Ovarian Factors Research Articles

Induction of the LH Surge in Premenarchal Girls Confirms Early Maturation of the Hypothalamic-Pituitary-Ovarian Axis.

To determine whether premenarchal girls exhibit positive estradiol feedback similar to regularly cycling adult women when given exogenous estradiol. This was a prospective clinical cohort study at 2 institutions. Nine girls and 6 women received a 7-day course of transdermal estradiol designed to produce physiologic, mid-cycle circulating estradiol levels. Participants collected daily morning urine for luteinizing hormone (LH), estradiol metabolites (E1c), and progesterone metabolites (Pdg), corrected for creatinine. Main outcomes were percentage increase in LH from nadir to peak and the absolute value of peak LH between the 2 groups, using t testing and linear mixed-effects modeling. All participants exhibited a positive feedback response to estradiol. Adult women had a 532.8% (95% confidence interval [CI]: 253.7-1119) increase in LH after estradiol exposure; premenarchal girls had a 497.9% increase (95% CI: 274.5-903.2; P = .86). The absolute value of the LH surge in women was 9.50 mLU/mgCr (95% CI: 2.59- 43 34.90) and in premenarchal girls was 2.57 mLU/mgCr (95% CI: 0.53-12.49; P = .15). Premenarchal girls can mount an LH surge proportionally similar to regularly cycling adults. This occurs earlier in puberty than previously believed, in contrast to current dogma that maturation of the hypothalamic-pituitary-ovarian axis occurs after menarche and is the rate-limiting step for the establishment of regular, ovulatory cycles. Failure to achieve regular cycles may instead be due to nutritional or ovarian factors. Young girls who fail to ovulate shortly after menarche may warrant further evaluation for endocrinopathies.

Prognostic factors in intrauterine insemination cycles.

ObjectiveThis study aimed to evaluate the clinical pregnancy rate of intrauterine insemination cycles in relation to patient age, cause of infertility, ovulation induction method, number of mature follicles and sperm with progressive motility.MethodsThis retrospective observational study included 237 intrauterine insemination cycles performed from 2011 to 2015 at the Assisted Reproduction Service of the Hospital das Clínicas of the Ribeirão Preto Medical School, University of São Paulo. Student's t-test was used to compare quantitative variables and the chi-square test was used to compare qualitative variables.ResultsPatient age was inversely and significantly correlated with pregnancy rates (p=0.001) (Pregnant women = 32.56±5.64 years, non-pregnant women = 36.64±5.03 years). Cause of infertility, ovulation induction method, number of mature follicles and sperm with progressive motility were not associated with pregnancy rates. The overall clinical pregnancy rate was 7.59%. In the subgroup of patients (n=102 cycles) considered ideal for intrauterine insemination (age ≤35 years, unexplained infertility, ovarian factor infertility or minimal endometriosis, and a partner with sperm count ≥2.5×106 retrieved on the day of insemination) the pregnancy rate was 12.74%.ConclusionIn the studied group, female patient age was the only variable significantly correlated with intrauterine insemination success rates.

Effect of regular exercise on reproductive function of aged female in mouse model

Purpose: This study examined whether regular exercise can improve ovarian angiogenic factors expression, oocyte quality, and fertility in aged female mice. Materials and Methods: Aged C57BL female mice (30-32 weeks) were treated with regular exercise or without exercise for six weeks and then mated with male mice. After mating, the pregnancy outcome was examined. Female mice of two age groups (6-8 and 30-32 weeks) were regularly exercised for six weeks. After superovulation, mating, and zygote retrieval, ovarian VEGF and eNOS expression, and ovarian apoptosis were examined. Results: The number of pregnant mice, offspring, and embryo development rate in aged mice were significantly higher in the exercise group compared with controls. Ovarian VEGF and eNOS expression was increased, but ovarian apoptosis was decreased in the exercise group. Conclusions: This study demonstrates that regular exercise in aged mice improves oocytes quality and fertility, possibly by regulating ovarian eNOS and VEGF expression.

Developmental competence and apoptotic gene expression patterns of mature and immature human oocytes retrieved from controlled ovarian stimulation cycles

The purpose was to assess the developmental competence of the in vitro or in vivo matured human oocytes as well as the apoptotic genes expression of cumulus cells (CCs) regarding nuclear maturity status of associated oocytes retrieved from stimulated ICSI cycles. A total of 590 oocytes and the associated CCs were retrieved and divided into groups of test and control according to the nuclear maturity status in order to the developmental evaluation as well as expression patterns of apoptosis-related genes using real time PCR. The fertilization and embryo formation rates were 60.3% and 87.5% vs.69.1% and 92.8% in test and control groups, respectively. Good quality embryos on day 3 were 62.2% in test and 69.1% in control groups. There were significant differences in the rates of normal fertilized as well as unfertilized oocytes between the groups. Also, mRNA levels of some apoptotic genes were significantly higher in the CCs obtained from immature oocytes among patients with premature ovarian factors (POF) rather than other infertility etiologies (p < 0.001). The data demonstrated the developmental competence of in vitro matured oocytes −even to good quality cleavage embryos- is not completely consistent with molecular integrity and well-mannered gene expression patterns resulting to ICSI success. It seems that using immature oocytes could be helpful for patients at risk of ovarian hyperstimulation syndrome (OHSS) as the same as patients with diminished ovarian reserve.

Uttara Basti and Ayurved protocol in the management of primary infertility-A Case Report

Infertility is commonly increasing problem which any gynecologist has to face in their gynecological carrier. It affects the mental and physical health of a woman and disturbs her family as well as social life. The ovulatory factor is responsible for 30-40% and tubal blockage accounts for 25-30%. In this case report a patient of primary infertility was treated with local vaginal douching and Panchakarma [Yoga Basti, Anuvasana Basti, Nirooha Basti] as per protocol. Uttara Basti was administered after cessation of menstruation i.e., from 5th or 6th day of menstrual cycle with Narayana Taila 5 ml for 5days for 3 consecutive months. Pushpa dhanwa Ras, Phala Kalyana Ghrita, Dashamoolarista were given orally with above procedure for 30 days. Patient conceived after three cycles with combined Ayurved protocol of Panchakarma, Uttar Basti and oral Ayurvedic medications.

Continuous soy isoflavones exposure from weaning to maturity induces downregulation of ovarian steroidogenic factor 1 gene expression and corresponding changes in DNA methylation pattern

Female Wistar rats were treated with orally administered soy isoflavones at concentrations of 0, 25, 50, or 100mg/kg body weight from weaning until sexual maturity (3 mo.), and ovarian steroidogenesis was evaluated. After soy isoflavones were administered, a significant (P<0.05) decrease (44%) in the serum estrodial levels of the high-dose (HD) group were observed. Cultured granulosa cells from the middle- (MD) and HD groups showed significantly (P<0.05) reduced (31%, 45%, respectively) in vitro estradiol secretion, and those from the HD group showed significantly (P<0.05) reduced progesterone (25%) secretion. Compared with the control group, the mRNA expression of the steroidogenic acute regulatory protein (Star), cytochromeP450 cholesterol side chain cleavage (Cyp11a1 and Cyp19a1), and hydroxysteroid dehydrogenase 3b (Hsd3b) genes also decreased. Real-time quantitative PCR and Western blotting revealed a significant (P<0.05) decrease in key transcription factor steroidogenic factor-1 (SF-1) expression in the HD group. The detection of DNA methylation using bisulfitesequencing PCR (BSP) suggested a significantly (P<0.05) increased total methylation rate in the proximal SF-1 promoter in the HD group. Further studies showed that treatment with soy isoflavones can significantly (P<0.05) increase the mRNA expression of DNA methyltransferase (DNMT) 1 and DNMT3a. This study proved that soy isoflavone administration from weaning until sexual maturity could inhibit ovarian steroidogenesis, suggesting that SF-1 might play an important role in this effect. In addition, DNA methylation might play a role in the downregulation of SF-1 gene expression induced by soy isoflavones.

ANTIOXIDANT STATUS OF THE FOLLICULAR LIQUID AND ITS RELATION WITH THE QUALITY OF EMBRYON IN INFERTILITY PATIENTS PASSING THROUGH THE PROCEDURE OF EXTRACORPORAL FERTILIZATION

The aim of the study is to evaluate the antioxidant properties of the follicular fluid with a new chemiluminescent method in women with a reduced ovarian reserve and tubal factor of the infertility, undergoing in vitro fertilization (IVF) procedure, and to compare the obtained data with embryo quality. Material and methods. Samples of the follicular fluid were obtained during oocyte sampling in 16 women with a reduced ovarian reserve and 16 women with a tubal peritoneal factor of the infertility. Patients in both groups were matched for the age, body mass index and hormonal stimulation protocol (short protocol). The antioxidant activity of the follicular fluid was measured by the method of luminol-activated chemiluminescence using 2,2’-azobis (2-amidinopropane) dihydrochloride as a source of radicals. The total antioxidant activity (AOA) and antioxidant activity due to the action of proteins (AOA-b) were determined. Results. The kinetic curve of chemiluminescence of the follicular fluid is similar in shape to the curve of the antioxidant activity of the blood plasma. As in blood plasma, antioxidant activity is caused by uric acid and proteins - albumins and globulins. As a result of the study, three groups of patients were identified, whose AOA significantly differed: patients with low embryo quality and decreased antioxidant activity, AOA 11.4 ± 2.5 mM ascorbate (n = 16); patients with a good quality embryo, AOA 21.4 ± 3.8 mM (n = 10); patients with a low embryo quality and an elevated AOA of 33.7 ± 2.9 mM (n = 6). Conclusions. Based on the comparison of AOA (in ascorbate units) with the quality of the embryo, three areas can be proposed: 1) a zone of reduced antioxidant activity (less than 15 μM, oxidative stress) - these patients had embryos of poor quality; 2) the zone of normal AOA (15-30 μM) - the patients received good quality embryos; 3) zone of increased AOA (more than 30 μM, antioxidant stress) - embryos of poor quality. Thus, it can be assumed that optimal development of embryos in the follicle requires the optimal value of antioxidant activity, since both its reduction (oxidative stress) and increase (antioxidant stress) adversely affect the quality of the embryo and the outcome of IVF. These data correspond to the modern concept that optimal development of the oocyte requires an optimal level of production of reactive oxygen species.

A Clinical study of Ayurvedic regime (Yogbasti,Yonidhavan, Peechu, and abhyantarchikitsa) in the patient of infertility due to unovulatary cycles – A pilot study.

Infertility is very common problem arising now a days due to changing lifestyle .according to Ayurveda , Rutu, Kshetra, Ambu, and Beeja are basic important things for garbhadharna and successful pregnancy. Amongst there beeja factor in femalesi.e ovulation contributes 15 to 25% and is the second common cause of infertility. &#x0D; ovulatory factor is an important subject in infertility among women,according about 40% cases over the past few decades modern medical science develop different types of modalities for infertility like Hormonal therapy, in- vitro fertilization embryo transfer, gammet intra fallopian transfer etc. but having limited success rate. Additionally their procedures have adverse effect on physical and mental health of couple plus they are costly. To overcome this inconvenience population is turning towards traditional mode of treatment i.e. Ayurveda.

Cadmium exposure in newborn rats ovary induces developmental disorders of primordial follicles and the differential expression of SCF/c-kit gene

Since the 1990s, the rising problem that gonad reproductive toxicity on adult female after exposing to cadmium (Cd), an environmental endocrine disruptor, has attracted high attention at home and abroad,and was systematically studied. Our research focuses on a further problem is that early cadmium exposure (during birth to before puberty) impact on development and function of ovarian cells and its possible mechanism. Our research focuses on the changes of ovarian cells growth and development after the newborn rat ovaries with cadmium exposure in vitro, and different expression of ovarian cells development-related factors, SCF/c-kit and changes of their DNA methylation status. We obtained ovaries from 4-day-old SD rats and cultured them in DMEM/F12 mixed with α-MEM media in vitro. Different doses of cadmium were designed as control, 0.5, 5, 10 and 50μM, and then the constituent ratio of ovarian follicle and follicular oocytes diameter were observed with microscope after 4-h exposure. We found that the increased constituent ratio of original follicle and decreased diameter of all levels of follicular oocytes(compared with control, with statistically significant differences, P<0.01).After the measurement of expression of SCF/c-kit by qRT-PCR and Western Blotting, the mRNA and protein expression of SCF/c-kit in ovarian were both decreased. We further found that the increased constituent ratio of growth follicle and increased diameter of oocytes under the treatment of adding SCF in cell culture media. Finally, MALDI-TOF-MS method showed DNA-low methylation status of SCF/c-kit promoter region after Cd exposure. Overall, we concluded that the exposure of cadimium (5–50μM) on newborn rats ovaries could inhibit follicle development.SCF/c-kit system might mediate follicle development damage caused by cadmium, which is associated with DNA hypomethylation of SCF/c-kit promoter region may be worthy of further study.

Selective Fetal Reduction of Conjoined Twins in Twin Pregnancy

ABSTRACT Background The incidence of conjoined twins is rare. In early pregnancy, transvaginal ultrasound may facilitate diagnosis and prompt intervention can be done. Case Report A 35 years old patient with history of infertility for 17 years conceived after In vitro fertilization–embryo transfer with donor oocytes due to ovarian factor; three embryos were transferred. Transvaginal sonography was done on 21st day after transfer and it revealed three gestational sacs with fetal pole in all the sacs. Repeat TVS done on 65th day post embryo transfer revealed one gestational sac with single live embryo, second sac with two embryos joined at thorax and abdomen with a common heart, and two heads. Couple was then counseled for fetal reduction in view of expected poor outcome of conjoined twins. Selective fetal reduction was done at 12 weeks gestation with intra-cardiac potassium chloride administration. Pregnancy is now ongoing with an apparently normal live singleton fetus. Conclusion When conjoined twins are detected early, fetal reduction is a good modality of management. These pregnancies are associated with severe complications, maternal and fetal morbidity and mortality. Hence, the sooner the fetal reduction is, the better the management of conjoined twins. How to cite this article Choudhary S, Mishra V, Aggarwal R, Agarwal H. Selective Fetal Reduction of Conjoined Twins in Twin Pregnancy. J South Asian Feder Obst Gynae 2017;9(3):277-279.

Modern approaches to sterility treatment in women with ovary endometriosis using extracorporeal fertilization

Aim of research: to raise the effectiveness of sterility treatment in women with ovary endometriosis using extracorporeal fertilization and vitamin D.Materials and methods of research. There were examined 90 women with ovary endometriosis, divided in three clinical groups. The first group included 30 women, who underwent the program of extracorporeal fertilization traditionally after the surgical treatment of ovary endometriosis. The second group consisted of 30 women with sterility, who underwent the program of extracorporeal fertilization before the surgical intervention as to ovary endometriosis, the third one included 30 patients with sterility, who underwent the program of extracorporeal fertilization before the surgical intervention as to endometriosis and took cholecalciferol 5000 IU/day during 12 weeks. The control group included 30 women without endometriosis, who underwent the program of extracorporeal fertilization because of tube-peritoneal sterility.Results of research. The ovarian reserve in women, who underwent the operation as to ovary endometriosis, is essentially decreased that is proved by the ultrasound determination of antral follicles condition and is explained by the uncontrolled extraction of ovarian follicles at the operation.Ovary endometriosis leads to the decrease of oocytes quality at the expanse of dysregulation of paracrine ovarian factors, characterized by the ratio IL-8/IL-12. The study of the content of 25(ОН)-vitamin D demonstrated its low level in women with ovary endometriosis and sterility comparing with the control (р&lt;0,05). The use of cholecalciferol 5000 IU/day during the program of extracorporeal fertilization favored the increase of its effectiveness.The received data demonstrate the optimization of sterility treatment in women with ovary endometriosis using the program of extracorporeal fertilization before the surgical treatment and additional use of vitamin D. The elaborated method allows to increase the pregnancy frequency, favors the decrease of the number of days of stimulation, decrease of the total dose of preparations, necessary for ovulation stimulation that is probably conditioned by the absence of the injury of antral follicles by the surgical intervention. The use of the tactics of sterility treatment with ovary endometriosis using extracorporeal fertilization before the surgical treatment at the background of the therapy by vitamin D increases its effectiveness almost twice due to the decrease of the risk of the ovarian reserve destruction at the surgical treatment at normalization of the content of vitamin D. Conclusion. The sterility treatment in women with ovary endometriosis using extracorporeal fertilization before the surgical treatment at the background of vitamin D intake allows to increase the effectiveness of the therapy essentially at the expanse of the use of the untouched ovarian reserve and normalization of paracrine indices of folliculogenesis

R-spondin2, a novel target of NOBOX: identification of variants in a cohort of women with primary ovarian insufficiency

BackgroundR-spondin2 (Rspo2) is a secreted agonist of the canonical Wnt/β-catenin signaling pathway. Rspo2 plays a key role in development of limbs, lungs and hair follicles, and more recently during ovarian follicle development. Rspo2 heterozygous deficient female mice become infertile around 4 months of age mimicking primary ovarian insufficiency (POI). The study aimed to investigate the regulation of RSPO2 and its potential involvement in pathophysiology of POI.MethodsWe cloned the RSPO2 promoter and performed transcriptional assays to determine if RSPO2 can be regulated by NOBOX, an ovarian transcription factor. Then, we evaluated 100 infertile women after obtaining a detailed history of the disease and follicle-stimulating hormone measurements, besides karyotype determination and fragile-X premutation syndrome investigation. All exons, intron-exon boundaries and untranslated regions of the RSPO2 gene were identified by sequencing, and the results were statistically analyzed.ResultsWe found that RSPO2 can be regulated by NOBOX via the presence of NOBOX Binding Element in its promoter. Among 9 identified variants in POI women, 4 of them were equally homozygous, 4 have never been described (c.-359C > G, c.-190G > A, c.-170 + 13C > T and c.-169-8 T > A), only one c.557 T > C was predicted to alter a single amino acid in the RSPO2 protein (p.Leu186Pro).ConclusionsRSPO2 is a novel target gene of the NOBOX key transcription factor, confirming its important role during the follicular growth in ovary. However, RSPO2 mutations are rare or uncommon in women with POI.

Abstract 2293: Oligomenorrhea, polycystic ovary syndrome, and risk of ovarian cancer histotypes, evidence from the Ovarian Cancer Association Consortium

Abstract Background: Oligomenorrhea, defined as infrequent or irregular periods has been shown to be associated with epithelial ovarian cancer risk in some but not all studies. Polycystic ovary syndrome (PCOS), which is characterized by oligomenorrhea and abnormal hormone levels including hyperandrogenism, hyperinsulinemia, and gonadotropin imbalance, has been suggested to increase ovarian cancer risk. However, these associations have been rarely examined by histologic subtype. We sought to examine these associations among 14 studies participating in the Ovarian Cancer Association Consortium. Methods: Participants included 16,594 patients with invasive (n=13,719) or borderline (n=2,875) ovarian cancers and 17,718 controls who had answered questions regarding menstrual cycle irregularity, menstrual cycle length, and/or PCOS. Study specific odds ratios (ORs; 95% confidence intervals [95% CI]), adjusted for ovarian cancer risk factors, were calculated and then combined using a random-effects meta-analysis. Pooled histologic subtype specific ORs (95% CI) were calculated using polytomous logistic regression. Results: Women reporting menstrual cycle length &amp;gt;35 days had decreased risk of invasive ovarian cancer compared to women reporting cycle length ≤35 days (OR=0.70; 95% CI=0.58-0.84). Decreased risk of invasive ovarian cancer was also observed among women who reported irregular menstrual cycles compared to women with regular cycles (OR=0.83; 95% CI=0.76-0.89). No significant association was observed between self-reported PCOS and invasive ovarian cancer risk (OR=0.87; 95% CI=0.65-1.15). For menstrual cycle length &amp;gt;35 days, decreased risk was observed for all invasive histotypes: low grade serous (OR=0.48; 95% CI=0.25-0.92), high grade serous (OR=0.62; 95% CI=0.48-0.80), mucinous (OR=0.38; 95% CI=0.19-0.76), endometrioid (OR=0.75; 95% CI=0.54-1.06), and clear cell (OR=0.70; 95% CI=0.43-1.13) but not for serous borderline tumors (OR=1.18; 95% CI=0.87-1.59) (pheterogeneity=0.006). An increased risk of serous borderline disease was observed among women reporting irregular cycles (OR=1.34; 95% CI=1.16-1.55) (pheterogeneity&amp;lt;0.0001). No statistically significant differences by histologic subtype were observed for self-reported PCOS. Conclusion: In this large consortium analysis we observed a decreased risk of most invasive epithelial ovarian cancer histotypes among women reporting longer or irregular menstrual cycles. In contrast, such cycles were associated with increased risk of the serous borderline tumors. Citation Format: Holly R. Harris, Susan Jordan, Harvey Risch, Mary Anne Rossing, Marc T. Goodman, Francesmary Modugno, Susanne Krüger Kjær, Joellen M. Schildkraut, Elisa V. Bandera, Nicolas Wentzensen, Catherine Phelan, Hoda Anton-Culver, Anna H. Wu, Kathryn L. Terry. Oligomenorrhea, polycystic ovary syndrome, and risk of ovarian cancer histotypes, evidence from the Ovarian Cancer Association Consortium [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 2293. doi:10.1158/1538-7445.AM2017-2293

The anti-Müllerian hormone (AMH) induces forkhead box L2 (FOXL2) expression in primary culture of human granulosa cells in vitro.

Anti-Müllerian hormone (AMH) and forkhead box L2 (FOXL2) are two pivotal genes expressed in human granulosa cells (hGCs) where both genes share similar inhibitory functions on activation and follicular growth in order to preserve the ovarian follicle reserve. Furthermore, AMH and FOXL2 contribute to inhibit steroidogenesis, decreasing or preventing the activation of gonadotrophin-dependent aromatase CYP19A1 cytochrome P450 family 19 subfamily A member 1 (CYP19A1). The purpose of this study is to evaluate the role of AMH in regulating the expression of FOXL2. Primary cultures of hGCs were treated with increasing concentrations of recombinant human AMH (rhAMH; range 10-100ng/ml) for 3h. Negative controls were performed using corresponding amounts of AMH vehicle. Total RNA or proteins were purified and quantified by spectrophotometry. FOXL2 and CYP19A1 gene expression, normalized by reference gene ribosomal protein S7 (RpS7), was evaluated by RT-qPCR. Each reaction was repeated in triplicate. Statistical analysis was performed. Extracted proteins were analyzed by immunoblot using anti-FOXL2 and anti-β-actin as primary antibodies. rhAMH treatments tested did not modulate the basal expression of aromatase CYP19A1 gene. rhAMH (50ng/ml) was able to increase FOXL2 gene expression and its intracellular content. This study demonstrated the existence of an AMH-FOXL2 relationship in hGCs. AMH is capable of increasing both gene and protein expression of FOXL2. Because FOXL2 induces AMH transcription, these ovarian factors could be finely regulated by a positive feedback loop mechanism to preserve the ovarian follicle reserve.

Ovarian steroids, oxytocin, and tumor necrosis factor modulate equine oviduct function

The oviduct plays important roles in the early reproductive process. The aim of this study was to evaluate gene transcription and protein expression of progesterone receptor (PGR), estrogen receptors 1 (ESR1) and 2 (ESR2); oxytocin receptor (OXTR); prostaglandin F2α synthase (AKR1C3), and prostaglandin E2 synthase (Ptges) in mare oviduct in different estrous cycle stages. Estradiol (E2), progesterone (P4), oxytocin (OXT), and tumor necrosis factor α (TNF) effect on in vitro PGE2 and prostaglandin F2α (PGF2α) secretion by equine oviduct explants or by oviductal epithelial cells (OECs) were also assessed. During the breeding season, oviduct tissue was obtained post mortem from cyclic mares. Protein of ESR1, ESR2, PGR, AKR1C3, and Ptges was present in OECs, whereas OXTR was shown in oviduct stroma. In follicular phase, protein expression of ESR1, ESR2, PGR, and OXTR increased in oviduct explants (P < 0.05), whereas no estrous cycle effect was noted for AKR1C3 or Ptges. In follicular phase, mRNA transcription was upregulated for Pgr but downregulated for Oxtr, Ptges, and Akr1c3 (P < 0.05). Nevertheless, Esr1 and Esr2 mRNA levels did not change with the estrous cycle. In the ampulla, Esr1, Esr2, and Oxtr mRNA transcription increased, but not for Pgr or Ptges. In contrast, Akr1c3 mRNA level was upregulated in the infundibulum (P < 0.05). In follicular phase, E2, P4, and OXT downregulated PGE2 production by OEC (P < 0.05), but no difference was observed in mid-luteal phase. Explants production of PGE2 rose when treated with OXT in follicular phase; with TNF or OXT in early luteal phase; or with TNF, OXT, or P4 in mid-luteal phase. PGF2α production by OEC was downregulated by all treatments in follicular phase but upregulated in mid-luteal phase (P < 0.05). Oviduct explants PGF2α production was stimulated by TNF or OXT in all estrous cycle phases. In conclusion, this work has shown that ESR1, ESR2, OXTR, Ptges, and AKRLC3 gene transcription and/or translation is estrous cycle dependent and varies with oviduct portion (infundibulum vs ampulla) and cell type. Ovarian steroid hormones, OXT and TNF stimulation of PGF2α and/or PGE2 production is also estrous cycle dependent and varies in the different portions of mare oviduct. Differential transcription level and protein localization in various portions of the oviduct throughout the estrous cycle, as well as PG production, suggest coordinated physiologic actions and mechanisms of steroid hormones, OXT, and TNF in the equine oviduct.

Anti-Mullerian hormone level is independently affected only by the ovarian factor among clinical and endocrinological factors in polycystic ovary syndrome

Anti-Mullerian hormone level is independently affected only by the ovarian factor among clinical and endocrinological factors in polycystic ovary syndrome

Demographic analysis of a low resource, socioculturally diverse urban community presenting for infertility care in a United States public hospital

BackgroundInfertility is a prevalent disease of reproductive health that exerts an impact on an estimated 80 million people worldwide. For many, involuntary childlessness becomes a central and preoccupying issue in their lives, the impact of which is exacerbated by lack of access to basic care and treatment. These effects maybe further magnified among immigrant communities, a growing but highly marginalized population that has been shown in other areas of reproductive health to experience worse health outcomes and delays in access to care. To date, few studies have examined the unique medical and sociocultural considerations of infertility among immigrant populations in the United States.MethodsOur study is a cross-sectional analysis of women presenting for infertility evaluation at a county hospital serving a low resource, socioculturally diverse largely immigrant communities in comparison to infertile women from a largely affluent population presenting to a high resource, comprehensive fertility center. We employed surveys to evaluate demographics and socioeconomic parameters as well as abstracted data from medical records to obtain infertility diagnoses. Multivariate regression analysis was applied to examine impact of sociocultural factors as predictors of duration of untreated infertility disease burden experienced by patients.ResultsEighty-seven women were included in our analysis. In the county hospital/low resource clinic (LR), the mean age was 32.9 ± 4.9 vs 36.4 ± 6.3 years in the fee-for-service/high resource clinic (HR). The mean reported duration of infertility in LR and HR patients was 3.4 ± 3.0 vs 2.3 ± 1.5 years. 70% of LR patients were monolingual non-English speakers vs 5.4% of HR patients. 59% of LR patients reported an annual household income of less than $25,000 and 70% did not have a college degree. 81.1% of HR patients reported an income of higher than $100,000, and 81.1% had completed college or graduate school. The most common infertility diagnosis in the LR was anovulation (38%) and tubal factor (28%) compared to diminished ovarian reserve (37.8%) and male factor (51.4%) in the HR. After controlling for age at the initiation of pregnancy attempt, lower education level, lower income, and immigrant status were significantly correlated with a longer duration of infertility.ConclusionsWomen presenting for infertility care to a low resource county medical center represent immigrant communities and are generally of younger age, but with a longer duration of infertility. This study identifies lower educational level, income, and immigrant status as barriers in access to care.

Prenatal androgen exposure alters gene expression and promoter methylation of two ovarian follicle maturation factors

Prenatal androgen exposure alters gene expression and promoter methylation of two ovarian follicle maturation factors

Treatment Seeking Behavior and the Profile of Infertile Patients Attending the Tertiary Infertility Center at Dhaka

Background: Motherhood is an integral part of womanhood and being childless is a devastating experience for a woman in developing countries like Bangladesh. Majority of patients in developing countries have virtually no access to treatment. Few health facilities have provision for proper diagnosis and treatment for infertility. There is a general lack of awareness among the public regarding infertility. In the quest for conception, many couples adopt for alternative therapies and religious rituals killing crucial age and time.Objective: To find out the treatment seeking behavior and the profile of infertile patients attending a tertiary infertility center at Dhaka, Bangladesh .Methods: During a period of five years from January 2001 to December 2005, 8580 new patients attending a tertiary infertility center at Dhaka were included in the study.Results: Treatment seeking behavior of infertile patients attending Center for Assisted Reproduction, (CARe) Dhaka revealed 30% of the patients initially go to the traditional healers for the relief of infertility, 36% consult both traditional healers and doctors and 32% consulted with GP and Gynae specialist, and only 2% came straight to the tertiary center( CARe) for their subfertility. 55% of the patients attending the clinic were from urban area and 45% were from rural area. The maximum number of patients were from Dhaka division followed by Chittagong, Khulna, Barisal, Sylhet and Rajshahi. The overall primary and secondary infertility were in 63.34% and 36.66% of the patients respectively. 90% of the patients were Muslim and 9% were Hindu and 1% were from other religion. Only 32.37 % of the patients took treatment in the clinic for their infertility. Male factor problems as identified among the male partners of the infertile couples were azoospermia in 18%, abnormal semen parameter in 24%,and normal semen parameter in 58 %. Among the female partners completing investigations, 17% suffered from anovulation, 20% from premature ovarian failure and 3% from ovarian failure , with a total of 40% of the women suffering from ovarian factor, 8% suffered from endometriosis, 7% from bilateral tubal block, 3% from uterine factor problem. In 42% women there was no apparent cause in the females. Untreatable causes of infertility among the infertile couples were in 3.75% of the patients. Ovarian failure was in 3% cases, testicular failure in 0.5% and uterine factor in 0.25% of cases. 75% of the women were less than thirty five years of age where as 29 % of the males were less than 35 years.Conclusion: Causes of infertility vary from region to region so also social and cultural conditions. Financial condition also affects the health seeking behavior of the patients. For the purpose of management of infertile couples the cause of infertility is important to understand so that the options of treatment and the prognosis can be discussed with the patients.J Bangladesh Coll Phys Surg 2016; 34(3): 140-144

Frozen embryo transfer cycles in women with deep endometriosis

Objective: To compare the transfer pregnancy rates with frozen embryos from patients with deep endometriosis and non-endometriosis patients.Methods: We conducted a retrospective cohort study of review of medical records of 181 women aged 18–40 years, undergoing transfer of frozen embryos into a fertility center. The data collected was from January 2007 to December 2013.Results: Regarding the patients with endometriosis, there was no statistical difference in proportion to compare polycystic ovarian syndrome, male factor, tubal factor and unexplained infertility.Conclusion: There was no difference between pregnancy rates obtained from frozen embryo transfer in deep endometriosis compared to other causes of infertility.