ABSTRACT
Introduction: In the last 10 years, blue light (BL) sources such as tablets and phones has increased in every age group. Especially due to the Covid-19 pandemic, screen exposure has also increased in childhood. However, the effects of BL exposure in the puberty process aren't clear. We aimed to examine the effect of BL exposure and exposure time on puberty Methods: Immature eighteen 21-day-old female Sprague Dawley rats were divided into three groups consisting of six rats in each group: Control Group (CG), Experiment Group-1 (EG-1), Experiment Group-2 (EG-2). CG rats were maintained under standard conditions with 12/12-hour light-dark cycles. The rats of EG-1 and EG-2 were exposed to BL (450-470 nm / irradiance level 0.03 uW/cm2) for 6 hours and 12 hours, respectively. Rats were exposed to BL until the first signs of puberty and then they were euthanasiad. Serum FSH, LH, Estrodiol, testosterone, DHEA-S, leptin, melatonin were studied by ELISA method. Ovaries and uterus were dissected for histomorphological examination Results: The medians of the pubertal entry days of the CG, EG-1 and EG-2 were 38th, 32th, and 30th days, respectively. (p: 0.001) A negative correlation was found between the puberty entry day of the groups and the exposure to BL and the duration of exposure. (r:-0.910, p<0.001) The FSH, testosterone, DHEA-S, leptin levels of all groups were similar. (p> 0.05) However, LH and estradiol levels of EG-1 were higher compared CG. (p:0.027) There was a negative correlation between BL exposure, exposure time and melatonin levels (ro:- 0.537, p: 0.048) Ovarian tissue was compatible with pubertal period in all groups. As the BL exposure time increased, capillary dilatation and edema in the over tissue increased. Prolonged exposure caused polycystic over like (PCO-like) morphological changes and apoptosis in granulosa cells. Conclusion(s): Our study is the first to show the effects of BL exposure on puberty. In our study, we showed that exposure of BL and the duration of exposure lead to early puberty. PCO-like, inflammation and apoptosis were detected in the ovaries with the increase in BL exposure time. There are studies showing that there is an increase in cases with precocious puberty and acceleration in puberty pace during the closure period compared to the pre-pandemic period. In our study, we experimentally demonstrated the effects of BL exposure on puberty and the relationship between increased exposure time.
ABSTRACT
Objective: To compare the role of intra-ovarian Platelet-Rich Plasma (PRP) versus marrow derived Stem-Cells (SC) instillation for improvement in ovarian-reserve (AFC,AMH, FSH). Design: A prospective comparative study. Method: 72 infertile females (20-39 years) with poor ovarian reserve (AMH <1.2 ng/ml;AFC < 5) (POSEIDON criterion) were enrolled for study between January 2020 -December 2021. The two comparative groups underwent either intra-ovarian PRP instillation (n = 42) or autologous SC transplantation (n = 30). After the two groups were matched (PRP vs. SC) for baseline characteristics (Age, AMH, AFC, FSH, Estradiol), 30 subjects in each group were compared for change in serum FSH/AMH/Estradiol levels and AFC at 1st month and 3rd month post intervention from the baseline. This was also compared between the two groups using Student t-test. The cost and procedural pain measured using Visual analog scale (VAS) were also compared. Results: After matching for baseline characteristics, significant ∼ 1.8/2 and ∼1.5/1.6fold increase in AFC at 1st/3rd month post intervention (p < 0.001) was observed after PRP instillation and SC transplantation respectively. However, PRP group fared better than SC group at 3rd month post intervention (7.07 vs. 5.60, p = 0.02), while no significant difference existed amongst the two at 1st month of follow up. Levels of Serum FSH, AMH and Estradiol (p > 0.05) did not differ significantly from the baseline at 1st and 3rd month post intervention in both the groups. Similarly, there was no significant difference between the two groups in serum FSH level (7.98 IU/ml vs. 9.62 IU/ml, p = 0.062;8.26 IU/ml vs. 9.50 IU/ml, p = 0.15), AMH level (1.62 ng/ml vs. 1.02 ng/ ml, p = 0.27;1.35 ng/ml vs. 0.95 ng/ml, p = 0.24), Estradiol level (49.12 pg/ml vs. 56.48 pg/ml p = 0.443;54.7 pg/ml vs. 61.12 pg/ml, p = 0.44) at 1st and 3rd month post intervention respectively. PRP is comparatively more cost effective and is associated with lesser pain (32.5 mm vs. 28.13 mm, p = 0.02) then SC group thus showing better compliance and acceptability. Conclusion: Both PRP and SC therapies improves the ovarian reserve markers however, response to PRP is superior to SC. Also, further to note that PRP is minimally invasive and has better compliance and acceptability. The main limitation of this study is small sample size and due to Covid pandemic inability to perform the IVF cycles to show improvement in clinical pregnancies and live births. Therefore, a large randomized trial is required to validate these results.