Disorders Of Female Reproductive System Research Articles

The Potential of Tissue Engineering in Treatment of Female Reproductive System Disorders: A Review

The Potential of Tissue Engineering in Treatment of Female Reproductive System Disorders: A Review

Role of Shatapushpa Taila oral use in Vandhya w.s.r. to PCOS - Retrospective case series

Infertility is a fast emerging global disease and is at its peak incidence worldwide due to faulty diet and lifestyle of this era. It is defined as the inability of a couple to achieve conception after one year of unprotected coitus. This condition may be further classified as primary infertility, in which no previous pregnancies have occurred, and secondary infertility, in which a prior pregnancy, although not necessarily a live birth, has occurred. Most couples are more correctly considered to be subfertile, rather than infertile, because they will ultimately conceive if given enough time. Most couples presenting with a fertility problem will not be having absolute infertility, but rather relative subfertility with a reduced chance of conception because of one or more factors in either or both partners. This concept of subfertility can be reassuring to couples too. Disorders of ovulation account for about 30% to 40% of all cases of female infertility and are generally among the most easily diagnosed and most treatable causes of infertility. Shatapushpa is one among the best drugs in management of Vandhya due to ovulatory dysfunction owing to the properties described. Even a Vandhya or Shanda can deliver a child, on consumption of Shatapushpa signifies its prime role. Control of Vata Dosha is the principal step in management of female reproductive system disorders. Taila is the best medium for control of Vata. An attempt is made to evaluate the role of Shatapushpa Taila in Vandhya management wsr to PCOS with aid of case series.

Oxidative stress on vessels at the maternal-fetal interface for female reproductive system disorders: Update.

Considerable evidence shows that oxidative stress exists in the pathophysiological process of female reproductive system diseases. At present, there have been many studies on oxidative stress of placenta during pregnancy, especially for preeclampsia. However, studies that directly focus on the effects of oxidative stress on blood vessels at the maternal-fetal interface and their associated possible outcomes are still incomplete and ambiguous. To provide an option for early clinical prediction and therapeutic application of oxidative stress in female reproductive system diseases, this paper briefly describes the composition of the maternal-fetal interface and the molecular mediators produced by oxidative stress, focuses on the sources of oxidative stress and the signaling pathways of oxidative stress at the maternal-fetal interface, expounds the adverse consequences of oxidative stress on blood vessels, and deeply discusses the relationship between oxidative stress and some pregnancy complications and other female reproductive system diseases.

Mouse Cre drivers: tools for studying disorders of the human female neuroendocrine-reproductive axis†.

Benign disorders of the human female reproductive system, such primary ovarian insufficiency and polycystic ovary syndrome are associated with infertility and recurrent miscarriage, as well as increased risk of adverse health outcomes, including cardiovascular disease and type 2 diabetes. For many of these conditions, the contributing molecular and cellular processes are poorly understood. The overarching similarities between mice and humans have rendered mouse models irreplaceable in understanding normal physiology and elucidating pathological processes that underlie disorders of the female reproductive system. The utilization of Cre-LoxP recombination technology, which allows for spatial and temporal control of gene expression, has identified the role of numerous genes in development of the female reproductive system and in processes, such as ovulation and endometrial decidualization, that are required for the establishment and maintenance of pregnancy in mammals. In this comprehensive review, we provide a detailed overview of Cre drivers with activity in the neuroendocrine-reproductive axis that have been used to study disruptions in key intracellular signaling pathways. We first summarize normal development of the hypothalamus, pituitary, ovary, and uterus, highlighting similarities and differences between mice and humans. We then describe human conditions resulting from abnormal development and/or function of the organ. Finally, we describe loss-of-function models for each Cre driver that elegantly recapitulate some key features of the human condition and are associated with impaired fertility. The examples we provide illustrate use of each Cre driver as a tool for elucidating genetic and molecular underpinnings of reproductive dysfunction.

Anticonvulsant Effect of Asparagus racemosus Willd. in a Mouse Model of Catamenial Epilepsy.

Asparagus racemosus Willd. (Family Liliaceae), also known as female reproductive tonic, is traditionally used across the Sub-Himalayan region in Uttarakhand, India for treatment of epilepsy and disorders of female reproductive system. Therefore, in this study, we investigated the anticonvulsant effect of A. racemosus in a mouse model of catamenial epilepsy. We artificially increased progesterone and neurosteroid levels (a state of pseudo-pregnancy) in adult Swiss albino female mice by injecting pregnant mares' serum gonadotropin (PMSG) (5IUs.c.), followed by human chorionic gonadotropin (HCG) (5IUs.c.) after 46h. In the following 10days, A. racemosus treatment was given along with measurement of progesterone, estradiol, and corticosterone levels in the blood. Neurosteroid withdrawal was induced by finasteride (50mg/kg, i.p.) on treatment day 9. Twenty-four hours after finasteride administration (day 10 of treatment), seizure susceptibility was evaluated with the sub-convulsant pentylenetetrazole (PTZ) dose (40mg/kg i.p.). Four hours after PTZ, animals were assessed for depression like phenotypes followed by euthanasia and separation of brain parts (cortex and hippocampus). The results showed that PMSG and HCG treatment elevated progesterone and estradiol levels. Treatment with finasteride increased seizure susceptibility and depression due to decreased progesterone and elevated estrogen levels coupled with decreased monoamine and elevated corticosterone levels. A. racemosus treatment, on the other hand, significantly decreased seizure susceptibility and depression like behaviors, possibly because of increased progesterone, restored estradiol, corticosterone, and monoamine levels. We concluded that herbal formulations using A. racemosus root extracts may be used as monotherapy or adjuvant therapy along with available AEDs for the better and safe management of catamenial epilepsy as well as comorbid depression.

English

BACKGROUND Among all the disorders of female reproductive system, adnexal masses are one of the most common disorders. The main purpose of the study was to evaluate an adnexal mass and to differentiate the mass as benign or malignant and facilitate selection of appropriate treatment algorithm. For few benign lesions, radiological follow-up is very suitable for further management and additional follow-up may not be useful when an imaging abnormality is not found. METHODS Our study was conducted in Osmania General Hospital and its allied hospital named Government Maternity Hospital, Hyderabad, on about 150 patients. This is an institution-based, multicentric, cross-sectional, prospective, analytical study. All clinically suspected female patients with adnexal masses referred to the Department of Radiodiagnosis were evaluated. These patients were first subjected to ultrasonography, followed by magnetic resonance imaging (MRI) (plain and contrast wherever required). MRI findings were compared with ultrasonography. These findings were compared with operative findings and histopathological findings, wherever performed. RESULTS In the present study, females in the age group of 21 – 40 years showed majority of pelvic lesions - 81 (54 %). Most of the pelvic masses were arising from the ovary - 102 (68 %). Majority of the adnexal lesions on MRI were benign in nature - 132 (88 %). MRI showed a sensitivity of 100 %, specificity of 97.7 %, and a positive predictive value of 83 %, & a negative predictive value of 100 %. CONCLUSIONS In practice, ultrasonography (USG) is the primary modality for diagnosing the pelvic mass. MRI is superior to ultrasound and can be used as problem solving technique in the assessment of pelvic mass. The multiplanar imaging capability allows accurate identification of origin of mass and characterisation of mass. This is helpful to the preoperative planning of sonographically detected mass and avoids surgery in possible cases. MRI is the technique of choice for staging, treatment planning and post treatment follow-up of pelvic malignancies. KEYWORDS MRI, USG, Adnexal Masses, Ovarian Masses, Board Ligament Lesions, Fallopian Tube Lesions, Cysts

Will stem cells from fat and growth factors from blood bring new hope to female patients with reproductive disorders?

Female reproductive system disorders (FRSD) with or without infertility are prevalent women's health problems with a variety of treatment approaches including surgery and hormone therapy. It currently considering to sub-branch of regenerative medicine including stem cells or growth factors injection-based delivery treatment might be improved female reproductive health life. The most common products used for these patients treatment are autologous cell or platelet-based products from patients, including platelet-rich plasma, plasma rich in growth factor, platelet-rich fibrin, and stromal vascular fraction. In this review, we discuss each of the above products used in treatment of FRSD and critically evaluate the clinical outcome.

Pathomorphological features of the endometrium in patients with abnormal uterine bleeding in the presence of uterine leiomyoma

Hypothesis/Aims of study. One of the problems discussed in the field of obstetrics and gynecology is the combined pathology of the reproductive system. Among the female reproductive system disorders associated with uterine leiomyoma, endometrial pathology prevails in the form of local inflammatory, receptor and hormonal changes. The aim of this study was to evaluate the structural features of the endometrium and its receptivity in patients with uterine leiomyoma, depending on its histological type and localization.
 Study design, materials and methods. We examined 128 women with leiomyoma manifesting abnormal uterine bleeding, using clinical, instrumental and morphological methods.
 Results. Combined pathological changes in the endometrium are more characteristic of submucous leiomyoma compared to intramural and subserous leiomyomas. The proliferative activity of endometrial cells in submucous leiomyoma is two or more times higher than in intramural and subserous leiomyoma. In submucous leiomyoma, cell proliferation occurs significantly more often than in other locations of myomatous nodes.

The Potential of Novel Chitosan-Based Scaffolds in Pelvic Organ Prolapse (POP) Treatment through Tissue Engineering.

The growing number of female reproductive system disorders creates a need for novel treatment methods. Tissue engineering brings hope for patients, which enables damaged tissue reconstruction. For this purpose, epithelial cells are cultured on three-dimensional scaffolds. One of the most promising materials is chitosan, which is known for its biocompatibility and biodegradability. The aim of the following study was to verify the potential of chitosan-based biomaterials for pelvic organ prolapse regeneration. The scaffolds were obtained under microwave-assisted conditions in crosslinking reactions, using dicarboxylic acids and aminoacid as crosslinkers, including l-glutamic acid, adipic acid, malonic acid, and levulinic acid. The products were characterized over their physicochemical and biological properties. FT–IR analysis confirmed formation of amide bonds. The scaffolds had a highly porous structure, which was confirmed by SEM analysis. Their porosity was above 90%. The biomaterials had excellent swelling abilities and very good antioxidant properties. The cytotoxicity study was performed on vaginal epithelial VK2/E6E7 and human colon cancer HCT116 cell lines. The results showed that after certain modifications, the proposed scaffolds could be used in pelvic organ prolapse (POP) treatment.

The Role of Zinc in Selected Female Reproductive System Disorders.

Zinc is an essential microelement that plays many important functions in the body. It is crucial for the regulation of cell growth, hormone release, immunological response and reproduction. This review focuses on its importance in the reproductive system of women of reproductive and postmenopausal ages, not including its well described role in pregnancy. Only recently, attention has been drawn to the potential role of zinc in polycystic ovary syndrome (PCOS), dysmenorrhea, or endometriosis. This review is mainly based on 36 randomized, controlled studies on reproductive, pre- and post-menopausal populations of women and on research trying to explain the potential impact of zinc and its supplementation in the etiology of selected female reproductive system disorders. In women with PCOS, zinc supplementation has a positive effect on many parameters, especially those related to insulin resistance and lipid balance. In primary dysmenorrhea, zinc supplementation before and during each menstrual cycle seems to be an important factor reducing the intensity of menstrual pain. On the other hand, little is known of the role of zinc in endometriosis and in postmenopausal women. Therefore, further studies explaining the potential impact of zinc and its supplementation on female reproductive system would be highly advisable and valuable.

Frequency and pattern of thyroid dysfunction in diabetic and non-diabetic women with primary infertility: experience in a tertiary care hospital in Dhaka, Bangladesh

Background: Thyroid hormones have profound effects on reproduction and pregnancy. A relationship betweenthe thyroid gland and the gonads is suggested by the far more frequent occurrence of thyroid disorders inwomen. Hormonal disorders of female reproductive system are comprised of a number of problems resultingfrom dysfunction of hypo-thalamic-pituitary ovarian axis. These relatively common disorders often lead toinfertility. Concomitant Diabetes and other metabolic abnormalities or endocrinopathy flare up the condition.This study was conducted to find out any difference in thyroid function among diabetic and non-diabeticpatient presenting with primary infertility.
 Methods: In this study total 174 patients were included and allocated into two groups, 87 in each group.Group I were diabetic infertile women and group II were non diabetic infertile women. Thyroid hormoneprofile were done and compared between groups. The data were based on the answers came from interviewsand medical records registered in the OPD follow up, investigation report, treatment paper and notes inhospital file sheet. Data processing work was consisted of registration schedules, editing computerization,preparation of dummy table, analyzing and matching of data.
 Results: No difference was observed in respect of demographic profile. It was observed that, majority ofpatients 73(41.9%) belonged to age 26-33 years, mean age was found 26.3±10.9 years in Group-I and 26.7±11.6years in Group-II. Low T3 was found in 15(17.2%) patients and in 9(10.3%) patients group I and group IIrespectively. Mean FT4 was found 8.25±1.5 pmol/L in group I and 10.57±1.82 pmol/L in group II. Raised TSHwas found in 23(26.4%) patients and 13(14.9%) patients in group I and group II respectively. On interpretationof thyroid function test, 71.8% (125/174) patients had normal finding or in euthyroid status (64.3% in group Iand 79.3% in group II). Present study shows that, frequency of thyroid dysfunction was common in group-Ipatients than group-II (35.6% vs. 20.6%). primary hypothyroidism was predominant abnormality, noted15(17.2%) patients in group I and 9(10.3%) patients in group II patients.
 Conclusion: Hypothyroidism is the most common thyroid dysfunction found in infertile females and it ispredominant in diabetic infertile group. Hence assessment of thyroid function should be considered as animportant component in infertility work up of women.
 Birdem Med J 2020; 10(2): 92-96

Effect of herbo-mineral formulation (Shilajatu Rasayana) in letrozole-induced polycystic ovarian syndrome

The major cause of female infertility in recent years is polycystic ovarian syndrome commonly called as PCOS, compared to yonivyapath (disorders of female reproductive system) described in Ayurveda. Shilajatu Rasayana herbo-mineral preparation mentioned in Rasendra Chudamani indicated in yonyaamaya (disorders of female reproductive system), gulma (tumors), meha (hyperinsulinemia), pandu (anemia), etc. is expected to contribute positive and better result in letrozole-induced PCOS, considering the previous analytical and experimental studies. Letrozole, Shilajatu Rasayana, clomiphene citrate, ghee, and female albino rats formed the materials for the study. Totally thirty female rats were initially induced to develop PCOS by injecting letrozole. The induction of PCOS in rats was checked through vaginal smear analysis and further confirmed by hormonal assay. PCOS-induced rats were treated with clomiphene citrate (standard), Shilajatu Rasayana (test drug), and ghee (control). Ovarian and uterine weight, hormonal assay, and histomorphometric changes were observed and recorded. Shilajatu Rasayana has shown a significant result in letrozole-induced PCOS by regulating hormones, reduction of cystic follicles, maturation of ovarian follicles, and decreasing the increased ovarian and uterine weight.

The effect of single nucleotide genetic polymorphisms of folic acid cycle on the female reproductive system disorders

Currently the significant part of reproductive disorders such as refractory pregnancy loss (RPL), infertility, unsuccessful in vitro fertilization (IVF) are thought to be connected with different genetic factors. One of the main hereditary risk factors for obstetrical pathology development is the presence of polymorph alleles in several genes of folic acid cycle. The present study is dedicated to investigation of the effect of folic acid cycle polymorph variants MTHFR C677 T, MTR A2756G and MTRR A66G on the RPL development and unsuccessful IVF. The samples of peripheral blood of 138 women were tested and showed a statistically significant increase of pathologic genetic alleles of MTRR A66G and MTHFR C677T frequency in two groups of patients with reproductive disorders, i.e. RPL and IVF, versus the control group. Also the advantage of simultaneous analysis of three folic cycle genetic polymorphisms at once in women with reproductive function disorder was demonstrated in comparison with the analysis of isolated polymorphism MTHFR C677T. The combination of polymorph alleles has a significant influence on the pathology development and by many times increases the risk of RPL development and unsuccessful IVF.

Clinical peptidomic analysis by a one-step direct transfer technology: Its potential utility for monitoring of pathophysiological status in female reproductive system disorders

To date, numerous studies have searched for candidate molecules or clinical examination methods as potential biomarkers for monitoring intractable diseases, such as carcinomas. Evidence accumulated over the past decade shows that many proteolytic peptides appear in human humoral fluids, including peripheral blood, in association with an individual's health condition. Although an analysis of the whole peptide (the 'peptidome') using mass spectrometry is thought to be one of the most powerful and promising experimental approaches, it has failed to identify biomarkers in the clinical blood samples, presumably due to the methodological limitations. In general, commonly used techniques for proteomic analysis of blood require the removal of large amounts of serum/plasma proteins prior to mass spectrometry analysis, and this step seems to have resulted in the overlooking of important biomarkers during the analytical process. Here, we provide a brief overview of a new quantitative peptidomic analysis by a one-step direct transfer technology without depletion of major blood proteins. Using this technology, we herein report experimental data on serum peptidomic analysis for patients with pregnancy-induced hypertension as a clinical model. In addition, we refer to the potential utility of this approach for the monitoring of pathophysiological status in female reproductive system disorders in general.

Ghrelin

Ghrelin is considered the endogenous ligand of growth hormone secretagogue receptor type 1a, and its modulatory actions have been demonstrated in a large array of endocrine and nonendocrine functions. According to recent studies, ghrelin seems to act at different levels of the reproductive system, exerting predominantly inhibitory effects on mammalian reproduction. It has been shown to influence the reproductive system by regulating hormone secretion from the brain and by acting directly on the gonads to affect tissue development and steroidogenesis. Thus, the endocrine network, which integrates energy balance and fertility, might involve ghrelin. Furthermore, ghrelin levels and actions have been assessed in various female reproductive system disorders. The findings could lead to a better understanding of the pathogenesis of these disorders and, possibly, to more beneficial therapeutic strategies.

Residential Exposure of Environment Toxic Substance Outcome during Menstrual Cycle

Problem statement: It was intended to diagnose and treat the disorders of female reproductive system where they are exposed to environmentally toxic pesticides and estrogenic compounds like bisphenol A which are the main reason for the infertility problems. Approach: Human saliva contains arrays of proteins that have distinct biological functions. Results: Salivary hormones concentrations of luteinising hormone, follicle stimulating hormone, estrogen as well as estrone-1-glucuronide, were assayed in 20 normal menstruating women who were among the reproductive phases like preovulatory phase (6-12 days); Ovulatory phase (13-14 days) and Postovulatory phase (15-26 days). It was intended to diagnose and treat the disorders of female reproductive system where they are exposed to environmentally toxic pesticides and estrogenic compounds like bisphenol A which are the main reason for the infertility problems. In this context, the detection of fertile period suggests that the mean value of luteinising hormone (56.58±12.96 mIU L-1) indicates the surge during the time of ovulation. Identifying the period of ovulation would be the easiest way to detect other constituents like follicle stimulating hormone, estrogen and its conjugate like estrone-1-glucuronide are extensively high (p<0.05) was observed. Conclusion: Our results indicated that the salivary hormones like estrogen and its conjugate indicates decrease in ovulatory and postovulatory phase. Further, the environmental toxic materials can also cause problems like infertility. The conclusion is that any physiological effects of estrogen from drinking water will be undetectable in people. The results from hormones suggested that they may be considered in the diagnosis and treatment of ovulation using saliva as the noninvasive specimen.

Some minor female reproductive system disorders: findings in the Oxford-Family Planning Association contraceptive study

BackgroundThe Oxford-Family Planning Association (Oxford-FPA) contraceptive study has provided information on many serious diseases of the female reproductive tract. No information has been published about a number of common minor...

Association between insurance status and admission rate for patients evaluated in the emergency department.

To determine if differences exist in hospital and intensive care unit (ICU)/operating room admission rates based on health insurance status. This was a retrospective, cross-sectional study of data from hospital clinical and financial records for all 2001 emergency department (ED) visits (80,209) to an academic urban hospital. Hospital admission and intensive care unit (ICU)/operating room admissions were analyzed, controlling for triage acuity, primary complaint, diagnosis, diagnosis-related group (DRG) severity, and demographics. Multivariate logistic regression models identified factors associated with hospital admission for under insured (self-pay and Medicaid) compared with other insured (private health maintenance organization, preferred provider organization, worker's compensation, and Medicare) patients. Compared with the other insured group, under insured patients were less likely, overall, to be admitted to the hospital (odds ratio [OR], 0.82; 95% CI = 0.76 to 0.90), controlling for all other factors studied. Subgroup analysis of common complaints showed under insured patients with a chief complaint of abdominal pain (OR, 0.67; 95% CI = 0.55 to 0.80) or headache (OR, 0.61; 95% CI = 0.39 to 0.95) had the lowest adjusted ORs for admission to the hospital, compared with other insured patients. Under insured patients with DRG of "menstrual and other female reproductive system disorders" (OR, 0.17; 95% CI = 0.06 to 0.51) or "esophagitis, gastroenteritis, and miscellaneous digestive disorders" (OR, 0.55; 95% CI = 0.28 to 0.96) also were less likely to be admitted compared with the other insured group. No significant differences in ICU/operating room admission rates were found between insurance groups. Whereas there was no difference in admission rates to the ICU/operating room by insurance status, this single-center study does suggest an association between insurance status and admission to a general hospital service, which may or may not be causally related. Factors other than provider bias may be responsible for this observed difference.

Association between Insurance Status and Admission Rate for Patients Evaluated in the Emergency Department

Abstract Objectives: To determine if differences exist in hospital and intensive care unit (ICU)/operating room admission rates based on health insurance status. Methods: This was a retrospective, cross‐sectional study of data from hospital clinical and financial records for all 2001 emergency department (ED) visits (80,209) to an academic urban hospital. Hospital admission and intensive care unit (ICU)/operating room admissions were analyzed, controlling for triage acuity, primary complaint, diagnosis, diagnosis‐related group (DRG) severity, and demographics. Multivariate logistic regression models identified factors associated with hospital admission for underinsured (self‐pay and Medicaid) compared with other insured (private health maintenance organization, preferred provider organization, worker's compensation, and Medicare) patients. Results: Compared with the other insured group, underinsured patients were less likely, overall, to be admitted to the hospital (odds ratio [OR], 0.82; 95% CI = 0.76 to 0.90), controlling for all other factors studied. Subgroup analysis of common complaints showed underinsured patients with a chief complaint of abdominal pain (OR, 0.67; 95% CI = 0.55 to 0.80) or headache (OR, 0.61; 95% CI = 0.39 to 0.95) had the lowest adjusted ORs for admission to the hospital, compared with other insured patients. Underinsured patients with DRG of “menstrual and other female reproductive system disorders” (OR, 0.17; 95% CI = 0.06 to 0.51) or “esophagitis, gastroenteritis, and miscellaneous digestive disorders” (OR, 0.55; 95% CI = 0.28 to 0.96) also were less likely to be admitted compared with the other insured group. No significant differences in ICU/operating room admission rates were found between insurance groups. Conclusions: Whereas there was no difference in admission rates to the ICU/operating room by insurance status, this single‐center study does suggest an association between insurance status and admission to a general hospital service, which may or may not be causally related. Factors other than provider bias may be responsible for this observed difference.