Receptivity, autophagy, and implantation in endometriosis; does antioxidant work? An experimental study.

Implantation is a key point in pathological processes associated with infertility, especially in endometriosis. In this complex process, there is limited evidence to demonstrate the role of receptivity and autophagy. The present study aimed to evaluate LC3A/B, P62/SQSTM1, Beclin 1, and integrin expressions and receptivity and autophagy processes in endometriosis in pregnant rats with healthy endometriosis on day 6 of the process. Pregnancy was observed in all rats in the control group (8/8), while the pregnancy was 4/8 in the endometriosis group, and 6/8 in the endometriosis + ALA group. LC3A/B and P62/SQSTM1 expression increased significantly in the endometriosis + ALA group, compared with endometriosis groups (p < .05). The effect of ALA on autophagy and receptivity in endometriosis was shown for the first time. Antioxidant and anti-inflammatory treatments in endometriosis should be investigated as new treatment modalities for implantation problems. PRACTICAL APPLICATIONS: Endometriosis, the etiology of which remains unknown, is an important cause of infertility. Implantation is the key point in pathological processes associated with infertility. In this complex process, there is limited evidence to demonstrate the role of receptivity and autophagy. The present study aimed to evaluate LC3A/B, P62/SQSTM1, Beclin 1, and integrin expressions and receptivity and autophagy processes in endometriosis in pregnant rats with healthy endometriosis on day 6 of the process. Oral alpha-lipoic acid was administered to one group and the effect of this powerful antioxidant on the process was evaluated.

Telomere Length in Idiopathic Recurrent Pregnancy Loss.

OBJECTIVE: Telomere length is used as an indicator of biological aging. It is well known that one of the most remarkable risk factors of recurrent pregnancy losses is advanced maternal age. The objective of this study was to investigate the correlation between idiopathic recurrent pregnancy loss and telomere length. METHOD: The study group included 40 women, while the control group consisted of 41 healthy women whose age and body mass index were matched. A venous blood sample was taken from all participants into EDTA tubes in the early follicular phase, and telomere length was measured through the qPCR technique. RESULTS: When the mean TL of the groups was compared, it was determined that TL was significantly shorter among the iRPL group (7763.89±924.58 base pair) compared to the control group (8398.84±1102.95 base pair) (p<0.006). Whereas FSH and E2 were higher in the iRPL group, TAFC was lower (p<0.001). When the correlation between telomere length and endocrine parameters was statistically tested in the iRPL group, a negative correlation was found between FSH and telomere length (r=-0.437; p<0.001). CONCLUSION: Shortened telomere length might play a role in the etiology of iRPL. We are of the opinion that patients with RPL should be screened for the presence of cardiovascular diseases and other chronic diseases, as is the case for POF.

The effect of a natural molecule in ovary ischemia reperfusion damage: does lycopene protect ovary?

Ovarian ischemia is a gynecological emergency case that occurs as a result of ovarian torsion. Oxidative stress plays a central role in the development of ischemia/reperfusion (IR) injuries. Lycopene (LYC) is a lipophilic, natural carotenoid well known for its antioxidant properties. This study provides information on the potential applications of lycopene. The Wistar Albino rats were distributed into six groups: Sham group (only a laparotomy was performed), Control group [laparotomy and intraperitoneal dissolvent (olive oil)], IR group, IR+olive oil group, IR+LYC 2.5 mg/kg/dose, intraperitoneal group, IR+LYC 5 mg/kg/dose intraperitoneal group. Evaluated in terms of histopathological changes, tissue malondialdehyde levels (MDA), ovarian expressions of phosphorylated nuclear factor-kappa B (p-NF-κB) and the TUNEL method was utilized to show apoptosis of ovarian tissue. There was a significant decrease in MDA, p-NF-κB values and the proportion of apoptotic cells assessed by TUNEL compared to the group that did not receive intraperitoneal LYC in rat injury with IR damage (P<0.05). In histopathological damage scoring, it was observed that the cell damage was significantly reduced in LYC-administered groups. LYC showed significant ameliorative effects on ovary injury caused by IR through acting as an antioxidant, antiinflammatory, and antiapoptotic agent.

The Effect of Maternal Pulmonary Function Test Parameters on Umbilical Cord Blood Gas and the Duration of Labor.

OBJECTIVE: To evaluate the relationship between the maternal pulmonary function test (PFT) and the Apgar score of the newborn, umbilical cord blood (UCB) gas values and the duration of delivery. MATERIAL AND METHODS: The present study included 41 volunteer nulliparous pregnant women who presented to our obstetrics clinic and PFTs were performed by using spirometry. RESULTS: A significant positive correlation was observed between 5th-minute Apgar scores and maternal FEV1 (forced expiratory volume in the first second) (lt), FEV1%, FVC (lt), FVC% (r=0.509, p=0.003; r=0.47, p=0.007; r=0.434, p=0.013; r=0.417, p=0.017; respectively). A significant positive correlation was observed between UCB pH value and maternal FEV1 (lt), FVC (lt) (r=0.515, p=0.003; r=0.351, p=0.049; respectively). CONCLUSION: Our results showed that FEV1 and FVC values, which indicate maternal respiratory functions, may affect Apgar scores of the newborn and UCB gas values.

Environmental Exposures in the Etiology of Abortion: Placental Toxic and Trace Element Levels.

PURPOSE: Intensive research has been conducted on the effects of toxic and trace elements on pregnancy. Previous studies indicated a possible relationship between placental levels of these elements and first-trimester abortion; however, their effects on the further gestational weeks are not clear. This study aimed to investigate the effect of changes in the levels of placental trace and toxic elements on second-trimester abortion. METHODS: The patient group consisted of 30 women with missed abortion. The control group comprised 60 healthy term and singleton pregnant women who gave birth. Placental samples were obtained from the patients and the healthy controls, and the concentrations of placental elements were measured using inductively coupled plasma mass spectrometry. RESULTS: In the abortion group, placental arsenic, cadmium, mercury, lead, antimony, tin, cobalt, manganese, and selenium levels were significantly higher than those of the control group (p<0.05). Antimony was determined as an independent predictor with an odds ratio of 6.1 in toxic elements (p=0.025), and selenium was determined as an independent predictor with an odds ratio of 2.3 in trace elements (p=0.015). CONCLUSION: The changes in trace element and toxic element levels, especially an increase in antimony and selenium, in placental tissue due to environmental exposure may play an important role in second-trimester abortion.

Can Inflammatory Hematological Parameters be a Guide to Late-onset Fetal Growth Restriction?

PURPOSE: To compare the rates obtained from hematological parameters in cases of late-onset idiopathic fetal growth restriction (FGR) with healthy pregnancies and to evaluate the effect on neonatal outcomes. METHODS: The study group consisted of 63 pregnant women with late-onset idiopathic FGR and the control group consisted of 91 healthy pregnant women. The determined rates were calculated from the control hemograms of patients at 28 weeks. Both groups were compared for neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and other parameters. RESULTS: NLR, leukocyte and neutrophil levels were significantly higher in the FGR group (p<0.05). There was no significant difference in PLR, platelet and lymphocyte levels between the groups (p>0.05). To predict FGR, the best cut-off value of NLR was determined to be 4.11 with 56% sensitivity and 88% specificity values. CONCLUSION: Neutrophil, lymphocyte and platelet interactions have an important role in FGR development. Inflammation can be involved in the etiopathogenesis in late-onset FGR.

Are Heavy Metal Exposure and Trace Element Levels Related to Metabolic and Endocrine Problems in Polycystic Ovary Syndrome?

This study aimed to determine the relationship between the metabolic and endocrinological pathologies in polycystic ovary syndrome (PCOS) and the levels of arsenic, chromium, cadmium, lead, mercury, antimony, zinc, and copper to evaluate the relationship of these toxic metals with inflammatory/oxidative parameters. This study included a total of 154 patients (84 with PCOS, 70 healthy volunteers). Metabolic and endocrine parameters and arsenic, chromium, cadmium, lead, mercury, antimony, zinc, and copper serum levels of the patients were compared between the groups. Considering the action mechanism of toxic metals, serum malondialdehyde (MDA), superoxide dismutase (SOD), serum total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), tumor necrosis factor-alpha (TNFα), and high-sensitivity C-reactive protein (HsCRP) levels were determined. Serum TAS (p = 0.002), OSI (p = 0.006), SOD (p = 0.006), zinc (p = 0.010), and copper (p = 0.030) values were statistically lower whereas TOS (p = 0.008), MDA (p < 0.001), HsCRP (p < 0.001), TNFα (p < 0.001), antimony (p < 0.001), cadmium (p < 0.001), lead (p < 0.001), and mercury (p < 0.001) levels were significantly higher in the PCOS group than those determined in the control group. Antimony was positively correlated with fasting glucose (FG) and HOMA-IR while cadmium, in addition to FG and HOMA-IR, positively correlated with insulin and lead had a positive correlation only with FG (p < 0.05). Also, these three heavy metals correlated positively with some oxidative system and inflammatory parameters and negatively with the antioxidant system parameters (p < 0.05). In conclusion, heavy metal exposures in PCOS may be related to insulin resistance and hirsutism through oxidative and inflammatory mechanisms. This approach can be used to identify the risky patient group and to develop new treatment modalities.

Effect of psychiatric symptoms and male sexual function of couples on the success of treatment for vaginismus.

Background This study evaluated psychiatric factors and sexual functions of women with vaginismus and their partners during the treatment process. METHODS: The study was performed on 110 women diagnosed with vaginismus and their partners. The women underwent cognitive behavioural therapy (CBT), and couples were divided into two groups: successful and unsuccessful therapy. Sexual function in couples was evaluated using the Golombok Rust Index of Sexual Satisfaction (GRISS) in men and the Female Sexual Function Index in women. The psychopathological symptoms of participants were evaluated using the Symptom Check List-90-Revised (SCL-90-R). RESULTS: Of the 110 women in this study, 98 completed CBT and treatment was successful for 59 (60.2%). GRISS scores pertaining to the subscales of infrequency (66.7% and 39.0%), non-communication (56.4% and 22.0%), avoidance (76.9% and 52.5%), impotence (56.4% and 33.9%) and premature ejaculation (64.1% and 32.2%) before treatment were significantly lower in the successful than unsuccessful treatment group (P < 0.05). Furthermore, there was a positive correlation between complaints of impotence and premature ejaculation in men and symptoms of depression and anxiety in men. In the successful treatment group, pretreatment values were lower for the SCL-90-R subscales of anxiety and depression in men and anxiety, depression, phobic anxiety and obsessive compulsiveness in women than in the unsuccessful treatment group. CONCLUSIONS: The psychiatric symptoms and sexual functions of couples were found to affect the success of treatment for vaginismus. As such, treatments should be administered in accordance with other symptoms present in couples.

Giant Meckel's diverticulum torsion that mimics adnexal pathology.

Meckel's diverticulum is a real diverticulum located at the antimesenteric portion of intestinal loops and including all layers of the intestinal wall. It is the most common congenital anomaly of the gastrointestinal tract, and its incidence is 1-3%. Many asymptomatic cases are diagnosed when complications occur. A 23-year-old female patient applied to gynaecology emergency clinic with pelvic pain complaint. Laparotomy was performed with the diagnosis of acute abdomen because the physical examination and imaging studies did not exclude tuboovary pathology. Giant Meckel's diverticulitis and ischemic bowel loops that had been torsion were observed. Obstruction is the most common complication and generally originates from inflammation, adhesions, intussusception and omphalo-mesenteric band. In this case, it was seen that mobilized diverticulitis can be complicated without any fibrous band or adhesion to adjacent organs. This case supports that there can be torsion of bowel in free Meckel's diverticulum. Meckel's diverticulum settled in the pelvic region can make a clinical manifestation that is difficult to distinguish from adnexal diseases. It should be kept in mind for cases that start with pelvic pain, form adnexal pathology suspicion and cause an acute abdomen.