fenômenos psicológicos presentes em casais que frequentam o ambulatório municipal de infertilidade.

Effect Of Cigarette Smoking On Sperm Morphology Of Infertile Men

Background:Cigarette smoking is a serious health problem of most societies. Smoking has been suggested to contribute to a number of diseases including male infertility. The present study was aimed at studying effect of cigarette smoking on Sperm morphology of infertile men.Material And Methods:A total of one hundred infertile men (50 Non-smokersand 50 Smokers) between the age group 20-45 years were taken into study. The Sperm morphology in the infertile Non-smokersand infertile Smokers group were compared using Z Test. Infertile Smokers which were divided into Group A (?1 and ?10 cigarettes/ day), Group B (>10 and <20 cigarettes/ day) and Group C (?20 cigarettes/ day) were analyzed for Sperm morphology by ANOVA Test. Result:We observed that Sperm morphology was significantly lower (p<0.01) in infertile Smokers group than infertile Non-smokersgroup. We also observed that Sperm morphology was significantly decreased (p<0.01) in accordance with the severity of smoking.Conclusion:Cigarette smoking adversely affect sperm morphology.

La infertilidad, un problema de salud en la población niquereña / Infertility, a health problem in the population from Niquero / Infertilidade, um problema de saúde da população niquereño

RESUMEN Introducción: la infertilidad se ha reconocido como un problema médico-social. El municipio de Niquero no escapa a esta situación. Objetivo: caracterizar la infertilidad en Niquero durante el 2018. Método: se realizó un estudio observacional descriptivo, de corte transversal. El universo quedó conformado por275 parejas y la muestra por 114 (muestreo no probabilístico). Se analizaron las variables: edad y sexo, tipo y tiempo de infertilidad, estado actual de las parejas y presencia de factores de riesgo. Para el análisis se utilizó la estadística descriptiva, empleando medidas de resúmenes (frecuencia absoluta y porcentaje). Resultados: resultaron mayoría las mujeres en el grupo de 30-34 años, el 42,1% y los hombres de 35 y más años con el 36,8%. Predominó la infertilidad secundaria en el 62,3 % de las féminas y la primaria fue diagnosticada en el 53,5% de los hombres. Actualmente el 55,3% se encuentran en condición de pasivo y el 8,8 % lograron el embarazo o parto. El 46,5% presentaron infertilidad durante 3-6 años. La sepsis vaginal estuvo presente como factor de riesgo en el 59,6%. Conclusiones: la infertilidad en las parejas estudiadas se encontró mayormente en edades óptimas para la reproducción. Predominó la infertilidad secundaria en las féminas y la primaria en los hombres. La mayoría de las parejas se encuentra en condición de pasivo. Sobresalieron los que han sido infértiles por 3-6 años. La sepsis vaginal fue el factor de riesgo más cuantificado.

ABSTRACT Introduction: infertility constitute a medical-social problem of reproductive health. Niquero municipality is not an exception. Objective: to characterize the infertility in Niquero municipality during 2018. Method: a cross-sectional, observational descriptive study was carried out. The universe was formed by 275 couples, and the sample comprises 114. The type of sampling was a non-probabilistic. The ages and sex, type and time of infertility, actual condition, and risks factors´ in couples were the variables analyzed. As statistical methods, the distribution of absolute frequencies and percentages were used. Results: the group comprising 30-34 years old prevailed in infertile women, 42,1%, among the males the group with more than 35 years old, with 36,8%. Among the types of infertility, secondary was the most prominent in the distribution for feminine, 62, 3%, and the primary was diagnosed in 53,5%. Predominantly the couples with 3-6 years of infertility, 46,5 %; 55, 3% had in passive situation and 8, 8 % of them got pregnant and had their birth. Vaginal infections, was the most important risk factor, 59, 6%. Conclusions: infertility in the couples studied was mainly found in best ages for reproduction, prevailing secondary infertility in the females and primary for the men. The major percentage of couples was in passive condition. Infertility between 3-6 years was the mostly associated. Vaginal infection was the predominant factor.

RESUMO Introdução: a infertilidade tem sido reconhecida como um problema médico-social. O município de Niqueronão escapa dessa situação. Objetivo: caracterizar a infertilidade em Niquero durante 2018. Método: foi realizado um estudo descritivo, transversal e observacional. O universo foi composto por 275 casais e a amostra por 114 (amostragem não probabilística). Foram analisadas as variáveis: idade e sexo, tipo e tempo de infertilidade, situação atual dos casais e presença de fatores de risco. Para a análise foi utilizada estatística descritiva, por meio de medidas resumo (frequência absoluta e percentual). Resultados: a maioria eram mulheres no grupo de 30-34 anos, 42,1%, e homens com 36,8%. A infertilidade secundária predominou em mulheres, 62,3%, e a infertilidade primária foi diagnosticada em homens, 53,5%. Atualmente 55,3 % estão em condição passiva e 8,8%, conseguiram gravidez ou parto. Um 46,5% tiveram infertilidade por 3-6 anos. A sepse vaginal esteve presente como fator de risco em 59,6%. Conclusões: a infertilidade nos casais estudados foi encontrada principalmente em idades ideais para a reprodução. Infertilidade secundária predominou em mulheres e primária em homens. A maioria dos casais está em condição passiva. Aqueles que eram inférteis por 3-6 anos se destacaram. A sepse vaginal foi o fator de risco mais quantificado.

Analysis of semen quality of 38 905 infertile male patients during 2008-2016 in Wenzhou, China / 亚洲男科学杂志(英文版)

This study analyzed the trend in semen quality of infertile male patients in Wenzhou, China, based on the data obtained from 38 905 patients during 2008-2016 in The First Affiliated Hospital of Wenzhou Medical University (Wenzhou, China). The results showed that only 24.9% of the patients had normal semen quality. For the semen quality of infertile male patients, that of the workers and 40-year-olds was significantly worse than the other occupational and age groups. For all the infertile patients, low semen volume, asthenozoospermia, and teratozoospermia accounted for 8.4%, 50.5%, and 54.1%, respectively. During 2008-2016, the annual mean percentage of fast forward motile spermatozoa, percentage of total forward motile spermatozoa, and percentage of spermatozoa with normal morphology decreased linearly with slopes of -2.11, -2.59, and -0.70, respectively. The proportion of patients with asthenozoospermia and multi-abnormal spermatozoa increased during 2008-2016 with slopes of 4.70 and 4.87, respectively, while for low semen volume, it decreased with a slope of -0.47 in the same time period. The proportion of patients with teratozoospermia increased from 2008 to 2011 and from 2011 to 2016 with slopes of 17.10 and 2.09, respectively. In general, the deteriorating trend of semen quality of infertile male patients in Wenzhou was obvious. Future efforts should be made to reveal the adverse influences on semen quality, such as occupational exposure, environmental quality, and living habits. Furthermore, more pervasive reproduction health education is necessary.

Significance of Combined Use of Kamishoyosan and Tokishakuyakusan for General Infertility Treatment / 日本東洋医学雑誌

We aimed to clarify the significance of using Kampo therapy centered on kamishoyosan and tokishakuyakusan together with general infertility treatment. The subjects were 41 women who visited a Kampo outpatient clinic for infertility and received general infertility treatment with Kampo therapy (Kampo group). The control group was 781 women who received only general infertility treatment at the same time (non-Kampo group). In comparing both groups, we conducted a retrospective survey on the pregnancy rate by cycle and the pregnancy rate by prescription. The pregnancy rate in the first cycle was 24.4% in the Kampo group and 8.5% in the non-Kampo group, and the pregnancy rate was higher in the Kampo group (P = 0.003). There was no difference in pregnancy rates after the second cycle. The pregnancy rate by prescription was 26.7% for kamishoyosan, 22.2% for tokishakuyakusan, and 8.5% for the non-Kampo group. In the comparison between the first cycle pregnant group and the non-pregnant group, the qi counter flow score was clearly higher in the first cycle pregnant group (P = 0.012). It is suggested that combined use of Kampo therapy including kamishoyosan and tokishakuyakusan may be effective from an early stage. Meanwhile, if pregnancy does not occur even after the combined use of Kamp therapy, it would be an opportunity to consider stepping up as Western medical therapy.

Age-specific serum anti-Mullerian hormone reference values for infertile Filipino women in a tertiary in vitro fertilization center in the Philippines / Philippine Journal of Obstetrics and Gynecology

Background@#Anti-Mullerian hormone (AMH) levels have been used as an invaluable tool in reproductive medicine for over a decade, especially in predicting ovarian reserve and follicular response during in vitro fertilization (IVF) cycles. Age-specific reference values of AMH levels have been derived from mostly Western and few Asian population groups but none from the Philippines. In this study, we attempted to determine the first age-specific AMH reference values from infertile Filipino women to be able to provide local infertility centers a guide in treating Filipinos and those with similar racial and lifestyle characteristics. @*Materials and Methods@#This was a retrospective cross-sectional study that was conducted at the Center for Advanced Reproductive Medicine and Infertility at St. Luke's Medical Center Global City. Age, serum AMH levels, body mass index (BMI), and cause of infertility of Filipino women who underwent IVF from August 2015 to March 2020 were taken. AMH was assayed using the automated Access AMH Immunoassay (Beckman Coulter). @*Results@#A total of 1463 women who underwent IVF and with valid AMH results were initially found but only 1233 were included in the study. Mean age was 36.67 + 4.35 years and mean BMI was 24.43 + 4.14 kg/m2. There was minimal effect of BMI on AMH levels and increasing age (R2 = 0.0068), but there were significant differences of mean AMH levels among the general causes of infertility. The mean and median AMH values decreased with advancing age (R2 = 0.1391) although the mean values were consistently higher than the median values. The mean level of the AMH was 2.32 ± 1.90 ng/mL with a 0.16 ng/ml (confidence interval: 0.14–0.19 ng/ml) level decrease per year of increase in age. By age category, the following were the derived AMH values (ng/ml) at the 25th to 75th percentiles: 25–29 = 1.52–4.92; 30–34 = 1.60–4.10; 35–39 = 0.95–3.13; 40–44 = 0.44–1.99; 45 = 0.47–1.08. The mean AMH in this study appears to be similar to several but lower than most other reported AMH nomograms from other population groups. @*Conclusion@#The first age-specific AMH reference values for infertile Filipino women are presented and may serve as a useful diagnostic marker in local infertility centers, especially those treating Filipino patients or others with similar characteristics.

Y chromosome microdeletion screening using a new molecular diagnostic method in 1030 Japanese males with infertility / 亚洲男科学杂志(英文版)

The azoospermia factor (AZF) region is important for spermatogenesis, and deletions within these regions are a common cause of oligozoospermia and azoospermia. Although several studies have reported this cause, the present research, to the best of our knowledge, is the first large-scale study assessing this factor in Japan. In this study, 1030 male patients with infertility who were examined for Y chromosome microdeletion using the polymerase chain reaction-reverse sequence-specific oligonucleotide (PCR-rSSO) method, a newly developed method for Y chromosome microdeletion screening, were included. The study enrolled 250 patients with severe oligospermia and 717 patients with azoospermia. Among the 1030 patients, 4, 4, 10, and 52 had AZFa, AZFb, AZFb+c, and AZFc deletions, respectively. The sperm recovery rate (SRR) of microdissection testicular sperm extraction in patients with AZFc deletions was significantly higher than that in those without AZF deletions (60.0% vs 28.7%, P = 0.04). In patients with gr/gr deletion, SRR was 18.7%, which was lower than that in those without gr/gr deletion, but was not statistically significant. In conclusion, our study showed that the frequency of Y chromosome microdeletion in male patients in Japan was similar to that reported in patients from other countries, and SRR was higher in patients with AZFc deletion.

The association between the two more common genetic causes of spermatogenic failure: a 7-year retrospective study / 亚洲男科学杂志(英文版)

Chromosomal abnormalities and Y chromosome microdeletions are considered to be the two more common genetic causes of spermatogenic failure. However, the relationship between chromosomal aberrations and Y chromosome microdeletions is still unclear. This study was to investigate the incidence and characteristics of chromosomal aberrations and Y chromosome microdeletions in infertile men, and to explore whether there was a correlation between the two genetic defects of spermatogenic failure. A 7-year retrospective study was conducted on 5465 infertile men with nonobstructive azoospermia or oligozoospermia. Karyotype analysis of peripheral blood lymphocytes was performed by standard G-banding techniques. Y chromosome microdeletions were screened by multiplex PCR amplification with six specific sequence-tagged site (STS) markers. Among the 5465 infertile men analyzed, 371 (6.8%) had Y chromosome microdeletions and the prevalence of microdeletions in azoospermia was 10.5% (259/2474) and in severe oligozoospermia was 6.3% (107/1705). A total of 4003 (73.2%) infertile men underwent karyotyping; 370 (9.2%) had chromosomal abnormalities and 222 (5.5%) had chromosomal polymorphisms. Karyotype analysis was performed on 272 (73.3%) patients with Y chromosome microdeletions and 77 (28.3%) had chromosomal aberrations, all of which involved sex chromosomes but not autosomes. There was a significant difference in the frequency of chromosomal abnormalities between men with and without Y chromosome microdeletions (P< 0.05).

Effect Of Tobacco Chewing On Seminal Parameters In Male Partners Of Infertile Couples

Background: Male factors contribute to almost 50% of infertile couples. Deleterious effects of tobacco smoking on male reproductive system are well known. Research studies report contradictory findings about the effect of tobacco chewing on male fertility. Aim and objectives: To study effect of tobacco chewing on seminal parameters in male partners of infertile couples. Material and Methods: Present study was conducted on 100 male partners of infertile couples (50 tobacco chewers and 50 non-chewers) in age group of 21-40 years in the semen analysis laboratory in department of Physiology of Government Medical College, Nagpur from October 2014 to March 2016. Seminal parameters like volume of ejaculate, sperm count, sperm motility and motile sperm count were measured and compared in both groups. Result: Tobacco chewers had significantly lower values of all the seminal parameters as compared to non-chewers. Significantly low values of all parameters were observed in severe tobacco chewers as compared to mild and moderate tobacco chewers. Conclusion: Tobacco chewing has adverse effect on seminal parameters of male partners of infertile couples thus proving its pronounced role in male infertility. Severity of this effect increases as duration of tobacco chewing is prolonged.

Role of Diagnostic Laparoscopy in Evaluation of Infertile Women

Objective: To find out the magnitude of different types ofpelvic pathologies female infertility by laparoscopy.Methods: Seventy five infertile women who had undergoneinfertility evaluation by laparoscopy to see the pelvic pathologyor evaluation of pelvic organs at infertility department of BangoBandhu Sheikh Mujib medical university between July 2016 toJune 2017, were studied. Assessment of these patients wascarried out carefully before starting the endoscopic procedures.A full history was taken which was followed by thoroughgeneral, abdominal and pelvic examination than laparoscopywas performed under G/A.Results: The mean age ranged from 18 to 42 years. Amongthem 51(68%) patients were aged between 21 to 30 years. 51(68%) patients had primary infertility and 24 patients (32%) hadsecondary infertility.44 (58%) had normal tubes, 08 (10.67%)had some form of peritubal adhesion and 14 (18.67%) hadtubal block, either unilateral or bilateral. 52 (69.33%) patientshad normal pelvic peritoneum, 16 (21.33%) had pelvicadhesion probably from pelvic inflammatory diseases and07 (9.33%) had frank endometriosis. 23 (30.66%) had normalovaries, 32 (42.66%) had polycystic ovaries (pcos), 06 (08%)had periovarian adhesions, 04 (5.33%) patients had simpleovarian cysts, while 02 (2.66%) had endometriotic (chocolate)cysts.Conclusion: Ovarian pathology was the highest pelvicabnormality (69%) followed by tubal pathology (38%) anduterine pathology (29%)

Proteomic analysis reveals dysregulated cell signaling in ejaculated spermatozoa from infertile men / 亚洲男科学杂志(英文版)

Dysfunctional sperm maturation is the primary reason for the poor sperm motility and morphology in infertile men. Spermatozoa from infertile men were fractioned on three-layer density gradient (80%, 60%, and 40%). Fraction 1 (F1) refers to the least mature stage having the lowest density, whereas the fraction 4 (F4) includes the most dense and morphologically mature motile spermatozoa. Fraction 2 (F2) and fraction 3 (F3) represent the intermediate stages. Proteins were extracted and separated by 1-dimensional gel. Bands were digested with trypsin and analyzed on a LTQ-Orbitrap Elite hybrid mass spectrometer system. Functional annotations of proteins were obtained using bioinformatics tools and pathway databases. A total of 1585 proteins were detected in the four fractions of spermatozoa. A dysregulated protein turnover and protein folding may lead to accumulation of defective proteins or proteins that otherwise would have been eliminated during the process of maturation, resulting in the impairment of sperm function. Aberrant chaperone expression may be a major contributing factor to the defective sperm function. Androgen receptor was predicted as a transcription regulator in one of the networks and the affected pathways were chaperone-mediated stress response, proteosomal pathway, and sperm function. The downregulation of key pathways and proteins which compromises the fertilizing potential of spermatozoa may provide insight into the mechanisms that lead to male infertility.

Proteomic analysis reveals dysregulated cell signaling in ejaculated spermatozoa from infertile men / 亚洲男科学杂志(英文版)

Dysfunctional sperm maturation is the primary reason for the poor sperm motility and morphology in infertile men. Spermatozoa from infertile men were fractioned on three-layer density gradient (80%, 60%, and 40%). Fraction 1 (F1) refers to the least mature stage having the lowest density, whereas the fraction 4 (F4) includes the most dense and morphologically mature motile spermatozoa. Fraction 2 (F2) and fraction 3 (F3) represent the intermediate stages. Proteins were extracted and separated by 1-dimensional gel. Bands were digested with trypsin and analyzed on a LTQ-Orbitrap Elite hybrid mass spectrometer system. Functional annotations of proteins were obtained using bioinformatics tools and pathway databases. A total of 1585 proteins were detected in the four fractions of spermatozoa. A dysregulated protein turnover and protein folding may lead to accumulation of defective proteins or proteins that otherwise would have been eliminated during the process of maturation, resulting in the impairment of sperm function. Aberrant chaperone expression may be a major contributing factor to the defective sperm function. Androgen receptor was predicted as a transcription regulator in one of the networks and the affected pathways were chaperone-mediated stress response, proteosomal pathway, and sperm function. The downregulation of key pathways and proteins which compromises the fertilizing potential of spermatozoa may provide insight into the mechanisms that lead to male infertility.

Caracterización clínico-epidemiológica de parejas infértiles / Clinical-Epidemiological characterization of infertile couples

Introducción: Aproximadamente, el 15 por ciento de todos los matrimonios no tienen hijos. Según estudios realizados en Cuba, la prevalencia de infertilidad oscila entre 12 y 14 por ciento, destacándose dentro de sus causas los factores pélvicos que afectan las trompas o el endometrio con 30-50 por ciento, seguido de la disfunción ovulatoria con el 10 a 25 por ciento y solo 10 por ciento son de causa desconocida. Objetivo: Caracterizar a las parejas infértiles según variables clínico epidemiológicas seleccionadas. Métodos: Se realizó un estudio observacional, descriptivo, transversal a 224 parejas infértiles, en la provincia Santiago de Cuba. Cuba, en el periodo 2015-2016. Resultados: El 40,3 por ciento de las parejas estudiados presentaron infecciones de transmisión sexual de diferentes etiologías y el 45,6 por ciento se diagnosticaron con infertilidad secundaria. Conclusiones: La edad de la mujer por encima de los 35 años, los antecedentes patológicos personales, la ingestión de medicamentos, la presencia previa de infección de trasmisión sexual así como el antecedente de varios episodios de enfermedad pélvica inflamatoria, están relacionadas con la etiología infecciosa de la infertilidad y pudieran constituir las principales causas de este trastorno en nuestro país(AU)

Introduction: Approximately 15 percent of all marriages do not have any children. According to studies carried out in Cuba, the prevalence of infertility ranges from 12 to 14 percent, among whose highlighted causes are pelvic factors that affect the tubes or the endometrium, accounting for 30-50 percent, followed by ovulatory dysfunction, accounting for 10-25 percent, while only 10 percent are of unknown cause. Objective: To characterize infertile couples based in the selected clinical-epidemiological variables. Methods: An observational, descriptive, cross-sectional study was carried out with 224 infertile couples in Santiago de Cuba Province, Cuba, in the period from 2015 to 2016. Results: 40.3 percent of the studied couples had sexually transmitted infections of different etiologies, while 45.6 percent were diagnosed with secondary infertility. Conclusions: The age of the woman over 35 years, personal pathological antecedents, ingestion of medications, the previous presence of sexually transmitted infections, as well as the history of several episodes of pelvic inflammatory disease, are related to the infectious etiology of infertility and could be the main causes of this disorder in our country(AU)

Increased cryo-survival rate in ejaculated human sperm from infertile men following pre-freeze in vitro myo-inositol supplementation / 대한생식의학회지

OBJECTIVE: To investigate the effects of in vitro myo-inositol (Myo-Ins) supplementation of cryopreserved human semen on the cryo-survival rate (CSR). METHODS: Semen samples were obtained from 41 infertile men. Following routine semen analysis, each sample was divided into two equal aliquots (0.5 mL each). One aliquot was treated with 1 mg of Myo-Ins dissolved in 10 µL of sperm preparation medium. The second aliquot was treated with 10 µL of the same medium (control). Both aliquots were incubated for 20 minutes prior to freezing to slow the freezing process. The frozen samples were examined for post-thaw percentages of total motility (TM), progressive motility (PM), and the CSR, defined as the percentage of post-thaw TM divided by the percentage of pre-freeze TM and multiplied in 100. The results were expressed as median and interquartile range (25th and 75th percentiles). RESULTS: The pre-freeze TM (50% [30%–50%]) and PM (35% [20%–35%]) were significantly higher than the post-thaw TM and PM in the Myo-Ins group (15% [10%–35%] and 10% [5%–20%]; p < 0.001 and p < 0.001, respectively) and the control group (10% [6%–30%] and 5% [3%–15%]; p < 0.001 and p < 0.001, respectively). The CSR of the 41 semen aliquots supplemented with Myo-Ins (40% [25%–70%]) was significantly higher than that of the control samples (30% [13%–58%], p=0.041). The CSR of the 26 abnormal semen samples that were supplemented with Myo-Ins (38% [20%–50%]) was significantly higher than that of the control samples (23% [12%–30%], p=0.031). CONCLUSION: In vitro Myo-Ins supplementation of ejaculated human sperm from infertile men resulted in a significant increase in the CSR in samples with abnormal pre-freeze sperm parameters.

Evaluación de la integridad del ADN espermático y su repercusión en los parámetros seminales de varones infértiles / Evaluation of the integrity of sperm DNA and its impact on the seminal parameters of infertile males

Resumen OBJETIVO: Determinar las repercusiones del daño al ADN espermático en los parámetros seminales más estudiados en diagnóstico clínico de varones infértiles. MATERIALES Y MÉTODOS: Estudio de casos y controles, prospectivo y comparativo efectuado en pacientes masculinos atendidos en el Centro Integral de la Mujer y Reproducción Asistida de Puebla, México. Parámetros de estudio: edad, movilidad, morfología, diagnóstico seminal, leucocitos y factor de infertilidad. Los resultados se analizaron con Graphpad Prisma 5.0 y se consideraron estadísticamente significativos con p < 0.005. RESULTADOS: Se estudiaron 110 pacientes: 33 con mala integridad del ADN espermático (grupo 1) y 77 con buena integridad (grupo 2). La concentración espermática y la movilidad tipo A+B en el grupo 2 fue significativamente más alta que en el grupo 1 (p < 0.0001) en donde se registró mayor número de móviles no progresivos e inmóviles. La morfología normal fue más alta en el grupo 2 (p = 0.0063). En los varones menores de 40 años se observó un número significativamente mayor de casos de buena integridad espermática (p = 0.013). El diagnóstico seminal demostró que los varones con mala integridad tuvieron alteraciones espermáticas más severas. Los factores de infertilidad más frecuentes implicados en ambos grupos fueron: aborto de repetición, edad de la pareja, falla previa en la técnica de reproducción asistida, factor masculino severo y factor tubárico. CONCLUSIONES: La mala integridad del ADN espermático tiene repercusiones en la concentración espermática, movilidad y morfología, además de alterar el diagnóstico seminal, pues los varones tuvieron trastornos más severos cuando no hubo algún factor de infertilidad que describiera un comportamiento específico relacionado con la mala integridad espermática.

Abstract OBJECTIVE: To determine the impact of sperm DNA damage on the most studied seminal parameters in clinical diagnosis of infertile males. MATERIALS AND METHODS: Prospective and comparative case-control study that included male patients seen at Centro Integral de la Mujer y Reproducción Asistida de Puebla, Mexico. Study parameters: age, mobility, morphology, seminal diagnosis, leukocytes and infertility factor. The results were analyzed with Graphpad Prism 5.0 and were considered statistically significant with p < 0.005. RESULTS: 110 male patients were studied: 33 patients with poor sperm DNA integrity (group 1) and 77 patients with good integrity (group 2). Sperm concentration and type A + B mobility in group 2 was significantly higher than in group 1 (p <0.0001), where a greater number of non-progressive and immobile mobiles was recorded. The normal morphology was higher in group 2 (p = 0.0063). In men under 40 years of age, a significantly higher number of cases of good sperm integrity was observed (p = 0.013). The seminal diagnosis showed that males with poor integrity had more severe sperm alterations. The most frequent infertility factors involved in both groups were: repeat abortion, age of the couple, previous failure in the technique of assisted reproduction, severe male factor and tubal factor. CONCLUSIONS: The poor integrity of the sperm DNA has repercussions on sperm concentration, mobility and morphology, alters the seminal diagnosis, since males had more severe alterations when there was no infertility factor that described a specific behavior related to poor sperm integrity.

Application Analysis of All-blastocyst-culture in Elderly Infertile Patients with Low Ovarian Reserve / 中山大学学报(医学科学版)

[Objective]To determine whether all-blastocyst-culture can benefit elderly infertile patients with low ovarian reserve.[Methods]To retrospectively analyze elderly patients with low ovarian reserve undergoing IVF/ICSI in Reproductive Medicine Re?search Center of the Sixth Affiliated Hospital of Sun Yat-sen University from May 2016 to April 2017.We divide them into group A (All-blastocyst-culture)and group B(None-blastocyst-culture)based on different culture approach of D3 transferrable embryo. To compare the cumulative biochemical pregnancy rate ,cumulative clinical pregnancy rate between them.[Results]A total of 231 eligi?ble patients are included,with130 in group A and 101 in group B. The basic conditions of the two groups show no difference. Cumula?tive biochemical pregnancy rate/clinical pregnancy rate in group A is higher than that of group B ,though the difference is not statisti?cally significant(P>0.05). After removing patients who did not undergo embryo transfer due to failure in blastocyst culture ,the cumu?lative biochemical pregnancy rate/clinical pregnancy rate in group A is significantly higher than group B(P<0.05). Multivariate analy?sis of the patient′s basic condition and the outcome of blastocyst culture showed that the number of D3 transferrable embryo was a risk factor for the failure of blastocyst culture(OR=0.277,95%CI:0.103~0.744,P<0.05).[Conclusion]All-blastocyst-culture will not adversely affect the pregnancy outcome of elderly infertile patients with low ovarian reserve. On the contrary ,once they obtain transfer?rable embryos, pregnancy outcome in All-Blastocyst-Culture group are better than None-Blastocyst-Culture group. A small number of D3 transferrable embryo is a risk factor for failure to culture blastocyst. If the patients were fully informed consent ,we can consider implementing all-blastocyst-culture for elderly infertile patients with low ovarian reserve.

Profile of MicroRNA Expression in Endometrial Cell during In Vitro Culture According to Progesterone Concentration

Artificial uterus using endometrium implant can be a novel treatment strategy for infertile women with refractory endometrial dysfunction. At early pregnancy, the function of uterine endometrial cells for the communication between the conceptus of pre-implantation period and maternal reproductive system is essential. MicroRNA (miR) expression profile of endometrial cells according to progesterone, a crucial pregnancy-maintaining hormone, provides important data for in vitro endometrial cell culture strategy that is useful for engineering artificial uteri using endometrial implants. The present study aimed to evaluate the miR expression profile of in vitro cultured endometrial cells under hormonal milieu mimicking early pregnancy period in terms of progesterone concentration. We cultured murine uterine endometrial cells, human uterine endometrial carcinoma cells, and immortalized human uterine endometrial cells using different progesterone concentrations, and analyzed the expression of miRs critical for early pregnancy. The expression of miR-20a, -21, -196a, -199a, and -200a was differently regulated according to progesterone concentration in different endometrial cell lines. The analysis of candidate target genes showed that the expression of phosphatase and tensin homolog, mucin 1 (MUC1), progesterone receptor, transforming growth factor β receptor II, matrix metallopeptidase-9 was up-regulated by progesterone treatment in mouse and human endometrial cell lines. These results indicate that physiological concentration range (10⁻⁷ and 10⁻⁹ M) of progesterone affect the survival and target gene expression via modulating miR expression. Taken together, progesterone can be a crucial factor in regulating miR expression on in vitro cultured endometrial cells.

Intrafollicular Soluble RAGE Benefits Embryo Development and Predicts Clinical Pregnancy in Infertile Patients of Advanced Maternal Age Undergoing In Vitro Fertilization / 华中科技大学学报（医学）（英德文版）

Soluble receptor for advanced glycation end products (sRAGE) can decoy the toxic AGEs and is considered to be a protective factor.This study aimed to evaluate the correlation between intrafollicular sRAGE levels and clinical outcomes in infertile women of young or advanced maternal age (AMA) undergoing in vitro fertilization (IVF).A total of 62 young women and 62 AMA women who would undergo IVF were included in this prospective study.The intrafollicular sRAGE concentration was measured to determine its association with the number of retrieved oocytes,fertilized oocytes,high-quality embryos or achievement of clinical pregnancy in young and AMA women,respectively.Besides,correlations between sRAGE and age or follicle-stimulating hormone (FSH) were examined.We found that the intrafollicular sRAGE levels were higher in young patients than those in AMA patients,suggesting that the sRAGE levels were inversely correlated with age.In young patients,sRAGE showed no correlation with the number of retrieved oocytes,fertilized oocytes,high-quality embryos or achievement of clinical pregnancy.But it was found that AMA patients with more retrieved oocytes,fertilized oocytes and high-quality embryos demonstrated higher sRAGE levels,which were a prognostic factor for getting clinical pregnancy independent of age or FSH level.In conclusion,the sRAGE levels decrease with age.Elevated intrafollicular sRAGE levels indicate good follicular growth,fertilization and embryonic development,and successful clinical pregnancy in AMA women,while in young women,the role of sRAGE may not be so predominant.