Association of leptin and insulin resistance in PCOS: a case-controlled study

Background: Endocrine abnormalities related to polycystic ovary Syndrome [PCOS] are important problems

Objective: To compare serum leptin levels between infertile women with and without PCOS. To rank sensitivity of six indirect methods for detection of insulin resistance [IR] and to evaluate the association between leptin and IR in PCOS group

Materials and methods: This Case-controlled study performed on 189 infertile women referred to Shiraz Mother and Child Hospital during 2012-2015. Ninety-nine PCOS cases according to Rotterdam criteria were compared to 90 cases without PCOS. Serum leptin, body mass index [BMI], several hormones, and their correlation coefficients with leptin were compared. IR in PCOS women was measured by indirect methods, including fasting blood sugar [FBS], fasting insulin [FI], glucose/insulin, homeostatic model assessment of insulin resistance [HOMA-IR], quantitative insulin sensitivity check index [QUICKI], and MacAuley index. Association between IR and leptin was evaluated. Independent sample t-test and Pearson's test were used

Results: Infertile women with PCOS had higher BMI [26.47 +/- 3.62 vs. 24.82 +/- 5.18 kg/m[2]] and serum leptin levels [41.79 +/- 187.89 vs. 19.38 +/- 12.57 ng/mL]. Leptin showed significant association with weight and BMI in both groups [p<0.001] and to age in non-PCOS group. HOMA-IR showed the highest rate of IR followed by FI and QUICKI methods. The mean leptin levels had positive association with IR assessed by HOMA-IR [p<0.001], QUICKI [p<0.001], FI [p=.002], and FBS [p=0.02]

Conclusion: BMI and IR have positive association with serum leptin in PCOS infertile women. HOMA-IR followed by FI and QUICKI is the most sensitive test for detection of IR

T helper cell subsets and related cytokines in infertile women undergoing in vitro fertilization before and after seminal plasma exposure / 대한생식의학회지

OBJECTIVE: In vitro fertilization (IVF) is a well-known method for the treatment of infertility. The present study aimed to compare the differences between infertile women with successful and unsuccessful IVF outcomes regarding the expression of T helper (Th) cell transcription factors and a group of related cytokines before and after exposure to their husbands' seminal plasma. METHODS: This study was performed on 19 couples with unexplained infertility undergoing IVF treatment. Among the studied group, nine and 10 couples had successful and unsuccessful IVF outcomes, respectively. This study was carried out using real-time polymerase chain reaction. RESULTS: Before seminal plasma exposure, the expression levels of T-bet (p < 0.007), interferon-γ (p=0.013), and tumor necrosis factor (TNF)-α (p=0.017) were higher in the infertile women with IVF failure than in those with successful IVF outcomes, while those of GATA3 (p < 0.001), Foxp3 (p=0.001), and interleukin (IL)-35 (p < 0.003) were lower. After seminal exposure, the expression of T-bet (p=0.02), Rorc (p < 0.001), TNF-α (p=0.001), Foxp3 (p=0.02), and interferon-γ (p=0.001) increased in the unsuccessful IVF group, while the expression of Foxp3 (p=0.02), Rorc (p < 0.001), IL-23 (p=0.04), IL-17 (p=0.02), IL-6 (p < 0.001), transforming growth factor-β (p=0.01), and IL-35 (p < 0.001) increased in the successful IVF group. CONCLUSION: In summary, IVF failure was associated with imbalanced Th1/Th2/Th17/Treg responses. Moreover, our results show that seminal plasma might have a positive effect on IVF outcomes via changes in peripheral blood T cell subsets.

Sublingual versus vaginal misoprostol for the induction of labor at term: a randomized, triple-blind, placebo-controlled clinical trial

Background: We sought to compare the effectiveness and safety of sublingual versus vaginal misoprostol for the termination of pregnancy with a live full-term fetus

Methods: This randomized, triple-blind, placebo-controlled clinical trial was performed on 200 primiparous women with normal, singleton, full-term pregnancies candidated for the induction of labor. Sublingual and vaginal tablets containing misoprostol [25 mcg] or placebo in similar shapes were administered every 4 hours until the Bishop score reached above 8. Maternal and neonatal complications and outcomes were compared

Results: There were 100 parturient women in each group. The mean maternal age, gestational age, and Bishop score at the commencement of misoprostol had no statistical differences between the sublingual and vaginal groups. The mean time interval between misoprostol commencement and delivery was 497.10 +/- 291.49 and 511.67 +/- 08.46 minutes for the sublingual and vaginal groups, correspondingly. Twenty-two women had Cesarean deliveries in the sublingual group versus 14 in the vaginal group. Meconium-stained amniotic fluid was seen in 12 women in the sublingual group and 4 in the vaginal group [P=0.03]. Late fetal heart rate deceleration was observed in 8 women in the sublingual group and 4 in the vaginal group [P=0.22]. The mean neonatal birth weight, blood gas value at birth, Apgar score, and length of admission time in the neonatal intensive care unit were not different between the 2 groups

Conclusion: Sublingual and vaginal misoprostol had similar effectiveness; however, meconium-stained liquor was observed considerably more frequently with sublingual misoprostol than with vaginal misoprostol

Genomic DNA extraction from sperm

Unlike the somatic cells, sperm DNA is very compact due to replacement of histones with protamines. Disulfide bridges formed within and between the protamines inhibit the extraction of sperm DNA through standard techniques used for the somatic cells. Furthermore, the spermatozoa themselves are protected by a membrane which is rich in disulfide bonds, making cell lysis very difficult. Following a comprehensive literature search, we developed a protocol for DNA extraction from sperm and semen fluid. The quality of extracted DNA was checked running on agarose gel, used for bisulfite conversion and PCR amplification

Absence of Correlation between Changes in the Number of Endothelial Progenitor Cell Subsets

BACKGROUND AND OBJECTIVES: Previously, various methodologies were used to enumerate the endothelial progenitor cells (EPCs). We now know that these methodologies enumerate at least three different EPC subsets: circulating angiogenic cells (CACs), colony-forming unit endothelial cells (CFU-ECs), and endothelial colony-forming cells (ECFCs). It is not clear whether there is a correlation between changes in the number of these subsets. The aim of the current study is to find an answer to this question. MATERIALS AND METHODS: The number of all EPC subsets was quantified in the peripheral blood of nine pregnant women in their first and third trimesters of pregnancy. We enumerated 14 cell populations by quantitative flow-cytometry using various combinations of the markers, CD34, CD133, CD309, and CD45, to cover most of the reported phenotypes of CACs and ECFCs. Culturing technique was used to enumerate the CFU-ECs. Changes in the number of cells were calculated by subtracting the number of cells in the first trimester peripheral blood from the number of cells in the third trimester peripheral blood, and correlations between these changes were analyzed. RESULTS: The number of CFU-ECs did not correlate with the number of ECFCs and CACs. Also, CACs and ECFCs showed independent behaviors. However, the number of CACs showed a strong correlation with the number of CD133+CD309+ cells (p=0.001) and a moderate correlation with the number of CD34+CD309+ cells (p=0.042). Also, the number of ECFCs was correlated with the number of CD309+CD45- cells (p=0.029) and CD34+CD45- cells (p=0.03). CONCLUSION: Our study showed that the three commonly used methods for quantifying EPC subsets represent different cells with independent behaviors. Also, any study that measured the number of EPCs using the flow cytometry method with a marker combination that lacks CD309 may be inaccurate.

The potential role of granulosa cells in the maturation rate of immature human oocytes and embryo development: A co-culture study / 대한생식의학회지

OBJECTIVE: In order to increase the number of mature oocytes usable for intracytoplasmic sperm injection (ICSI), we aimed to investigate the effect of co-culturing granulosa cells (GCs) on human oocyte maturation in vitro, the fertilization rate, and embryo development. METHODS: A total of 133 immature oocytes were retrieved and were randomly divided into two groups; oocytes that were cultured with GCs (group A) and oocytes that were cultured without GCs (group B). After in vitro maturation, only oocytes that displayed metaphase II (MII) underwent the ICSI procedure. The maturation and fertilization rates were analyzed, as well as the frequency of embryo development. RESULTS: The mean age of the patients, their basal levels of follicle-stimulating hormone, and the number of oocytes recovered from the patients were all comparable between the two study groups. The number of oocytes that reached MII (mature oocytes) was 59 out of 70 (84.28%) in group A, compared to 41 out of 63 (65.07%) in group B (p=0.011). No significant difference between fertilization rates was found between the two study groups (p=0.702). The embryo development rate was higher in group A (33/59, 75%) than in group B (12/41, 42.85%; p=0.006). The proportion of highest-quality embryos and the blastocyst formation rate were significantly lower in group B than in group A (p=0.003 and p<0.001, respectively). CONCLUSION: The findings of the current study demonstrate that culturing immature human oocytes with GCs prior to ICSI improves the maturation rate and the likelihood of embryo development.

relationship between neutralization techniques and induced abortion

Induced abortion is not only a serious threat for women's health, but also a controversial topic for its ethical and moral problems. We aimed to evaluate the relationship between neutralization techniques and attempting to commit abortion in married women with unintended pregnancy. After in-depth interviews with some women who had attempted abortion, neutralization themes were gathered. Next, to analyze the data quantitatively, a questionnaire was created including demographic and psychosocial variables specifically related to neutralization. The participants were divided into two groups [abortion and control] of unintended pregnancy and were then compared. Analysis of psychosocial variables revealed a significant difference in the two groups at neutralization, showing that neutralization in the control group [56.97 +/- 10.24] was higher than that in the abortion group [44.19 +/- 12.44]. To evaluate the findings more accurately, we examined the causal factors behind the behaviors of the abortion group. Binary logistic regression showed that among psychosocial factors, neutralization significantly affected abortion [95% CI=1.07-1.35]. Despite the network of many factors affecting induced abortion, neutralization plays an important role in reinforcing the tendency to attempt abortion. Furthermore, the decline of religious beliefs, as a result of the secular context of the modern world, seems to have an important role in neutralizing induced abortion

Pregnancy outcome of parturients below 16 years of age

To compare the pregnancy outcome of parturients with less than 16 years of age to parturients with 24-28 years of age. The hospital admission charts of 100 women aged below 16 as the study group and one-hundred women aged 24-28 years as the control group who delivered in Zeinabieh Hospital affiliated to Shiraz University of Medical Sciences, Shiraz, Iran since March 2000 to February 2001 were retrospectively studied. The mean age for the study group was 14.5 +/- 1.4 years and the mean age of the control group was 26.5 +/- 1.8 years. Preterm birth happened in 18% of the study group compared to 10% of the control group [p=0.15]. The mean birth weight was 2701 grams for the study group and 2776 grams for the control group. Fifteen percent of the newborns in the study group had low birth weights compared to 16% in the control group [p=1]. Five percent of the neonates in the study group had 5-minute Apgar scores of less than 7 compared to 7% in the control group [p=0.77]. Preeclampsia was not seen in the study group but was diagnosed in 2% of females in control group [p=0.49]. In 3% of females in the study group cesarean delivery was performed compared to 9% in the control group [p=0.25]. No maternal mortality was seen in either group. There was no significant difference in the obstetric and neonatal outcome of parturients younger than 16 years compared to the parturients 24-28 years of age