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Objectives: We aimed to demonstrate the difference between the premenopausal and postmenopausal women in respect of the clinical course and outcome of the Covid-19 disease. In addition, we investigated the epidemiological and hormonal factors which may have an influence on the progression, severity and mortality of the disease. Study design: A cross-sectional study. Main Outcome Measure(s): Our primary outcome was to demonstrate the poor clinical course and outcome of the Covid-19 disease in the postmenopausal women. Our secondary outcome was to establish the contribution of the hormonal status of the patients to the clinical course of the Covid-19 disease. Result(s): In our cohort, 86 women had mild, 128 women had moderate and 53 women had severe Covid-19 disease. 101 women were at premenopausal state while 152 women were at postmenopausal state. There was a statistically significant difference between the patients with mild, moderate and severe Covid-19 disease with respect to age, BMI, gravidity, parity, smoking, co-morbidities, being in pre-menopausal period, O2 saturation, diastolic blood pressure, parameters of complete blood count, biochemical tests, LH, FSH, E2, DHEA-S, length of hospital stay, body temperature, and the percentage of patients with dyspnea. In the total group, being one year younger decreased the odds of having severe Covid-19 disease 0.338 fold relative to the mild disease (CI: 0.164-0.697, p=0.003). Even though statistically less significant, younger age has a positive impact for the postmenopausal group (OR: 0.378, CI: 0.157-0.910, p=0.030). In the total group, the decrease in the serum DHEA-S level was associated with a 2.604 fold increase in the odds of having severe Covid-19 disease relative to the mild disease (CI:1.254-5.410, p=0.010). For the pre-menopausal group of patients, the decrease in serum DHEA-S level increased the odds of having severe disease by 3.864 fold (CI: 1.269-11.764, p=0.017). In the total group, 1 unit increase in the level of serum LH increased the odds of having mild disease compared to severe disease by 2.821 fold (CI:1.002-5.410, p=0.050). Conclusion(s): The prognosis of Covid-19 disease is more favorable in the premenopausal women with higher serum E2 levels compared to the postmenopausal women. The age and serum levels of DHEA-S and LH are important predictors of the severity of Covid-19 infection for women.Copyright © 2023
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Androgen insensitivity syndrome has a wide spectrum of presentations. It results from a mutation in androgen receptor (AR) gene. It ranges from mild androgen insensitivity syndrome (MAIS) which is the mildest form to complete androgen insensitivity syndrome (CAIS). In case of MAIS, the abnormality that can be observed appears to be male infertility and sexual difficulties including premature ejaculation and erectile dysfunction. In this case report, we discuss a case of MAIS in a 37-year-old male who presented with infertility, premature ejaculation, and secondary erectile dysfunction.Copyright © 2023, Ibn Sina Trust. All rights reserved.
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Objectives Severe acute respiratory syndrome coronavirus 2 has infected millions of people worldwide with extensive affection and damage to body systems and organs;hence, the study of post-coronavirus disease (COVID) sequences is mandatory. Till now, reports are upcoming on the considerable effects of COVID-19 on male sexual health with no final data. Patients and Methods: Our cohort study included 76 male COVID-19-infected patients, confirmed positive via nasopharyngeal PCR swab. The rationale of this study was to estimate the influence of clinical, laboratory, and radiological severity parameters of COVID-19 on male erectile dysfunction based on erectile scores and male sex hormones (follicle-stimulating hormone, luteinizing hormone, testosterone, and estradiol). Result(s): Our results have demonstrated a highly statistically significant correlation between COVID-19 severity (mild, moderate, and severe cases) and both erectile scores (erection hardness score and International Index of Erectile Dysfunction-5) and testosterone hormones at first and third month after COVID (P0.001), except for testosterone level at third month and COVID-19 severity, which showed a statistically significant difference, with P value of 0.031. Conclusion(s): The current study correlated the effect of COVID-19 severity in the terms of clinical, laboratory, and radiological presentations on male sexual dysfunction (erectile scores and testosterone hormone) at first and third month after hospital discharge, with statistical significance being highly affected in severe rather than moderate and mild cases. This strengthens the obvious effect of COVID-19 infection on male sexual dysfunction. Copyright © 2023 The Egyptian Journal of Chest Diseases and Tuberculosis.
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Background: Evidence reveals that COVID-19, in addition to impacting the respiratory system, affects other organs, including the male and female reproductive systems. The purpose of this study was to examine the impact of COVID-19 on the human reproductive system. Method(s): Data were collected in SID, Science Direct, PubMed, and Google Scholar databases. The Keywords including COVID- 19, reproductive system, fertility, and factors related to mesh term utilization and Boolean strategy were used. Papers from 2019 to 2022 were extracted. Finally, out of 58 searched articles, 20 articles related to the purpose of the study were reviewed. Result(s): The results were organized into two categories. The first category deals with the effect of COVID-19 on the female reproductive system including Sleep disorders following quarantine on gonadotropin release and its effect on the ovaries and menstrual cycle, preterm delivery, increased cesarean delivery, the possibility of intrauterine infection of the fetus and dysfunction of the reproductive glands. The second category concerns the effect of COVID-19 on the male reproductive system including abnormal semen quality, possible effect on gonocyte differentiation in the early stages of spermatogenesis, negative effect on spermatogenesis, testicular dysfunction, and changes in testosterone concentration by increasing serum LH, testicular inflammation, decreased sperm concentration in semen, impaired sperm motility, dysfunction of the reproductive glands, significant damage to the seminiferous tube, swelling of Sertoli cells, decreased Leydig cells, significant disorder on semen volume and impaired sperm morphology. Conclusion(s): The findings revealed that COVID-19 has an impact on various aspects of the human reproductive system. Midwives and gynecologists should alleviate couples' fears about infertility by recognizing these cases and offering suitable counseling to couples infected with COVID-19.
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Objective: This study aimed to compare the effects of clomiphene citrate (CC) combined with metformin or placebo on infertile patients with poly cystic ovary syndrome (PCOS) and insulin resistance (IR). Material(s) and Method(s): We included 151 infertile women with PCOS and IR in a university hospital from November 2015 to April 2022 in this prospective, double-blind, randomized, placebo-controlled trial. Patients were randomized into two groups;group A: received CC plus metformin (n = 76) and group B: received CC plus placebo (n = 75). The ovulation rate was the main outcome measure. Clinical pregnancy, ongoing pregnancy, live birth and abortion rates were secondary outcome measures. Result(s): There was no remarkable difference in ovulation rate in two groups. Moreover, no significant changes were observed in clinical pregnancy, ongoing pregnancy, live birth and abortion rates between two groups. A larger proportion of women in group A suffered from side effects of metformin (9.3% versus 1.4%;p=0.064), although this was not significant. Conclusion(s): In IR infertile women with PCOS, metformin pre-treatment did not increase the ovulation, clinical pregnancy and live birth rates in patients on clomiphene citrate.Copyright © 2023 Tehran University of Medical Sciences.
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The proceedings contain 429 papers. The topics discussed include: a short peptide encoded by long non-coding RNA small nucleolar RNA host gene 6 promotes cell migration and epithelial-mesenchymal transition by activating transforming growth factor-beta/SMAD signaling pathway in human endometrial cells;a short peptide encoded by long non-coding rna small nucleolar rna host gene 6 promotes cell migration and epithelial-mesenchymal transition by activating transforming growth factor-beta/smad signaling pathway in human endometrial cells;compatible cut-off values for luteinizing hormone and the luteinizing hormone/follicle-stimulating hormone ratio in diagnostic criteria of the Japan society of obstetrics and gynecology for polycystic ovary syndrome;intracytoplasmic sperm injection cycle success in patients under 35 years old with diminished ovarian reserve plus severe male factor;assisted reproductive technology and neonatal intensive care unit: a retrospective observational study from a single center;the value of clinical symptoms, the neutrophil-to-lymphocyte ratio, and ultrasonographic features in predicting adnexal torsion: a case-control study;construction of a diagnostic classifier for cervical intraepithelial neoplasia and cervical cancer based on xgboost feature selection and random forest model;and impact of the COVID-19 pandemic on surgery for benign diseases in gynecology: a nationwide survey by the japan society of obstetrics and gynecology.
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Stress during Coronavirus disease-2019 (COVID-19) pandemic affects the physiological and immunological response to women's reproductive health. Meanwhile, Apium graveolens and Eucalyptus globulus are immunomodulators related to women's reproductive health. This investigation had a goal to examine the effectiveness of A. graveolens and E. globulus towards the expression of Heat Shock Protein-70 (HSP70) as the primary biomarker of stress, Tumor Necrosis Factor-Alpha (TNF-alpha) as a pro-inflammatory protein, along with Luteinizing Hormone (LH) and Growth Differentiation Factor 9 (GDF-9) as folliculogenesis markers. An experimental randomized controlled trial was utilized by using a pre-test and post-test control group design. Sixty women, who had stress based on DASS-21 questionnaire, were divided into two groups in Nusukan Health Center, Indonesia. The intervention group was orally administered with 300 mg A. graveolens capsules and E. globulus essential oil for 14 days, while the control group was given a placebo. Blood samples and stress levels were then evaluated before and after the intervention. No significant difference was found in the stress levels of the control and treatment groups at the pre-test. Meanwhile, the intervention group had the decreased HSP70, TNF-alpha, and stress levels (p<0.001). In contrast, increased LH and GDF-9 levels were displayed in the intervention group compared to the control group (p<0.001). These findings revealed that A. graveolens supplementation and E. globulus essential oil have the ability to decrease stress and are able to protect folliculogenesis markers on women's reproductive health due to stressful conditions during pandemic COVID-19. Copyright © 2022 by Indonesian Journal of Pharmacy (IJP).
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Aim: To evaluate the effect of COVID-19 on sex hormone levels between men who have recovered from COVID-19 infection and men who have never been infected.Method: This study included 80 men who applied to the Infertility Clinic with a diagnosis of primary or secondary infertility. Semen analysis was performed twice, before COVID-19 and after the treatment of COVID-19 disease. In addition, Luteinizing hormone (LH), Follicle-stimulating hormone (FSH), testosterone (T), and 17β-estradiol (E2) levels were compared between the men after COVID-19 disease and uninfected men.Results: There was a significant difference in progressive sperm motility and immobility before and after the COVID-19 disease. Progressive sperm motility was decreased after COVID-19 disease while immobility was increased after COVID-19. The serum T level was lower and the E2 level was higher in men after COVID-19 disease compared to uninfected men.Conclusions: COVID-19 may adversely affect gonadal functions by causing to more deterioration of the hormone levels and semen parameters in infertile males. Therefore, gonadal function evaluation, including semen and sex-related hormones examination, is required to follow up the male COVID-19 patients with a reproductive plan.
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Introduction: This study aimed to evaluate the levels of sex hormones in patients with COVID-19 in Ahvaz, Iran. Methods: A prospective longitudinal study was conducted at Razi hospital, Ahvaz, Iran, from July 2020 to Febuary 2021. The levels of sex hormones including estradiol, progesterone, luteinizing hormone (LH), follicle stimulating hormone (FSH), and total and free testosterone were measured in 162 patients with COVID-19 infection during hospitalization and 1 month after discharge. A demographic questionnaire and a checklist were used to collect the data. Mann-Whitney U test, χ 2 test, Fisher's exact test, Wilcoxon test, and logistic regression were used to analyze the data. Results: Sex hormones were assessed in 162 patients at baseline; however, a month after discharge, only 69 patients provided consent for assessment, and 9 had passed away. The estradiol level was 407.70 ± 623.37 and 213.78 ± 407.17 pg/ml in female patients with severe and moderate diseases at baseline, respectively which reduced to 195.33 ± 380.04 and 58.20 ± 39.45 pg/ml after discharge (p = 0.011 and p = 0.001). The alteration in the levels of progesterone, LH, and FSH were not significant.The level of LH in both groups of male patients with severe (6.64 ± 2.91 IU) and moderate disease (6.42 ± 4.44 IU) was high, which reduced after discharge (4.16 ± 2.44 and 3.93 ± 3.15 IU, respectively), but this decrease was significant only in the patients with severe disease (p < 0.0001). The alteration of FSH and free testosterone were not significant. The level of testosterone was 1.19 ± 0.73 and 1.46 ± 1.22 ng/ml at baseline in patients with severe and moderate diseases which increased to 2.64 ± 1.25 ng/ml, p < 0.0001, and 2.54 ± 0.93 ng/ml, p = 0.001, respectively after discharge. Conclusion: Our findings showed that the level of estradiol in female patients increased significantly while the level of testosterone in male patients decreased during the active phase of infection. Due to the attrition of patients in the follow-up period, more studies are needed to confirm these results.
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Study question: Do the Merck family of fertility pen injectors (follitropinalfa, follitropin-alfa/lutropin-alfa, choriogonadotropin-alfa) meet the International Organization for Standardization (ISO 11608-1:2000/2012/ 2014) product-validation requirements? Summary answer: Each presentation of the family of fertility pen injectors performed as per the state-of-the-art product-validation specifications for dose accuracy in ISO 11608-1:2000/2012/2014 under atmospheric conditions. What is known already: Pen injectors for medically assisted reproduction must comply with ISO 11608-1:2000/2012/2014, which specifies essential performance requirements, including dose accuracy, and represent a benchmark for product reliability. Product-validation studies of the follitropin-alfa pen injector showed that three presentations (300 IU, 450 IU, and 900 IU) reliably dispensed accurate doses under a range of conditions, but no information was available for the follitropin-alfa/lutropin-alfa and choriogonadotropinalfa pen injectors. This study was done to confirm that the incremental dose/ clicks system was accurate for equivalence of volume (dose) delivered at standard atmospheric conditions for the complete Merck family of fertility pen injectors (follitropin-alfa, follitropin-alfa/lutropin-alfa, choriogonadotropin-alfa). Study design, size, duration: Laboratory-based dose accuracy measurement testing was carried out under standard atmospheric conditions, as specified in ISO 11608-1:2000/2012/2014, between 2015 and 2020. Participants/materials, setting, methods: Set doses (Vset) for three dose dial settings (minimum dose [Vmin], midpoint dose [Vmid] and maximum dose [Vmax] [follitropin-alfa, choriogonadotropin-alfa, and follitropinalfa/ lutropin-alfa]) or a single Vset (choriogonadotropin-alfa) were assessed, as appropriate. The last dose administered by the multi-dose device and cartridge and total extractable dose were assessed on the 900 IU and 300 IU follitropin- alfa and the 900 IU/450IU and 300/150 IU follitropin-alfa/lutropinalfa- pen presentations. Sixty measurements per assessment were made for each Vset. Main results and the role of chance: Measurements were performed at two manufacturing sites. Dose accuracy tests for Vmin, Vmid and Vmax (dose dial settings of 12.5 IU, 87.5 IU and 150 IU, respectively, for the 150 IU pen [n=2,226 (one site)];dose dial settings of 12.5 IU, 162.5 IU and 300 IU, respectively, for the 300 IU pen [n=742 per site];and dose dial settings of 12.5 IU, 237.5 IU and 450 IU, respectively, for the 450 IU [n=180 per site] and 900 IU pens [n=410 per site]) for the follitropin-alfa and the follitropinalfa/ lutropin-alfa pen injectors were within the acceptable limits defined in ISO 11608-1:2000/2012/2014. The results of further assessments of last dose and total extracted volume for each presentation of these devices were also within acceptable limits. Dose accuracy tests for the single use/single dose device classification (D1) of the choriogonadotropin-alfa pen injector (n=210 [one site]) showed that the Vset (6,500 IU) was within the acceptable limits according to ISO 11608-1:2000/2012/2014. Furthermore, dose accuracy tests for the single use/variable dose device classification (D2) of the choriogonadotropin-alfa pen injector (n=180 [one site]) showed that the Vmin (260 IU), Vmid (3,380 IU) and Vmax (6,500 IU) values were also the within acceptable limits. Limitations, reasons for caution: These assessments were carried out by laboratory scientists, who are not the intended users of the pen injectors, and were not delivered into human tissue;therefore, although these conditions meet the international standards, they do not reflect the real-world use of the pen injectors by patients. Wider implications of the findings: The Merck family of fertility pen injectors functions reliably and the incremental dose/clicks system dispenses accurate doses, providing users with confidence that they can accurately administer the prescribed dose and minimize drug wastage outside of a clinic environment, which is ore important than ever in light of the COVID pandemic.
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Commonly used clinical chemotherapy drugs, such as cyclophosphamide (CTX), may cause injury to the ovaries. Hormone therapies can reduce the ovarian injury risk;however, they do not achieve the desired effect and have obvious side effects. Therefore, it is necessary to find a potential therapeutic candidate for ovarian injury after chemotherapy. N-Benzyl docosahexaenamide (NB-DHA) is a docosahexaenoic acid derivative. It was recently identified as the specific macamide with a high degree of unsaturation in maca (Lepidium meyenii). In this study, the purified NB-DHA was administered intragastrically to the mice with CTX-induced ovarian injury at three dose levels. Blood and tissue samples were collected to assess the regulation of NB-DHA on ovarian function. The results indicated that NB-DHA was effective in improving the disorder of estrous cycle, and the CTX+NB-H group can be recovered to normal levels. NB-DHA also significantly increased the number of primordial follicles, especially in the CTX+NB-M and CTX+NB-H groups. Follicle-stimulating hormone and luteinizing hormone levels in all treatment groups and estradiol levels in the CTX+NB-H group returned to normal. mRNA expression of ovarian development-related genes was positive regulated. The proportion of granulosa cell apoptosis decreased significantly, especially in the CTX+NB-H group. The expression of anti-Müllerian hormone and follicle-stimulating hormone receptor significantly increased in ovarian tissues after NB-DHA treatment. NB-DHA may be a promising agent for treating ovarian injury.
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AIM: Levamisole, an antiparasitic drug, was reported to have positive effects in various clinical trials in the treatment of COVID-19. However, the number of studies on the effects of levamisole on the reproductive system and sexual behavior in male rats is limited. The present study aimed to investigate the possible effects of levamisole on sexual behavior, testicular histopathology, serum gonadotropin, and testosterone levels in male rats. METHODS: Twenty male Sprague-Dawley rats were divided into two groups as control and levamisole were used. Rats were given levamisole (2 mg/kg) dissolved in distilled water for 30 days, while only distilled water was administered to the control group by oral gavage. Finally, sexual behavior tests (SBT) were performed for 30 min. Then, the animals were decapitated, blood samples and testis tissues were taken. The Bax, Hsp70 and cytochrome c immunohistochemistry staining were performed in testis tissues, and gene expression levels were measured by real-time PCR. The luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone levels were measured by ELISA in serum samples. RESULTS: In SBT parameters, mount latency (ML, p<0.001), intromission latency (IL, p<0.01), and the postejaculatory interval (PEI, p<0.01) were significantly prolonged. Also, the copulatory rate (CR, p<0.05) was significantly reduced. Serum LH, FSH, and testosterone levels did not change. In the histopathological stainings, irregularities in the seminiferous tubule germinal epithelium, congestion, edema in the interstitial area, and metaphase arrest in some spermatocytes were detected in the levamisole group (p<0.001). Levamisole treatment also significantly increased cytochrome c, Bax, and Hsp 70 immunoreactivities and Bax (p=0.05) and Hsp 70 (p<0.01) gene expression levels in testicular tissue. CONCLUSION: Levamisole may decrease sexual motivation and copulation efficiency. Also, it may adversely affect testicular histopathology in male rats.
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Coronavirus disease 2019 (COVID-19) is now a major public health problem worldwide. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectivity is extremely strong. One major target of the virus is the lung, which can lead to death due to the development of respiratory distress syndrome and even multiple system organ failure. The possible pathophysiology by which SARS-CoV-2 affects the object is by way of the receptor, angiotensin-converting enzyme 2 (ACE2). From the study of the viral structure and infection mechanisms, researchers have discovered that the ACE2 acts as a receptor for SARS-CoV-2. According to previous studies, ACE2 is one of the key enzymes in the RAS system. Physiological functions can be found in angiosarcomas and in the kidney, liver, intestine and so on. Whether SARS-CoV-2 infection leads to male fertility impairment has recently received attention. Nevertheless, the association between SARS-CoV-2 infection and reproductive health is currently poorly understood. Using key words including “SARS-CoV-2”, “reproductive health”, “ACE2” and “2019-nCoV”, we retrieved original articles and reviews from the PubMed and WEB OF SCI databases published before December 16, 2020 and performed a thorough review of them. Compared with females, we discovered that infected person with SARSCoV-2 was higher in males. Men who were infected with SARS-CoV-2 may be easy to suffer from impaired reproductive health. These investigations would help for a comprehensive grasp of the relationship between SARS-CoV-2 infection and reproductive health.
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BACKGROUND: SARS-CoV-2 which causes coronavirus disease 2019 (COVID-19) binds to angiotensin-converting enyzme 2 (ACE2) and enters the host cell. ACE2 protein is expressed highly in the testis. AIM: The aim of this study was to compare male reproductive hormones such as total testosterone (TT), luteinizing hormone (LH), follicular stimulant hormone (FSH), and prolactin between patients with COVID-19, age-matched cases with non-COVID-19 respiratory tract infection, and age-matched controls. METHODS: This was a prospective cohort study and included 262 men aged between 20 and 65 years. The study comprised 3 groups including patients with COVID-19 (n = 89), cases with non-COVID-19 respiratory tract infection (n = 30), and age-matched controls (n = 143). All cases were evaluated using TT, LH, FSH, and prolactin. Correlations between TT and clinical parameters of patient groups were investigated using Pearson's correlation test. OUTCOMES: The primary outcome of the study was detection of the difference of TT, FSH, LH, and prolactin levels between the groups. Secondary outcome was to correlate TT and hospitalization time and oxygen saturation on hospital admission (SpO2) of patients. RESULTS: The mean age of study groups was 49.9 ± 12.5 years, 52.7 ± 9.6 years, and 50 ± 7.8 years, respectively (P = .06). Serum TT levels was median 185.52 ng/dL in patients with COVID-19, median 288.67 ng/dL in patients with non-COVID-19 respiratory tract infection and median 332 ng/dL in control cases, (P < .0001). The proportion of patients with testosterone deficiency in group 1, group 2, and group 3 was 74.2%, 53.3%, and 37.8%, respectively (P < .0001). Serum LH levels (P = 0.0003) and serum prolactin levels (P = .0007) were higher in patients with COVID-19 and patients with non-COVID-19 respiratory tract infection than control cases. Correlation analysis revealed significant negative correlation between serum TT levels and hospitalization time of patients with COVID-19 (r = -0.45, P < .0001). In addition, a significant positive correlation was observed between SpO2 and serum TT levels in patients with COVID-19 ( r = 0.32, P = .0028). CLINICAL IMPLICATIONS: Physicians may consider to evaluate male patients with COVID-19 for concomitant androgen deficiency. STRENGTHS & LIMITATIONS: Strengths include the evidence about the alteration of male reproductive hormones under COVID-19. Limitations include the analysis limited to one general hospital, only a single measurement of TT was available, free and bioavailable testosterone levels were not evaluated. CONCLUSION: This study demonstrates COVID-19 is associated with decreased level of TT and increased level of LH and prolactin. More serious COVID-19 causes more reduction in TT levels and prolongs hospitalization period. Kadihasanoglu M, Aktas S, Yardimci E, et al. SARS-CoV-2 Pneumonia Affects Male Reproductive Hormone Levels: A Prospective, Cohort Study. J Sex Med 2021;18:256-264.