Male Factor Research Articles

Exercise Training and Cardiovascular Risk Factors in Males with Overweight or Obesity: A Systematic Review of Randomized Controlled Trials

Background and Objectives: Obesity is a significant risk factor for cardiovascular disease. Physical exercise has been established as an effective intervention for reducing cardiovascular mortality. This systematic review aimed to investigate the effects of various exercise modalities on cardiovascular risk factors in men with obesity. Materials and Methods: This review included randomized controlled trials (RCTs) published between 2005 and November 2023. Studies were eligible if they assessed the impact of exercise interventions on blood pressure (BP), lipid profiles, and glucose/insulin regulation in males aged 18 years or older with a body mass index (BMI) of 25 kg/m2 or greater. The quality of included studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. Results: A total of 25 RCTs were included in the analysis, with PEDro scores ranging from 3 to 7. High-intensity interval training (HIIT) was associated with significant reductions in BP, with an average decrease of 12.5 mmHg. However, the magnitude of BP reduction varied across studies, likely due to differences in training protocols and study quality. Resistance training (RT) was associated with modest improvements in glycemic control, with some studies reporting a reduction in fasting blood glucose levels by 5–10%. Combined exercise (CT) programs, which included both aerobic and resistance training, as well as aerobic exercise alone, were shown to improve lipid profiles, with some studies showing reductions in total cholesterol levels ranging from 10–15%. However, the findings were inconsistent, highlighting the need for further research to better understand the potential benefits and optimal exercise regimens. Conclusions: This systematic review supports the potential of exercise training in reducing cardiovascular risk factors in men with obesity, though the effectiveness varies depends on the type of exercise. Combined exercise programs have shown promise for lipid profiles, but further research is needed to confirm these effects. HIIT has been linked to BP reductions in some studies, although the results are inconsistent and depend on protocols and study quality. The limitations in study quality may impact the reliability of these findings.

Using a robust model to detect the association between anthropometric factors and T2DM: machine learning approaches

BackgroundThe aim of this study was to evaluate the potential models to determine the most important anthropometric factors associated with type 2 diabetes mellitus (T2DM).MethodA dataset derived from the Mashhad Stroke and heart atherosclerotic disorders (MASHAD) study comprising 9354 subject aged 65 − 35. 25% (2336 people) of subjects were diabetic and 75% (7018 people) where non-diabetic was used for the analysis of 10 anthropometric factors and age that were measured in all patients. A K-nearest neighbor (KNN) model was used to assess the association between T2DM and selected factors. The model was evaluated using accuracy, sensitivity, specificity, precision and f1-measure parameters. The receiver operating characteristic (ROC) curve and factor importance analysis were also determined. The performance of the KNN model was compared with Artificial neural network (ANN) and support vector machine (SVM) models.ResultAfter feature selection analysis and assessing multicollinearity, six factors (Mid-arm Circumference (MAC), Waist Circumference (WC), Body Roundness Index (BRI), Body Adiposity Index (BAI), Body Mass Index (BMI), age) were used in the final model. BRI, BAI and MAC factors in males and BMI, BRI, and MAC factors in females were found to have the greatest association with T2DM. The accuracy of the KNN model was approximately 93% for both genders. The best K (number of neighbors) for the model was 4 which had the lowest error rate. The area under the ROC curve (AUC) was 0.985 for men and 0.986 for women. The KNN model achieved the best result of the models explored.ConclusionThe KNN model had a high accuracy (93%) for predicting the association between anthropometric factors and T2DM. Selecting the K parameter (nearest neighbor) has an essential impact on reducing the error rate. Feature selection analysis reduces the dimensions of the KNN model and increases the accuracy of final results.

How Relevant are Male Factors for Fertilization and Early Embryo Development? Looking into the (Epi)genome, Proteome and Metabolome

How Relevant are Male Factors for Fertilization and Early Embryo Development? Looking into the (Epi)genome, Proteome and Metabolome

Prevalence and level of stress among final-year students at a health science institute in Bangladesh

BackgroundFinal-year students studying in various health science institutes are usually very stressed about their studies so that they can complete their studies without any hurdles. This stress can lead to poor academic and professional results because psychological issues such as anxiety and depression are frequently overlooked and not treated. This study aimed to measure the prevalence of stress and also assess the level of stress symptoms among the final year students of health science institute in Bangladesh.MethodsA prospective cross-sectional study involving 134 final-year students of Bangladesh Health Professions Institute (BHPI), which is a well-known health science institute in Bangladesh measured the prevalence of stress and assessed the level of stress symptoms using the Academic Stress Scale (ASS-40). Data was collected through face-to-face interviews and analysed using SPSS software 25.0. Descriptive and inferential statistics were used to analyse the data retrieved from the students. The Pearson correlation coefficient was used to find any deep relation between the levels of stress symptoms of the students with their age.ResultsThe prevalence of stress symptoms among the 134 students was 68.60%. The scenario of having stress symptoms was higher among male students and factors like fear of failure (29.20%), followed by teacher-student relationship/teaching method (28.80%) with addressable factors including personal inadequacy (25.50%) working as a stressor for this students. A negligible association (p > 0.05) was found between the age and the level of stress of the students.ConclusionMore than two-thirds of the students experienced stress symptoms during the final days in their institutions. This implies that the educational system, means of teaching, teaching materials, teachers as well as the services provided by the institutions cannot provide a conducive environment for effective learning as well as creating a secure future for the students as long as they can cope with the academic pressure. A student's educational career is being nipped in the bud due to the weak system of our education and institutional system.

Effect of Existential Group Therapy on the Quality of Sexual Life in Infertile Men's Spouses

Background and Objective: Infertility leads to a crisis in people's lives that can have many psychological consequences, and one of these consequences is the reduction of the quality of sexual life. Since the spouses of infertile men are as stressed as infertile women in many aspects, including sexual life, the present research aimed to investigate the effect of existential group therapy on the quality of sexual life of women who have dealt with male factor infertility. Materials and Methods: The present study followed a randomized controlled clinical trial from 2020-2021 on 96 women aged 20-45 with male-caused infertility. The samples were randomly divided into intervention and control groups. The data collection tool included a demographic questionnaire and a questionnaire on the quality of sexual life. The intervention was carried out in eight 90-minute sessions per week based on the existential group therapy counseling model. The data were collected before and after the intervention and analyzed using the SPSS (version 25) software. It is noteworthy that the level of significance was lower than 0.05. Results: Following the intervention, the quality of sexual life score in the intervention group was 67.42±17.83, indicating a statistically significant improvement compared to the pre-intervention scores and the control group (P<0.001). The analysis of the mean difference in the quality of sexual life scores between the two time points for the intervention and control groups revealed a significant difference (P<0.001). Conclusion: Existential group therapy counseling is effective in improving the quality of sexual life in women faced with male-factor infertility. Due to the effectiveness of this method, it is recommended to be used in counseling in infertility centers.

Sperm DNA fragmentation index: limited effectiveness on predicting embryo quality in assisted reproduction technology treatments

PurposePrior sperm DNA fragmentation index (DFI) thresholds for diagnosing male infertility and predicting assisted reproduction technology (ART) outcomes fluctuated between 15 and 30%, with no agreed standard. This study aimed to evaluate the impact of the sperm DFI on early embryonic development during ART treatments and establish appropriate DFI cut-off values.MethodsRetrospectively analyzed 913 couple’s ART cycles from 2021 to 2022, encompassing 1,476 IVF and 295 ICSI cycles, following strict criteria. The WHO guidelines directed the semen analysis, while the acridine orange test (AOT) determined the DFI. Male factors (age, BMI, DFI, infertility duration, sperm parameters) and female parameters (age, BMI, AMH, retrieved oocytes) were evaluated. We also assessed embryological parameters like fertilization rate, cleavage rate, and blastocyst quality. Correlations between DFI and embryo quality were examined and DFI cut-off values were established using ROC analysis.ResultsThe Sperm DFI demonstrated a positive correlation with male age and a negative correlation with sperm motility, concentration, and normal morphology, while showing no relation to BMI. No connection between DFI and embryological parameters in only IVF and ICSI groups was found, but a negative correlation with fertilization rate was seen in all ART cycles. ROC curve analysis revealed a DFI cut-off value of 21.15% having 36.7% sensitivity and 28.9% specificity in predicting high fertilization rate (≥ 80%).ConclusionSperm DFI had a negative correlation with fertilization rate, but limited predictive efficacy and no significant link to other embryological parameters. DFI assessments may improve early embryo development prediction during ART treatments, particularly in older males or those exhibiting poor sperm quality.

Trichomoniasis in Men: A Neglected Factor in Male Infertility?

This study is aimed to detect the frequency of trichomoniasis, a sexually transmitted infection caused by an anaerobic protozoan Trichomonas vaginalis, in men referred to the Fertility and Infertility Research Center Hamadan University of Medical Sciences. In this cross-sectional study, a group of 197 male volunteers who sought medical attention for issues related to infertility participated. The urine and semen samples were collected in sterile conditions. Both urine and semen sediment were promptly examined under a microscopy to detect the presence of motile trophozoites. Subsequently, 50µl of urine sediment were inoculated into the Dorset culture medium, whereas 50µl of semen sediment were inoculated into the Diamond culture (TYI-S-33) and incubated at 35.5oC. Finally, the processed urine samples were used for molecular analysis. The investigated subjects had an average age ranging from 36 to 40 years. There were 181 volunteers with fertility issues, outnumbering the 16 individuals with normal fertility. Spermogram analysis showed that 48% of participants had non-motile or progressive sperms, and 48% had abnormalities in sperm morphology. T. vaginalis was not detected through microscopic assessment, but PCR and sequence analysis revealed one case in a 33-year-old infertile individual, who had only 0.3% normal sperm with 19% motility. The isolated T.vaginalis was found to have the G genotype based on the sequencing analysis. Trichomoniasis in males was considered unimportant, with the belief that it would improve on its own. This study suggests that parasites can be considered as one of the male infertility factors, however, the impact is not fully understood. This investigation confirmed the effectiveness of molecular techniques in detecting trichomoniasis in males.

BMAL1 improves assisted reproductive technology outcomes in patients with polycystic ovary syndrome by targeting BMP6 and regulating ovarian granulosa cell apoptosis.

To investigate BMAL1 and BMP6 expressive differences in ovarian granulosa cells (OGCs) of patients with polycystic ovary syndrome (PCOS), explore regulatory relationship, assess their impacts on OGC proliferation and apoptosis, and analyze their correlations with ART outcomes of patients. A clinical study selected 40 PCOS patients who underwent IVF/ICSI in our hospital from January to October 2022 and 39 controls with male or tubal factor infertility. RT-qPCR and Western blot assessed BMAL1 and BMP6 mRNA/protein levels. The number of oocytes retrieved, 2PN fertilized oocytes, available embryos, and high-quality embryos were compared between groups and analyzed their correlations with BMAL1 and BMP6 expression levels. Cellular experiments were performed by overexpressing or knocking down BMAL1 in KGN cells by plasmid transfection. The dual-luciferase reporter assay was used to identify BMAL1/BMP6 regulatory relationship. CCK-8 and flow cytometry assessed cellular proliferation and apoptosis. BMAL1 mRNA/protein expression (P < 0.001) in the PCOS group was significantly lower than that in controls, as was the number of high-quality embryos (P = 0.001). Contrastingly, BMP6 (P < 0.001) was significantly higher in the PCOS group. BMAL1 expression levels were negatively correlated with BMP6 (r = - 0.684, P = 0.002) and positively correlated with the number of 2PN fertilized oocytes, available embryos, and high-quality embryos (r = 0.659, P = 0.003; r = 0.623, P = 0.006; and r = 0.738, P < 0.001). Cellular experiments showed that overexpression of BMAL1 significantly decreased relative luciferase activity (P < 0.01). Overexpression of BMAL1 significantly decreased KGN cell apoptosis (P < 0.01) and enhanced proliferation (P < 0.01). BMAL1 regulates OGCs proliferation and apoptosis by targeting BMP6, thereby influencing ART outcomes in patients with PCOS. This study might provide molecular factors that indicate ART outcomes and therapeutic targets for PCOS. Registration number: ChiCTR2100052331; registration date: 2021-10-24.

Monocyte and Macrophage in Follicular Liquid: Predictive Markers of Embryo Quality in Women with Obesity and Infertility.

Over the past five years, the pregnancy rate in assisted reproductive technology (ART) programs in Russia has remained relatively stable. The aim of this study was to assess the distribution of monocyte and macrophage subsets in the blood and follicular fluid of infertile women undergoing assisted reproductive technology. The study involved 45 women with a mean age of 35 ± 4.66 years. Monocytes and macrophages were identified using flow cytometry. We observed a decrease in the CD68+CD163+CD206+ and the CD68+CD163-CD206+ cells in patients with a body mass index (BMI) >25 by 0.19 times and 6.56 times, respectively, compared to the group with a BMI <25 (p = 0.031). Patients with fair oocyte quality had 3.6 times more oocytes than those with poor quality (p = 0.010). The relative content of CD14+163-206+ monocytes was found to be 24.15 times higher in the follicular fluid of women with poor embryo quality compared to the group with good embryos (p = 0.010). We also noted that the number of oocytes increased in women with male factor infertility (p = 0.020) and those with unspecified infertility when compared to tubal infertility. An increase in the relative content of CD14+163+206+ in the blood was higher in women with other causes of female infertility compared to those with male factor infertility (p = 0.010). The relative content of M2-monocytes (CD14+163+206-) in the blood was 4.38 times higher in women with male factor infertility than in women with unexplained infertility (p = 0.010). A critical component of the inflammatory reaction in patients undergoing in vitro fertilization (IVF) involves more than just the activation of pro-inflammatory cells in response to ovarian stimulation. Our research shows that changes in the distribution of monocytes and macrophages can influence embryo implantation success and pregnancy outcomes in women. These processes are influenced by various infertility-related factors, including those mentioned above. However, these findings are preliminary and require further investigation.

Association of Premature Ventricular Contraction (PVC) with hematological parameters: a data mining approach

Premature ventricular contraction (PVC) is characterized by early repolarization of the myocardium originating from Purkinje fibers. PVC may occur in individuals who are otherwise healthy. However, it may be associated with some pathological conditions. In this research the association between hematological factors and PVC was studied. In this study, 9,035 participants were enrolled in the Mashhad stroke and heart atherosclerotic disorder (MASHAD) cohort study. The association of hematological factors with PVC was evaluated using different machine learning (ML) algorithms, including logistic regression (LR), C5.0, and boosting decision tree (DT). The dataset was divided into training and test, and each model’s performance was appraised on the test dataset. All data analyses used SPSS version 26 and SPSS Modeler 10. The results show that the Boosting DT was the most effective algorithm. Boosting DT had an accuracy of 98.13% and 96.92% for males and females respectively. According to the models, RDW and PLT were the most significant hematological factors for both males and females. WBC, PDW, and HCT for males and RBC, MCV, and MXD for females were also important. Some hematological factors associated with PVC were found using ML models. Further studies are needed to confirm these results in other populations, considering the novelty of the exploration of the relationship between hematological parameters and PVC.

The Genetic Landscape of Male Factor Infertility and Implications for Men’s Health and Future Generations

The Genetic Landscape of Male Factor Infertility and Implications for Men’s Health and Future Generations

The Clinical Use of Myo-Inositol in IVF-ET: A Position Statement from the Experts Group on Inositol in Basic and Clinical Research and on PCOS (EGOI-PCOS), the Polish Society of Andrology, and the International Scientific Association for the Support and Development of Medical Technologies.

Background: Myo-inositol plays a vital role in human health, functioning as a second messenger of FSH and facilitating the transport of glucose into the cell. Consequently, myo-inositol is regularly utilized in the treatment of polycystic ovary syndrome (PCOS), wherein it acts upon metabolic factors, improving insulin sensitivity and reducing total androgen levels. Patients with PCOS frequently suffer from infertility; thus, the use of myo-inositol has been explored in improving assistive reproductive technique (ART) procedures. This is by no means limited to patients with PCOS, as inositol has found applications in non-PCOS patient groups in addition to in male factor infertility. This joint statement from the Experts Group on Inositol in Basic and Clinical Research and on PCOS (EGOI-PCOS), the Polish Society of Andrology, and the International Scientific Association for the Support and Development of Medical Technologies discusses the latest evidence on this topic, with the aim of interrogating whether myo-inositol could be implemented in everyday ART patient care. Methods: The authors conducted a narrative review performed via an independent literature search between July and August 2024, using the search platforms PubMed, Web of Science, and Google Scholar. Results: In both non-PCOS and PCOS populations seeking IVF care, MI supplementation prior to ovarian stimulation may positively affect gonadotropin use and duration, oocyte and embryo quality, fertilization, and clinical pregnancy rates. Conclusions: This position statement recommends that myo-inositol be considered as a potential pretreatment strategy prior to ovarian hyperstimulation with gonadotropins.

Transcriptomic landscape of Hras12V oncogene-induced hepatocarcinogenesis with gender disparity

The genesis of hepatocellular carcinoma (HCC) is closely related to male factors and hyper-activated Ras signals. A transcriptomic database was established via RNA-Seq of HCC (T) and the adjacent precancerous liver tissue (P) of Hras12V transgenic mice (Ras-Tg, HCC model) and the normal liver tissue of wild-type mice (W) of both sexes. Comparative analysis within W, P, and T and correlation expression pattern analysis revealed common/unique cluster-enriched items towards HCC between the sexes. Specifically, the numbers of differentially expressed genes (DEGs) were much higher in females than in males, and tumor suppressor genes, such as p21Waf1/Cip1 and C6, were significantly higher in the female P. This finding denotes the higher sensitivity of female hepatocytes to the Ras oncogene and, therefore, the difficulty in developing HCC. Moreover, convergence in HCC between the sexes suggests the underlying mechanisms for the ineffectiveness of sex hormone therapies. Additionally, expression pattern analysis revealed that the DEGs and their relevant pathways were either positively or negatively associated with the HCC/Ras oncogene. Among them, the vital role of glutathione metabolism in HCC was established. This work provides a basis for future research on elucidating the underlying mechanisms, selecting the diagnostic biomarker, and planning the clinical therapy in HCC.

Predicting the risk of a high proportion of three/multiple pronuclei (3PN/MPN) zygotes in individual IVF cycles using comparative machine learning algorithms.

The majority of machine learning applications in assisted reproduction have been focused on predicting the likelihood of pregnancy. In the present study, we aim to investigate which machine learning models are most effective in predicting the occurrence of a high proportion (>30%) of 3PN/MPN zygotes in individual IVF cycles. Eight machine learning algorithms were trained and compared, including the AdaBoost and Gaussian NB. Data from IVF cycles carried out from September 2015 to September 2019 were used as a training set. Cycle data from October 2019 to June 2020 were used as a validation set to verify the training model. Cycles with a 3PN/MPN zygote proportion higher than 30% were classified as high 3PN/MPN zygote proportion cycles. The AdaBoost algorithm was the best model for model construction and external validation. In both the training and validation sets, age, basal FSH, FSH and E2 level on the day of Gonadotrophin (GN) stimulation, and FSH and LH levels on the day of HCG were statistically higher in patients with 3PN/MPN>30% than in patients with 3PN/MPN≤30%; AFC, AMH, E2 level on HCG day and total number of oocytes were lower in patients with 3PN/MPN>30% than in patients with 3PN/MPN≤30%. The top five predictors were the number of oocytes retrieved, age, male factor infertility, AFC, and total days of GN stimulation. By applying a suitable machine learning algorithm, we can potentially predict the risk of a high proportion of 3PN/MPN zygotes in individual IVF cycles before insemination and avoid polyspermy fertilization by ICSI fertilization method.

Current drawbacks and future perspectives in the diagnosis and treatment of male factor infertility, with a focus on FSH treatment: an expert opinion.

Infertility is defined as the inability to conceive after 1year of unprotected intercourse, affecting approximately 15-20% of couples in Western countries. It is a shared problem within the couple; when the main issue lies with one of the partners, it is preferable to refer to "male factor" or "female factor" infertility rather than simply male or female infertility. Despite male factor infertility accounting for half of all couple infertility cases, the clinical approach to the male partner is not uniformly standardized across international guidelines. To provide an expert overview, we have comprehensively reviewed and critically analyzed the most up-to-date literature on this sensitive topic, leading to the development of a proposal for tailored assessment of the diagnostic-therapeutic pathway and preventive strategies. The diagnostic approach also considers that infertile men are objectively less healthy than their fertile counterparts of the same age and ethnicity. This article discusses the diagnostic flow, the classification of male factor infertility, the definition of idiopathic infertility, the involvement of general health, and treatment recommendations, emphasizing follicle-stimulating hormone treatment in selected groups of patients. We provide expert opinion on current drawbacks and future perspectives in this field, with practical advice for the clinical practice of general practitioners and expert in reproductive medicine.

A Case-Control Study of the Association Between GSTP1 Gene Polymorphisms (rs1695 and rs1138272) and the Susceptibility to Male Infertility in the Moroccan Population.

Background: Infertility affects 10-15% of couples worldwide, with male factors accounting for half of cases. Environmental, behavioral, and genetic problems contribute to spermatogenic failure in 30% of idiopathic male infertility cases. Other factors, such as oxidative stress (OS), cause impaired spermatogenesis, abnormal sperm morphology, and reduced motility, eventually triggering male infertility. In the male reproductive tract, glutathione S-transferase (GST) family antioxidants are essential for preventing OS, detoxification, and DNA damage protection. Methods: GSTP1 isoenzyme, one of GST members, has previously been linked to male infertility, and this case-control study is the first to assess the possible association of GSTP1 gene polymorphisms (rs1695 and rs1138272) with nonobstructive azoospermia and severe oligospermia within 300 patients and 300 controls from the Moroccan population using an allele-specific PCR. The statistical analysis was performed with the R programming language. Results: Genotyping of GSTP1 polymorphisms fitted the Hardy-Weinberg equilibrium in both cases and controls (p > 0.05), but no significant association was found in rs1695 (odds ratio [OR] = 1.238, 95% confidence interval [CI] = 0.855 to 1.794, p = 0.258, power = 0.204) and in rs1138272 (OR = 1.192, 95% CI = 0.852 to 0.1668, p = 0.304, power = 0.176). Likewise, results from haplotype analysis (OR = 1.25, 95% CI = 0.61 to 2.57, p = 0.537) and SNP-SNP interactions (OR = 1.522, 95% CI = 0.838 to 2.762, p = 0.166) demonstrated no correlation with the risk of male infertility. Conclusion: The two SNPs (rs1695 and rs1138272) of the GSTP1 gene loci are not associated with male infertility susceptibility in Moroccan subjects. Yet, future investigations with a larger sample size may conclusively help to confirm this association.

Lower Semen Quality Among Men in the Modern Era-Is There a Role for Diet and the Microbiome?

The prevalence of infertility is increasing worldwide; poor nutrition, increased sedentary lifestyles, obesity, stress, endocrine-disrupting chemicals, and advanced age of childbearing may contribute to the disruption of ovulation and influence oocyte and sperm quality and overall reproductive health. Historically, infertility has been primarily attributed to female factors, neglecting the importance of male fertility; this has resulted in an incomplete understanding of reproductive health. Male factors account for 40-50% of infertility cases. In half of these cases, the proximal cause for male infertility is unknown. Sperm contributes half of the nuclear DNA to the embryo, and its quality is known to impact fertilisation rates, embryo quality, pregnancy rates, risk of spontaneous miscarriage, de novo autosomal-dominant conditions, psychiatric and neurodevelopment conditions, and childhood diseases. Recent studies have suggested that both the microenvironment of the testes and diet quality may play an important role in fertility; however, there is limited research on the combination of these factors. This review summarises current known causes of male infertility and then focuses on the potential roles for diet and the seminal microbiome. Future research in this area will inform dietary interventions and health advice for men with poor semen quality, potentially alleviating the need for costly and invasive assisted reproduction treatments and allowing men to take an active role in the fertility conversation which has historically focussed on women individually.

Sex Disparity in the Nutrition-Related Determinants of Mild Cognitive Impairment: A Case-Control Study.

Sex differences in nutrition-related determinants of mild cognitive impairment (MCI) exist among the elderly. This study aimed to explore sex-specific influencing factors of MCI. A case-control study was conducted in 2020 involving 1086 elderly people aged 55 years and above from four sites in Zhejiang Province, China. Data on demographics, cognitive assessment, depression scale, daily food intake, and physical examinations were collected. The assessment of plant-based diet patterns depended on an overall plant-based diet index (PDI), a healthful plant-based diet index (hPDI), and an unhealthful plant-based diet index (uPDI). Multivariate logistic regression models were employed to assess the determinants of MCI in females and males. Among 571 females, 141 (24.7%) had MCI, and 126 (24.5%) had MCI among 514 male participants. In females, the multivariate analysis revealed that being unmarried/divorced/widowed (OR = 1.95, 95% CI: 1.10-3.45), having depression (OR = 6.06, 95% CI: 1.87-19.66), and having a uPDI score ≥ 55 (OR = 2.41, 95% CI: 1.50-3.89) were associated with a significantly elevated risk of MCI. Conversely, a cereal consumption of ≥300 g/d (OR = 0.32, 95% CI: 0.19-0.53) was linked to a significantly reduced risk. In males, vegetable consumption ≥ 150 g/d (OR = 0.39, 95% CI: 0.23-0.66), vegetable oil consumption ≥ 22 g/d (OR = 0.502, 95% CI: 0.307-0.820), and cereal consumption ≥ 300 g/d (OR = 0.44, 95% CI: 0.27-0.71) were associated with a lower MCI risk. Meanwhile, rural residence (OR = 1.90, 95% CI: 1.12-3.25) and advanced age, especially 75 years old and above (OR = 4.71, 95% CI: 2.44-9.12), were also risk factors in males. Notably, the Restricted Cubic Spline (RCS) model showed that females with a uPDI score < 55 had a lower prevalence of MCI, while those with a score ≥ 55 faced a higher risk. This study indicates potential sex disparities in the risk factors for MCI. Future research should prospectively establish causal relationships. Additionally, precise intervention strategies are urgently needed.

Factors influencing endometrial receptivity in women with recurrent implantation failure

BackgroundEmbryo implantation involves two key elements: a good quality embryo and receptive endometrium. Endometrial receptivity abnormalities are known as one of the possible causes of recurrent implantation failure (RIF), especially when the embryo is euploid. This study was aimed to evaluate the impact of age and other clinical factors on endometrial receptivity in women with RIF.Methods68 women with RIF (defined as at least three unsuccessful transfers of good quality embryo of at least 1BB category of blastocysts) and 49 controls (women undergoing IVF treatment because of idiopathic infertility or male factor) were included to the study. After preparation of the endometrium by the hormone replacement therapy endometrial biopsies were taken from each patient and sequenced with beREADY test TAC targeting 67 biomarker genes for endometrial receptivity. Depending on the test result patients were classified into one of four different groups: pre-receptive (n = 16), early-receptive (n = 54), receptive (n = 44) and late-receptive (n = 3).ResultsIn women with RIF pre-receptive endometrium has been detected substantially more often than in controls − 13 (19,1%) vs. 3 (6,1%) patients (p = 0,043). Early-receptive endometrium was diagnosed in the majority of patients with idiopathic infertility − 12 (66.7%) vs. 6 (33.3%) women (p = 0.042) and with polycystic ovary syndrome (PCOS) − 12 (70,6%) vs. 3 (17.7%) women (p = 0,0447). We found significant association between abnormal endometrial receptivity and patient’s age and duration of infertility. Young women were diagnosed significantly more often as normal or late-receptive, whereas older women with longer history of infertility as early-receptive and pre-receptive.ConclusionsIn patients with RIF in comparison to other women undergoing IVF procedures, patient’s age and infertility duration are the most important factors related to endometrial receptivity abnormalities, indicating that older women with a longer history of infertility may benefit the most from endometrial receptivity testing.Trial registrationNot applicable.

Reply to Editorial Comment on "Male Factor Infertility and the Rural-Urban Continuum".

Reply to Editorial Comment on "Male Factor Infertility and the Rural-Urban Continuum".