In vitro maturation medium supplementation: utilization of repaglinide, L-carnitine, and mesenchymal stem cell-conditioned medium to improve developmental competence of oocytes derived from endometriosis mouse models

Endometriosis (EMS) is one of the most prevalent causes for female infertility. Herein, we investigated the effect of the repaglinide (RG), L-carnitine (LC), and bone marrow mesenchymal stem cell-conditioned medium (BMSC-CM) supplementation during in vitro maturation (IVM) on the quality, maturation, and fertilization rates, as well as embryonic quality and development of oocytes derived from normal and EMS mouse model. Immature oocytes were collected from two groups of normal and EMS-induced female NMRI mice at 6-8 weeks of age. Oocytes were cultured in IVM medium unsupplemented (control group), or supplemented with 1 M RG, 0.3 and 0.6 mg/mL LC, and 25 and 50% BMSC-CM. After 24 h of oocyte incubation, IVM rate and antioxidant status were assessed. Subsequently, the rates of fertilization, cleavage, blastulation, and embryonic development were assessed. Our results demonstrated that supplementation of IVM medium with LC and BMSC-CM, especially 50% BMSC-CM, significantly enhanced IVM and fertilization rates, and markedly improved blastocyst development and total blastocyst cell numbers in EMS-induced mice compared to the control group (53.28±0.24 vs 18.09±0.10%). Additionally, LC and BMSC-CM were able to significantly modulate EMS-induced nitro-oxidative stress by boosting total antioxidant capacity (TAC) and mitigating nitric oxide (NO) levels. Collectively, LC and BMSC-CM supplementation improved oocyte quality and IVM rates, pre-implantation developmental competence of oocytes after in vitro fertilization, and enhanced total blastocyst cell numbers probably by attenuating nitro-oxidative stress and accelerating nuclear maturation of oocytes. These outcomes may provide novel approaches to refining the IVM conditions that can advance the efficiency of assisted reproductive technologies in infertile couples.

Association of Overweight and Consistent Anovulation among Infertile Women with Regular Menstrual Cycle: A Case-control Study / Associação entre sobrepeso e anovulação consistente em mulheres inférteis com ciclo menstrual regular: Um estudo de caso-controle

Abstract Objective It has been suggested that excess body weight could represent a risk factor for infertility outcomes. The present study aimed to evaluate the association of overweight and anovulation among infertile women with regular menstrual cycles. Methods We conducted a retrospective case-control study with consistently anovulatory patients undergoing assisted reproduction treatment. The patients were stratified into normal weight (body mass index [BMI]: 18.5-24.9kg/m2) and overweight (BMI: 25.0- 29.9kg/m2).Those with polycystic ovary syndrome or obesity were excluded. The groups were matched for age, duration of infertility, prolactin, follicle stimulating hormone (FSH), thydroid stimulating hormone (TSH), luteinizing hormone (LH), and estradiol levels. Results Overweight was significantly associated with anovulation, when using the World Health Organization (WHO) criteria for anovulation: progesterone levels>5.65 ng/ml and ultrasonography evidence of follicle collapse (odds ratio [OR]: 2.69; 95% confidence interval [CI95%]: 1.04-6.98). Conclusion Body mass index above the normal range jeopardizes ovulation among non-obese infertile women with regular menstrual cycles.

Resumo Objetivo O excesso de peso corporal tem sido associado como fator de risco para infertilidade. Este estudo teve como objetivo avaliar a associação de sobrepeso e anovulação entre mulheres inférteis com ciclos menstruais regulares. Métodos Realizamos um estudo retrospectivo de caso-controle com mulheres com anovulação consistente em tratamento por reprodução assistida. As pacientes foram estratificadas entre aquelas com peso normal (índice de massa corporal [IMC]: 18,5- 24,9 Kg/m2) e as com sobrepeso (IMC: 25,0-29,9 Kg/m2). As pacientes com síndrome do ovário policístico ou obesidade foram excluídas. Os grupos foram pareados por idade, duração da infertilidade, níveis de prolactina, hormônio folículo-estimulante (FSH), hormônio tiroestimulante (TSH), hormônio luteinizante (LH) e estradiol. Resultados O excesso de peso associou-se significativamente à anovulaçãoquando usados os critérios de anovulação da Organização Mundial de Saúde (OMS): níveis de progesterona>5,65 ng/ml e evidência ultrassonográfica de colapso folicular (razão de chances [RC]: 2,69; IC95%: 1,04-6,98). Conclusão O IMC acima da faixa normal compromete a ovulação em mulheres inférteis não obesas com ciclos menstruais regulares.

Aumento da Rigidez Arterial Pulmonar e Comprometimento do Acoplamento Ventrículo Direito-Artéria Pulmonar na SOP / Increased Pulmonary Arterial Stiffness and Impaired Right Ventricle-Pulmonary Artery Coupling In PCOS

Resumo Fundamento: A síndrome dos ovários policísticos (SOP) é a doença endócrino-metabólica mais comum em mulheres em idade reprodutiva, e ocorre em uma a cada 10 mulheres. A doença inclui irregularidade menstrual e excesso de hormônios masculinos e é a causa mais comum de infertilidade em mulheres. A dispneia é um sintoma frequente e muitas vezes acredita-se que seja decorrente da obesidade, mas não se sabe se é decorrente de disfunção cardíaca. Objetivo: Avaliar o acoplamento ventrículo-arterial (VDAP) e a rigidez arterial pulmonar em pacientes com SOP. Métodos: Foram incluídos 44 pacientes com SOP e 60 controles; amostras de sangue venoso foram coletadas para exames laboratoriais e ecocardiograma transtorácico 2-D, Modo-M e com Doppler tecidual foram realizados em todos os participantes. Um valor de p<0,05 foi considerado estatisticamente significativo. Resultados: Quando comparadas ao grupo controle, as pacientes com SOP apresentaram valores maiores de rigidez da artéria pulmonar (p = 0,001), que se correlacionaram positivamente com o índice HOMA-IR (r = 0,545 e p <0,001). O acoplamento VDAP também estava comprometido em 34% dos pacientes do estudo. Conclusão: A rigidez da artéria pulmonar está aumentada e o acoplamento VDAP está comprometido em pacientes com SOP. (Arq Bras Cardiol. 2021; 116(4):806-811)

Abstract Background: Polycystic ovary syndrome (PCOS) is the most common endocrine-metabolic disease in women in reproductive age, and occurs in one of 10 women. The disease includes menstrual irregularity and excess of male hormones and is the most common cause of female infertility. Dyspnea is a frequent symptom and is often thought to be due to obesity, and whether it is due to cardiac dysfunction is unknown. Objective: To evaluate right ventricle-pulmonary artery (RV-PA) coupling and pulmonary arterial stiffness in patients with PCOS. Methods: 44 PCOS patients and 60 controls were included; venous blood samples were taken for laboratory tests and 2-D, m-mode and tissue doppler transthoracic echocardiography were performed for all the participants. P<0,05 was considered as statistically significant. Results: When compared to the control group, PCOS patients had higher pulmonary artery stiffness values (p=0,001), which were positively correlated with HOMA-IR (r=0,545 and p<0,001). RV-PA coupling was also impaired in 34% of the study patients. Conclusion: Pulmonary artery stiffness is increased and RV-PA coupling is impaired in patients with PCOS. (Arq Bras Cardiol. 2021; 116(4):806-811)

Detección atípica de Chlamydia pneumoniae no humana en una muestra endocervical. Reporte de caso / Atypical detection of non-human Chlamydia pneumoniae in an endocervical sample. Case Report

Resumen ANTECEDENTES: Chlamydia trachomatis es uno de los principales microorganismos de trasmisión sexual asociado de manera importante con infertilidad femenina. La detección de genotipos y nuevas variantes de Chlamydia trachomatis permite conocer su prevalencia, distribución geográfica, identificar la aparición de resistencia antimicrobiana y las asociaciones clínicas o comportamientos sexuales y desarrollar vacunas. Este caso clínico es el primer informe de infección endocervical por una cepa diferente a C trachomatis. CASO CLÍNICO: Paciente de 25 años, con diagnóstico de infertilidad primaria de 2 años de evolución por factor endocrino-ovárico (sobrepeso e hipotiroidismo subclínico) y por factor masculino de hipospermia y teratozoospermia. El cultivo microbiológico endocervical detectó la infección por Ureaplasma spp y Chlamydia spp. La identificación de la cepa de Chlamydia mediante secuenciación del gen 16S del ARNr informó que era Chlamydia pneumoniae. La existencia de un plásmido en esta cepa de C pneumoniae confirmó que la infección endocervical fue por una cepa de Chlamydia pneumoniae no humana. CONCLUSIÓN: Este caso clínico sugiere la posibilidad de que una cepa de C pneumoniae no humana sea capaz de trasmitirse sexualmente a los humanos, estar circulando en la población mexicana y causar infertilidad, aunque aún se desconocen el origen y la dirección de la trasmisión.

Abstract BACKGROUND: Chlamydia trachomatis is one of the leading sexually transmitted microorganisms that is significantly associated with the development of female infertility. The detection of genotypes and new variants ofChlamydia trachomatisallows us to know their prevalence and geographic distribution, identify the appearance of antimicrobial resistance, clinical associations, or sexual behaviors, and develop vaccines. This clinical case reports for the first time endocervical infection by a strain other thanC. trachomatis. CLINICAL CASE: A 25-year-old woman with primary infertility of 2 years of evolution due to endocrine-ovarian factor (overweight and subclinical hypothyroidism) and male factor characterized by hypospermia and teratozoospermia. Endocervical microbiological culture detected infection byUreaplasma urealyticumandChlamydiaspp. Identification of theChlamydiastrain by sequencing the 16S rRNA gene reported that it wasChlamydia pneumoniae. The presence of plasmid in this strain ofC. pneumoniaeconfirmed that the endocervical infection was by a non-humanChlamydia pneumoniaestrain. CONCLUSION: This clinical case suggests that a non-human strain ofC. pneumoniaecan be sexually transmitted to humans, circulating in the Mexican population, and causing infertility, although the origin and direction of transmission are still unknown.

Reproductive outcomes in cases of subclinical hypothyroidism and thyroid autoimmunity: a narrative review / Resultados reprodutivos nos casos de hipotireoidismo subclínico e autoimunidade tireoidiana: Uma revisão narrativa

Abstract Thyroid diseases are relatively common in women in the reproductive period. It is currently understood that clinically-evident thyroid disorders may impair ovulation and, consequently, fertility. However, to date it has not been proven that high serum levels of thyroid-stimulating hormone and/or positivity for antithyroid antibodies are associated to a reduction in fertility, mainly in the absence of altered thyroxine levels. The present comprehensive review aims to present current data on the association between subclinical hypothyroidism and/or thyroid autoimmunity and reproductive outcomes.

Resumo As doenças da tireoide são relativamente comuns em mulheres no período reprodutivo. Atualmente, entende-se que distúrbios da tireoide clinicamente evidentes podem prejudicar a ovulação e, consequentemente, a fertilidade. No entanto, não se provou até o presente que níveis séricos altos do hormônio estimulador da tireoide e/ou positividade para anticorpos antitireoidianos estão associados a uma redução na fertilidade, sobretudo na ausência de níveis alterados de tiroxina. Esta revisão narrativa tem como objetivo apresentar dados atuais sobre a associação entre hipotireoidismo subclínico e/ou autoimunidade tireoidiana e resultados reprodutivos.

Micoplasma hominis y Ureaplasma spp en mujeres que consultan por infertilidad / Mycoplasma Hominis and Ureaplasma Spp. in women attending to infertility consultations

RESUMEN Introducción: Las infecciones por micoplasmas y ureaplasmas pueden producir fallos en la reproducción y vincularse con problemas de infertilidad femenina. Objetivo: Determinar la frecuencia de infecciones por Micoplasma hominis y Ureaplasma spp en mujeres que consultan por infertilidad e identificar si existe asociación entre las infecciones detectadas y los antecedentes de infecciones de transmisión sexual y enfermedad inflamatoria pélvica, procederes ginecológicos y síntomas de infecciones. Métodos: Se realizó un estudio descriptivo transversal, para evaluar muestras de exudados endocervicales de 175 mujeres, con edades entre 20 y 45 años, provenientes de la consulta de infertilidad del Instituto Nacional de Endocrinología, entre junio de 2016 y enero de 2017. Para la detección de micoplasmas urogenitales se utilizó el juego de reactivos Myco Well D-One. Se tuvieron en cuenta los aspectos éticos y se utilizó la prueba Chi Cuadrado para evaluar la significación estadística de las posibles asociaciones. Resultados: De las 175 muestras evaluadas, 102 (58,1 por ciento) mostraron la presencia de infecciones, de ellas 65 correspondieron a Ureaplasma spp (37,1 por ciento), 11 a Micoplasma hominis (6,2 por ciento), y 26 a asociaciones de Micoplasma hominis y Ureaplasma spp (14,8 por ciento). Se identificó asociación entre las infecciones detectadas y la presencia de antecedentes de infecciones de transmisión sexual y enfermedad inflamatoria pélvica, no así con relación a los procederes ginecológicos y síntomas de infecciones. Conclusiones: La frecuencia total de infecciones fue relativamente alta y la especie más frecuente el Ureaplasma spp. Las infecciones detectadas estuvieron asociadas a algunos de los factores estudiados(AU)

ABSTRACT Introduction: Infections caused by Mycoplasmas and Ureaplasmas may result in faults in the reproduction process and can be linked to female infertility. Objective: To determine the frequency of infection by Mycoplasma hominis and Ureaplasma spp. in women who attend to infertility consultations and if these are associated with a history of sexually transmitted infections and pelvic inflammatory disease, gynaecological procedures and symptoms of infections. Methods: A descriptive cross-sectional study was conducted to evaluate samples of endocervical swabs of 175 women between the ages of 20 to 45 years, from the Infertility consultation of the National Institute of Endocrinology, during June 2016 to January 2017. For the detection of urogenital mycoplasmas it was used the reagents kit Myco Well D-One. There were taken into account the ethical aspects and it was used the chi-square test to assess the statistical significance of the possible associations. Results: Of the 175 evaluated samples, 102 (58.1 percent) showed the presence of infections, 65 of them corresponded to Ureaplasma spp (37.1 percent), 11 to Mycoplasma hominis (6.2 percent), and 26 associations of Mycoplasma hominis and Ureaplasma spp (14.8 percent). It was identified association between the detected infections and the presence of a history of sexually transmitted infections and pelvic inflammatory disease, but not with the gynaecological procedures and the symptoms of infections. Conclusions: The total frequency of infection was relatively high and the most prevalent specie was the Ureaplasma spp. The detected infections were associated with some of the factors studied(AU)

Intento de validación al español del instrumento FertiSTAT en población universitaria joven de Chile, 2018 / Spanish validation try of the FertiSTAT instrument in young university chilean population, 2018

INTRODUCCIÓN: Infertilidad es una enfermedad del sistema reproductivo. Su prevalencia ha aumentado, por diversos factores de riesgo. Actualmente no existe un sistema estandarizado en Chile para pesquisar dichos factores tempranamente, por lo que un instrumento con dicho fin sería útil. La encuesta inglesa FertiSTAT, cumple dicho rol desde 2010. El objetivo fue validarla al idioma español. MATERIAL Y MÉTODO: Estudio cuantitativo, transversal, que utilizó a la población estudiantil femenina, de 18 a 44 años, de la Universidad de Concepción 2018, mediante un muestreo presencial, no probabilístico, secuencial en dependencias de la Universidad. El instrumento FertiSTAT, fue revisada por experto y traducida al español de forma independiente. Al ser 19 preguntas en total, fueron necesarios 38 sujetos para prueba piloto y 190 sujetos para validación mediante pruebas psicométricas, realizadas mediante programa IBM-SPSS Statistic 22. Aprobado por comité de ética de la facultad de medicina de la Universidad de Concepción. RESULTADOS: Promedio de edad fue de 20.9 años. Respecto a las pruebas psicométricas: Alfa de Cronbach 0.213. Se obtuvieron correlaciones positivas significativas de baja intensidad. El análisis factorial concluyó en 8 dominios para explicar el 66.39% del grupo. DISCUSIÓN: El instrumento es poco confiable, con mayor número de dominios que el original. Dicho resultado se podría deber a un método no adecuado con preguntas mal estructuradas, errores en los sujetos de investigación e investigadores y una selección de muestra no adecuada. Sería útil revalidar en consultas preconcepcionales o policlínicos de fertilidad. Aun así, se logró traducir un instrumento al español que pesquisa factores de riesgo de infertilidad

INTRODUCTION: Infertility is a disease of the reproductive system. Its prevalence has increased, due to several risk factors. Currently, there is no standardized method in Chile to early identify these factors, so an instrument for this purpose would be useful. The English FertiSTAT survey fulfills this role since 2010. The objective was to validate it to Spanish language. MATERIAL AND METHOD: Quantitative, cross-sectional study that used the female student population, from 18 to 44 years old, from University of Concepción 2018, through a face-to-face, non-probabilistic, sequential sampling at the University's facilities. The FertiSTAT tool was reviewed by an expert and translated into Spanish by an interpreter; both independently. There were 19 questions in total, 38 subjects were needed for pilot test and 190 subjects for validation through psychometric tests, done through the IBM-SPSS Statistic 22 program. Ethics committee approval by the ethic committee of medicine faculty of the Universidad de Concepción. RESULTS: Average age was 20.9 years. About the psychometric tests: Cronbach Alpha; 0.213. Positive correlations were obtained of low intensity. The factorial analysis obtained 8 domains that explain 66.39% of the group. DISCUSSION: The tool is unreliable, with more domains than the original. This result could be due to a poor method with bad structured questions, mistakes in the research subjects and researchers, and an inadequate sample selection. It would be useful to re-validate in pre-conception or fertility polyclinics. At the end, it achieved a Spanish translated tool, which looks for infertility risk factors.

Psychosocial Predictors of Infertile Women's Distress

PURPOSE: The aim of this study was to examine whether psychological distress of infertile women would differ according to demographic and infertility characteristics, and psychosocial variables such as neuroticism, self-esteem, coping style, and dyadic communication patterns. METHODS: A total of 466 infertile Korean women attending four infertility clinics and being recruited through an online survey center participated in the study. Psychological distress was assessed using the Korean version of the Depression Anxiety Stress Scale. The data were analyzed using Pearson's correlation coefficients, a one-way analysis of variance, and hierarchical multiple regression. RESULTS: Overall psychological distress among infertile women did not differ significantly from that of healthy adult groups. However, infertile women who were of younger age or in the treatment preparation or rest period were shown to have a higher level of psychological distress. Hierarchical regression analyzes showed that after controlling demographic and infertility characteristics, psychosocial variables such as neuroticism, self-esteem, active/passive avoidance coping, and dyadic demanding/withdrawn communication patterns explained 52.5 % of psychological distress. CONCLUSION: The findings of this study suggest that a high-risk group is characterized with high neuroticism, low self-esteem, avoidance coping, and dyadic demanding/withdrawn communication pattern. There is a crucial need for developing an intervention which addresses infertile women's coping styles and marital communication.

In-depth analysis of damage to the fallopian tubes caused by endometriosis / 中国实用妇科与产科杂志

Endometriosis is associated with femaleinfertility,but the underlying mechanism has not beenfully understood.As is reported,endometriosis cancause tubal obstruction,hydrosalpinx,tubal adhesionand microstructural damage.Also,the ectopic implantsmay result in decreased ciliary beat frequency andweakened muscular contractile activity of the tube,aswell as abnormal components of tubal fluid.All thesechanges lead to impaired female fertility.This reviewfocuses on the damage to the structure and function offallopian tube caused by endometriosis.

The role of 3.0 T MR hysterosalpingography work?up in the diagnosis of female infertility / 中华放射学杂志

Objective To evaluate the role of 3.0 Tesla magnetic resonance hysterosalpingography (MR?HSG) work?up in the diagnosis of female infertility. Methods Between July 2015 and December 2018, a total of 1 052 infertile women aged from 20 to 40 years in the Affiliated Hospital of Nanjing University of Chinese Medicine were prospectively enrolled in the study. All the patients underwent pelvic plain scanning and X?ray hysterosalpingography (HSG) followed by MR?HSG examination, and the patency of the fallopian tubes as well as the abnormalities of the uterus and ovaries were evaluated. Among which 33 cases were randomly selected. The chi?square test and Kappa test were used to compare the difference and the consistency of the two methods in the evaluation of fallopian tubes. Results MR?HSG and HSG had good consistency in evaluating tubal patency (Kappa=0.88, P<0.01), and there was no statistically significant difference between the two groups (P=0.65). The examination of MR?HSG was successfully completed in 97.1%(1 021/1 052) cases. There were 81.7% (834/1 021) cases had at least one abnormality. Bilateral tubal, uterine and ovarian abnormalitiesoccurred in 42.6% (435/1 021), 34.2% (349/1 021)and 46.8% (478/1 021) cases, respectively. In which tubal abnormalities display the results as follows: bilateral obstructed 4.7% (48/1 021), bilateral poor pass 8.5% (87/1 021), one smooth one obstructed11.7% (119/1 021), one smooth one poor pass 12.6% (129/1 021), and one poor pass one obstructed 5.1% (52/1 021). Conclusion 3.0 T MR?HSG is expected to be a routineexam for evaluating female infertility, which allows a comprehensive assessment of tubal patency and other pelvic abnormalities of infertile women.

Estilo de vida, contaminación atmosférica y problemas que afectan la salud reproductiva en la mujer / Life style, atmospheric pollution and reproductive issues affecting women´s health Abstract

Resumen A nivel mundial, la infertilidad en las parejas ha ido en aumento. Hay muchas causas implicadas en este problema, sin embargo, un factor que influye y que cada vez cobra mayor presencia e importancia es la contaminación atmosférica. Aunque tanto las mujeres como los hombres pueden presentar alteraciones que les impidan ser fértiles, en esta revisión se describen 2 factores que han demostrado afectar la salud reproductiva femenina: el estilo de vida y la contaminación ambiental. Entre los factores de estilo de vida que afectan a la salud reproductiva en las mujeres se incluyen el tabaquismo, la obesidad, el estrés y el aplazamiento de la maternidad. Por el lado de la contaminación atmosférica, se ha demostrado que los plaguicidas organoclorinados, los derivados de combustibles fósiles, los hidrocarburos aromáticos policíclicos, los óxidos de azufre y de nitrógeno, los metales y las partículas suspendidas, generan efectos adversos sobre la capacidad de embarazarse. La evidencia epidemiológica y experimental es cada vez mayor, y demuestra que hay una relación consistente entre la presencia de estos factores y los problemas que tienen cada vez más parejas en el mundo para concebir un hijo. Aunados al estilo de vida, en muchos países son frecuentes los problemas de contaminación que inciden en la infertilidad de la población. Esto hace fundamental crear conciencia. Aunque es cierto que las ciudades o zonas industrializadas es donde se observan estos problemas con mayor frecuencia, no son privativos ni se restringen a esos lugares, nos afectan a todos y, al menos en lo que concierne a la contaminación, todos podemos y debemos participar en la mejora de las condiciones de vida que van de la mano con nuestra salud reproductiva.

Abstract Infertility in couples has been increasing worldwide. There are a lot of causes involved in this issue, however one factor that is gaining a greater presence and importance is air pollution. Although both women and men can present alterations that prevent them from being fertile, this review describes two factors that are known to affect female reproductive health: lifestyle and environmental pollution. Lifestyle factors that affect reproductive health in women include smoking, obesity, stress, and deferment of motherhood. Regarding air pollution, it is known that organo-chlorinated pesticides, fossil fuel derivatives, polycyclic aromatic hydrocarbons, sulfur and nitrogen oxides, metals and suspended particles all produce adverse effects in the possibility of getting pregnant. The increasing body of epidemiological and experimental evidence shows a consistent relationship between the presence of these factors and the issues that a growing number couples around the world present to conceive a child. Along with the lifestyle, pollution is a common cause of infertility in the population in many countries of the world. Hence, it is essential to raise awareness in the population about these consequences. Although ,these problems are more frequently observed in cities or industrialized areas, they are not exclusive or restricted to these places, they affect us all, and at least as far as pollution is concerned, we all can and should participate in the improvement of our living conditions that go along with our reproductive health.

Fertility preservation in pediatric and young adult female cancer patients

As the 5-year survival rate increases up to 80% in pediatric cancer patients, the number of women patients with reduced gonadal function by chemotherapy and radiotherapy increases. The gonadal toxicity of pediatric patients varies highly according to the chemotherapeutic agent and the type of radiotherapy. Although American Society of Clinical Oncology published the guideline for fertility preservation, additional scientific and ethical concerns should be considered for clinical practice. In addition, only the experimental method can be applied for the prepubertal patients in contrast to the postpubertal patients. In this review, we will discuss some options for preserving fertility among women’s quality of life issues.

THE STUDY OF FEMALE INFERTILITY WITH ANTI-TPO AND ANTI-TG AUTOIMMUNE DEFICIENCY IN THYROID GLAND / Шинэ санаа Шинэ нээлт

@#BACKGROUND. According to the World Health Organization (WHO), 10-15% of couples of reproductive age have infertility. According to researcher D. Sukhe (1999), hormonal infertility in the reproductive age of women was 33.6%, which was a large part of the cause of infertility. In recent years, the number of cases of endocrine disorders, including malignancy and sexually transmitted infections, have been increasing year by year. According to WHO reports, thyroid disorders have a prevalence of 49.3% among active reproductive age (30-50) group. According to the report of the Health Development Center in 2016, since the thyroid disorders are the second most common disease in endocrine gland disease, our study has found that the infertility in reproductive age of women can be substantial due to the loss of thyroid gland. OBJECTIVE. To study the relationship between the thyroid gland antibodies and female infertility. MATERIAL AND METHODS. The study was carried out in 20-45 year old couples and was modeled as an analytical study model. The questionnaire was used for the couple’s interviews, antroplogical measurements, and serum was analysed. On the serum, anti-TPO and аnti-TG carbohydrates were identified by the Cobas e-411 analyzer under the manufacturer’s accompanying protocol. RESULTS. Prevalence of TAI, in 6.7% positive anti-Tg were found, and 14.3% had positive TPO. In 3.7% of cases, both types of autoantibodies were present. We analysed binary logistic regression for anti-TPO and anti-TG autoantibody in the positive and negative group in relation to the past obstetrics history. A=Accoding to the analysis, evidence of positive anti-TPO and anti-Tg increased the risk of miscarriage by 2.2 times (OR = 2.2, p <0.01). CONCLUSION: Women with infertility in our study have high percentage of subclinical hypothyroidism and have higher rate of thyroid autobodies in serum which could be a problem for women with infertility and pregnancy complications due to the loss of thyroid gland. Thus, there is a need to develop intervention guidelines for recovery and treatment of these types of infertility.

Effect of imblanced vaginal flora on female infertility / 上海交通大学学报（医学版）

Recently the incidence of female infertility is on the rise. The variable and complicated cause of infertility makes it difficult to diagnose in clinical practise. The relationship between vaginal flora and host immune system plays a vital role in female physiological function. Vaginal microbiota dysbiosis may be related to all kinds of infertility, such as tube infertility, endometriosis, anovulatory infertility and idiopathic infertility. In other words, vaginal microbiota dysbiosis may take part in the infertile process. For now the mechanism is far from clear. Some scientists suppose that Lactobacillus deficiency, chronic inflamation and low estrogen level might get involved in this pathophysiological progression, which needs to be studied in the furture.

Chinese medicine as complementary therapy for female infertility / 中国结合医学杂志

Chinese medicine (CM) has been used in clinical treatment for thousands of years in China, Japan, Korea, and other countries. CM is at present attracting many attentions around the world for reproductive health care and disease prevention, including treatment of female infertility. This review focuses on the CM treatment for female infertility patients, and supplies a summary on the efficacy, safety, and mechanism of some Chinese herbal medicines, herbal medicine-derived active compounds, and acupuncture. A large number of researches have reported that CM could alleviate or even cure female infertility by regulating hormone, improving reproductive outcome of in vivo fertilization, affecting embryonic implantation, curing polycystic ovarian syndrome, endometriosis, pelvic inflammatory disease, relieving mental stress, and regulating immune system. Meanwhile, a few studies claimed that there was little adverse reaction of CM in randomized controlled trials. However, up to present there is a lack of adequate evidences with molecular mechanistic researches and randomized controlled trials to prove the CM as an effective and safe treatment for infertility. Thus, utility of CM as a complementary medicine will be a feasible method to improve the outcome of female infertility treatment.

IDENTIFING SOME RISK FACTORS OF FEMALE INFERTILITY / Шинэ санаа Шинэ нээлт

@#BACKGROUND: Infertility rate among Mongolian couples was about 8.7% in 2003. According to researchers in Mongolia, the causes of infertility in male is about 25.6%, in female is about 45.8%, in both couples is 18.8% and unexplained infertility is about 9.8%. Women’s previous disease such as abdominal inflammatory diseases, disorders of pregnancy and surgical diseases of reproductive system can lead to infertility. Infertility has been setting 5th rank on list of human disability as shown as problem about quality of human life. METHODS: We surveyd about secondary infertile women, who has approved by inclusion criteria and determined infertility risks. We designed case-control study. We collected 52 data at “Post partum department” of “First Maternity Hospital” for control group, and 22 data at “Women stationary” of “First Maternity Hospital” for case group (ratio 2:1). Data analyzed by STATA for OR (logistic regression tests) and Microsoft Excel. RESULT: The most common previous disease is pelvic inflammatory disease (OR=2.2) р<0.001 before infertility situation. There was statistical reliability diseases. Including: female reproductive system surgery (OR=2.1), pelvic surgical diseases (OR=1.9) and complication of previous pregnancy (1.2). CONCLUSION: Pelvic inflammatory disease, surgical diseases of female reproductive system, complication of previous pregnancy and pelvic surgical diseases are the risk factors of female secondary infertility.

Descripción de niveles de ansiedad, desesperanza y autoestima en un grupo de mujeres chilenas con diagnóstico de infertilidad primaria: un estudio piloto / Description of anxiety, hopelessness and self-esteem levels in a group of Chilean women diagnosed with primary infertility: A pilot study

describir los niveles de ansiedad, desesperanza y autoestima de mujeres con diagnóstico de infertilidad primaria que acuden a iniciar tratamiento de fertilización in vitro en un centro privado de alta complejidad.Materiales y métodos: serie de casos en la que se incluyeron mujeres chilenas con diagnóstico de infertilidad primaria entre los 20 y 45 años, sin hijos, heterosexuales, con óvulos propios, que aceptaron participar del estudio previo consentimiento informado, quienes acudieron entre junio y diciembre del año 2012 a iniciar tratamiento de fertilización in vitro a una institución privada de referencia especializada en el manejo de este problema en Concepción (Chile). Muestra no probabilística, consecutiva. Se analizaron variables biosociales, antecedentes de patología previa, niveles de ansiedad, desesperanza, autoestima y apoyo social percibido. El análisis estadístico se realizó con el programa SPSS versión 19.0, aplicando análisis univariado.Resultados: se analizó una muestra de 40 mujeres, con un promedio de edad de 35,75 años, las cuales poseen educación técnica o universitaria completa, todas trabajaban y tenían un nivel de ingreso medio-alto. El antecedente de patologías previas más frecuente correspondió a ovario poliquístico (50 %). En las mujeres estudiadas se observó ansiedad en el 47,5 %, desesperanza en el 62,5 % y baja autoestima en el 55 %. El 50 % de ellas percibió un bajo apoyo social.Conclusiones: en mujeres con infertilidad se encontraron importantes niveles de ansiedad, desesperanza y baja autoestima. Es importante hacer una evaluación de estas condiciones en mujeres sometidas a tratamiento de infertilidad ya que la condición de salud mental constituye un importante aspecto de la salud sexual y reproductiva de las mismas...

To describe levels of anxiety, hopelessness and self-esteem in women with a diagnosis of primary infertility seeking to initiate in vitro fertilization treatment at a high-complexity private centre.Materials and methods: Case series including Chilean women aged 20 to 45, who came between June and December 2012 to initiate in vitro fertilization treatment at a private referral institution in Concepcion, Chile, specialized in the management of this problem. The women were childless, heterosexual and had a diagnosis of primary infertility. They had their own eggs and agreed to participate in the study after going through the informed consent process. A consecutive non-probabilistic sample was used. The variables analysed included biosocial factors, prior disease history, levels of anxiety, hopelessness and self-esteem, and perceived social support. A univariate statistical analysis was performed using the SPSS software package, version 19.0.Results: A sample of 40 women was analysed. Mean age was 35.7 years. All the women had completed technical or university education, they all worked, and their level of income was medium to high. The most frequent history of prior disease was was polycystic ovary (50%). In the women included in the study, anxiety was found in 47.5%, hopelessness in 62.5% and low self-esteem in 55%. There was a perception of low social support in 50% of them.Conclusions: Significant levels of anxiety, hopelessness and low self-esteem were found in women with infertility. It is important to evaluate these conditions in women undergoing infertility treatment, considering that mental health is an important component of sexual and reproductive health...

Detection and Clinic Application of Antiphospholipid Antibody and Anti-β2-GPⅠ in Female Infertility / 现代检验医学杂志

Objective To analyze the correlation of different antiphospholipid antibody isotypes in female infertility.Methods Selected 296 patients with female infertility and 31 normal female between May 2015 to August 2015 in Dalian Women’s and Children’s Medical Centre.All the antibodies were detected by chemilumininescence.The positiverate of antipholipid an-tibodies in female infertility patients and health controls were calculated.The concentrations of antiphospholipid antibodies in different groups were compared with Mann-Whitney U test.Results The positive rate of aCL IgG of female infertility and normal female were 0.34% and 0.00%.The positive rate of aCL IgM of female infertility and normal female were 1.35%and 0.00%.The positive rate ofβ2 GPⅠ IgG of female infertility and normal female were 0.00% and 0.00%.The positive rate ofβ2 GPⅠ IgM of female infertility and normal female were 0.34% and 0.00%.aCL IgG were differet beween female infertility and normal female (P=0.013),others had on significant difference.Conclusion Need to detect LA,combined with aCL and anti-β2 GPⅠ,exclusively diagnose APS,layed the foundation of sequential treatment.

Value of Testing Serum Testosterone and AMH in the Diagnosis of Female Infertility / 现代检验医学杂志

Objective To study the application of androgens,AMH for female infertility diagnosis value.Methods Used chemiluminescence to detect androgen testosterone (To),androstenedione (AND),17 (HS)To hydrogen sulfate therapy (17HS),sex hormone binding globulin (SHG)and resistance To seedling le’s hormone (anti-Mullerian hormone,AMH)of 258 cases of patients with female infertility.According to the reason of infertility,female infertility patients were divided into observation group (158 cases of endocrine infertility)and control group (100 cases of tubal factor infertility)and two groups of data had statistical analysis with t test.Used Pearman’s correlation method to analyse the relationship between serum AMH level and AND,SHG in patients wirh female infertility.and used ROC curve to evaluate efficiency of AND and AMH to the diagnosis of female infertility.Results ①The indicators To observation group AND control group,AND,AMH and SHG were (1.25±0.41 vs 0.25±0.15)nmol/L,(4.9±0.62 vs 1.80±0.51)nmol/L,(13.6±3.5 vs 6.4±1.81)ng/ml and (64.2±32.1 vs 89.3±30.2)nmol/L,respectively.Compared with the control group,observation group To,AND and AMH were significantly higher than the control group (t=13.02,11.36,9.35,P values<0.01),but SHG was significantly low-wer than thecontrol group(t=7.35,P<0.01).②Between the biology to produce ets (AMH:7.63~10.1 ng/ml,AND:0.3~3.3 ng/ml,17 HS:18~144μg/dl,SHG:80~560 nmol/L)as the standard,in the observation group:17 HS increased 17.7%,AND increased 72.2%,AMH increased 87.9% and SHG 51.2% reduction.③AMH level and the AND existed positive correlation (r=0.579,P<0.05),negatively correlated with SHG (r=0.763,P<0.05).④AMH,AND and SHG diagnosis of infertility area under the ROC curve (AUC),were 0.921,0.863 and 0.736 respectively,best cutoff value were11.26 ng/ml,4.62 nmol/L and 32.62 ng/ml respectively,and sensitivity of 89.7%,72.9% and 59.6%.Specific degrees were 86.2%,86.2% and 75.6% respectively,and accuracy of 87.1%,87.1% and 81.6%.Jointed inspection of AND,AMH and SHG in the diagnosis of infertility,the sensitivity of the specific degree were 96.3% and 90.2% respectively.Conclusion It showed that AMH,AND and SHG have diagnostic value of internal secretory infertility with ROC curve analysis.De-tection of combined AMH,AND and SHG is more meaningful to the early diagnosis and treatment of infertility.

Perspectiva de casais em relação à infertilidade e reprodução assistida: uma revisão sistemática / Perspective of couples about assisted reproduction and infertility: a systematic review

Objetivos: Analisar as expectativas de casais frente ao diagnóstico de infertilidade e como a reprodução assistida pode contribuir para mudar essa realidade. Métodos: Revisão sistemática da literatura científica acerca das possibilidades de um casal conceber ou não uma criança. Optou por privilegiar periódicos de indexação científica, consultou os periódicos Capes e a biblioteca virtual da saúde, usou as bases de dados SciELO, Lilacs e Medline. Resultados: Foram analisadas três categorias do fenômeno: infertilidade em mulheres, homens e o casal, reprodução assistida e impacto psicológico da experiência de infertilidade no casal. A infertilidade é um problema que afeta homens e mulheres a idade e outros fatores são responsáveis por muitas vezes a não conclusão de um sonho de gerar uma vida. Conclusões: A reprodução assistida é um campo do conhecimento pertinente para pensar mudanças e progressos no qual os avanços da ciência e da tecnologia oferecem recursos inúmeros para o tratamento da infertilidade humana e que podem fazer a diferença na vida desses indivíduos que procuram a parentalidade.

Objectives This article aims to analyze the expectations of couples facing the diagnosis of infertility and how assisted reproduction can contribute to change this reality. Methods: This is a systematic review of the scientific literature about the possibilities of a couple to conceive a child or not. We decided to focus scientific periodicals indexing, querying Periodic CAPES and virtual health library, using the databases Scielo, Lilacs and Medline. Results: They were analyzed three categories of the phenomenon: Infertility in women, men and couples, assisted reproduction and the psychological impact of infertility experience in the couple. Infertility is a problem that affects men and women age and other factors are responsible for often non­completion of a dream to create a life. Conclusions: The assisted reproduction is a field of knowledge pertinent to think about change and progress which advances Science and technology offer numerous resources for the treatment of human infertility and that can make a difference in the lives of individuals seeking parenting.