Abstract
Diagnostic imaging has significantly grown over the last thirty years as indispensable support for diagnostic, prognostic, therapeutic and monitoring procedures of human diseases. This study explored the effects of low-dose X-ray medical diagnostics exposure on female fertility. To aim this, cumulus-oocyte complexes (COCs) recovered from the ovaries of juvenile sheep and human ovaries were used as complementary models for in vitro studies. In the sheep model, the effects of low-dose X-rays on oocyte viability and developmental competence were evaluated. In human ovaries originated from two age group (21–25 and 33–36 years old) subjects with gender dysphoria, X-rays effects on tissue morphology, follicular density and expression of apoptosis-related (NOXA, PUMA, Bcl2, Bak, γH2AX) and cell cycle-related genes (p21 and ki67) were investigated. It was noted that in sheep, the minimum dose of 10 mGy did not influence most of examined parameters at oocyte and embryo levels, whereas 50 and 100 mGy X-ray exposure reduced oocyte bioenergetic/oxidative activity but without any visible effects on oocyte and embryo development. In addition, blastocyst bioenergetic/oxidative status was reduced with all used doses. Overall data on human ovaries showed that low-dose X-rays, similarly as in sheep, did not alter any of examined parameters. However, in women belonging to the 33–36 year group, significantly reduced follicular density was observed after exposure to 50 and 100 mGy, and increased NOXA and Bax expression after exposure at 50 mGy. In conclusion, used low-doses of X-ray exposure, which resemble doses used in medical diagnostics, produce weak damaging effects on female fertility with increased susceptibility in advanced age.
Highlights
In the last thirty years, diagnostic imaging had a considerable development, thanks to significant innovation of image detectors and computer science, becoming an indispensable support for diagnosis, prognosis and monitoring of diseases, and the implementation of interventional diagnostic and therapeutic procedures [1,2]
Representative micrographs of cumulus-oocyte complexes (COCs) exposed to low-dose Xray radiations and examined for oocyte maturation and bioenergetic parameters, and cumulus cells apoptosis are shown in Figs 2 and 3, respectively
The present study provides reassuring data on the risk that low-dose X-ray radiation could damage female fertility
Summary
In the last thirty years, diagnostic imaging had a considerable development, thanks to significant innovation of image detectors and computer science, becoming an indispensable support for diagnosis, prognosis and monitoring of diseases, and the implementation of interventional diagnostic and therapeutic procedures [1,2]. Mettler et al [4] reported an increase in the annual effective dose per capita (data collected from 1980–2006) from 0.54 millisieverts (mSv; 1 Sv ffi 1 gray (Gy); [5]) to about 3.0 mSv, due to the use of CT and nuclear medicine techniques. An updated version of this report (data collected from 2006 to 2016) showed that the effective dose from diagnostic and interventional medical procedures is estimated at 2.3 mSv [6]. Comparisons of radiation doses from diagnostic examinations with average natural back-ground radiation, show that the effective doses for normal-sized adults undergoing body CT and chest x-ray are approximately 3.5 mSv and 0.1 mSv, respectively, which is the equivalent to 1 year and 10 days of natural background radiation humans are exposed as part of our normal lives, respectively, [7,8,9]. A single CT of the abdomen may produce a dose of around 10 mSv, and patients who undergo multiple CTs or a single multiphasic CT fall into this dose range [7]
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