Factors preventing materno-fetal transmission of SARS-CoV-2.

Although many pregnant women have been infected by coronavirus, the presence of intrauterine vertical transmission has not been conclusively reported yet. What prevents this highly contagious virus from reaching the fetus? Is it only the presence of a strong placental barrier, or is it the natural absence of the some receptor that the viruses use for transmission? We, therefore, need to comprehensively understand the mechanism of action of the mammalian epithelial barriers located in two different organs with functional similarity. The barriers selected as potential targets by SARS-CoV-2 are the alveolo-capillary barrier (ACB), and the syncytio-capillary barrier (SCB). Caveolae are omega-shaped structures located on the cell membrane. They consist of caveolin-1 protein (Cav-1) and are involved in the internalisation of some viruses. By activating leukocytes and nuclear factor-κB, Cav-1 initiates inflammatory reactions. The presence of more than one Cav-1 binding sites on coronavirus is an important finding supporting the possible relationship between SARS-CoV-2-mediated lung injury. While the ACB cells express Cav-1 there is no caveolin expression in syncytiotrophoblasts. In this short review, we will try to explain our hypothesis that the lack of caveolin expression in the SCB is one of the most important physiological mechanisms that prevents vertical transmission of SARS-CoV-2. Since the physiological Cav-1 deficiency appears to prevent acute cell damage treatment algorithms could potentially be developed to block this pathway in the non-pregnant population affected by SARS-CoV-2.

Effect of surgical and natural menopause on proximal femur morphometry in obese women.

The purpose of this study is to determine whether there are differences in proximal femur parameters of women subjected to menopause surgically or naturally. In this study, 10 parameters belonging to proximal femur of a total of 60 women cases of whom 30 had a mean age of 55.53 ±â€¯4.57 years; body mass index, 33.06 ±â€¯4.21 kg/m2; menopause age, 48.10 ±â€¯5.92; and menopause years, 7.50 ±â€¯4.58; and who were subjected to natural menopause; and 30 women whose mean age was 56.10 ±â€¯6.87 years; body mass index, 33.33 ±â€¯3.76 kg/m2; menopause age, 48.00 ±â€¯4.64 years and menopause year, 8.10 ±â€¯7.29; who were subjected to surgical menopause, and who did not use hormone replacement, were examined by radiography. Their anthropometric measurements, body compositions, blood hormone analyses (FSH, LH, estradiol, progesterone) and bone mineral densities (femur neck, femur total, lumbar t-score) were evaluated. It was found that there was no difference between surgical and natural menopause with respect to proximal femur parameters (p > 0.05). It was also found that FSH levels were high in the surgical menopause group and there were significant differences between the groups (p < 0.040). No significant difference was found even though bone mineral density t-score tests were lower in the surgical menopause group (p > 0.05). It was found that the difference in low bone mineral density level and high FSH values in the surgical menopause group do not have a relationship with proximal femur morphometry. It was determined that even though the women did not have ovaries, there was no difference between surgical menopause women and natural menopause women with respect to proximal femur morphometry.

Navigation problems of ICSI or naive blastocyst can be solved with artificial blastocyst.

Embryos have evolved a remarkable capacity to find implantation site. The impressive navigation ability of natural blastocysts may rely on highly sensitive signals arising from embryos and specialized signal processing strategies in the endometrium. Navigation capabilities may be compromised in ICSI embryos because of altered biochemical signaling. The design and delivery of artificial blastocyst (AB) carrying strong chemical signals may allow ICSI embryos to more easily locate to and be retained in the implantation zone. ICSI embryos will attach easily to the implantation zone after it is found by the AB. Co-transfer of the AB together with the ICSI embryo may overcome potential difficulties in implantation due to impaired embryo-maternal communication in cases with implantation failure.

Turkish adaptation of the Pelvic Organ Prolapse Symptom Score and its validity and reliability.

INTRODUCTION AND HYPOTHESIS: The purpose of this study was to adapt the Pelvic Organ Prolapse Symptom Score (POP-SS) into Turkish and evaluate its reliability and validity. METHODS: The POP-SS was adapted into Turkish by following the steps of the intercultural adaptation process. One hundred and three women with symptomatic or asymptomatic pelvic organ prolapse (POP) completed the Turkish POP-SS and other valid and reliable Turkish tools for POP: Pelvic Organ Prolapse Distress Inventory 6 (POPDI-6), Colorectal-Anal Distress Inventory 8 (CRADI-8), Urinary Distress Inventory 6 (UDI-6), Pelvic Floor Distress Inventory 20 (PFDI-20), and Pelvic Organ Prolapse Impact Questionnaire 7 (POPIQ-7). Pelvic Organ Prolapse Quantification (POP-Q) system was also used to assess pelvic support, and patients were divided into three groups based on POP-Q scores. Cronbach's alpha was used to determine internal consistency, and intraclass correlation coefficient (ICC) was estimated for test-retest reliability. POP-SS validity was assessed by using the Spearman rank correlation and Kruskal-Wallis analyses. The underlying scale structure was determined by exploratory factor analysis. RESULTS: The POP-SS scale had high internal consistency (Cronbach's alpha = 0.705) and test-retest reliability (ICC = 0.981; p < 0.001). Among groups, there was statistically significant differences in POP-SS scores. POP-SS scores were also significantly correlated with POPDI-6 (r = 0.830), CRADI-8 (r = 0.525), UDI-6 (r = 0.385), PFDI-20 (r = 0.752), and POPIQ-7 (r = 0.690) (p < 0.001). Two factors were identified by exploratory factor analysis. CONCLUSIONS: The Turkish version of POP-SS is a valid and reliable tool for Turkish women with POP.

Reliability and validity of a Turkish version of the Global Pelvic Floor Bother Questionnaire.

INTRODUCTION AND HYPOTHESIS: The aim of this study was to translate the Global Pelvic Floor Bother Questionnaire (GPFBQ) into Turkish and to assess its validity and reliability. METHODS: The Turkish adaptation of the GPFBQ was created by following the stages of the intercultural adaptation process. A test-retest interval of 1 week was used to assess the reliability, which was examined by the intraclass correlation coefficient. The validity of the GPFBQ was assessed and compared with the Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7) using Spearman's rank correlation coefficients. For construct validity, confirmatory factor analysis was performed. RESULTS: A total of 131 women, whose mean age was 46.83 years, were included in the study. The test-retest reliability of the GPFBQ was excellent (0.998, p < 0.0001). The GPFBQ correlated significantly with the PFDI-20 (r = 0.860, p = 0.00) and PFIQ-7 (r = 0.802, p = 0.00). Confirmatory factor analysis was performed to determine construct validity, and it was found that it had four dimensions. CONCLUSIONS: The Turkish version of the GPFBQ is a valid and reliable tool for assessing the symptoms of bother and severity in Turkish-speaking women with pelvic floor dysfunction.

The effect of serum and follicular fluid anti-Mullerian hormone level on the number of oocytes retrieved and rate of fertilization and clinical pregnancy.

OBJECTIVE: The objective of this study was to evaluate the relationship between oocyte yield, fertilization, and clinical pregnancy (CP), and anti-Mullerian hormone (AMH) level in serum and follicular fluid during in vitro fertilization treatment. METHODS: Forty-four infertile women who underwent IVF treatment using multiagonist protocol were included in this study. Baseline level of AMH in serum and follicular fluid was measured on third day of menstrual cycle. AMH level in serum and follicular fluid was then measured again on day of oocyte pick-up. Pearson correlation and binary regression tests were used for statistical analysis. For Type 1 error, p=5% was selected as cut-off value for statistical significance. RESULTS: Serum AMH level was positively correlated with total number of oocytes retrieved and rate of fertilization and CP (r=0.397, p=0.008; r=0.401, p=0.007; and r=0.382, p=0.011, respectively). There was significantly negative correlation between serum level of follicle-stimulating hormone (FSH) and fertilization rate (r=-0.320; p=0.034), as well as serum FSH level and CP rate (r=-0.308; p=0.042). There were no significant correlations between AMH level in follicular fluid and IVF treatment outcomes. CONCLUSION: Serum AMH levels may be more reliable for prediction of total number of oocytes retrieved and rate of fertilization and CP than AMH levels in follicular fluid.

The effect of parity on pelvic floor muscle strength and quality of life in women with urinary incontinence: a cross sectional study.

[Purpose] The purpose of this study was to analyze the pelvic floor muscle (PFM) activity after vaginal birth, and the effect of parity on PFM strength and quality of life (QoL) in women with urinary incontinence. [Subjects and Methods] Patients (n=241) who gave birth vaginally and experienced urinary incontinence were divided into three groups: group 1 consisted of women having 1-3 children, group 2 consisted of women having 4-6 children, and group 3 consisted of women having more than 6 children. All patients underwent detailed examination of the PFM. The Turkish version of the self-administered Incontinence Quality of Life Instrument (I-QoL) questionnaire was used to evaluate the effects of stress urinary incontinence on participants' QoL. [Results] Comparison of PFM strengths showed a significant intergroup difference. Group 1 showed significantly higher PFM strength scores than those of groups 2 and 3. I-QoL scores related to stress incontinence showed a significant intergroup difference. As number of deliveries increased, quality of life decreased. Comparison of PFM strengths and I-QoL scores related to stress incontinence showed a significant intergroup difference. [Conclusion] Increasing the awareness of PFM training in women will reduce potential postpartum incontinence due to a weak PFM strength; and will increase quality of life.

A comparison between stabilization exercises and pelvic floor muscle training in women with pelvic organ prolapse.

OBJECTIVE: This study aimed to compare the effectiveness of stabilization exercises and pelvic floor muscle training in women with stage 1 and 2 pelvic organ prolapse. MATERIALS AND METHODS: In a total 38 women with pelvic organ prolapse whose average age was 45.60 years, pelvic floor muscles were evaluated with electromyography, and prolapse with pelvic organ prolapse quantification system, and the quality of life with prolapse quality of life questionnaire. Afterwards, the subjects were divided into two groups; stabilization exercise group (n=19) and pelvic floor muscle training group (n=19). Stabilization exercise group were given training for 8 weeks, 3 times a week. Pelvic floor muscle training group were given eight-week home exercises. Each group was assessed before training and after eight weeks. RESULTS: An increase was found in the pelvic muscle activation response in the 2 groups (p≤0.05). There was no difference in EMG activity values between the groups (p>0.05). A difference was found in the values Aa, Ba and C in subjects of each group (p≤0.05), and the TVL, Ap, Bp and D values of subjects in pelvic floor muscle training group (p≤0.05) in the before and after pelvic organ prolapse quantification system assessment, however, no difference was found between the groups (p≤0.05). A positive difference was found in the effect of prolapse sub parameter in each of the two groups, and in general health perception sub parameter in subjects of stabilization exercise group (p<0.05) in the prolapse quality of life questionnaire. CONCLUSIONS: It was concluded that both training programs increased the pelvic floor muscle strength, provided a decline in prolapse stages. Stabilization exercise has increased general health perception unlike home training, thus, these exercises can be added to the treatment of women with prolapse.

Choroidal thickness changes during the menstrual cycle.

PURPOSE: To evaluate the effects of the menstrual cycle on the choroidal thickness of healthy women of reproductive age using spectral-domain optical coherence tomography. MATERIALS AND METHODS: A total of 23 right eyes of 23 women with regular natural menstrual cycles of 28-30 d and ages 22-30 years were included in this prospective study. The choroidal thicknesses of the women were measured using high-resolution spectral-domain optical coherence tomography line scans with the activated enhanced depth imaging mode in the early follicular, ovulatory and mid-luteal phases of the menstrual cycle (3rd, 14th and 21st days) using a follow-up scanning protocol of the Spectralis optical coherence tomograph by setting the early follicular phase scan as the reference image. Choroidal thickness measurements were taken at the fovea and at two points that were 1500 µm nasal and temporal to the fovea. The mean arterial pressure, spherical equivalent, intraocular pressure, central corneal thickness and retinal and retinal nerve fiber layer thicknesses were also measured. All measurements were taken within the same menstrual cycle. RESULTS: The mean ± standard deviation (standard error of the mean) of subfoveal choroidal thicknesses in the early follicular, ovulatory and mid-luteal phases were 383.87 ± 84.38 (17.59), 373.74 ± 82.40 (17.18) and 359.09 ± 79.65 (16.61) µm, respectively. The relative reductions in choroidal thickness between early follicular and ovulatory phases and early follicular and mid-luteal phases were 2.64% and 6.47%, respectively. The subfoveal choroidal thickness was decreased significantly in the mid-luteal phase when compared with both the early follicular (p < 0.001) and ovulatory phases (p = 0.003). However, the measures of subfoveal choroidal thickness in the early follicular phase were non-conclusively greater (p = 0.071) than in the ovulatory phase. Additionally, the mean arterial pressure, spherical equivalent, intraocular pressure, central corneal thickness and retinal and retinal nerve fiber layer thicknesses did not significantly differ during the menstrual cycle (p > 0.05 for all). CONCLUSIONS: The choroidal thickness decreased significantly in the mid-luteal phase of the menstrual cycle in young, healthy women. These findings emphasize the importance of the menstrual phase in the interpretation of choroidal thickness measurements in women of reproductive age.

Oxytocin versus sustained-release dinoprostone vaginal pessary for labor induction of unfavorable cervix with Bishop score ≥ 4 and ≤ 6: a randomized controlled trial.

AIM: To compare the efficacy and safety of high-dose intravenous oxytocin and sustained-release dinoprostone vaginal pessaries for cervical ripening and labor induction in pregnant patients at term with poor Bishop scores. MATERIAL AND METHODS: Women at term with a Bishop score ≥ 4 and ≤ 6 were randomized into two groups to undergo induction of labor with either high-dose oxytocin administered intravenously (n = 90) or dinoprostone-only vaginal pessary without oxytocin augmentation (n = 90). The main outcome measures were rate of cesarean delivery, induction to delivery interval, number of deliveries achieved within 4, 8, 12, and 16 h of labor induction, maternal complications during induction, fetal outcome, and total hospital stay. In this study, per-protocol analysis was performed. RESULTS: There were fewer cesarean deliveries with oxytocin compared to dinoprostone-only groups (7/79 vs 14/89); however, the difference was not statistically significant. The induction-delivery intervals (7.9 h vs 12.0 h, P < 0.001; and 5.7 vs 10.4 h, P < 0.001; oxytocin vs dinoprostone-only for primiparous and multiparous patients, respectively) were significantly shorter in oxytocin-induced patients compared to dinoprostone-only. A significantly higher percentage of patients delivered in the oxytocin group compared to the dinoprostone-only group in 4, 8, 12, 16, and 20 h. CONCLUSION: Intravenous oxytocin is effective to stimulate labor at term for patients with Bishop scores ≥ 4 and ≤ 6, with a shorter time interval from induction to vaginal delivery.

Role of elective cesarean section in prevention of pelvic floor disorders.

PURPOSE OF REVIEW: The article reviews the current evidence and the role of elective Cesarean section in the prevention of pelvic floor disorders (PFDs). RECENT FINDINGS: Recent studies have revealed that operative vaginal delivery is an important risk factor for PFDs. The cause of PFD is multifactorial. Pregnancy itself also increases the PFDs. Elective Cesarean section carries diminished risk for stress urinary incontinence. Pelvic floor muscle training should be offered to all women in their first pregnancy as a preventive strategy. SUMMARY: The health provider should not offer elective Cesarean section to a pregnant woman without any prior risk of pelvic organ disorder for the prevention of urinary stress incontinence, anal incontinence, or pelvic organ prolapsus weighing the risks of Cesarean section.

Use of progestogens in pregnant and infertile patients.

Progesterone is an essential hormone in the occurence and maintenance of pregnancy. Natural or synthetic progestogens are commonly used in pregnant patients or patients undergoing infertility treatments for various indications. Most frequently put indications for the use of progestogens in these patient populations are the prevention of spontaneous preterm birth, the prevention of pregnancy loss in pregnancies with an unexplained recurrent pregnancy loss and in patients with threatened abortion. It is also used in pregnant women undergoing nonobstetric surgery, for infertility or recurrent pregnancy loss that is thought to be due to luteal phase defect or as a luteal support in stimulated IVF cycles. We aimed to review the current evidence for the use of progestogens in each of these settings.

Is cesarean section a real panacea to prevent pelvic organ disorders?

INTRODUCTION AND HYPOTHESIS: The aim of this study is to compare the pelvic floor muscle strength after vaginal delivery vs. after cesarean section. METHODS: Five groups of 50 cases each were designated as follows: nullipara (control group), spontaneous vaginal delivery (SVD), repeat SVD (SVD-R), cesarean section (CS), and repeat CS (CS-R). Perineometric measurements, stress urinary incontinence (SUI) symptoms, pelvic organ prolapse quantification examinations, and Incontinence-Specific Quality of Life Questionnaire (IQOL) were evaluated. RESULTS: In all delivery groups, pelvic muscle strength was significantly lower than the control group (65.10 ± 15.69, 56.29 ± 17.39, 54.28 ± 20.08, 56.82 ± 17.62, and 57.92 ± 16.45 (cm H(2) ± SD) for the control, SVD, SVD-R, CS, and CS-R groups, respectively; p < 0.05). However, no significant difference was found among the delivery groups. There were significant differences in SUI symptoms between the control (2%) and SVD-R (26%) groups and between the SVD (10%) and SVD-R groups (p < 0.001 and p = 0.037, respectively). No statistically significant correlations between IQOL and perineometric measurements were noted (r = 0.097 and p = 0.598). CONCLUSIONS: Pregnancy increases postpartum muscle weakness independent of the mode of delivery. Increased SUI symptoms are associated with vaginal delivery.

The use of extracorporeal magnetic innervation for the treatment of stress urinary incontinence in older women: a pilot study.

PURPOSE: Stress urinary incontinence (SUI) is a major health problem that has substantial and important effects on health-related quality of life. In recent years, extracorporeal magnetic innervation (ExMI) has become a preferred method of treatment in urinary incontinence. This study presents the effects of ExMI treatment on pelvic floor muscle strength, urinary symptoms, incontinence conditions and quality of life of older women with SUI. METHODS: A total of 13 patients between the ages of 61 and 69 (mean 65.23 ± 2.8 years) were treated for SUI with ExMI. The following parameters were investigated: urinary symptoms, pelvic floor electromyographic (EMG) activity, 1-h pad test, incontinence conditions utilizing visual analog scale (VAS) and quality of life using Turkish version of the Urogenital Distress Inventory (UDI-6) and the Incontinence Quality of Life Instrument (I-QoL). All assessments were conducted at baseline and at the end of the study. Treatment lasted for 20 min, twice a week and for a total of 6 weeks. RESULTS: The urinary symptoms and incontinence conditions decreased after the ExMI treatment sessions. The pad test results indicated a reduction in urine loss (p = 0.016). EMG values were improved (p = 0.005). Scores of I-QoL, UDI-6 and VAS were reduced after the treatment, respectively (p = 0.002), (p = 0.002) and (p = 0.006). CONCLUSION: Extracorporeal magnetic innervation can be considered as it is an alternative, non-invasive and painless treatment method with good compliance for treatment of SUI in older patients.

In vivo evaluation of the genotoxic effects of gonadotropins on rat reticulocytes.

BACKGROUND: Gonadotropins, as ovulation-inducing drugs, have been used widely to treat infertility. An epidemiologic correlation between infertility therapy and ovarian cancer development has been reported. However, the effect of gonadotropins in the formation of reproductive tract cancers is controversial. OBJECTIVE: The aim of the study was to determine the in vivo genotoxic effects of gonadotropins on rat reticulocytes. METHODS: In this prospective, randomized, controlled study, rats were randomly assigned to 1 of 5 groups. The calculated rat doses of 0.65 human menopausal gonadotropin (hMG), 0.95 hMG, 0.65 follitropin beta (FB), 0.95 FB, or normal saline (control group) were injected, respectively. These calculated rat doses (U/g) are based on average human gonadotropin doses of 150 and 225 IU/d for a 70-kg woman given in 2-mL saline (the control group received 2 mL of saline). Injections were administered once per day for 5 days, followed by 5 days of rest. Each treatment was repeated for 6 estrus cycles in the rats for a total of 12 estrus cycles. Six months after the last day of the 12(th) cycle, the rats were euthanized. Bone marrow tissues were removed, and pluripotent reticulocyte cells with micronuclei, nuclear buds, and binuclear abnormalities were analyzed using an in situ micronuclei assay under light microscopy. The proportion of micronucleated cells, cells with anaphase bridge, nuclear buds, and other nuclear abnormalities were measured. RESULTS: The number of cells with nuclear buds and binuclear abnormalities in the hMG 225 and FB 225 groups was significantly higher (P < 0.05) than that from the hMG 150, FB 150, and control groups in the cytogenetic analysis of bone marrow stem cells. An increased rate of genotoxicity in all gonadotropin groups versus that of placebo was found. CONCLUSION: In rats, the micronucleus genotoxicity assay suggests a dose-dependent gonadotropin effect on genomic instability in bone marrow stem cells in vivo.

Effects of pinealectomy and melatonin supplementation on endometrial explants in a rat model.

OBJECTIVE: To determine the effects of pinealectomy on endometrial explants in rats and evaluate the activity of superoxide dismutase (SOD) and catalase (CAT) and the levels of malondialdehyde (MDA) in the rat endometriosis model. STUDY DESIGN: Rats with experimentally induced endometriosis were randomly divided into three groups after second-look laparotomies. Group 1 (pinealectomy, n = 8) and Group 2 (pinealectomy+melatonin, n = 8) underwent pinealectomies after the second-look laparotomies. Group 3 was presented as control group (vehicle solution+without pinealectomy (n = 6)). Melatonin was administered intraperitoneally for 4 weeks in Group 2, whereas an equal volume of vehicle solution was given to Groups 1 and 3. Evaluation of the volume of the endometrial explants, histopathological examination and preservation of explant epitheliums according to the scoring system were undertaken. RESULTS: There was a statistically significant increase in spherical explant volumes of Group 1 compared to Groups 2 and 3. In Group 1, the level of MDA was significantly higher and SOD and CAT activity was significantly lower compared to Groups 2 and 3. A statistically significant increase in the epithelial lining scores of explants was noted in Group 1 compared to Groups 2 and 3. CONCLUSION: The effects of pinealectomy on the progression of endometriosis explants were reversed by melatonin.

Intraperitoneal administration of single dose type I collagen or low dose melatonin to prevent intraperitoneal adhesion formation: a comparative study.

OBJECTIVE: To compare the prevention of adhesion formation by type I collagen or melatonin solutions in the rat model. STUDY DESIGN: A total of 40 female Wistar albino rats were randomly assigned to four groups-type I collagen, melatonin, vehicle control and sham groups. Following midline laparotomy, a standard injury was made on the right uterine horn using bipolar cautery. The animals in the sham group underwent midline laparatomy only. One milliliter of type I collagen, melatonin or vehicle control was instilled onto the injured area immediately before abdominal closure. Fourteen days after the surgery, the type and extent of adhesion formation as well as the uterine horn tissue superoxide dismutase (SOD) and catalase (CAT) activity, and malondialdehyde (MDA) levels were measured. RESULTS: Both the type and extent of adhesion formation were significantly lower in the type I collagen and melatonin groups compared to the control group. The tissue SOD and CAT activity was significantly higher, and MDA levels were significantly lower in the type I collagen and melatonin groups compared to the control group. CONCLUSION: Intraperitoneal administration of type I collagen or low dose melatonin solution onto the injured areas may be an attractive adjuvant to reduce postoperative adhesion formation.

In vivo evaluation of the genotoxic effects of clomiphene citrate on rat reticulocytes: a micronucleus genotoxicity.

OBJECTIVE: To determine the genotoxic effects of clomiphene citrate (CC) on rat reticulocytesin vivo. METHODS: In this prospective, randomized, controlled study, rats were each assigned randomly to the CC 50, CC 100, CC 200, or control group and were given repeat doses of 0.16, 0.32 or 0.64 mg CC, or normal saline, respectively. Each study group received its CC dose in 2 ml of saline intraperitoneally for 5 days, while the control group received only 2 ml of saline. Each treatment cycle was repeated six times. Six months later, the rats were euthanized. Bone marrow tissues were removed, and pluripotent reticulocyte cells with micronuclei, nuclear buds, and binuclear abnormalities were analyzed using an in situmicronuclei assay under light microscopy. The proportion of micronucleated erythrocytes was measured. RESULTS: Fewer cells with nuclear buds and binuclear abnormalities were detected in the CC 50 group and controls. The CC 100 and 200 groups had significantly (p < 0.05) more nuclear buds and binuclear abnormalities compared with the CC 50 group and controls in the cytogenetic analysis of bone marrow stem cells. CONCLUSION: In rats, the micronucleus genotoxicity assay suggests a dose-dependent CC effect on genomic instability in bone marrow stem cells in vivo.

Effect of clomiphene citrate on ovarian, endometrial, and cervical histologies in a rat model.

OBJECTIVE: To examine the effect of clomiphene citrate (CC) on the ovarian, endometrial, and cervical histologies in a rat model. METHODS: The rats (n = 40) were randomly assigned to 4 treatment groups: CC 50 (repetitive doses of 0.2 mg CC); CC 100 (repetitive doses of 0.4 mg CC); CC 200 (repetitive doses of 0.8 mg CC), and control (repetitive doses of normal saline). Each study group received its CC dose intraperitoneally in 2 ml saline for 5 days and the controls received 2 ml saline only. Each treatment cycle was repeated six times. Six months later the rats were euthanized. Their ovaries, uterine horns, and cervices were removed and examined for histologic changes. RESULTS: We found no significant difference in the number of follicles and corpora lutea of the study groups (p > 0.05). The numbers of granulosa, theca, and luteal cells of the CC 100 and CC 200 groups were significantly higher than those of the CC 50 group and controls (p < 0.05). There was no important finding related to pre-malign and malign changes in ovarian, endometrial and cervical samples of the control and CC 50 groups. Focal atypia and atypical mitoses were noted in 2 cases of granulosa cells in the CC 100 and CC 200 groups. CONCLUSION: We did not find an association between the use of CC and ovarian, endometrial, and cervical neoplasms; nevertheless, we noticed an increase in granulosa, theca and luteal cells with high doses of CC, which may be a risk factor for granulosa, theca, and luteal cell tumors.