High serum AMH inhibits pathological growth of the low biomass endometrial microbiome.

OBJECTIVE: Although host microbiome play a role in both hormonal status and fertility, this issue has not yet been clarified. Since the endometrium is a sterile tissue, it is accepted that microbiota does not grow under normal conditions. The aim of the study was to reveal the characteristics of endometrial microbiota according to serum AMH levels in women with implantation failure. PATIENTS AND METHODS: Forty-five women aged 20-30 years with two or more implantation failures were included in the study. They were divided into 3 groups according to their serum AMH values: Group 1 -AMH <1.3 ng/ml; Group 2 - AMH between 1.3-2.6 ng/ml; Group 3 - AMH >2.6 ng/ml. Twenty-two healthy fertile women who were the same age as the infertile group and applied for cervical smear screening were accepted as the control group. Following the embryo transfer, the tip of the catheter was inserted into the transport medium under sterile conditions. Sowing was carried out by touching the tips of the catheter to the blood agar medium. After the evaluation of the petri dishes at the end of 48 hours of incubation, colonies were stained with Gram stain. Microorganisms in the colonies were identified with the Vitek-2 device according to their gram-staining characteristics and their antibiograms were made. RESULTS: A negative correlation was detected between low AMH values and the microbiome detection rates in endometrial cultures. In patients with low serum AMH levels, the chance of endometrial microbiota growth was higher in the endometrial culture medium. The most common bacteria were found to be MSSA, MRKNS and lactobacillus. Clinical pregnancy rates were found to be significantly higher in the group with high AMH levels. As AMH levels increased, positive flora detection rates decreased, while clinical pregnancy rates increased. CONCLUSIONS: Low serum AMH level increases the rate of positive endometrial microbiome in culture and decreases clinical pregnancy rates.

Vitamin D supplementation inhibits NF-kß signaling pathway in lean and obese women with PCOS.

OBJECTIVE: This study aims at investigating the effect of vitamin D (VD) replacement therapy on serum nuclear factor-kappa ß (NF-kß) levels in both lean and obese women with Polycystic Ovary Syndrome (PCOS). PATIENTS AND METHODS: 50 women with PCOS with VD levels lower than 20 ng/mL were included in the study. Participants were equally divided into two groups, as lean and overweight/obese PCOS, according to their body mass index (BMI) values. Patients in both groups received 2000 IU/day oral VD replacement for two months. Serum NF-kß, VD, demographic and hormonal values of the patients were recorded before and after VD replacement therapy. RESULTS: Serum insulin and homeostatic model assessment (HOMA-IR) values of overweight/obese women with PCOS were significantly higher than lean women with PCOS. Pre-replacement NF-kß levels were found to be significantly higher in the overweight/obese PCOS group (3.22 ± 1.09 ng/mL) than in the lean PCOS group (1.22 ± 0.43 ng/mL) (p < 0.03). Serum NF-kß levels of the patients in the overweight/obese group (1.10 ± 0.30 ng/mL) and the lean group (0.83 ± 0.10 ng/mL) decreased significantly after VD replacement. No significant difference was found between the groups in terms of HOMA-IR, insulin, and total testosterone levels at the end of VD replacement therapy. CONCLUSIONS: VD replacement therapy contributes to the improvement of subfertility and metabolic imbalance by reducing serum NF-kß levels in both lean and obese women with PCOS.

Relationship between serum vitamin D levels semen parameters and sperm DNA damage in men with unexplained infertility.

OBJECTIVE: The aim of the study was to investigate the relationship between serum level of vitamin D, semen analysis parameters and sperm DNA damage in men with unexplained subfertility. PATIENTS AND METHODS: Fifty-eight men diagnosed with unexplained infertility and 50 age and BMI matched fertile men were included in the study. A participant whose semen parameter is normal but pregnancy is not achieved was accepted as unexplained male infertility. Blood samples were taken from all participants following three-day abstinence for measurement of vitamin D. Sperm DNA damage was assessed by Aniline Blue staining of the collected samples. RESULTS: Compared with the fertile men, male patients with unexplained infertility had significantly lower vit D levels (27.00 ng/mL (12.63-39.30) vs. 23.66 ng/mL (7.50-55.00), p<0.004). While the number of patients with vitamin D levels lower than 20 ng/mL was 26 (44.8%) in the infertile group, it was recorded as 5 (10.0%) in the fertile group (p<0.001). DNA damage was found in 31.50% (9.0-71.0) of the infertile men and 26.00% (11.0-54.0) of the fertile men. DNA damage was found to be significantly higher in the unexplained infertile group (p<0.002). In men with unexplained male infertility, serum vit D levels were positively correlated with total sperm count (r = 0.527, p<0.001), total motility (r = 0.527, p<0.001) and sperm morphology (r = 0.416, p = 0.001). There was a negative and significant correlation between vit D levels and sperm DNA damage (r = -0.605, p<0.001). In the logistic regression analysis, serum vit D > 20 ng/mL led to an improvement in fertility outcome. CONCLUSIONS: Men with unexplained infertility exhibit decreased serum vit D levels and increased sperm DNA damage.