Female Tract Research Articles

An unusual case of aggressive endometrial adenocarcinoma metastasis to the clivus: illustrative case.

Though endometrial carcinomas are a relatively common cancer of the female genitourinary tract, they rarely metastasize. Similarly, clival metastases make up a tiny fraction of all brain metastases. To the authors' knowledge, an endometrial carcinoma clival metastasis has never been described in the literature; therefore, the authors present the following unusual case of a 69-year-old female with a history of an initially grade 2 endometrial adenocarcinoma that metastasized to her clivus. Endometrial carcinoma has the potential to metastasize to the clivus. Endometrial carcinoma, even when initially low grade, can metastasize intracranially. Prompt diagnosis with tissue biopsy and radiation is the mainstay of treatment, although the prognosis remains poor. https://thejns.org/doi/10.3171/CASE24392.

Effects of gender-affirming hormone therapy on lower urinary tract symptoms and sexual function among transgender individuals.

Gender-affirming hormone therapy (GAHT) includes estrogen preparations and androgen inhibitors for transgender women, and testosterone preparations for transgender men. The aim of the study was to investigate possible effects of GAHT on lower urinary tract symptoms (LUTS) and sexual function among transgender individuals. Fifty-one transgender men and 47 transgender women were prospectively recruited. Four validated female questionnaires (Bristol Female Lower Urinary Tract Symptoms [BFLUTS] questionnaire, the Medical, Epidemiologic, and Social aspects of Aging [MESA] questionnaire, Urgency, the Severity and Impact Questionnaire [USIQ], and the Female Sexual Function Index [FSFI]) and two validated male questionnaires (International Prostate Symptom Score [IPSS], and the International Index of Erectile Function [IIEF]) were used to assess LUTS and sexual function among transgender men and women, respectively, before and during GAHT. Follow-up was performed over a period of 3-12 months. Thirty-four transgender men (mean age 24.4 ± 7.6 years) and 31 transgender women (mean age 29 ± 8.7 years) completed all questionnaires, before and during GAHT. Testosterone treatment was associated with a statistically significant improvement in sexual desire among transgender men, as reflected in the FSFI questionnaire (4.5 ± 1.2 vs. 3.6 ± 1.3, P = 0.002). None of the three LUTS questionnaires showed statistically significant changes during the treatment with testosterone preparations. Estrogen treatment was associated with a statistically significant decrease in erectile function among transgender women, as reflected by the IIEF questionnaire (9.0 ± 7.2 vs. 14.1 ± 11.1, P = 0.012). No significant changes were found in LUTS during the treatment with estrogen preparations, except for a slight worsening of nocturia (2.1 ± 1.8 vs. 1.1 ± 1.4, P = 0.009). GAHT was not found to be associated with significant LUTS in both transgender men and women. Nevertheless, some effects on sexual function were observed, mainly a decrease in erectile function among transgender women and an increase in sexual desire among transgender men.

The Streptococcus agalactiae LytSR two-component regulatory system promotes vaginal colonization and virulence in vivo.

Streptococcus agalactiae (or group B Streptococcus, GBS) is a leading cause of neonatal sepsis and meningitis globally. To sense and respond to variations in its environment, GBS possesses multiple two-component regulatory systems (TCSs), such as LytSR. Here, we aimed to investigate the role of LytSR in GBS pathogenicity. We generated an isogenic lytS knockout mutant in a clinical GBS isolate and used a combination of phenotypic in vitro assays and in vivo murine models to investigate the contribution of lytS to the colonization and invasive properties of GBS. Deletion of the lytS gene in the GBS chromosome resulted in significantly higher survival rates in mice during sepsis, accompanied by reduced bacterial loads in blood, lung, spleen, kidney, and brain tissues compared to infection with the wild-type strain. In a mouse model of GBS vaginal colonization, we also observed that the lytS knockout mutant was cleared more readily from the vaginal tract compared to its wild-type counterpart. Interestingly, lower levels of proinflammatory cytokines were found in the serum of mice infected with the lytS mutant. Our results demonstrate that the LytSR TCS plays a key role in GBS tissue invasion and pathogenesis, and persistence of mucosal colonization.IMPORTANCEStreptococcus agalactiae (group B Streptococcus, or GBS) is a common commensal of the female urogenital tract and one of WHO's priority pathogens. The bacterium has evolved mechanisms to adapt and survive in its host, many of which are regulated via two-component signal transduction systems (TCSs); however, the exact contributions of TCSs toward GBS pathogenicity remain largely obscure. We have constructed a TCS lytS-deficient mutant in a CC-17 hypervirulent GBS clinical isolate. Using murine models, we showed that LytSR regulatory system is essential for vaginal colonization via promoting biofilm production. We also observed that lytS deficiency led to significantly attenuated virulence properties and lower levels of proinflammatory cytokines in blood. Our findings are of significant importance in that they unveil a previously unreported role for LytSR in GBS and pave the way toward a better understanding of its ability to transition from an innocuous commensal to a deadly pathogen.

Sperm Metabolism.

Bioenergetics plays a crucial role in sperm functions, including motility, capacitation-related protein modifications, oocyte recognition and interaction, all of which are essential for fertilization. Sperm metabolism is recognized as flexible, responding to environmental cues and energetic demands during ejaculation, the journey along the female tract, and until fertilization. Recent studies suggest that sperm metabolic functions are relevant beyond fertilization and may influence zygote and embryo development, impacting paternal-derived effects on offspring development and health. In recent years, sperm metabolic functions and homeostasis have gained increasing interest in male reproduction research. Given the crucial implications of sperm metabolism on fertility-related processes, this field is of interest not only in human male fertility but also in livestock research, semen conservation, and assisted reproductive techniques. Newly developed assessment tools are allowing a better understanding of sperm metabolism under different conditions and identifying species-specific peculiarities. This review aims to discuss the current knowledge of mammalian sperm metabolism, focusing on species-specific features, changes during the sperm journey, and potential contributions to translational research and reproductive biotechnologies. Furthermore, we propose future perspectives on sperm bioenergetics research.

Identification and functional characteristics of CHD1L gene variants implicated in human Müllerian duct anomalies

BackgroundMüllerian duct anomalies (MDAs) are congenital developmental disorders that present as a series of abnormalities within the reproductive tracts of females. Genetic factors are linked to MDAs and recent advancements in whole-exome sequencing (WES) provide innovative perspectives in this field. However, relevant mechanism has only been investigated in a restricted manner without clear elucidation of respective observations.MethodsOur previous study reported that 2 of 12 patients with MDAs harbored the CHD1L variant c.348-1G>C. Subsequently, an additional 85 MDAs patients were recruited. Variants in CHD1L were screened through the in-house database of WES performed in the cohort and two cases were identified. One presented with partial septate uterus with left renal agenesis and the other with complete septate uterus, duplicated cervices and longitudinal vaginal septum. The pathogenicity of the discovered variants was further assessed by molecular dynamics simulation and various functional assays.ResultsUltimately, two novel heterozygous CHD1L variants, including a missense variant c.956G>A (p.R319Q) and a nonsense variant c.1831C>T (p.R611*) were observed. The variants were absent in 100 controls. Altogether, the contribution yield of CHD1L to MDAs was calculated as 4.12% (4/97). All three variants were assessed as pathogenic through various functional analysis. The splice-site variant c.348-1G>C resulted in a 11 bp sequence skipping in exon 4 of CHD1L and led to nonsense mediated decay of its transcripts. Unlike WT CHD1L, the truncated R611* protein mislocalized to the cytoplasm, abolish the ability of CHD1L to promote cell migration and failed to interact with PARP1 owing to the loss of macro domain. The R319Q variant exhibited conformational disparities and showed abnormal protein recruitment behavior through laser microirradiation comparing with the WT CHD1L. All these variants impaired the CHD1L function in DNA damage repair, thus participating in MDAs.ConclusionsThe current study not only expands the mutational spectrum of CHD1L in MDAs but determines three variants as pathogenic according to ACMG guidelines with reliable functional evidence. Additionally, the impairment in DNA damage repair is an underlying mechanism involved in MDAs.

Risk factors for long-term urination and sexual function impairment following laparoscopic resection of presacral lesions

BACKGROUNDPresacral cysts are rare congenital lesions predominantly affecting females. Surgery is often recommended after diagnosis due to the risk of malignant transformation and complications associated with cyst enlargement. Laparoscopic excision is increasingly favored due to its enhanced visualization and precision.AIMTo assess long-term urinary, sexual function outcomes and quality of life in female patients undergoing laparoscopic resection of presacral cysts.METHODSWe conducted a retrospective review of female patients who underwent laparoscopic resection of presacral cysts between August 2012 and May 2020. Patient demographics, surgical outcomes, and postoperative complications were analyzed. The urinary function was assessed using the International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Module (ICIQ-FLUTS), the sexual function was evaluated using the Female Sexual Function Index (FSFI), and quality of life was assessed using the 36-item Short-Form Health Survey (SF-36).RESULTSAmong the 32 female patients included, 10 experienced postoperative urinary incontinence, predominantly of the mixed type. The risk factors for urinary incontinence included abdominal distension and the proximity of the cyst to the rectum. Notably, urinary incontinence significantly impacted the overall lower urinary tract symptoms and quality of life. Additionally, seven patients reported postoperative sexual dysfunction, with previous abdominal or pelvic surgery and cyst location under S3 identified as risk factors, affecting the mental health aspects of their quality of life.CONCLUSIONLaparoscopic cyst resection in females poses risks of urinary and sexual dysfunction, potentially impacting quality of life. Thus, tailored management approaches are crucial.

84 a Population Based Study on Long Term Outcomes for Malignant Melanoma of the Female Genitourinary Tract, in the Pre-Immunotherapy Era

84 a Population Based Study on Long Term Outcomes for Malignant Melanoma of the Female Genitourinary Tract, in the Pre-Immunotherapy Era

The Effect of Seminal Plasma on the Equine Endometrial Transcriptome.

The establishment of pregnancy involves a fine-tuned balance between protection and tolerance within the maternal immune system, as the female needs to accept a foreign antigen (the semi-allogenic fetus) while still being able to combat pathogens from the uterus. In the horse, the first uterine exposure to paternal antigens is during mating when sperm is introduced to the tissue and draining lymphatics of the uterus. Additionally, it has been suggested that seminal plasma and its proteins within it play an essential role in preparing the female tract for a suitable immunologic environment but this has not been confirmed in the horse. Therefore, the objective of this study was to evaluate the endometrial transcriptome following insemination either with seminal plasma or with reduced seminal plasma. We hypothesised that reduced seminal plasma would alter the endometrial transcriptome and affect transcripts relating to immunotolerance, antigen presentation and embryo growth and development. To do so, six (n = 6) mares were inseminated in a randomised switch-back design over the course of four oestrous cycles. Mares were rectally palpated and scanned via ultrasonography for the detection of a pre-ovulatory follicle (>35 mm) alongside increasing uterine oedema and relaxed cervix, and then treated with one of four treatment groups including (1) 30 mL lactated Ringers solution (LRS; NegCon), (2) 500 × 106 spermatozoa in conjunction with 30 mL seminal plasma (SP+), (3) 30 mL lactated Ringers solution (LRS; wash out) and (4) 500 × 106 spermatozoa with seminal plasma reduced via gradient centrifugation and resuspended in 30 mL LRS (SP-). Human chorionic gonadotropin (hCG) was administered to standardise the time to ovulation and endometrial biopsies were collected 7 days after insemination. RNA was isolated utilising Trizol, and RNA-Seq was performed by Novogene, with 97.79% total mapping and 40 million read depth. p value was set to <0.05. When comparing SP+ to SP-, 158 differentially expressed genes (DEGs) were identified. Biological processes impacted included antigen processing and regulation, cholesterol synthesis, and immune/inflammatory response. Gene ontology (GO) enrichment analysis using DAVID v6.8 revealed that many of these DEGs were involved in biological process such as antigen presentation (HLA-DM beta chain, HLA-DRB, HLA-DQA and RASGRP1), immune cell signalling (CXCL9, CXCL1, DEFB1 and MIP-2B), embryo growth and development (INHA, KLF2, RDH10, LAMA3 and SLC34A2) and embryo metabolism (ABCA1, ABCA2, APOA1, LDL, INSR, IGFBP2 and IGFBP3). Overall, reduction of seminal plasma from the insemination dose impacted the endometrial transcriptome at the time of early embryonic exposure to the uterine environment. Further work is justified to evaluate these alterations impact on embryo maturation, placental development, pregnancy outcome and development of offspring.

Adjustable continence therapy (ProACT/ACTTM) with periurethral balloons for treatment of stress urinary incontinence: a narrative review.

First-line surgical management of stress urinary incontinence (SUI) currently involves implantation of an artificial urinary sphincter (AUS) in male patients and midurethral sling in female patients. Still, there is demand for a less invasive treatment option without the need to use a device during voiding. Since its first description in 2005, many clinics have implemented adjustable continence therapy balloons in male (ProACTTM) and female patients (ACTTM). Publications on the use of ProACT/ACTTM were reviewed from 2002 until September 2022, focusing on functional and safety outcomes, including predictors of treatment failure and complications. Most publications report the use of ProACTTM in patients after prostate surgery, with approximately 60% experiencing a cure rate and 82% achieving over 50% improvement. Consistent functional outcome assessment in female and neurogenic lower urinary tract dysfunction (NLUTD) patients lacks. Few predictors of treatment failure were described, resulting in an advise to not use the balloons after male pelvic radiation therapy. High revision rates were observed in all patient groups, with balloon defects as one of the most common causes for revision. Based on the current literature, ProACTTM is safe and effective in male patients after prostate surgery, but the role of ProACT/ACTTM in female and NLUTD patients is still unclear. There is need for research of higher level of evidence with uniform outcome assessments. Preferably, ProACTTM is prospectively compared with AUS in a randomized setting. In addition, development of better-quality balloons should reduce mechanical failure and revision surgeries, resulting in improved functional and patient satisfaction outcomes.

Reproductive Tract Microbial Transitions from Late Gestation to Early Postpartum Using 16S rRNA Metagenetic Profiling in First-Pregnancy Heifers.

Studies in recent years indicate that reproductive tract microbial communities are crucial for shaping mammals' health and reproductive outcomes. Following parturition, uterine bacterial contamination often occurs due to the open cervix, which may lead to postpartum uterine inflammatory diseases, especially in primiparous individuals. However, investigations into spatio-temporal microbial transitions in the reproductive tract of primigravid females remain limited. Our objective was to describe and compare the microbial community compositions in the vagina at late gestation and in the vagina and uterus at early postpartum in first-pregnancy heifers. Three swab samples were collected from 33 first-pregnancy Holstein Friesian heifers: one vaginal sample at gestation day 258 ± 4, and vaginal and uterine samples at postpartum day 7 ± 2. Each sample underwent 16S rRNA V4 region metagenetic analysis via Illumina MiSeq, with bioinformatics following Mothur MiSeq SOP. The reproductive tract bacterial communities were assigned to 1255 genus-level OTUs across 30 phyla. Dominant phyla, accounting for approximately 90% of the communities, included Proteobacteria, Firmicutes, Actinobacteria, Bacteroidetes, and Fusobacteria. However, the results revealed distinct shifts in microbial composition between the prepartum vagina (Vag-pre), postpartum vagina (Vag-post), and postpartum uterus (Utr-post). The Vag-pre and Utr-post microbial profiles were the most distinct. The Utr-post group had lower relative abundances of Proteobacteria but higher abundances of Bacteroidetes, Fusobacteria, and Tenericutes compared to Vag-pre, while Vag-post displayed intermediate values for these phyla, suggesting a transitional profile. Additionally, the Utr-post group exhibited lower bacterial richness and diversity compared to both Vag-pre and Vag-post. The unsupervised probabilistic Dirichlet Multinomial Mixtures model identified two distinct community types: most Vag-pre samples clustered into one type and Utr-post samples into another, while Vag-post samples were distributed evenly between the two. LEfSe analysis revealed distinct microbial profiles at the genus level. Overall, specific microbial markers were associated with anatomical and temporal transitions, revealing a dynamic microbial landscape during the first pregnancy and parturition. These differences highlight the complexity of these ecosystems and open new avenues for research in reproductive biology and microbial ecology.

Draft genomes of Neisseria perflava UMB0578, Proteus mirabilis UMB8339, and Enterococcus faecalis UMB7967 isolated from urine samples.

The urinary tract of females harbors a variety of microorganisms, both for those with and without symptoms. Here, we present the draft genome sequences of three isolates from urine samples-Neisseria perflava UMB0578, Proteus mirabilis UMB8339, and Enterococcus faecalis UMB7967.

The Role of Some Antibiotics on Male and Female Urinary Tract Infections

The Role of Some Antibiotics on Male and Female Urinary Tract Infections

Bacillus coagulans LMG S-24828 Impairs Candida Virulence and Protects Vaginal Epithelial Cells against Candida Infection In Vitro.

Probiotics are living microbes that provide benefits to the host. The growing data on health promotion, following probiotics administration, increased interest among researchers and pharmaceutical companies. Infections of the lower genital tract in females, caused by a wide range of pathogens, represent one of the main areas for the use of probiotics and postbiotics. Vulvovaginal candidiasis (VVC) affects 75% of women of reproductive age at least once during their lifetime, with 5-8% developing the recurrent form (RVVC). The disease is triggered by the overgrowth of Candida on the vaginal mucosa. Here, in order to establish its probiotic potential in the context of VVC, we evaluated the anti-fungal effects of the spore-producing Bacillus coagulans LMG S-24828 against C. albicans and C. parapsilosis as well as its beneficial effects in counteracting Candida vaginal infection in vitro. Our results show that both live B. coagulans and its Cell-Free Supernatant (CFS) exerted antifungal activity against both fungi. Moreover, live B. coagulans reduced hyphal formation, inhibited C. albicans adhesion to vaginal epithelial cells, showed co-aggregation capacity, and exerted a protective effect on vaginal epithelial cells infected with C. albicans. These data suggest that B. coagulans LMG S-24828 may provide benefits in the context of Candida vaginal infections.

Evaluation of Latrogenic Genitourinary Fistula after Major Gynaecological Operation in Patient Group Admitted in BSMMU

Introduction: Close proximity of urinary tract and genital systems in females poses potential risk of fistulas formation during surgical interventions. Gynaecological malignancy, bleeding, prolonged surgery, the presence of active infection during operation, endometriosis, large uterus, previous pelvic operation, pelvic adhesions and myoma uteri are major predisposing factors that may increase the risk of urological injuries &amp; genitourinary fistulas. Genitourinary fistulas result in continuous or intermittent urinary incontinence and a significant public health issue with negative physical, emotional and social impacts on individuals. Materials and Methods: This cross sectional observational study was conducted in Department of Obstetrics &amp;Gynaecology, Bangabandhu Sheikh Mujib Medical University, Dhaka, from 27th March 2017 to 26th September 2017. The sample was collected by purposive sampling technique. The study subjects were women with iatrogenic fistula (diagnosed after a clinical examination and investigations) attended in out-patients or in-patients department. Result: Mean age of patients was 32.5 ± 9.54 years. Vesicovaginal fistula was commonest cause for iatrogenic genitourinary fistula, present in 34 patients. Ureterovaginal fistula was 10 patients and 6 patients detected urethrovaginal. Aetiological factors revealed that, 46.0% occurred during vaginal hysterectomy, 18.0% due to abdominal hysterectomy, 20.0% due to laparotomy with salphingoophorectmy and 16.0% during laparotomy with cystectomy. Conclusion: The commonest urogenital fistula is the vesicovaginal fistula. Urinary leakage following gynaecological surgery is a dreaded complication due to the formation of urogenital fistula. Thorough evaluation, using all diagnostic tools for complete diagnosis, understanding the pathophysiology and choosing the best surgical procedure are mandatory to obtain good outcomes after the surgical procedures. Medicine Today 2024, Vol.36 (2): 110-113

Draft genomes of two Enterobacter hormaechei strains isolated from catheterized urine samples from females experiencing overactive bladder symptoms.

In this study, we present the draft genome of two Enterobacter hormaechei strains isolated from catheterized urine specimens from females with overactive bladder (OAB) symptoms. Through the sequencing of these E. hormaechei strains, we aim to better understand its presence and putative role in OAB in the female urinary tract.

Glucose prevents the acquisition of the capacitated state in pig spermatozoa.

Mammalian spermatozoa need to undergo a process named capacitation to be able to fertilize an oocyte. During their journey in the female tract, spermatozoa obtain energy while exposed to a changing environment containing a variety of metabolic substrates. The energy requirements for sperm capacitation are species-specific. In addition, the available energy source can hinder the process of sperm capacitation and eventually the acrosome reaction. To evaluate whether the metabolic substrates available in the in vitro sperm capacitation medium allow or interfere with the pig sperm capacitation process. The effect of different metabolic substrates on sperm capacitation process was evaluated by analyzing phosphorylation in the p32 protein; the acrosome reaction and the ATP intracellular content. The presence of glucose in the in vitro capacitating medium diminishes, in a concentration-dependent manner, parameters associated with the capacitated status: induced acrosome exocytosis, plasma membrane destabilization, and protein tyrosine phosphorylation. Conversely, sperm incubation with pyruvate or lactate, either individually or in combination, allows the attainment of the capacitated status. Unexpectedly, pig spermatozoa incubated without any extracellular energy substrates or with a non-metabolizable substrate (l-glucose) for 4h displayed similar sperm viability to the control and exhibited a capacitated phenotype. The capacitation-like phenotype observed in starved pig spermatozoa (absence of glucose, lactate, and pyruvate) was dependent on extracellular bicarbonate and calcium levels, and these spermatozoa exhibited lower intracellular ATP content compared to those not capacitated. Nevertheless, the intracellular content of calcium was not modified in comparison to the control. Our findings suggest that the metabolic substrates used to fuel pig sperm metabolism are important in achieving the capacitated status. The results of this work could be used to refine the capacitating medium employed in pig in vitro fertilization.

Primary urethral carcinoma in female: An extremely rare case series at a single tertiary referral hospital and literature review

Introduction and importancePrimary urethral carcinoma (PUC) is exceedingly uncommon and accounts for 0.02 % of all female cancers and <1 % of female genitourinary tract malignancy. PUC in female usually presents late with a higher disease stage and, hence, has higher cancer-specific mortality. Due to its rarity, the current recommendation for the management of PUC is still unclear. Case presentationThis study reports two rare cases of 59-year-old and 65-year-old women with PUC, presenting with chief complaint of hematuria. Urethrocystoscopy and biopsy were performed. Pathology results revealed mucinous adenocarcinoma (AC) and urothelial carcinoma (UC) of the urethra, respectively. Radiological imaging was conducted for staging. Both were diagnosed with cT4N2M0. The first patient underwent anterior pelvic exenteration with bilateral ureterocutaneoustomy (UCS), while the second patient received cisplatin-based chemotherapy before the surgery. Radiological follow-up was planned 3 months after the surgery. Clinical discussionBoth mucinous AC and UC are considered incredibly unusual subtypes, with no defined treatment guidelines. Anterior exenteration with or without neoadjuvant chemotherapy may be opted for advanced PUC affecting the proximal urethra and adjacent organs. Following the previous studies, in this case series, both patients (locally advanced) underwent anterior exenteration. Additionally, the UC subtype received multimodal treatment with neoadjuvant chemotherapy which was shown to improve overall survival. ConclusionIn conclusion, PUC is extremely rare, and the choice of management remained various. Long-term follow-up for these patients is mandatory to improve understanding of this incredibly uncommon disease.

P-065 HyperSperm, a new sperm preparation method for IVF/ICSI improves sperm capacitation while maintaining a high safety profile

Abstract Study question Does HyperSperm improve sperm capacitation without affecting sperm quality? Summary answer HyperSperm enhances sperm hyperactivated motility, a hallmark of capacitation, without compromising sperm viability, acrosome integrity, or DNA fragmentation. What is known already HyperSperm is a novel semen preparation method for IVF/ICSI based on mimicking effective capacitation that occurs in the female tract. HyperSperm, which consists of 3 media used sequentially to treat sperm before insemination, gave rise to more high-quality blastocysts compared to current standard of care in a pilot split oocyte study in 10 couples. Study design, size, duration This prospective in vitro study was conducted between July 2023 and January 2024 in an academic department. A consecutive cohort of 15 normozoospermic individuals were recruited and included. Each participant provided a semen sample by masturbation after written informed consent was obtained on the day of the collection. Participants/materials, setting, methods Semen samples from normozoospermic individuals (n = 15) were divided into two halves. After density gradient centrifugation, Control half was incubated in modified HTF (Human Tubal Fluid) for 2-4 hours, while the other half underwent HyperSperm treatment. The following parameters were assessed: sperm viability (eosin exclusion); motility and kinematic parameters (CASA); acrosome integrity (fluorescein-labeled Pisum sativum lectin staining); and DNA fragmentation by TUNEL. Differences between groups were evaluated by paired T-test. Significant differences were considered when p &amp;lt; 0.05. Main results and the role of chance Following treatments, sperm viability (90±3% Control vs. 91±3% HyperSperm) and motility (87±2% Control vs. 89±3% HyperSperm) were similar between groups (p &amp;gt; 0.05). Notably, HyperSperm induced a significant hyperactivation increase (9±2% Control vs. 22±3% HyperSperm), along with associated kinematic parameters (i.e., curvilinear velocity and lateral head displacement) (p &amp;lt; 0.05). Furthermore, HyperSperm treatment did not promote motility decrease over time. Finally, there were no differences in the percentage of sperm with intact acrosome (91±2% Control vs. 90±2% HyperSperm) and DNA fragmentation (3±1% Control vs. 3±1% HyperSperm) between groups (p &amp;gt; 0.05). Altogether, HyperSperm has shown to significantly improve sperm capacitation parameters while maintaining a high safety profile in the treated sample. Limitations, reasons for caution The study is limited to normozoospermic samples, and further research should validate these findings across broader male populations undergoing IVF/ICSI. Wider implications of the findings HyperSperm has demonstrated an increase in the production of high-quality blastocysts via IVF, that would reduce barriers to treatment access through higher cumulative success rates and lower treatment repetitions. The observed increase in hyperactivation combined with the safety profile of HyperSperm supports its potential for future adoption in reproductive clinics. Trial registration number not applicable

HAP-PEE: A Danish National Study of Challenges Related to Urinating When Away from Home in Women with Neuromuscular Diseases, Impact on Activity and Participation and Prevalence of Lower Urinary Tract Symptoms.

Little is known about the challenges faced by women with a neuromuscular disease (NMD) when having to go to the toilet in other places than home; a topic that is highly important for participation and bladder health. The aim was to investigate whether women with NMD have problems in going to the toilet when not at home, the problems' impact on their social activities, education, and working life, which strategies they use to manage the problems, and the prevalence of lower urinary tract symptoms (LUTS). A national survey containing questions on type of NMD, mobility, impacts on social activities, education, working life, and bladder health was developed by women with NMD and researchers. LUTS were assessed by the International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms Modules (ICIQ-FLUTS). Female patients≥12 years (n = 1617) registered at the Danish National Rehabilitation Centre for Neuromuscular Diseases were invited. 692 women (43%) accepted the invitation; 21% were non-ambulant. 25% of respondents avoided going to the toilet when not at home. One third of respondents experienced that problems in going to the toilet impacted their social life. 43% of respondents refrained from drinking to avoid voiding when not at home, 61% had a low frequency of urinating, 17% had experienced urinary tract infections, and 35% had experienced urine incontinence. Problems were seldom discussed with professionals, only 5% of participants had been referred to neuro-urological evaluation. The results highlight the difficulties in urinating faced by women with NMD when not at home and how these difficulties impact functioning, participation, and bladder health. The study illustrates a lack of awareness of the problems in the neuro-urological clinic. It is necessary to address this in clinical practice to provide supportive treatment and solutions that will enable participation for women with NMD.

Draft genome sequences of three Lactobacillus crispatus strains, isolated from the female urinary tract.

Lactobacillus crispatus is a frequent member of the female urogenital microbiota. Here, we present the draft genome assemblies of three L. crispatus strains: UMB4356, UMB5661, and UMB6244. All strains were isolated from voided urine samples from females with type 2 diabetes.