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Rev. bras. ginecol. obstet ; 43(6): 457-466, June 2021. tab, graf
Article in English | LILACS | ID: biblio-1341145


Abstract Objective Abnormalities in the eutopic endometrium of women with endometriosis may be related to disease-associated infertility. Although previous RNA-sequencing analysis did not show differential expression in endometrial transcripts of endometriosis patients, other molecular alterations could impact protein synthesis and endometrial receptivity. Our aim was to screen for functional mutations in the transcripts of eutopic endometria of infertile women with endometriosis and controls during the implantation window. Methods Data from RNA-Sequencing of endometrial biopsies collected during the implantation window from 17 patients (6 infertile women with endometriosis, 6 infertile controls, 5 fertile controls) were analyzed for variant discovery and identification of functional mutations. A targeted study of the alterations found was performed to understand the data into disease's context. Results None of the variants identified was common to other samples within the same group, and no mutation was repeated among patients with endometriosis, infertile and fertile controls. In the endometriosis group, nine predicted deleterious mutations were identified, but only one was previously associated to a clinical condition with no endometrial impact. When crossing the mutated genes with the descriptors endometriosis and/or endometrium, the gene CMKLR1 was associated either with inflammatory response in endometriosis or with endometrial processes for pregnancy establishment. Conclusion Despite no pattern of mutation having been found, we ponder the small sample size and the analysis on RNA-sequencing data. Considering the purpose of the study of screening and the importance of the CMKLR1 gene on endometrial

Resumo Objetivo Anormalidades no endométrio eutópico de mulheres com endometriose podem estar relacionadas à infertilidade associada à doença. Embora a análise prévia de sequenciamento de RNA não tenha evidenciado expressão diferencial em transcritos endometriais de pacientes com endometriose, outras alterações moleculares poderiam afetar a síntese de proteínas e a receptividade endometrial. Nosso objetivo foi rastrear mutações funcionais em transcritos de endométrios eutópicos de mulheres inférteis com endometriose e de controles durante a janela de implantação. Métodos Os dados do sequenciamento de RNA de biópsias endometriais coletados durante a janela de implantação de 17 pacientes (6 mulheres inférteis com endometriose, 6 controles inférteis, 5 controles férteis) foram analisados para a descoberta de variantes e a identificação de mutações funcionais. Um estudo direcionado das alterações encontradas foi realizado para compreender os dados no contexto da doença. Resultados Nenhuma das variantes identificadas foi comuma outras amostras dentro do mesmo grupo, assim como nenhuma mutação se repetiu entre pacientes com endometriose, controles inférteis e férteis. No grupo de endometriose, foram identificadas nove mutações deletérias preditas, mas apenas uma foi previamente associada a uma condição clínica sem impacto endometrial. Ao cruzar os genes mutados com os descritores endometriose e/ou endométrio, o gene CMKLR1 foi associado a resposta inflamatória na endometriose e a processos endometriais para estabelecimento da gravidez. Conclusão Apesar de nenhum padrão de mutação ter sido encontrado, ponderamos o pequeno tamanho da amostra e a análise dos dados de sequenciamento de RNA. Considerando o objetivo do estudo de triagem e a importância do gene CMKLR1 na modulação endometrial, este poderia ser um gene candidato para estudos adicionais que avaliem mutações no endométrio eutópico de pacientes com endometriose.

Humans , Female , Pregnancy , Embryo Implantation , Sequence Analysis, RNA , Endometriosis/complications , Endometriosis/genetics , Endometrium/metabolism , Infertility, Female/etiology , Mutation , Computer Simulation , Case-Control Studies , Prospective Studies , Receptors, Chemokine/genetics , Infertility, Female/metabolism
Rev. bras. ginecol. obstet ; 43(4): 304-310, Apr. 2021. graf
Article in English | LILACS | ID: biblio-1280037


Abstract Hydrosalpinx is a disease characterized by the obstruction of the salpinx, with progressive accumulation in the shape of a fluid-filled sac at the distal part of the tuba uterina, and closed to the ovary. Women with hydrosalpinges have lower implantation and pregnancy rates due to a combination of mechanical and chemical factors thought to disrupt the endometrial environment. Evidence suggests that the presence of hydrosalpinx reduces the rate of pregnancy with assisted reproductive technology. The main aim of the present is review to make an overview of the possible effects of hydrosalpinx on in vitro fertilization (IVF).We conducted a literature search on the PubMed, Ovid MEDLINE, and Google Scholar data bases regarding hydrosalpinx and IVF outcomes. Hydrosalpinx probably has a direct toxic effect on sperm motility and on the embryos. In addition, the increasing liquid inside the salpinges could alter the mechanisms of endometrial receptivity. The window of endometrial receptivity is essential in the implantation of blastocysts, and it triggers multiple reactions arising from the endometrium as well as the blastocysts. Hydrosalpinx could influence the expression of homeobox A10 (HOXA10) gene, which plays an essential role in directing embryonic development and implantation. Salpingectomy restores the endometrial expression of HOXA10; therefore, it may be one mechanism by which tubal

Humans , Female , Pregnancy , Embryo Implantation , Fertilization in Vitro , Treatment Failure , Fallopian Tube Diseases/complications , Salpingectomy , Infertility, Female/therapy , Blastocyst/physiology , Gene Expression , Endometrium/physiopathology , Fallopian Tube Diseases/surgery , Fallopian Tube Diseases/physiopathology , Homeobox A10 Proteins/genetics , Infertility, Female/etiology
Article in Chinese | WPRIM | ID: wpr-887933


Pelvic inflammatory disease(PID) has become one of the leading causes of female infertility, with an increasing incidence in recent years. Modern medicine believes that risk factors of PID will affect the formation of eggs and embryo implantation, especially on the encounter of gametes, fertilization, and transport of fertilized eggs to the uterine cavity. Therapies for infertility due to PID include medication, sonographic hydrotubation, surgery, and assisted reproductive technology. Professor Ma Kun believes that the disease is located in the uterus with appendages with the main pathogenesis of kidney deficiency and blood stasis. Blood stasis is the pathological basis, and kidney deficiency is the fundamental pathogenesis, which exhibits deficiency-excess in complexity. Kidney deficiency will cause blood stasis over time, while blood stasis will aggravate kidney deficiency in turn, making PID-induced infertility refractory. In clinical practice, basic therapies follow the principles of kidney-tonifying and blood-activating, removing blood stasis, dredging collaterals, and coordinating thoroughfare and conception vessels. The oral administration of Chinese medicine combined with enema, external application, and external washing displays better efficacy in improving the pelvic microenvironment and increasing the pregnancy rate and pregnancy success rate in the treatment of PID-induced infertility.

Female , Humans , Infertility, Female/etiology , Kidney , Medicine, Chinese Traditional , Pelvic Inflammatory Disease/drug therapy , Pregnancy , Pregnancy Rate
Article in Chinese | WPRIM | ID: wpr-887931


Hyperprolactinemia(HPRL) is one of the diseases leading to anovulatory infertility, which is a refractory gynecological disease and seriously affects female reproductive function. Professor MA Kun has summarized his experience in clinical and scientific studies for many years. And believes that kidney deficiency is the pathogenesis of HPRL and blood stasis is the dominant pathological manifestation of HPRL and can promote the progress of the disease. In view of this, Professor MA Kun took the therapy of kidney-tonifying and blood-activating as the principle for treating anovulatory infertility caused by HPRL, with soothing the liver and promoting Qi as adjuvant therapies. She has also summarized and refined the prescriptions for tonifying kidney and inducing ovulation, which have a remarkable clinical efficacy.

Drugs, Chinese Herbal/therapeutic use , Female , Humans , Hyperprolactinemia/drug therapy , Infertility, Female/etiology , Kidney , Medicine, Chinese Traditional
Article in Chinese | WPRIM | ID: wpr-887930


Under the guidance of the theory of "kidney governing reproduction", this study demonstrated the mechanism of six types of ovulatory infertility caused by kidney deficiency and blood stasis, including anovulatory bleeding, polycystic ovary syndrome, hyperprolactinemia, luteinized unruptured follicle syndrome, luteal phase deficiency, and primary ovarian insufficiency. A series of studies have confirmed that integrated Chinese and western medicine can increase the responsiveness of the ovaries to gonadotropins and improve ovarian function by regulating the effects of estradiol(E_2), prolactin(PRL), and reducing follicle-stimulating hormone(FSH), luteinizing hormone(LH), progestin(P), and testosterone(T). It can also improve ovulation rate and pregnancy success rate by promoting follicle development, discharging, and synchronizing endometrial growth. This study illustrated the diagnosis and treatment of ovulatory infertility caused by kidney deficiency and blood stasis with integrated traditional Chinese and Western medicine in the "disease-syndrome-symptom" research mode, and highlighted the traditional Chinese medicine(TCM) idea of differentiating diseases based on syndromes and unique advantages of the combination of disease differentiation and syndrome differentiation, and interpreted TCM principle of "treating different diseases with the same method".

China , Female , Follicle Stimulating Hormone , Humans , Infertility, Female/etiology , Kidney , Medicine, Chinese Traditional , Polycystic Ovary Syndrome , Pregnancy
Article in English | WPRIM | ID: wpr-880339


BACKGROUND@#Mounting evidence implicates an association between ambient air pollution and impaired reproductive potential of human. Our study aimed to assess the association between air pollution and ovarian reserve in young, infertile women.@*METHODS@#Our study included 2276 Korean women who attended a single fertility center in 2016-2018. Women's exposure to air pollution was assessed using concentrations of particulate matter (PM@*RESULTS@#The mean age was 36.6 ± 4.2 years and AMH level was 3.3 ± 3.1 ng/mL in the study population. Average AMH ratio was 0.8 ± 0.7 and low AMH was observed in 10.3% of women (n=235). The average concentration of six air pollutants was not different between the normal ovarian reserve and low AMH groups for all averaging periods. In multivariable models, an interquartile range (IQR)-increase in 1 month-average PM@*CONCLUSIONS@#In a cohort of infertile Korean women, there was a suggestive evidence of the negative association between ambient PM concentration and ovarian reserve, highlighting the potential adverse impact of air pollution on women's fertility.

Adult , Air Pollutants/adverse effects , Air Pollution/adverse effects , Environmental Exposure/adverse effects , Female , Humans , Infertility, Female/etiology , Ovarian Reserve/physiology , Republic of Korea
Article in English | WPRIM | ID: wpr-878330


Objective@#Prior pulmonary tuberculosis (PTB) on chest X-ray (CXR) was commonly found in infertile patients receiving examinations before @*Method@#We conducted a retrospective cohort study of 14,254 infertile patients who had received IVF-ET at Peking University Third Hospital in 2017. Prior PTB was defined as the presence of signs suggestive of old or inactive PTB on CXR, with or without a clinical TB history. Patients who had prior PTB on CXR but had not received a clinical diagnosis and anti-TB therapy were included for analysis. Live birth, clinical pregnancy, and miscarriage rates were compared between the untreated PTB and non-PTB groups.@*Results@#The untreated PTB group had significantly lower clinical pregnancy (31.7% @*Conclusions@#Untreated PTB was associated with adverse pregnancy outcomes after IVF-ET, especially in patients with unexplained infertility, highlighting the clinical significance of PTB in this specific patient population.

Abortion, Spontaneous/epidemiology , Adult , China/epidemiology , Embryo Transfer/statistics & numerical data , Female , Fertilization in Vitro/statistics & numerical data , Humans , Infertility, Female/etiology , Live Birth/epidemiology , Middle Aged , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Pregnancy Outcome/epidemiology , Radiography, Thoracic , Retrospective Studies , Tuberculosis, Pulmonary/epidemiology , Young Adult
Rev. chil. obstet. ginecol. (En línea) ; 85(1): 60-67, feb. 2020. graf
Article in Spanish | LILACS | ID: biblio-1092776


ANTECEDENTES El embarazo ectópico abdominal es el menos habitual de los embarazos ectópicos, con una prevalencia situada entre el 0.9 - 1.4%. La mortalidad materna es elevada, alcanzando un 20% y la viabilidad fetal mínima. El manejo médico en estas situaciones es complicado ya que no está bien establecido debido a su baja frecuencia. CASO CLÍNICO Mujer de 35 años, con antecedente de esterilidad por endometriosis y salpinguectomía bilateral. Tras 5 fecundaciones in vitro (FIV) consigue una primera gestación, con finalización mediante cesárea por no progresión de parto. Acude a urgencias en su segundo embarazo, logrado tras 3 (FIV), con edad gestacional de 7 semanas. Presenta sangrado vaginal escaso y la ecografía demuestra a nivel de Douglas y hacia fosa iliaca izquierda un saco gestacional de 3 cm con embrión sin latido cardiaco de 5 mm. El nivel de β-hcg es de 1477 mUI/ml. Se diagnostica de gestación ectópica abdominal y se opta por actitud expectante dada la estabilidad clínica de la paciente. En un control a las 48h la β-Hcg es de 464 mUI/ml y la paciente se mantiene estable. En controles posteriores se observan niveles descendentes de β-Hcg y tras un mes la resolución es completa. CONCLUSIÓN El embarazo ectópico abdominal es una entidad poco frecuente pero con una alta tasa de mortalidad. Aunque lo más común es optar por un abordaje quirúrgico es necesario individualizar cada caso y basarse en la clínica y las diferentes pruebas diagnósticas para seleccionar aquellos casos que se pueden beneficiar de un manejo conservador.

BACKGROUND Abdominal ectopic pregnancy accounts for only 0.9-1.4% of all ectopic pregnancies. The maternal mortality rate is high (up to 20%) and fetal viability mínimum. The managment, specially the conservatory management of these cases is difficult because of our limited experiencie due to its low frecuency. CASE PRESENTATION 35-year-old woman, with history of sterility due to endometriosis that required bilateral laparoscopic salpinguectomy. Her first pregnancy (after 5 in vitro fertilization cicles (IVF)) finalized with a caesarean section because of to the lack of labour progresion. She was admitted to our emergency department during her second pregnancy (after 3 IVF cicles), with 7 weeks of gestational age. She had a little vaginal bleeding. Ultrasound scan showed a 5mm gestational sac with a 3mm embryo without cardiac activity in the pouch of Douglas. The β-Hcg level was 1477mUI/ml. The final diagnosis was ectopic abdominal pregnancy and it was decided to undertake an expectant management because she was clinically stable. The β-Hcg level after 48 hours was 464 mUI/ml. In subsequent examinations β-Hcg showed descending levels and after one month the resolution was completed. CONCLUSION Abdominal ectopic pregnancy is very infrequent but it has a high mortality rate. The most common approach is surgical but it is necessary to study all signs and diagnostic tests to select patients that could get profit from a conservatory management.

Humans , Female , Pregnancy , Adult , Pregnancy, Abdominal/diagnosis , Fertilization in Vitro/adverse effects , Salpingectomy/adverse effects , Infertility, Female/etiology , Pregnancy, Abdominal/blood , Pregnancy, Ectopic , Ultrasonography, Prenatal , Chorionic Gonadotropin, beta Subunit, Human/blood , Watchful Waiting , Conservative Treatment
Einstein (Säo Paulo) ; 18: eAO5150, 2020. tab
Article in English | LILACS | ID: biblio-1090068


ABSTRACT Objective To verify the association of obesity and infertility related to anovulatory issues. Methods This case-control study was carried out with 52 women, aged 20 to 38 years, divided into two groups (infertile − cases − and fertile − control), seen at outpatient clinics, in the period from April to December, 2017. Results We found significant evidence that obesity negatively affects women's fertility (p=0.017). The group of infertile women was 7.5-fold more likely to be obese than fertile women. Conclusion Strategies that encourage weight control are indicated for women with chronic anovulation, due to hight metabolic activity of adipose tissue.

RESUMO Objetivo Verificar em mulheres a associação entre obesidade e infertilidade relacionada a questões anovulatórias. Métodos Estudo de caso-controle com 52 mulheres, de 20 a 38 anos, divididas em dois grupos (mulheres inférteis − casos − e férteis − controles), atendidas em ambulatórios, no período de abril a dezembro de 2017. Resultados Verificou-se evidência significativa de que a obesidade afeta negativamente na fertilidade das mulheres (p=0,017). O grupo de mulheres inférteis teve 7,5 vezes mais chances de serem obesas quando comparadas às mulheres férteis. Conclusão Estratégias que estimulem o controle do peso são indicadas para mulheres com anovulação crônica devido à elevada atividade metabólica do tecido adiposo.

Humans , Female , Adult , Young Adult , Infertility, Female/etiology , Anovulation/etiology , Obesity/complications , Exercise/physiology , Case-Control Studies , Anthropometry , Surveys and Questionnaires , Risk Factors , Sedentary Behavior , Infertility, Female/physiopathology , Infertility, Female/metabolism , Anovulation/physiopathology , Anovulation/metabolism , Metabolic Diseases/complications , Metabolic Diseases/physiopathology , Obesity/physiopathology , Obesity/metabolism
Rev. cuba. endocrinol ; 30(3): e211, sept.-dic. 2019. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1126442


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)

Humans , Female , Adult , Ureaplasma/cytology , Sexually Transmitted Diseases/etiology , Pelvic Inflammatory Disease/epidemiology , Mycoplasma hominis/cytology , Infertility, Female/etiology , Epidemiology, Descriptive , Cross-Sectional Studies
Prensa méd. argent ; 105(5): 317-319, jun 2019. tab
Article in English | LILACS, BINACIS | ID: biblio-1024650


Introduction: Celiac disease is an immune response to a gluten-based diet that affects the small intestines of people with a genetic predisposition to disease. Celiac has intra intestinal and extra instestinal manifestations., In recent years, celiac and infertility have been considered. The present study examines the effect of celiac disease and its treatment on the menstrual cycle, pregnancy and menopause. In this study, we compared the prevalence of celiac disease in fertile women with infertile women in Zahedan. Materials and Methods: In this case control study, 150 patients with unexplained infertility from Febraury 2016 to 2017 referred to Infrtility Clinic of Alis ibn-Abitaleb Hospital in Zahedan (Iran), were included in the study. Total IgA and IgA TTG were evaluated. IƒTTG is positive, for confirmation of diagnosis, biopsy is performed from the distal part of the duodenum. In control group, 150 fertile women with two or more children with the same characteristics were studied. Results: Theree patients with unexlained infertility (2%) were positive for TTG. Two of them (1/3%) were positive to celiac disease in small intestinal biopsy. None of the women in the control group had TTG positive (p=0.49) Discussion and Conclusion: It seems that some infertile patients with unexplained infertility suffer from celiac disease, but with a (p=0.49), it seems that celiac screening as a cause of infertility with unexplained cause needs more studies with larger sample size in Iran (AU)

Humans , Female , Menopause , Pregnancy , Case-Control Studies , Celiac Disease/therapy , Infertility, Female/etiology , Menstrual Cycle
Rev. cuba. obstet. ginecol ; 45(2): e449, abr.-jun. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1093634


Introducción: La infertilidad ha aumentado a nivel mundial como consecuencia del incremento de las infecciones de transmisión sexual y la enfermedad inflamatoria pélvica producidas fundamentalmente por Chlamydia trachomatis. Objetivo: Describir la relación existente entre la Chlamydia trachomatis y sus daños y consecuencias en mujeres infértiles. Métodos: Se estudiaron 552 mujeres, con diagnóstico de infertilidad y se selecciona una muestra de 175, con diagnóstico de infección por Chlamydia trachomatis. Resultados: Las mujeres en el estudio tenían una escolaridad media superior. La mayoría de las mujeres a pesar de padecer una infección por Chlamydia trachomatis no presentaron daño a órganos reproductores; y en las que sí, predominó la obstrucción tubaria bilateral. En los casos en que se diagnosticó daño al cuello uterino predominó la cervicitis. Conclusiones: La mayoría de las mujeres infértiles con infección por Chlamydia trachomatis eran adultas jóvenes con nivel escolar medio superior, con una infertilidad secundaria y sin daños estructurales en las trompas de Falopio y el cérvix uterino. Existe relación entre la Chlamydia trachomatis y la afección a las trompas de Falopio y el cérvix uterino(AU)

Introduction: Infertility has increased worldwide because of the increase in sexually transmitted infections and pelvic inflammatory disease caused mainly by Chlamydia trachomatis. Objective: To describe the relationship between Chlamydia trachomatis and its damages and consequences in infertile women. Methods: We studied 552 women with a diagnosis of infertility and we selected a sample of 175, with diagnosis of Chlamydia trachomatis infection. Results: The women in the study had high school level. Most of them did not have reproductive organ damage despite suffering from Chlamydia trachomatis infection. However, those who did not have this damage had bilateral tubal obstruction. Cervicitis predominated in those cases in which damage to the cervix was diagnosed. Conclusions: Most of the infertile women with Chlamydia trachomatis infection were young adults with a high school level, suffering secondary infertility and with no structural damage to the fallopian tubes and uterine cervix. There is a relationship between Chlamydia trachomatis and the affection to the fallopian tubes and uterine cervix(AU)

Humans , Female , Chlamydia Infections/complications , Chlamydia Infections/diagnosis , Infertility, Female/etiology , Infertility, Female/epidemiology
Rev. bras. parasitol. vet ; 28(2): 245-257, Apr.-June 2019. tab, graf
Article in English | LILACS | ID: biblio-1013737


Abstract This is a cross-sectional study to assess the presence of antibodies in ruminants against selected pathogens associated with reproductive disorders in cattle in four Brazilian states, including the zoonotic agent Coxiella burnetii. The used tests were Virus Neutralization Assay for IBR and BVD, Microscopic Agglutination Test for Leptospira spp., Indirect Fluorescent Antibody Test (IFAT) for C. burnetii and Toxoplasma gondii, and Enzyme-Linked Immunosorbent Assay for Neospora caninum and Trypanosoma vivax. Seropositivity for C. burnetii was 13.7% with titers from 128 to 131,072; 57.8% for BoHV-1, with titers between 2 and 1,024; 47.1% for BVDV-1a, with titers from 10 to 5,120; 89.2% for N. caninum; 50% for T. vivax; and 52.0% for Leptospira spp., with titers between 100 to 800 (the following serovars were found: Tarassovi, Grippotyphosa, Canicola, Copenhageni, Wolffi, Hardjo, Pomona and Icterohaemorrhagiae); 19.6% for T. gondii with titer of 40. This is the first study that has identified C. burnetii in cattle associated with BoHV and BVDV, N. caninum, Leptospira spp., T. gondii and T. vivax. Thus, future studies should be conducted to investigate how widespread this pathogen is in Brazilian cattle herds.

Resumo Este é um estudo transversal para avaliar a presença de anticorpos em ruminantes contra patógenos selecionados e associados a distúrbios reprodutivos em bovinos de quatro estados brasileiros, incluindo o agente zoonótico Coxiella burnetii. Os testes utilizados foram Teste de Vírus-Neutralização para BoHV e BVDV, teste de Aglutinação Microscópica para Leptospira spp., Reação de Imunofluorescência Indireta for C. burnetii e Toxoplasma gondii, e Ensaio de Imunoabsorção Enzimática para Neospora caninum e Trypanosoma vivax. A soropositividade para C. burnetii foi de 13,7% com títulos de 128 a 131.072; 57,8% para BoHV-1, com títulos entre 2 a 1.024; 47,1% para BVDV-1a, com títulos de 10 a 5.120; 89,2% para N. caninum; 50% para T. vivax; e 52,0% para Leptospira spp., com títulos entre 100 a 800 (sorovares encontrados: Tarassovi, Grippotyphosa, Canicola, Copenhageni, Wolffi, Hardjo, Pomona e Icterohaemorrhagiae) 19,6% para T. gondii com título de 40. Este é o primeiro estudo que evidencia a participação de C. burnetii em bovinos associada ao Vírus da Rinotraqueíte bovina infecciosa e da diarreia viral bovina, N. caninum, Leptospira spp., T. gondii e T. vivax em bovinos. Desta forma, futuros estudos devem ser conduzidos a fim de investigar o quão disseminado se encontra este patógeno em rebanhos bovinos brasileiros.

Animals , Female , Cattle , Q Fever/veterinary , Trypanosomiasis, African/veterinary , Bovine Virus Diarrhea-Mucosal Disease/complications , Cattle Diseases/epidemiology , Toxoplasmosis, Animal/complications , Coccidiosis/veterinary , Leptospirosis/veterinary , Q Fever/complications , Q Fever/diagnosis , Q Fever/epidemiology , Toxoplasma/immunology , Trypanosomiasis, African/complications , Trypanosomiasis, African/diagnosis , Trypanosomiasis, African/epidemiology , Bovine Virus Diarrhea-Mucosal Disease/diagnosis , Bovine Virus Diarrhea-Mucosal Disease/epidemiology , Brazil/epidemiology , Agglutination Tests , Enzyme-Linked Immunosorbent Assay/veterinary , Cattle Diseases/microbiology , Cattle Diseases/parasitology , Cattle Diseases/virology , Seroepidemiologic Studies , Toxoplasmosis, Animal/diagnosis , Cross-Sectional Studies , Trypanosoma vivax , Coxiella burnetii/immunology , Coccidiosis/complications , Coccidiosis/diagnosis , Coccidiosis/epidemiology , Diarrhea Viruses, Bovine Viral/immunology , Neospora/immunology , Fluorescent Antibody Technique, Indirect/veterinary , Abortion, Veterinary , Endometritis/etiology , Infertility, Female/etiology , Leptospira/immunology , Leptospirosis/complications , Leptospirosis/diagnosis , Leptospirosis/epidemiology
Rev. Hosp. Ital. B. Aires (2004) ; 39(1): 12-18, mar. 2019. ilus., tab.
Article in Spanish | LILACS | ID: biblio-1021819


El síndrome de Turner (ST) resulta de la ausencia completa o parcial del segundo cromosoma sexual en fenotipos femeninos. Tiene una incidencia de 1:2000- 2500 nacidas vivas. Recién en la última década se ha puesto atención a la salud de las adultas con ST. La mortalidad es 3 veces superior respecto de la población general debido al riesgo de disección aórtica por anomalías cardiovasculares estructurales y aterosclerosis vinculada a hipertensión arterial, diabetes, dislipidemia y obesidad. También presentan elevada prevalencia de enfermedades autoinmunitarias. Objetivo: evaluar la calidad del seguimiento clínico de pacientes adultas con ST, comparando los controles de salud preconformación y posconformación del Registro y de la Unidad Interdisciplinaria. En el año 2017 fuimos convocados para integrar el Programa de Enfermedades Raras del Hospital Italiano de Buenos Aires. A partir de la creación del Registro Institucional y del equipo multidisciplinario obtuvimos mejoría significativa en los controles por las especialidades de cardiología, endocrinología y otorrinolaringología, en los controles bioquímicos del metabolismo lipídico, hidrocarbonado, hepatograma, TSH y anticuerpos para celiaquía e imágenes cardiovasculares y densitometría ósea. En conclusión, el seguimiento sistematizado e institucional, mediante el Registro y la creación de la Unidad Interdisciplinaria de Síndrome de Turner, permitió encontrar las falencias del sistema de atención y optimizar el seguimiento de esta población. (AU)

Turner syndrome (TS) results from the complete or partial absence of the second sex chromosome in female phenotypes. It has an incidence of 1: 2000-2500 girls born alive. Only in the last decade has been paid attention to the health of adults women with TS. Mortality is 3 times higher than in the general population due to the risk of aortic dissection cause to structural cardiovascular anomalies and atherosclerosis related to hypertension, diabetes, dyslipidemia and obesity. They also have a high prevalence of autoimmune diseases. Until nowadays in Argentina do not exist a national registry of this disease that complies with the international follow-up recommendations for these patients. We proposed to develop the institutional register at 2014 and a multidisciplinary team was created to care and follow up girls and women with TS during 2015. It was indexed to Italian Hospital of Buenos Aires' Rare Diseases Program since 2017. After the creation of the institutional registry and the multidisciplinary team we obtained a significant improvement in cardiology, endocrinology and otorhinolaryngology schedule visits, in lipids and hydrocarbon metabolism, liver, thyroid and celiac diseases biochemical controls and in the performance of cardiovascular MNR and bone densitometry. In conclusion, the systematized and institutional follow-up, through the registry and the creation of the Interdisciplinary Unit of Turner Syndrome, allowed us to find the flaws of the care system and to optimize the follow up of this population. (AU)

Humans , Female , Adolescent , Adult , Middle Aged , Young Adult , Quality of Life , Turner Syndrome/prevention & control , Aftercare/statistics & numerical data , Aneurysm, Dissecting/etiology , Autoimmune Diseases/epidemiology , Turner Syndrome/complications , Turner Syndrome/etiology , Turner Syndrome/mortality , Turner Syndrome/epidemiology , Aftercare/methods , Cardiovascular Abnormalities/complications , Human Growth Hormone/therapeutic use , Diabetes Mellitus , Atherosclerosis/complications , Dyslipidemias/complications , Estrogens/therapeutic use , Gonadal Disorders/etiology , Hypertension/complications , Infertility, Female/etiology , Obesity/complications
Rev. inf. cient ; 98(2): 283-293, 2019.
Article in Spanish | LILACS, CUMED | ID: biblio-1017022


Introducción: la infertilidad adquiere cada día mayor auge en las sociedades. Objetivo: facilitar la labor del médico de la familia en la captación y seguimiento de los casos de infertilidad. Método: se realizó una revisión bibliográfica, mediante consulta digital de las revistas especializadas, actualizadas y de libre acceso disponibles en el sitio web de la Biblioteca Virtual de Salud. Para la localización de las publicaciones fueron empleadas varias palabras clave, que contuvieron fundamentalmente el término infertilidad. Las citas digitales más recientes y que mostraban el trabajo de manera íntegra, fueron sometidas a un análisis que permitió obtener la información. Desarrollo: dentro de las causas de infertilidad identificadas con mayor frecuencia se encuentran en el caso de las femeninas, las infecciones genitales y como exponente de la masculina con el varicocele. Conclusiones: fomentar la incorporación del conocimiento permitirá el diseño de acciones preventivas sobre los principales factores causales de la infertilidad desde la Atención Primaria de Salud(AU)

Introduction: infertility is becoming increasingly popular in societies. Objective: to facilitate the work of the family doctor in the collection and follow-up of cases of infertility. Method: a bibliographic review was carried out, through digital consultation of specialized journals, updated and freely available on the website of the Virtual Health Library. Several keywords were used to locate the publications, which mainly contained the term infertility. The most recent digital citations, which showed the work in their entirety, were subjected to an analysis that allowed obtaining the information. Development: Among the causes of infertility identified most frequently are in the case of females, genital infections and as an exponent of the male with the varicocele. Conclusions: promoting the incorporation of knowledge will allow the design of preventive actions on the main causal factors of infertility from the Primary Health Care(AU)

Introdução: a infertilidade está se tornando cada vez mais popular nas sociedades. Objetivo: facilitar o trabalho do médico de família na coleta e acompanhamento de casos de infertilidade. Método: foi realizada uma revisão bibliográfica, por meio de consulta digital de periódicos especializados, atualizado e disponível gratuitamente no site da Biblioteca Virtual em Saúde. Diversas palavras-chave foram utilizadas para localizar as publicações, que continham, principalmente, o termo infertilidade, sendo que as citações digitais mais recentes, que apresentaram o trabalho na íntegra, foram submetidas a uma análise que permitiu a obtenção das informações. Desenvolvimento: Dentro das causas da infertilidade identificaram mais freqüentemente encontrada no caso das mulheres, infecções genitais e como um expoente do sexo masculino com os varicocele. Consideraciones finais: promover a incorporação do conhecimento permitem o desenho de ações preventivas em principais fatores causais da infertilidade da Atenção Primária à Saúde(AU)

Humans , Female , Pelvic Inflammatory Disease/etiology , Infertility/etiology , Infertility, Female/etiology , Primary Health Care
Rev. chil. infectol ; 35(4): 371-376, ago. 2018. tab
Article in Spanish | LILACS | ID: biblio-978047


Resumen Introducción: La infección endocervical por Chlamydia trachomatis es considerada una de las principales causas de infertilidad en todo el mundo. Durante el embarazo puede conducir a complicaciones graves como la ruptura prematura de membranas y los partos prematuros. Objetivo: Determinar la prevalencia de infección genital por C. trachomatis en mujeres embarazadas e infértiles de la Ciudad de México. Métodos: La detección de C. trachomatis fue mediante reacción de polimerasa en cadena tiempo real (RPC-TR) con el kit comercial COBAS® TaqMan CT Test v2,0 (Roche Molecular System). Resultados: Se analizaron 2.352 muestras; 102 fueron positivas (4,3%). La prevalencia por edad mostró que las adolescentes embarazadas (15 a 19 años) fueron las de mayor riesgo de infección (10,9%, RR = 3,23 [IC 95%: 1,79-5,84]), seguido de mujeres jóvenes de 20 a 24 años, con prevalencia de 5,6% (RR = 1,65 [IC 95%: 0,82-3,34]). Discusión: Los resultados indican que la prevalencia está dentro del rango reportado en el concierto mundial. Sin embargo, las adolescentes embarazadas tuvieron mayor prevalencia que las mujeres infértiles. Conclusión: Es imperioso realizar un rastreo sistemático de infección por C. trachomatis en mujeres bajo 24 años de edad, y en mujeres embarazadas para disminuir los casos de infertilidad y las complicaciones perinatales.

Background: Endocervical infection by Chlamydia trachomatis is considered one of the leading causes of infertility worldwide. During pregnancy, it can lead to serious complications such as premature rupture of membranes and premature births. Aim: To determine the prevalence of genital infection by C. trachomatis in pregnancy and infertile women from Mexico City. Methods: The detection of C. trachomatis was performed by real-time PCR with the commercial kit COBAS® TaqMan CT Test v2.0 (Roche Molecular System). Results: We analyzed 2,352 endocervical swabs; 102 were positive (4.3%). Age prevalence showed that pregnant adolescents (15 to 19 years of age) had the highest risk of infection (10.9%, RR = 3.23 [95% IC: 1.79-5.84]), followed by young women aged 20 to 24 years, with a prevalence of 5.6% (RR = 1.65 [95% IC: 0.82-3.34]). Discussion: The results indicate that the prevalence is within the range reported worldwide. However, pregnant adolescents were those with a higher prevalence than infertile women were. Conclusion: A systematic screening of C. trachomatis infection in women younger than 24 years of age, and in pregnant women is necessary to reduce the incidence of infertility and perinatal complications.

Humans , Female , Pregnancy , Adolescent , Adult , Young Adult , Chlamydia Infections/epidemiology , Genital Diseases, Female/epidemiology , Perinatology , Chlamydia Infections/diagnosis , Chlamydia Infections/microbiology , Chlamydia trachomatis/isolation & purification , Prevalence , Prospective Studies , Age Factors , Academies and Institutes , Real-Time Polymerase Chain Reaction , Genital Diseases, Female/diagnosis , Infertility, Female/etiology , Infertility, Female/microbiology , Mexico/epidemiology
Clinics ; 73: e364, 2018. tab, graf
Article in English | LILACS | ID: biblio-952793


OBJECTIVES: Our purpose was to examine the associations of female genital infections and certain comorbidities with infertility. METHODS: The Taiwan National Health Research Database was searched for women with a new diagnosis of infertility between 2000 and 2013. Women without a diagnosis of infertility served as a control group and were matched with the infertility cases by age (±3 years) and index year. They were divided into two groups: ≤40 years old and >40 years old. Univariate and multivariate conditional logistic regression models were employed to identify the risk factors associated with infertility. RESULTS: A total of 18,276 women with a new diagnosis of infertility and 73,104 matched controls (mean cohort age, 31±6.2 years) were included. According to the adjusted multivariate analysis, pelvic inflammatory disease involving the ovary, fallopian tube, pelvic cellular tissue, peritoneum (odds ratio (OR)=4.823), and uterus (OR=3.050) and cervical, vaginal, and vulvar inflammation (OR=7.788) were associated with an increased risk of infertility in women aged ≤40 years. In women aged >40 years, pelvic inflammatory disease of the ovary, fallopian tube, pelvic cellular tissue, and peritoneum (OR=6.028) and cervical, vaginal, and vulvar inflammation (OR=6.648) were associated with infertility. Obesity, lipid metabolism disorders, dysthyroidism, abortion (spontaneous or induced), bacterial vaginosis, endometritis, and tubo-ovarian abscess were associated with an increased risk of infertility according to the univariate analysis but not the multivariate analysis. CONCLUSIONS: Female genital tract infections, but not the comorbidities studied here, are associated with an increased risk of infertility.

Humans , Female , Adult , Pelvic Inflammatory Disease/complications , Reproductive Tract Infections/complications , Infertility, Female/etiology , Case-Control Studies , Comorbidity , Logistic Models , Abortion, Spontaneous , Multivariate Analysis , Risk Factors , Age Factors , Abortion, Induced/adverse effects , Risk Assessment , Lipid Metabolism Disorders/complications , Genital Diseases, Female/complications , Obesity/complications
Rev. bras. ginecol. obstet ; 39(5): 217-223, May 2017. tab, graf
Article in English | LILACS | ID: biblio-898862


Abstract Purpose To evaluate the effect of mesenchymal stem cells (MSCs) on fertility in experimental retrocervical endometriosis. Methods A total of 27 New Zealand rabbits were divided into three groups: endometriosis, in which endometrial implants were created; mesenchymal, in which MSCs were applied in addition to the creation of endometrial implants; and control, the group without endometriosis. Fisher's exact test was performed to compare the dichotomous qualitative variables among the groups. The quantitative variables were compared by the nonparametric Mann-Whitney and Kruskal-Wallis tests. The MannWhitney test was used for post-hoc multiple comparison with Boniferroni correction. Results Regarding the beginning of the fertile period, the three groups had medians of 14±12.7, 40±5, and 33±8.9 days respectively (p = 0.005). With regard to fertility (number of pregnancies), the endometriosis and control groups showed a rate of 77.78%, whereas the mesenchymal group showed a rate of 11.20% (p = 0.015). No differences in Keenan's histological classification were observed among the groups (p = 0.730). With regard to the macroscopic appearance of the lesions, the mesenchymal group showed the most pelvic adhesions. Conclusion The use of MSCs in endometriosis negatively contributed to fertility, suggesting the role of these cells in the development of this disease.

Resumo Objetivo Avaliar o efeito das células-tronco mesenquimais sobre a fertilidade na endometriose retrocervical experimental. Métodos Um total de 27 coelhas da raça Nova Zelândia foram divididas em três grupos: endometriose, em que os implantes endometriais foram criados; mesenquimal, em que as células-tronco mesenquimais foram aplicadas complementarmente à criação implantes endometriais; e controle, sem endometriose. O teste exato de Fisher foi realizado para comparar variáveis dicotômicas qualitativas entre os grupos. As variáveis quantitativas foram comparadas pelos testes não paramétricos de MannWhitney e Kruskal-Wallis. O teste de Mann-Whitney foi utilizado para a comparação múltipla pós-hoc com correção de Boniferroni. Resultados em relação ao início do período fértil, os grupos endometriose, mesenquimal e controle tiveram medianas de 14±12,7; 40±5; e 33±8,9 dias, respectivamente (p = 0,005). Sobre a taxa de fertilidade (número de gravidezes), os grupos endometriose e controle mostraram uma taxa de 77,78%, enquanto o grupo mesenquimal mostrou uma taxa de 11,20% (p = 0,015). Não foram observadas diferenças na classificação histológica de Keenan entre os grupos (p = 0,730). No que diz respeito à aparência macroscópica das lesões, o grupo mesenquimal mostrou maiores adesões pélvicas. Conclusão O uso de células-tronco mesenquimais na endometriose contribuiu negativamente para a fertilidade, sugerindo o papel dessas células no desenvolvimento da doença.

Humans , Animals , Uterine Cervical Diseases/etiology , Endometriosis/etiology , Mesenchymal Stem Cells/physiology , Infertility, Female/etiology , Rabbits , Uterine Cervical Diseases/pathology , Disease Models, Animal , Endometriosis/pathology , Infertility, Female/pathology