Infertile Group Research Articles

Cytological and molecular screening of Chlamydia trachomatis in infertile women attending a maternity teaching hospital in Gezira State, Sudan: a cross-sectional study

Background: Chlamydia trachomatis (CT) is a sexually transmitted pathogen that threatens reproductive health worldwide. This study aims to screen CT urogenital infection using cytology and molecular methods in women suffering infertility. Methods: In total, 415 women suffering infertility, attending Wad Madani Maternity Hospital were included in this study and then classified into two groups: primary infertile women and secondary infertile women. Both urine (n= 415) and vaginal swab samples (n= 130) were collected and tested using Giemsa stain and Polymerase Chain Reaction (PCR) for detection of CT. Results: CT was detected in 33.7% (140/415) of urine samples and 73.1% (95/130) of vaginal swab samples using Giemsa stain, compared with 44.6% (185/415) and 84.6% (110/130) using PCR, respectively. In the primary infertile group (n= 265), chlamydia was detected in 35.8% (95/265) of urine and 75% (60/80) of swab samples by Giemsa stain compared with 50.9% (135/265) and 75% (60/80) of the samples by PCR. In the secondary infertile group (n= 150), chlamydia was detected in 30% (45/150) of urine and 70% (35/50) of swab samples by Giemsa stain compared with 33.3% (50/150) and 100% (50/50) of the samples by PCR. The associated risk factors were age, lower abdominal pain, and urethritis (p< 0.05). The sensitivity, specificity, positive predictive value, and negative predictive value of Giemsa stain in detecting chlamydia compared to PCR were 86.4%, 100%, 100%, and 83.6%, respectively. Conclusions: Giemsa stain can be used as a screening test for detection of urogenital chlamydia in urine and vaginal samples in places where PCR is difficult to be performed.

A decade of WHO 2010: total sperm number temporal trend and role of lifestyle factors.

After a huge decline in sperm concentration between 1938 and 1991 was reported, many researchers investigated the possibility of a worsening of human sperm quality. Despite massive efforts, published evidence is still controversial. Similarly, the role of lifestyle factors on semen parameters is debated. We conducted a monocentric Italian study to evaluate the total sperm number trend over the last 10 years (from 2010 to 2019). Additionally, we evaluated the association between lifestyle factors and total sperm number in order to identify possible damaging factors. We performed a retrospective study analyzing subjects aged 18-55 years who had their semen analyzed between 2010 and 2019. A total of 3329 subjects were included: 1655 subjects referred to our department (Department of Experimental Medicine, Sapienza University of Rome, Roma, Italy) for idiopathic infertility and 1674 subjects referred for preconceptional or andrological screening with no confirmed andrological diseases. Semen samples were examined according to World Health Organization (WHO) 2010 criteria by two seminologists with the same training and the same equipment. For statistical evaluations, only total sperm number (×10 6 per ejaculate) was taken into consideration. We detected no significant changes in mean total sperm number during the last decade, in either the entire population or the two subgroups (infertile group and control group). In a multivariate analysis total sperm number was significantly associated with the history of infertility, body mass index (BMI) and cigarette smoking. Our results suggest that infertile men are "vulnerable" subjects, particularly susceptible to several negative factors, many of which still remain unknown. Our study highlights the need for studies addressing men's lifestyle in order to find and reduce deleterious agents.

Depression and distress in couples with infertility - who suffers more?

Introduction/Objective. Infertility is the inability to achieve pregnancy after a year or more of unprotected sexual intercourse. It is a clinical and social issue affecting both sexes. Infertility can cause anxiety, depression, and personal distress with long-lasting consequences. Men and women tend to cope with infertility in different ways and reliance on certain coping mechanisms can be harmful. This study aims to examine the correlative effects of infertility, distress and depression among couples, and investigate sex disparities in levels of suffering. Methods. The research is a cross-sectional study that included 168 participants (84 couples) divided into two groups, control and infertility group. Beck Depression Inventory Second Edition (BDI-II) and the Brief Symptom Inventory (BSI) were used to identify and assess psychological symptoms. Statistical analysis was performed using SPSS at the 0.05 level of significance. Results. The results showed that there was a significant difference in the scores on BDI and BSI scales between the infertile and fertile groups, with participants in the infertile group reporting higher levels of depression and distress (t = -2.724, df = 166, p < 0.01; t = -3.609, df = 166, p < 0.01). Women had significantly higher scores on the depression scale than men (t = -2.079, df = 166, p < 0.05). Conclusion. In summary, the study found that couples dealing with infertility experience higher levels of distress and depression compared to the control group. Women in these couples are particularly vulnerable to depression. The study highlights the importance of addressing the mental health needs of individuals and couples dealing with infertility, in addition to treating the underlying medical issues.

Use of Uterine and Ovarian Arteries Doppler Parameters for the Prediction of Infertility in Females

Background: In the context of fertility, Doppler sonography is used to evaluate the blood flow to the uterus and ovaries. The blood flow to these organs plays a crucial role in the process of ovulation, fertilization, and implantation of the fertilized egg. Changes in the Doppler sonographic indices of the uterine and ovarian arteries can provide information about the blood flow to these organs and can help identify potential problems that may be affecting fertility. Objective: To evaluate the Doppler indices of uterine and ovarian arteries in fertile and infertile women and help clinicians develop more effective diagnostic and treatment strategies for infertility. Methodology: A cross-sectional Analytical study was conducted for a duration of 9 months at a Medics Dr. Amers, Lahore, Pakistan. The study included 150 fertile and 150 infertile females aged 18-45 and excluded all females using oral contraceptive and contraceptive devices. SPSS software version 25 was used to analyze the data. Results: Age of participants ranged between 19 to 43 years with a mean + SD age of 28 + 6.5 years. The mean + SD RI and PI of left ovarian artery was 0.48 + 0.03 and 1.1 + 0.13 in the fertile, 0.9 + 0.03 and 4.2 + 1.2 in the infertile group. The mean + SD RI and PI of right ovarian artery was 0.60 + 0.03 and 1.6 + 0.06 in the fertile, 0.8 + 0.01 and 3.0 + 0.4 in theinfertile group (Table 1) Overall, results shows that the four variables are significantly different between fertile and infertile groups, with higher values in the infertile group. Independent sample test showed statistical significance between RI and PI of right ovarian artery of both groups (P < 0.05). However, in left ovarian artery the values of PI in both groups showed a significance (P< 0.05) were as values RI are found to be insignificant (P > 0.05). Independent sample test showed statistical significance between RI and PI of right and left uterine artery of both groups (P < 0.05). The mean + SD endometrial thickness in fertile group was 11.0 + 2.6 mm it was 9 + 1.6 mm in infertile group (Table 3). Indicating a significant difference between the two groups (P < 0.05). Conclusion: Uterine and Ovarian artery hemodynamics plays an important role in fertility. Findings from this study revealed that a high RI and PI and thin endometrium significantly affects fertility. Key words: Resistive index, Pulsatility index, Infertility, Uterine artery, Ovarian artery.

Rapid detection and simultaneous identification of the Mycoplasma and Ureaplasma species by real-time PCR and melt curve analysis among fertile and infertile females.

Mycoplasma and Ureaplasma species threaten reproductive health and fertility worldwide. Due to the lack of sensitive, accurate, and affordable diagnostic tools, the simultaneous contributions of these agents in infertility have been overlooked. This study aims to detect and identify Mycoplasma and Ureaplasma species in the genital tracts of fertile and infertile females simultaneously. In a case-control study, cervicovaginal clinical samples were collected from patients referred to two teaching hospitals in Isfahan from July 2019 to February 2019. The initial screening was by using Real-time PCR and designed primer to evaluate the presence of Mycoplasma and Ureaplasma species including fertile and infertile women. The bacteria species were then detected and differentiated by using the melt curve and sequenced to confirm and identify. Finally, the standard curve was used to measure and compare the copy number of each species in each group. The isolates also were detected in clinical samples using the commercial PCR method. The frequencies of Mycoplasma genitalium and Mycoplasma hominis were (0.0, 10.0%) in the fertile group and (4.3%, 34.3%) in the infertile group, respectively. Ureaplasma parvum and Ureaplasma urealyticum species in the fertile group (7.1%, 5.7%) and in the infertile group (32.9%, 24.3) were determined, respectively. The comparison of the results obtained from PCR and Real-time PCR showed that the recent technique has the ability to track 101-103 copy numbers. The present method allows differential diagnosis and quantification of Mycoplasma and Ureaplasma species in a short time and simultaneously.

Association of methylenetetrahydrofolate reductase polymorphism and male infertility in type 2 diabetes mellitus patients

INTRODUCTION: As per World Health Organization, Infertility is a condition which is characterized by not getting conceived with more than 1-year of unprotected sexual intercourse without usage of any contraceptive aids. Folate has a significant role in the metabolism of the cells, like nucleic acids synthesis, gene expression by means of remethylation of the homocysteine into methionine. In the males, deficiency of folate leads to reduced proliferation of the sperm cells. Polymorphisms of methylenetetrahydrofolate reductase (MTHFR) and methionine synthase reductase genes result in alterations of the methylations resulting pathological conditions being a potential risk factor for male infertility. MATERIALS AND METHODS: A total of 100 diabetic infertile males were selected as the study group and 100 nondiabetic fertile males were included as the control group. Blood samples were analyzed for the MTHFR polymorphisms. DNA extraction was done and the extract is subjected to polymerase chain reaction amplification. The resultant is subjected to electrophoresis for MTHFR gene allele confirmation. Statistical analysis was done using IBM SPSS Statistics 20 package. Chi-square test, odds ratio has been done and P < 0.05 is considered statistically significant. RESULTS: Genotype frequencies of MTHFR C677T, A1298C in all the subjects were analyzed for the Hardy–Weinberg law of genetic equilibrium. Mutant polymorphisms of MTHFR C677T, i.e., thymine-thymine and cytosine-thymine were increased significantly. Similarly, MTHFR A1298C mutant polymorphisms, i.e. adenine-cytosine, cytosine-cytosine were increased significantly in the infertile group than in the fertile group. DISCUSSION: Mutations of both MTHFR C677T, A1298C are found to be linked with lowered enzyme activity. We found that the occurrence of mutant homozygous and mutant heterozygous genotypes was increased in a diabetic male infertile group when compared to nondiabetic fertile group. Hence, it can be concluded that presence of single-nucleotide polymorphisms of MTHFR will increase the risk of infertility in diabetic male population.

Comprehensive analysis of immune-related genes associated with the microenvironment of patients with unexplained infertility.

Disturbances in immunological responses and modulation lead to implantation and pregnancy failure and might be involved in the pathogenesis of infertility. This project aimed to screen and identify immune-related genes as potential biomarkers for treatment. Gene expression profiles were obtained from Gene Expression Omnibus (GEO) databases. Differentially expressed genes (DEGs) were screened using GEO 2R to explore potential biomarkers. Protein-protein interaction (PPI) network analysis and functional enrichment analysis were applied to explore possible mechanisms. The deconvolution algorithm [referred to as Cell-type Identification by Estimating Relative Subsets of RNA Transcripts (CIBERSORT)] was employed to assess tissue-infiltrating immune cells. Western blot analysis and immunohistochemistry (IHC) were conducted for determination of protein levels. In this research, we identified 24 candidate immune-related DEGs via combined DEGs and functional analysis. We also found that the ratio of M0 macrophages and resting mast cells was higher in infertile group (P<0.05), whereas the amounts of activated natural killer (NK) cells was significantly lower compared with the control group (P<0.05). Furthermore, we evaluated the relationship between immune cells and candidate genes and found that 17 genes were related to M0 macrophages, resting mast cells, or activated NK cells. The genes CD40, PRF1, and EDN3 were chosen based on validation from independent datasets. Finally, our clinical samples confirmed the expression of the 3 genes. The study recognized 3 genes that are signatures and could be potential biomarkers for unexplained infertility. These genes might guide the immunotherapy of these patients and become new treatment targets.

Genetic variations of antioxidant genes and their association with male infertility in Vietnamese men.

Antioxidant genes, such as superoxide dismutase (SOD), catalase (CAT), and nitric oxide synthase (NOS), play critical roles in spermatogenesis and sperm functions. Polymorphisms of antioxidant genes have been shown to be strongly associated with sperm quality which affects male fertility. To investigate the association of antioxidant gene polymorphisms to male infertility in Vietnamese men, in this case-control study, using Sanger sequencing, we genotyped four variants SOD1:7958G>A, SOD2:c.47T>C, CAT:-262C>T, and NOS3:-786C>T. We identified SOD1:7958GA genotype and NOS3:-786CT genotype in the infertility group were significantly higher than in the control with OR=2.191 (95% CI: 1.226-3.915, p=0.004) and OR=3.135 (95% CI: 1.591-6.180, p < 0.001), respectively. We also detected that the frequency of the SOD2:c.47TC genotype was significantly higher in the male infertility group than in fertile men (OR=1.941, 95% CI: 1.063-3.595, p=0.029). Gene-gene interactions between the SNPs of SOD1, SOD2, and CAT might increase the risk of male infertility patients. In particular, patients carrying the SOD1:GA+AA, SOD2:TC+CC, and CAT:CT/TT genotype pattern have an increased risk of male infertility (OR=7.614, p=0.007). To our knowledge, this is the first study to evaluate the association between the SOD1:7958G>A polymorphism and male infertility. Further studies with larger sample sizes and more genes are needed to better assess the association between variants of antioxidant genes and male infertility.

Postoperative Pregnancy Outcomes Following Laparoscopic Surgical Management in Women with Stage III/IV Endometriosis: A Single-Center Follow-Up Study.

The effects of laparoscopic surgical management in women with stage III/IV endometriosis remain controversial. The standard extent of resection for stage III/IV endometriosis with deep endometriosis to treat endometriosis-associated infertility is debatable. This study aimed to assess the postoperative pregnancy outcomes following a routine surgical intervention for stage III/IV endometriosis patients. Patients with stage III/IV endometriosis who underwent conservative laparoscopic surgery at our hospital between January 2010 and December 2018 were retrospectively analyzed. Statistical analyses were performed to determine the correlations between endometriosis features and postoperative pregnancy outcomes. Of 256 patients enrolled, 94 wished to conceive. Exclusion criteria: ≥40 years, adenomyosis, partners with infertility issues. Finally, 71 women were included. The overall postoperative pregnancy rate was 76.1% (n = 54): 49 and five from non-assisted reproductive technology (ART) and ART, respectively. The postoperative pregnancy rate in patients diagnosed with infertility presurgery (40/71) was 70.0% (n = 28): 24 (non-ART) and four (ART). The endometriosis fertility index (EFI) score was higher in the pregnant than in the nonpregnant group (P = 0.03). The EFI score and surgical score of EFI were higher in the non-ART than in the ART group (P = 0.04; P = 0.02); in the infertile group, they were higher in the pregnant than in the nonpregnant group (P = 0.018; P = 0.027). Our postoperative pregnancy rate after conservative laparoscopic surgery for patients with stage III/IV endometriosis compared favorably with previous reports. EFI was a significant predictor of postoperative pregnancy. Our surgical approach to maintain a high surgical score of EFI might help treat endometriosis-associated infertility.

Association of PRMT6, PEX10 and SOX5 genetic variants with idiopathic male infertility: Evidence from North Macedonian population and an updated meta-analysis

PRMT6, PEX10 and SOX5 genetic variants were identified as male infertility-associated loci in a genome-wide association study and further validated in various populations. Still, the results of previous case-control studies varied, which could be due to differences in participants? ethnic backgrounds. The main purpose of the present study was to evaluate the supposed association of these variants with idiopathic male infertility in North Macedonian population. Furthermore, we aimed to conduct the systematic quantitative data synthesis which includes the results of previous studies on the same issue in other European and non-European populations. A total of 137 men from North Macedonia diagnosed with idiopathic infertility and 130 age-matched fertile controls were included in the present case-control study. PCR-RFLP method was used for genotyping. Meta-analysis was performed by OpenMeta-analyst statistical software. Variants rs10842262 in SOX5, rs2477686 in PEX10 and rs12097821 in PRMT6 showed the lack of statistically significant differences in genotype distributions between men diagnosed with idiopathic infertility and the control group. Still, rs10842262 allele G frequency was significantly increased in men with poor sperm concentration (P= 0.024, OR = 2.10, 95%CI 1.08-4.06). Meta-analysis further showed the association of rs10842262 and rs12097821 with the risk of idiopathic male infertility. Our results obtained in North Macedonian population supported the previous reports on the involvement of rs10842262 in the genetic basis of male infertility. The meta-analysis confirmed the association of rs10842262 and rs12097821 with male infertility occurrence. Still, additional studies are needed to support the present findings.

The association between reactive oxygen species and α-tocopherol treatment in a sample of infertile Iraq male

Male infertility estimated about 20-70% of couples or >30 million men worldwide. The goal of this study was to elucidate the interrelations between oxidative stress (O.S) in seminal fluid and antioxidant inducing disruption of spermatogenesis. Twenty four infertile patients aged (23-41) years were involved in this study. Which were received α- tocopherol (vitamin E). This group (vit E group) was sub classified according to the WHO criteria (2010) into three different subgroups: oligoasthenoteratozoospermia (OAT) Asthenoteratozoo- spermia (A.T), and Asthenozoospermia (Astheno.). The control group consist of samples obtained from healthy donors of proven fertility (n=23). The main parameters were determined in seminal fluid of infertile patients and healthy men are the sperm and seminal plasma Malondialdehyde (MDA) concentration, and vitamin E concentration in seminal plasma. The results showed that, there was a high significant decrease (p≤0.001) in sperm parameters (concentration, progressive motility and normal morphology), and vitamin E concentration in infertile group compared with that fertile group.After analyzing the statistically difference in the different measured parameters between the vit E group after treatment, in comparison with that of before treatment; the following was observed A high significant increase (p≤0.001) were found in progressive motility, sperm [MDA] (MDAp), vitamin E concentration, and significant increase (P ≤0.05) in the sperm concentration. From all of these observations, it can be concluded that O.S contributes most likely to sperm damage and may be responsible for poor seminal fluid characteristic of the infertile patients involved in the present study. Antioxidants α-tocopherol (vitamin E) plays an important role in the improvement of seminal fluid parameters.

Oil-Based Hysterosalpingography ?mproves Leukaemia ?nhibitory Factor Expression ?n Endometrial Flushing Samples

Objective: The biological mechanism of the fertility-enhancing effect of hysterosalpingography (HSG) is not fully known. Leukemia inhibitory factor (LIF) is an important cytokine involved in implantation. This study was planned to investigate the effect of HSG on LIF mRNA expression in endometrial flushing samples. Methods: Forty infertile patients scheduled for HSG were included in the study. Before HSG, endometrial flushing was performed in the mid-luteal phase, followed by contrast-medium infusion into the cavity. Second flushing was done in the mid-luteal phase of the next cycle. Ten patients who underwent diagnostic hysteroscopy were taken as the second control group. LIF mRNA levels were measured by RT-PCR in endometrial flushing samples collected from each group. Results: The pre-HSG LIF mRNA levels of the infertile group were significantly lower than those of the fertile group. In infertile patients, LIF mRNA expression increased 3.2 times after HSG compared to baseline levels. LIF values reached fertile levels after HSG. While the LIF levels measured in the hysteroscopy group were significantly lower than in fertile patients, they were similar to the pre-HSG values of infertile patients. LIF levels of infertile patients after HSG were found to be significantly higher than those of the hysteroscopy group. Conclusions: In infertile patients, HSG contributes to receptivity by increasing LIF mRNA synthesis.

Comparing the quality of life of endometriotic patients’ before and after treatment with normal and infertile patients based on the EHP30 questionnaire

ObjectiveThis study aimed to determine the quality of life (QOL), in patients with endometriosis ± infertility (B and C groups) and compare those to healthy women, and also infertile groups without endometriosis as a control groups (A and D), considering the fact that endometriosis and infertility reduces the quality of life in patients.MethodsThe present prospective comparative study was carried out between January 2018 and September 2020. A total of 400 women were included (100 women in each group). The participants filled in a validated questionnaire of quality of life, Endometriosis Health Profile-30 (EHP-30), and a visual analog scale of pain used, at the first visit, and 3 months after the medical or surgical treatment in the endometriosis group without infertility, additionally.ResultsThe majority of the patients were married, categorized in the middle-class of socio-economic state and housewives. They were of Persian descent. BMI was high in the infertile groups; however, the time of infertility was not different between the two groups of B and C (P = 0.054). The mean score of QOL was significantly lower in B, C, and D groups in comparison to the healthy women as the control group (A) (P < 0.001). Moreover, the infertile group (B), in comparison to endometriosis ± infertility groups (C and D), had the lowest mean score of QOL (P < 0.001). In each group, those who were older and had better educational level reported a better quality of life than other participants in that group. Social support plays a very important role in reducing the endometriosis related pain symptoms both before and after treatment. Three months after the treatment of endometriosis (D), a significant improvement was observed in all the aspects of QOL-related endometriosis. Nonetheless, the improvement of the quality of life in the surgical group was significantly higher than that in the medical treatment. The mean visual analog score of pain decreased from 62.22 ± 22.78, to 5.15 ± 2.73 following the surgical treatment (P < 0.001).ConclusionThe lowest quality of life belonged to the infertile group, followed by the endometriosis group. The quality of life of the endometriosis group improved after the treatment. Thus, endometriotic patients’ treatment in terms of improvement of quality of life should be considered by all professional health care teams.

A Cross-Sectional Study Regarding Infertility Among Women in Iraq

Background & Objective: Infertility is the inability to become pregnant despite trying for at least a year. Infertility is also referred to as when a woman continues to experience miscarriages. Environmental factors, lifestyle, hormone issues, physical problems, and age can all contribute to female infertility. About 10-12% of couples struggle with infertility, a multifaceted issue with ramifications for society, the economy, and culture. The majority of female infertility cases are caused by issues with egg production. By analyzing samples from infertility clinics, the current study aims to investigate the degree of female infertility in Erbil, Iraq, while covering all facets of the condition.Materials & Methods: 595 infertile females receiving medical counseling from three infertile institutions between February 2020 to December 2021 were screened for the current study. In addition to anthropometric measurements, information about the etiology, duration, and lifestyle, factors of infertility has been gathered using a standardized questionnaire. Additionally, the sample was subjected to clinical examinations. Five groups of reproductive abnormalities were identified. Around 61.79% of women in the infertile group for the first two years had tubal obstruction, and 49.92% had hormonal deficiencies. Ovulation defects (4.62%) and undersized uteri (4.82%) predominated in the >10-year infertile group. Both weight and body mass index have shown a favorable association with infertility duration.Results: Our findings demonstrated a significant correlation between body mass index and infertility. Most academic and wealthy groups pursued medical advice to resolve issues related to infertility.Conclusion: Finally, it is suggested that female infertility can be managed and cured with hormone therapy, laparoscopic procedures, minor surgical procedures, and medicine.

Evaluation of laparoscopy results for the patients with chronic pelvic pain

Aim: The study aims to retrospectively evaluate the laparoscopy results of patients who underwent laparoscopy with chronic pelvic pain (CPPS) diagnosis in two groups of fertile and infertile patients.&#x0D; Material and Method: This retrospective study examined the electronic records of 170 patients who underwent laparoscopy due to CPPS were included in the study. The patients were divided into two groups: the CPPS and unexplained infertility group (n: 87) as the case group and the CPPS fertile group (n: 83) as the control group. Women aged 25-40 years with unexplained infertility and CPPS were included in the study. &#x0D; Results: Results found a statistically significant association between infertility in women and laparoscopy results (p0.05). There was no statistically significant association between women’s infertility and smoking status (p&gt;0.05). Mann-Whitney test did not find a statistically significant association between case and control regarding age and body mass index (BMI) (p&gt;0.05). There was a statistically significant difference between groups in terms of the duration of pain (p

Neurodevelopmental Disorders in Offspring Conceived via In Vitro Fertilization vs Intracytoplasmic Sperm Injection

Intracytoplasmic sperm injection (ICSI), the most common type of assisted reproductive technology (ART), might damage the sperm or embryo. The implications of male infertility and ICSI for the neurodevelopmental health of offspring remain unknown. To analyze the risks of neurodevelopmental disorders in offspring of couples with male or female infertility with or without ICSI use. This cohort study was conducted in Taiwan and used information collected from the national population registry data set, national birth data set, and national ART data set for all live singleton births from January 1, 2008, to December 31, 2016. The follow-up period started from the date of birth until the diagnosis of a disorder or December 31, 2018, whichever occurred first. Data were analyzed from July 1, 2021, to August 1, 2022. Male or female infertility with or without ICSI. The outcome was the incidence of autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and developmental delay in offspring with ART conception. Taiwan's national population registry data set was used to identify ASD, ADHD, and developmental delay diagnosed in outpatient clinic and hospitalization records. The study included 1 575 971 singleton births (mean [SD] age, 5.87 [2.60] years; 819 389 boys [52.0%]), of whom 1 568 257 (99.5%) had natural conception, 2111 (0.1%) had ART conception with male infertility, and 5603 (0.4%) had ART conception with female infertility. The risks of ASD (adjusted hazard ratio, 2.49; 95% CI, 1.61-3.84; P < .001) and developmental delay (adjusted hazard ratio, 1.92; 95% CI, 1.54-2.39; P < .001) in offspring with ART conception and ICSI use were significantly higher than those in offspring with natural conception. The same results were found in offspring of couples with either male or female infertility and ICSI intervention. Results of this study suggest that male infertility was not associated with an increased risk of neurodevelopmental disorders in offspring. In both male and female infertility groups, ICSI had unfavorable implications for the neurodevelopmental health of offspring in terms of increased risks of ASD and developmental delay.

Assessment of Seminal Plasma Creatine Kinase Activity and Malondialdehyde Concentration among Normozoospermia but Infertile Men

Background: Despite the considerable research efforts that have been made by Reproductive Biologists to understand the etiologies of male infertility, idiopathic male factor infertility still remains unexplained. It occurs in about 10% cases of infertility. Since the etiologies cannot be identified using routine semen analysis, it is important to identify cellular and sub-cellular sperm complications that may help to explain the cause(s) of the infertility, thus stimulate caregivers to direct the further work-up, diagnosis and counseling of affected individuals. The objective of this study was to determine seminal plasma creatine kinase (CK) activity and malondialdehyde (MDA) concentration among normozoospermia but infertile males. Materials and Methods: After routine semen analysis, seminal plasma CK activity and MDA were determined among 75 normozoospermia but infertile men and 50 men of proven fertility using spectrophotometric method. Unpaired Students-t-test and regression analysis were used to compare and associate CK activity and MDA concentration with sperm characteristics. Results: Significantly higher (p&lt;0.001) level of MDA and CK activity were observed among infertile subjects than control group. Sperm count, percent motility, and viability were significantly lower (p&lt;0.05) among study participants than control subjects. Similarly, percentage abnormal morphology was significantly higher (p&lt;0.05) among infertile subjects than control group. The Odds of elevated CK activity to impair sperm motility, viability and morphology were 9.12(CI 102.6, 318.3), 3.18 (CI 129.9, 170.8) and 1.9 (CI 192.2, 208.1) times respectively higher among infertile group than controls. Similarly, the Odds of higher levels of MDA to impair sperm cell motility, viability and morphology were 5.02(CI 2.14, 4.6), 2.26(CI 2.34, 3.64) and 2.9 (CI 2.12, 3.73) times respectively higher among infertile group than control subjects. Conclusions: The seminal plasma CK activity and MDA constitute good indicators of functional metabolic activity and fertility potentials of spermatozoa among subjects with unexplained infertility.

Infertile human endometrial organoid apical protein secretions are dysregulated and impair trophoblast progenitor cell adhesion.

Embryo implantation failure leads to infertility. As an important approach to regulate implantation, endometrial epithelial cells produce and secrete factors apically into the uterine cavity in the receptive phase to prepare the initial blastocyst adhesion and implantation. Organoids were recently developed from human endometrial epithelium with similar apical-basal polarity compared to endometrial gland making it an ideal model to study endometrial epithelial secretions. Endometrial organoids were established using endometrial biopsies from women with primary infertility and normal fertility. Fertile and infertile organoids were treated with hormones to model receptive phase of the endometrial epithelium and intra-organoid fluid (IOF) was collected to compare the apical protein secretion profile and function on trophoblast cell adhesion. Our data show that infertile organoids were dysregulated in their response to estrogen and progesterone treatment. Proteomic analysis of organoid apical secretions identified 150 dysregulated proteins between fertile and infertile groups (>1.5-fold change). Trophoblast progenitor spheroids (blastocyst surrogates) treated with infertile organoid apical secretions significantly compromised their adhesion to organoid epithelial cell monolayers compared to fertile group (P < 0.0001). This study revealed that endometrial organoid apical secretions alter trophoblast cell adhesiveness relative to fertility status of women. It paves the way to determine the molecular mechanisms by which endometrial epithelial apical released factors regulate blastocyst initial attachment and implantation.

A comparison between uterine artery blood flow in fertile and unexplained infertile women by Doppler ultrasound using pulsatility index and resistance index

Background and objectives: Infertility is inability to conceive after one year of regular unprotected intercourse. Unexplained infertility is present if the basic fertility investigations are normal. The objective of this study is to investigate the use of uterine artery blood flow as a cause of unexplained infertility (using pulsatility index, resistance index) and compare them to fertile women. Methods: A prospective cohort study was performed on 70 patients (35 fertile and 35 with unexplained infertility patients) in Sulaymaniyah Maternity Teaching Hospital, Kurdistan Region, Iraq, during October 2016 to December 2017. Transvaginal color Doppler ultrasound was done in the mid luteal phase (day 21 - 24) for uterine artery by using pulsatility index and resistance index. Results: The age of the patients ranged from 20 - 39 years. The uterine artery pulsatility index was significantly higher in the unexplained infertile women (mean ± SD = 2.78 ± 0.615) than fertile women (mean ± SD = 2.42 ± 0.325). The uterine artery blood flow resistance index was significantly higher in unexplained infertile group (mean ± SD = 0.899 ± 0.066) than fertile women (mean ± SD = 0.83 ± 0.054). Conclusions: Unexplained infertility is associated with decreased uterine artery blood flow and increase uterine artery resistance (pulsatility index and resistance index) when compared with fertile women.

Evaluation of chronotype and sleep quality in infertile population and comparison with fertile population: a cross-sectional study

Purpose Infertility is a stressful condition for couples and can affect patients’ circadian rhythm and sleep quality. The goal of this study is to assess differences in chronotype and sleep quality between infertile and fertile people. Methods A cross-sectional study was conducted. The infertile patient population consisted study group. Primiparous patients without any known gynecological disease who presented for routine cervical cancer screening follow-up were included in the control group. The Turkish version of the Morningness-Eveningness Questionnaire (MEQ) and Pittsburg Sleep Quality Index (PSQI) scores were evaluated between groups. Results A total of 227 patients were assessed. There were 110 patients in the study (infertile) group and 117 patients in the control (fertile) group. The evening chronotype proportion (23.6 vs. 0.9%, p < 0.001) was higher in the infertile group. The median of MEQ score was significantly higher in the fertile patients (50, IQR = 43 − 55 vs. 56, IQR = 51 − 59; p < 0.001), and the median of PSQI score was significantly higher in the infertile patients (5, IQR = 4 − 6, vs. 4, IQR = 3 − 5; p < 0.001). Conclusions In this study, we found significantly worse sleep quality, and more evening chronotype in the patients with infertility.