Female Reproductive Diseases Research Articles

A New Perspective on Thyroid Hormones: Crosstalk with Reproductive Hormones in Females.

Accumulating evidence has shown that thyroid hormones (THs) are vital for female reproductive system homeostasis. THs regulate the reproductive functions through thyroid hormone receptors (THRs)-mediated genomic- and integrin-receptor-associated nongenomic mechanisms, depending on TH ligand status and DNA level, as well as transcription and extra-nuclear signaling transduction activities. These processes involve the binding of THs to intracellular THRs and steroid hormone receptors or membrane receptors and the recruitment of hormone-response elements. In addition, THs and other reproductive hormones can activate common signaling pathways due to their structural similarity and shared DNA consensus sequences among thyroid, peptide, and protein hormones and their receptors, thus constituting a complex and reciprocal interaction network. Moreover, THs not only indirectly affect the synthesis, secretion, and action of reproductive hormones, but are also regulated by these hormones at the same time. This crosstalk may be one of the pivotal factors regulating female reproductive behavior and hormone-related diseases, including tumors. Elucidating the interaction mechanism among the aforementioned hormones will contribute to apprehending the etiology of female reproductive diseases, shedding new light on the treatment of gynecological disorders.

MicroRNA miR-24-3p Mediates the Negative Regulation of Lipopolysaccharide-Induced Endometrial Inflammatory Response by Targeting TNF Receptor-Associated Factor 6 (TRAF6).

PurposeEndometritis is a female reproductive disease that affects the cattle industries development and microRNAs (miRNAs) play a pivotal role and critical regulators of the innate immune response in varieties of diseases. The present study intends to investigate the regulatory role of miR‐24-3p in the innate immune response involved in endometritis and evaluate its therapeutic potential.MethodsWhole mice uteri and bovine endometrial epithelial cells (BEECs) were separately stimulated with LPS. The BEECs were also transfected with miR-24-3p mimic and negative control; siTRAF6 and siNC; pcDNA3.1 empty and pcDNA3.1(+)TRAF6 separately with LPS stimulation. The expression levels of miR‐24-3p and TRAF6 were measured via quantitative real‐time polymerase chain reaction (qRT-PCR) and Western blot, respectively. LPS‐induced inflammatory response assessed by inflammatory cytokines secretion and expression via ELISA and qRT-PCR. Bioinformatics analysis and luciferase reporter assay validated the interaction between miR‐24-3p and TRAF6. The activation of the NF‐ĸB/MAPK pathway and p65 phosphorylation was investigated by Western blot and immunofluorescence assay, respectively.ResultsThe expression of miR‐24-3p was decreased, and TRAF6 was elevated with an increased level of pro-inflammatory cytokines in LPS‐treated BEECs and mice uterus. The overexpression of miR‐24-3p suppressed LPS‐induced secretion of inflammatory cytokines (IL‐1β, IL‐6, IL-8 and TNF-α) and deactivation of NF‐ĸB/MAPK pathways. The downregulation of TRAF6 inhibited LPS‐induced inflammatory response in BEECs. TRAF6 is validated as a target of miR‐24-3p, and miR‐24-3p reversed the overexpression of cloned TRAF6 on inflammation response in BEECs.ConclusionOur findings demonstrate that the overexpression of miR‐24-3p attenuates endometrial inflammation and the expression of pro-inflammatory mediators via suppressing TRAF6. Therefore, modulating the pathogenesis of endometritis and possibly, a therapeutic potential against endometritis.

Naturopathy utilisation by Australian women with diagnosed endometriosis: A cross-sectional survey

Background and purposeEndometriosis is a painful female reproductive disease resulting in unmet health needs. Women with endometriosis frequently access different types of health care, yet little is known about naturopathic use. The purpose of this study is to explore the naturopathic utilisation by women with endometriosis in Australia. Materials and methodsThis study reports a cross-sectional survey of Australian women with endometriosis. Participants were recruited through the not-for-profit organisations Endometriosis Australia and EndoActive social media platforms. Data was collected through a self-administered questionnaire by those eligible to participate. Participants were included if they self-reported a diagnosis of endometriosis via laparoscopic surgery and were an Australian resident. ResultsOf the recruited 303 women with endometriosis, 60 women reported consulting with a naturopath for endometriosis care. Women consulting with a naturopath, reported also consulting with a laparoscopic surgeon (66.7%, p = 0.01), acupuncturist (53.3%, p ≤ 0.01), physiotherapist (41.7%, p = 0.01), nutritionists/dietitians (n = 22, 36.7%, p = 0.01) or homeopath (15.0%, p ≤ 0.001), in addition to their naturopath in the previous 12 months for endometriosis management. Compared to non-naturopathic users, women reported frequently experiencing dyspareunia (OR 2.9, CI 1.4–5.9, p = 0.002) and reported a higher use of vitamin D supplementation for endometriosis management (OR 4.9, CI 2.5–9.9, p ≤ 0.001). ConclusionWomen who use naturopathy for endometriosis appear to be high users of health care services, both within complementary medicine and conventional medicine. The efficacy and role of naturopathic treatments and care for women with endometriosis requires further investigation.

Inhibitory Effects of 6,8-Diprenylorobol on Endometriosis Progression in Humans by Disrupting Calcium Homeostasis and Mitochondrial Function.

6,8-Diprenylorobol is a flavonoid compound extracted from Cudrania tricuspidata. It has various biological functions, such as inhibiting melanin synthesis and inducting cell death in cancerous cells. In addition, Cudrania tricuspidata is known to be effective in female diseases, and previous studies have shown anticancer effects in cervical cancer, a female reproductive disease. Outside of that, Cudrania tricuspidata has various physiological effects. However, the effect of 6,8-diprenylorobol is not well known in other benign and chronic diseases, even in endometriosis, which commonly arises in the female reproductive tract. In the present study, we determined the inhibitory effects of 6,8-diprenylorobol on the growth of endometriosis VK2/E6E7 and End1/E6E7 cells. Results indicated that 6,8-diprenylorobol suppressed cellular proliferation and increased the disruption of the cell cycle, mitochondrial membrane potential (MMP), generation of reactive oxygen species, and Ca2+ homeostasis in both endometriosis cells. However, the proliferation of normal stromal cells isolated from endometrial tissue was not altered by 6,8-diprenylorobol. The change in Ca2+ levels was estimated in fluo-4- or rhod-2-stained VK2/E6E7 and End1/E6E7 cells after the treatment of the intracellular calcium regulators 2-aminoethoxydiphenyl borate (2-APB) and ruthenium red (RUR) with 6,8-diprenylorobol. A combination of 6,8-diprenylorobol with each regulator decreased the calcium accumulation in endometriosis cells. Furthermore, Western blot analysis indicated that 6,8-diprenylorobol inactivated AKT pathways, whereas it activated P38 MAPK pathways. In addition, 6,8-diprenylorobol decreased mitochondrial respiration, leading to the reduction in ATP production in VK2/E6E7 and End1/E6E7 cells. Collectively, our results suggested that 6,8-diprenylorobol might be a potential therapeutic agent or adjuvant therapy for the management of endometriosis.

N6-Methyladenosine Modifications in the Female Reproductive System: Roles in Gonad Development and Diseases.

N6-methyladenosine (m6A) is the most prevalent chemical modification in eukaryotic messenger RNAs. By participating in various RNA-related bioprocesses including RNA decay, splicing, transport and translation, m6A serves as a pivotal regulator of RNA fate and plays an irreplaceable role in cellular activities. The m6A modifications of transcripts are coordinately regulated by methyltransferase “writers” and demethylase “erasers”, and produce variable effects via different m6A reading protein “readers”. There is emerging evidence that m6A modifications play a critical role in a variety of physiological and pathological processes in the female reproductive system, subsequently affecting female fertility. Here, we introduce recent advances in research on m6A regulators and their functions, then highlight the role of m6A in gonad development and female reproductive diseases, as well as the underlying mechanisms driving these processes.

Comparative reproductive toxicity of phthalate on male and female reproductive potential of rodent when exposure occurs during developmental period

Phthalates are esters of 1, 2-dibenzene dicarboxylic acid, widely used in a variety of commodities such as vinyl flooring, lubricants, and various personal-care products like soaps, shampoos, hair sprays, etc. Phthalates are also used as plasticizers in polyvinyl chloride (PVC) polymers, which helps to make the plastics softer and more durable. Because of their widespread use, both adults and children get exposed to them. Given the fact that phthalates are not chemically bonded to the plastic matrix, they can leak out and pollute the environment around the plastic matrix.Number of studies have indicated that phthalate exposure relates to significant health hazards, including developmental and reproductive damage. Phthalates, according to the findings of the current review, are toxic to the reproductive organs of both male and female fetuses and weanlings when they get exposed during the pregnancy. Several studies have shown that organisms in their growth and developmental stages are especially sensitive to the harmful effects of chemicals, which may have a severe influence on the physiology of foetuses and young animals. Moreover, parameters such as age, gender, immunity, and other variables influence the impact of toxicants. When it comes to male reproductive organs, phthalates have mostly been found to have an adverse impact. While in adult females only few research studies have found harmful effects on female reproductive system. Phthalates have been shown to cause reduced fertility, decreased testicular weight, changes in accessory reproductive organs, and a variety of other female reproductive diseases, among other effects. These findings include an examination of mice female and male reproductive potential, as well as the impact of phthalates on their respective reproductive capabilities when exposure occurs during the formative stage of development.

Contemporary approach to diagnostics in women with suspected pelvic endometriosis

Endometriosis is a common chronic female reproductive system disease, characterised by the presence of endometrial tissue outside the endometrium and myometrium. It can severely compromise quality of life and have an impact on fertility. Although advances in conservative medical treatment options have been made, surgery is often a necessary part of treatment for this insidious disease.Historically, it was believed that only ovarian endometriosis could be diagnosed non-invasively by an ultrasound examination, while endometriosis at other locations could not be observed. With advances in imaging techniques over the last decades, this has changed dramatically and today deep pelvic endometriosis can be diagnosed non-invasively with high sensitivity and specificity. The aim of this review is to evaluate the contribution of clinical examination, laparoscopy, and non-invasive imaging techniques, mainly transvaginal ultrasound and magnetic resonance imaging, to diagnose deep pelvic endometriosis.Evidence shows that transvaginal ultrasound with high-quality equipment in experienced hands offers high diagnostic accuracy for deep pelvic endometriosis diagnosis. Comprehensive ultrasound examination should be used as a first-line method of choice in diagnostics of women with suspected endometriosisand chronic pelvic pain.

Per- and poly-fluoroalkyl substances (PFAS) and female reproductive outcomes: PFAS elimination, endocrine-mediated effects, and disease

Per- and poly-fluoroalkyl substances (PFAS) are widespread environmental contaminants frequently detected in drinking water supplies worldwide that have been linked to a variety of adverse reproductive health outcomes in women. Compared to men, reproductive health effects in women are generally understudied while global trends in female reproduction rates are declining. Many factors may contribute to the observed decline in female reproduction, one of which is environmental contaminant exposure. PFAS have been used in home, food storage, personal care and industrial products for decades. Despite the phase-out of some legacy PFAS due to their environmental persistence and adverse health effects, alternative, short-chain and legacy PFAS mixtures will continue to pollute water and air and adversely influence women’s health. Studies have shown that both long- and short-chain PFAS disrupt normal reproductive function in women through altering hormone secretion, menstrual cyclicity, and fertility. Here, we summarize the role of a variety of PFAS and PFAS mixtures in female reproductive tract dysfunction and disease. Since these chemicals may affect reproductive tissues directly or indirectly through endocrine disruption, the role of PFAS in breast, thyroid, and hypothalamic-pituitary-gonadal axis function are also discussed as the interplay between these tissues may be critical in understanding the long-term reproductive health effects of PFAS in women. A major research gap is the need for mechanism of action data – the targets for PFAS in the female reproductive and endocrine systems are not evident, but the effects are many. Given the global decline in female fecundity and the ability of PFAS to negatively impact female reproductive health, further studies are needed to examine effects on endocrine target tissues involved in the onset of reproductive disorders of women.

Role of vitamin D and insulin resistance in polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is considered the commonest endocrinological disorder in childbearing age women with an incidence of 10%. Vitamin D has been shown in several studies to have a positive impact on female reproductive diseases, as well as PCOS. The diagnosis of PCOS, clinical symptoms, pathophysiology, hypovitaminosis D, insulin resistance, and the various methods for vitamin D and insulin assessment are all covered in this study. Androgen hypersecretion, oligo-ovulation, and/or ovarian morphologic features are used to diagnose this condition. Androgen excess, neuroendocrine causes, and insulin resistance are all part of the pathophysiology. Some female genital organs have been found to contain vitamin D receptors. Insulin regulates steroid biosynthesis in the ovaries and follicular maturation, so vitamin D is essential.

A Review on Therapeutic Effects of Labisia pumila on Female Reproductive Diseases.

The Labisia pumila (LP) is a traditional plant that is locally known as Kacip Fatimah, Selusuh Fatimah, or Pokok Ringgang by the Malaysian indigenous people. It is believed to facilitate their childbirth, treating their postchild birth and menstrual irregularities. The water extract of LP has shown to contain bioactive compounds such as flavonoids, ascorbic acid, β-carotene, anthocyanin, and phenolic acid, which contribute extensive antioxidant, anti-inflammatory, antimicrobial, and antifungal. The LP ethanolic extract exhibits significant estrogenic effects on human endomentrial adenocarcinoma cell in estrogen-free basal medium and promoting an increase in secretion of alkaline phosphate. Water based has been used for many generations, and studies had reported that it could displace in binding the antibodies and increase the estradiol production making it similar to esterone and estradiol hormone. LP extract poses a potential and beneficial aspect in medical and cosmeceutical applications. This is mainly due to its phytoestrogen properties of the LP. However, there is a specific functionality in the application of LP extract, due to specific functional group in phytoconstituent of LP. Apart from that, the extraction solvent is important in preparing the LP extract as it poses some significant and mild side effects towards consuming the LP extracts. The current situation of women reproductive disease such as postmenopausal syndrome and polycystic ovary syndrome is increasing. Thus, it is important to find ways in alternative treatment for women reproductive disease that is less costly and low side effects. In conclusion, these studies proven that LP has the potential to be an alternative way in treating female reproductive related diseases such as in postmenopausal and polysystic ovarian syndrome women.

O-158 The effect of circadian rhythm disruption due to constant light on ovarian and oocyte aging through possible relationship between PER2 and mTOR signaling pathway

Abstract Study question Does circadian rhythm disruption by constant light affect the ovarian morphology and function, and cause ovarian and oocyte aging through possible relationship between PER2 and mTOR? Summary answer We demonstrated that circadian rhythm disruption by light may cause ovarian and oocyte aging. What is known already Circadian rhythm regulates multiple physiological processes and PER2 is one of the core circadian rhythm components. Changes in light conditions may cause circadian rhythm disruptions. Light exposure at night may cause attenuation in PER2 mRNA and protein levels. Circadian rhythm disruptions are thought to be associated with reproductive diseases. mTOR signaling pathway functions in folliculogenesis and oocyte maturation in ovary. Also, it is associated with ovarian and oocyte aging. Study design, size, duration A total of 32 female Balb/c mice which enter estrous cycle were used in the study. Mice were randomly assigned to one of two groups as 12:12h L:D and 12:12h L:L. During the experiment, 12:12h L:D (control group) was housed in a 12:12h light:dark cycle and 12:12h L:L (experiment group) was housed in a constant light conditions 12:12h light:light for 1 week. Participants/materials, setting, methods We housed 12:12h L:D group in standard lightening conditions and 12:12h L:L group in constant light for one week. We performed food intake and body weight change analysis. We evaluated ovarian morphology, follicle counting analysis. We evaluated ZP3 and nitrotyrosine (NTY) expression for oocyte aging markers. We performed western blot for PER2, mTOR, p-mTOR, p70 S6K, p-p70 S6K, and Caspase-3 protein levels. Main results and the role of chance We demonstrated that circadian rhythm disruption caused alteration in their food intake and decrease in primordial follicle numbers and increase in atretic follicles (p < 0.05). It caused increase in oxidative stress and decrease in ZP3 expression in oocytes (p < 0.05). We showed decreased protein levels of PER2, mTOR, p-mTOR and p70 S6K (p < 0.05). Limitations, reasons for caution The explanation of molecular mechanism underlying the relationship between circadian rhythm disruptions by light and ovarian function may lead the usage of circadian rhythm-based or light-based therapies currently using to treat some diseases on female reproductive system related diseases. Wider implications of the findings We conclude that constant light may reduce follicle reserve, cause follicles to go rapidly atresia and disrupt the oocyte quality, thus it may be a risk factor for female reproductive diseases such as premature ovarian insufficiency and early menopause. Trial registration number not applicable

Deletion of Gremlin-2 alters estrous cyclicity and disrupts female fertility in mice†.

Members of the differential screening-selected gene aberrative in neuroblastoma (DAN) protein family are developmentally conserved extracellular binding proteins that antagonize bone morphogenetic protein (BMP) signaling. This protein family includes the Gremlin proteins, GREM1 and GREM2, which have key functions during embryogenesis and adult physiology. While BMPs play essential roles in ovarian follicle development, the role of the DAN family in female reproductive physiology is less understood. We generated mice null for Grem2 to determine its role in female reproduction in addition to screening patients with primary ovarian insufficiency (POI) for variants in GREM2. Grem2-/- mice are viable, but female Grem2-/- mice have diminished fecundity and irregular estrous cycles. This is accompanied by significantly reduced production of ovarian anti-Müllerian hormone (AMH) from small growing follicles, leading to a significant decrease in serum AMH. Surprisingly, as AMH is a well-established marker of the ovarian reserve, morphometric analysis of ovarian follicles showed maintenance of primordial follicles in Grem2-/- mice like wild-type (WT) littermates. While Grem2 mRNA transcripts were not detected in the pituitary, Grem2 is expressed in hypothalami of WT female mice, suggesting the potential for dysfunction in multiple tissues composing the hypothalamic-pituitary-ovarian axis that contribute to the subfertility phenotype. Additionally, screening 106 women with POI identified one individual with a heterozygous variant in GREM2 that lies within the predicted BMP-GREM2 interface. In total, these data suggest that Grem2 is necessary for female fecundity by playing a novel role in regulating the HPO axis and contributing to female reproductive disease.

Investigation on factors related to uterine fibroids in rural women of northern Anhui province.

Given the increasing prevalence of hysteromyoma among the Chinese rural women of childbearing age, it is imperative that more attention should be given to researching risk factors that predispose women to this condition so that early preventive measures may be taken. Our study investigates potential risk factors for uterine fibroids such as participants' demographic characteristics (age, ethnicity, education), physiological characteristics (age at menarche, primiparous age), and the occurrence of several different female reproductive diseases (vaginitis, pelvic inflammatory disease). 2200 rural women of reproductive age were screened from a cross-sectional study carried out in the northern Anhui province. Data were collected by questionnaire surveys, gynecological and laboratory examinations and were subjected to univariate and multivariate analysis to evaluate the risk factors for uterine fibroids. Of the 2200 women, 440 had uterine fibroids. In general, women with endometriosis, ovarian cysts and early menarche were more likely to suffer from hysteromyoma. Factors including higher parity, late age of first childbirth, and a regular menstrual cycle were associated with the reduced risk of uterine fibroids. Our findings indicate that parameters such as earlier age of menarche, early primiparous age, lower parity and a variety of female reproductive diseases were associated with an increased risk of uterine fibroids. These findings may be used to guide the formulation of effective prevention and intervention protocols to improve the reproductive health of rural women.

Knowledge, Attitude, and Personal Hygiene Behaviors with Pathological Leukorrhea in Adolescent Girls at SMK 'Aisyiyah Palembang

Leukorrhea (Vaginal discharge) is one of the reproductive health problems that adolescent girls face. According to research, 75% of women worldwide have experienced leukorrhea. Leukorrhea, alternatively referred to as fluor albus, is a symptom of the female reproductive organs disease that can result in severe complications if left untreated. It is believed that a low level of knowledge, negative attitudes, and bad personal hygiene habits contribute to pathological leukorrhea. The purpose of this study was to examine the effect of knowledge, attitudes, and personal hygiene behaviour on pathological leukorrhea in adolescent girls attending the Vocational High School (SMK) 'Aisyiyah Palembang in 2020. This study used an analytical cross-sectional design and a simple random sampling method with 92 respondents. The results indicated a statistical significance between pathological leukorrhea and knowledge (p-value 0.004), attitude (p-value 0.001), and personal hygiene behaviour (p-value 0.001). Multivariate analysis revealed that the bad personal hygiene behaviour variable (p-value 0.018) was the most determinant associated with pathological leukorrhea (PR = 3.305, 95 per cent confidence interval [CI]:1.232-8.868). This study concludes that persistently bad personal hygiene practices may increase the risk of pathological leukorrhea in adolescent girls. Suggestions for young women to reduce their reliance on pantyliners, wear sweat-absorbing underwear, and avoid tight underwear.

Therapeutic Role of Mesenchymal Stem Cell-Derived Extracellular Vesicles in Female Reproductive Diseases.

Reproductive disorders, including intrauterine adhesion (IUA), premature ovarian insufficiency (POI), and polycystic ovary syndrome (PCOS), are great threats to female reproduction. Recently, mesenchymal stem cells derived–extracellular vesicles (MSC-EVs) have presented their potentials to cure these diseases, not only for the propensity ability they stemmed from the parent cells, but also for the higher biology stability and lower immunogenicity, compared to MSCs. EVs are lipid bilayer complexes, functional as mediators by transferring multiple molecules to recipient cells, such as proteins, microRNAs, lipids, and cytokines. EVs appeared to have a therapeutic effect on the female reproductive disorder, such as repairing injured endometrium, suppressing fibrosis of endometrium, regulating immunity and anti-inflammatory, and repressing apoptosis of granulosa cells (GCs) in ovaries. Although the underlying mechanisms of MSC-EVs have reached a consensus, several theories have been proposed, including promoting angiogenesis, regulating immunity, and reducing oxidate stress levels. In the current study, we summarized the current knowledge of functions of MSC-EVs on IUA, POI, and PCOS. Given the great potentials of MSC-EVs on reproductive health, the critical issues discussed will guide new insights in this rapidly expanding field.

Exploration of the potential roles of m6A regulators in the uterus in pregnancy and infertility

Infertility is a prevalent female reproductive disease worldwide. Currently, there are many unknown etiologies of infertility. N6-methyladenosine (m6A) is the most prevalent modification of eukaryotic mRNA. This study intended to investigate the implications of m6A regulators in the uterus for pregnancy and infertility. Pregnant ICR mice on days (D) 0, 4, 6, 10, and 15 were used to monitor m6A methylation in the uterus by liquid chromatography-tandem mass spectrometry (LC–MS/MS), and then m6A methylation regulators were detected by real-time quantitative PCR (qPCR), western blot and immunohistochemistry (IHC). We found that m6A levels increased and that m6A regulators were expressed differently in the uterus during pregnancy. Then, we acquired expression data from endometrial tissue from women with infertility and recurrent pregnancy loss from the Gene Expression Omnibus (GEO) database. The expression of m6A regulators in infertility was significantly dysregulated according to the data mining technique. Specifically, the mRNA levels of METTL16 (p = 0.0147) and WTAP (p = 0.028) were lower and those of ALKBH5 (p = 0.0432) and IGF2BP2 (p = 0.0016) were higher in the endometrium of infertile patients. Meanwhile, many immunity-related pathways are abnormal in infertility, such as cytokine-cytokine receptor interactions, natural killer cell-mediated cytotoxicity and leukocyte transendothelial migration. In conclusion, we found that the m6A levels in the uterus increased as pregnancy progressed, and these regulators were dysregulated in the endometrium of infertility patients. These results suggest that m6A methylation may be very important in the establishment of implantation and maintenance of pregnancy and may become a new direction for research on infertility.

An Insight on the Role of Altered Function and Expression of Exosomes and MicroRNAs in Female Reproductive Diseases.

Exosomes are small bilayer-lipid membrane vesicles secreted by living cells that are able to transfer regulatory molecules and genetic information from one cell to another. These vesicles are enriched with several nucleic acids including mRNAs, microRNAs (miRNAs), other non-coding RNAs, as well as proteins and lipids. Alterations in the exosomal content and functions are observed in numerous reproductive diseases in both animals and human cases. MicroRNAs, a class of small endogenous RNA molecules, can negatively regulate gene expression at the post-transcription level. Aberrant microRNA expression has been reported in multiple human reproductive diseases such as polycystic ovary syndrome, preeclampsia, uterine leiomyomata, ovarian cancer, endometriosis, and Asherman's syndrome. This study focuses to review recent research on alterations of microRNA expression and the role of exosomes in female reproductive diseases. It has been demonstrated that exosomes may be a potential therapeutic approach in various female reproductive diseases. In addition, changes in expression of microRNAs act as molecular biomarkers for diagnosis of several reproductive diseases in women, and regulation of their expression can potentially reduce infertility.

Exosomes as Biomarkers for Female Reproductive Diseases Diagnosis and Therapy.

Cell–cell communication is an essential mechanism for the maintenance and development of various organs, including the female reproductive system. Today, it is well-known that the function of the female reproductive system and successful pregnancy are related to appropriate follicular growth, oogenesis, implantation, embryo development, and proper fertilization, dependent on the main regulators of cellular crosstalk, exosomes. During exosome synthesis, selective packaging of different factors into these vesicles happens within the originating cells. Therefore, exosomes contain both genetic and proteomic data that could be applied as biomarkers or therapeutic targets in pregnancy-associated disorders or placental functions. In this context, the present review aims to compile information about the potential exosomes with key molecular cargos that are dysregulated in female reproductive diseases which lead to infertility, including polycystic ovary syndrome (PCOS), premature ovarian failure (POF), Asherman syndrome, endometriosis, endometrial cancer, cervical cancer, ovarian cancer, and preeclampsia, as well as signaling pathways related to the regulation of the reproductive system and pregnancy outcome during these pathological conditions. This review might help us realize the etiology of reproductive dysfunction and improve the early diagnosis and treatment of the related complications.

A multicriteria decision‐making framework for assessing the performance of gynecobstetrics departments: a case study

AbstractGynecobstetrics departments (GDs) oversee diagnosing, monitoring, and treating female reproductive diseases as well as assisting women during pregnancy. Their importance motivates the creation of suitable performance evaluation approaches for identifying weaknesses and designing focused interventions. Therefore, the aim of this paper is twofold: (a) provide an approach for GD performance evaluation and (b) propose interventions tackling the GDs’ weaknesses. The fuzzy analytic hierarchy process (FAHP) was first applied to calculate the initial criteria and subcriteria weights under vagueness. Then, the decision‐making trial and evaluation laboratory (DEMATEL) was implemented to evaluate interrelations. FAHP and DEMATEL were later combined to estimate the final criteria and subcriteria weights under vagueness and interdependency. Finally, the technique for order of preference by similarity to ideal solution (TOPSIS) was used to rank the GDs and detect improvement opportunities. A case study of a cluster including three GDs is presented to validate the proposed approach. The results evidenced that patient safety and service quality are the most critical aspects in GD performance evaluation. The results from this application can be used by healthcare managers for designing focused interventions targeting improved performance of GDs. This paper fully exploits the advantages of FAHP, DEMATEL, and TOPSIS methods for evaluating performances of GDs. Furthermore, this study presents a novel decision‐making model representing the multifactorial context of the GD performance.

Effects of Environmental Endocrine-Disrupting Chemicals on Female Reproductive Health.

Environmental endocrine-disrupting chemicals (EDCs) are xenobiotic compounds that are frequently contacted in daily life. With the species and quantity of substances created and utilized by human beings significantly surpassing the self-purification capacity of nature, a large number of hazardous substances are enriched in the human body through the respiratory tract, digestive tract, and skin. Some of these compounds cause many problems endangering female reproductive health by simulating/antagonizing endogenous hormones or affecting the synthesis, metabolism, and bioavailability of endogenous hormones, including reproductive disorders, fetal birth defects, fetal developmental abnormalities, endocrine and metabolic disorders, and even gynecological malignancies. Therefore, the study of the relationship between environmental EDCs and female reproductive diseases and related mechanisms is of considerable significance to women, children health care, and improve the quality of the population.