Ovarian Defects Research Articles

The DSL ligand APX-1 is required for normal ovulation in C. elegans

DSL ligands activate the Notch receptor in many cellular contexts across metazoa to specify cell fate. In addition, Notch receptor activity is implicated in post-mitotic morphogenesis and neuronal function. In C. elegans, the DSL family ligand APX-1 is expressed in a subset of cells of the proximal gonad lineage, where it can act as a latent proliferation-promoting signal to maintain proximal germline tumors. Here we examine apx-1 in the proximal gonad and uncover a role in the maintenance of normal ovulation. Depletion of apx-1 causes an endomitotic oocyte (Emo) phenotype and ovulation defects. We find that lag-2 can substitute for apx-1 in this role, that the ovulation defect is partially suppressed by loss of ipp-5, and that lin-12 depletion causes a similar phenotype. In addition, we find that the ovulation defects are often accompanied by a delay of spermathecal distal neck closure after oocyte entry. Although calcium oscillations occur in the spermatheca, calcium signals are abnormal when the distal neck does not close completely. Moreover, oocytes sometimes cannot properly transit through the spermatheca, leading to fragmentation of oocytes once the neck closes. Finally, abnormal oocytes and neck closure defects are seen occasionally when apx-1 or lin-12 activity is reduced in adult animals, suggesting a possible post-developmental role for APX-1 and LIN-12 signaling in ovulation.

107 Localization of Kisspeptin Immunoreactivity in the Cat Ovary on Different Reproductive Stages

Kisspeptin (Kp) is considered one of the main regulators of the reproductive axis, exerting its effects via stimulating GnRH expression in the hypothalamus. Apart from its central localization in the hypothalamus, the presence of Kp has been reported in the ovary, with possible local function. To date, very little is known about the ovarian Kp in the domestic cat. Therefore, our aim was to investigate the presence and localization of Kp at different reproductive stages in domestic cat ovaries. Twenty ovaries were collected from free-ranging domestic cats (body weight 2.7–4.5 kg) after routine ovariohysterectomy. Reproductive stages were classified by ovarian gross morphology, vaginal cytology, and blood progesterone level. Ovarian samples were grouped into inactive (n = 6), follicular (n = 8), and luteal stages (n = 6). Tissues were fixed in 4% paraformaldehyde and processed routinely. Immunohistochemistry was performed using polyclonal rabbit Kp-10 primary antibody (AB9754; Millipore, Billerica, MA, USA) at 1:500 at 4°C overnight. Immunoreactive cells were identified by avidin-biotin-peroxidase system. Rat hypothalamic tissue was used as a positive control. Primary antibody was substituted with PBS and normal rabbit IgG as the negative and isotypic negative controls, respectively. In addition, primary antibody was incubated with metastin overnight and applied for preabsorption test. Negative, isotypic negative, and preabsorption tests showed no staining. Immunoreactive Kp was detected in the ovaries of all reproductive stages with no obvious changes in localization or intensity of staining between stages. Kisspeptin was present in the cytoplasm of oocytes, granulosa cells, and theca cells of preantral (primordial, primary, and secondary) follicles and antral follicles. Interestingly, in most follicles, Kp staining was more prominent in theca cells and oocytes compared with granulosa cells. In corpus luteum, Kp was localised in the cytoplasm of luteal cells, with more intense staining on the periphery of corpus luteum compared with the middle in 3 luteal samples, whereas the rest of the samples demonstrated homogeneous staining distribution. Apart from oocytes and steroidogenic cells, Kp was also present in the cytoplasm of cells of the ovarian surface epithelium. Our study for the first time demonstrated the presence and localization of Kp in the ovary of the domestic cats. The localization of Kp in the cat oocyte is similar to previous reports on hamsters and dogs, indicating a possible function in oocyte development. The staining in steroidogenic cells, mainly theca cells and luteal cells, is in good agreement with studies on hamsters, rats, humans, and marmosets, suggesting the possible local involvement of Kp in steroidogenesis. In addition, Kp staining in the ovarian surface epithelium suggests a possible role in the ovarian remodeling after ovulatory defects, as reported in humans and marmosets. This research was funded by the RGJ PhD program PHD/01882556; RG 7/2559.

Genetics of Ayurveda in Infertility

Introduction: Infertility is the clinical entity where couple fail to conceive even after one year of regular unprotected sexual activity. Many factors are responsible for infertility like ovulation defects, spermatogenic failure, parental age, obesity, anatomical defects, infections, also with specific karyotype and genotype. Materials and Methods: Data was collected from Classical references and modern textual references are collected to show how Ayurveda explains beautifully about the infertility, genetic cause for it. Results: Effort are made to explain genetic theory according to Ayurveda in the context of Infertility Discussion: To have a healthy individual constitution impact of certain factors are very essential, which includes healthy reproductive organs of both male and female, healthy sperm and ovum, dietic regimen, Prakruti of couple, seasonal effect, Panchamahabhoota and Shadbhavas. Impact of Doshas on these will have vital role in formation of genetic code and reproductive capacity of individual. Hence all the above factors may be said as factors responsible for genetic modification influencing the fertility in Ayurveda. This knowledge is highly essential and need of the day for welfare of better society with good progeny through means of Ayurveda.

Sequential nursing of acute pulmonary embolism after operation in a patient with ovarian cancer merger immunoglobulin defects

Objective To investigate the treatment and nursing of patients with pulmonary embolism after ovarian cancer combined with common variant immunoglobulin deficiency. Methods The clinical data of 1 case of acute pulmonary embolism after operation in a patient with ovarian cancer merger immunoglobulin defects were analyzed retrospectively. Results After the rescue patients, close observation of vital signs change, according to nursing bleeding and thrombosis, strengthen psychological support and other measures. The patient was discharged after 56 days of treatment and care. Conclusions The early detection of acute pulmonary embolism, timely diagnosis and treatment, close observation of vital signs, the nursing care of bleeding and thrombosis, in order to improve the success rate of treatment of acute pulmonary embolism. Key words: Acute pulmonary embolism; Immunoglobulin defects; Nursing care

Understanding follicle growth in vitro: Are we getting closer to obtaining mature oocytes from in vitro-grown follicles in human?

Obtaining and fertilizing mature oocytes from immature follicles that were grown outside the body has conceptually attracted scientists for centuries, with initial attempts first documented in the 19th century. Significant progress has been made since then, due in part to a better understanding of folliculogenesis and improved techniques of in vitro follicle growth. Indeed, in vitro growth is now considered a reasonable approach to preserve or restore fertility when immature follicles and their oocytes need to be grown and matured outside the body. Certain patients would benefit from in vitro follicle growth, particularly those who carry a risk of cancer re-seeding after grafting of frozen-thawed ovarian tissue or who are at the risk of premature ovarian failure due to several intrinsic ovarian defects and genetic mutations that lead to accelerated follicle atresia and early exhaustion of the ovarian reserve. This review provides an update on the current status of in vitro growth of preantral human follicles, from initial efforts to the most recent achievements.

The use of fibrin sealant (Tisseel) in laparoscopic excision of ovarian endometrioma

ObjectiveTo evaluate the use of Tisseel, a 2-component fibrin sealant agent for the control of minor bleeding and repair of the ovarian defect at the end of laparoscopic cystectomy (LC) of endometriomas. Materials and methodsFrom January 2011 to December 2015, an observational study of all patients who underwent LC of endometrioma using Tisseel (group A) was performed. The demographic and operative data, including age, body mass index, operative indications, operative time, estimated blood loss, complications, and postoperative hospital stay duration were recorded. A contemporary cohort of patients, who underwent LC of endometrioma without Tisseel (group B) was also retrospectively compared. ResultsA total of 274 patients were recruited in this study (53 LCs with Tisseel and 221 LCs without Tisseel, respectively). Complete hemostasis was achieved in all patients. The mean size of main mass was significantly larger in the group A than in the group B (7.8 ± 2.4 cm vs. 7.0 ± 2.3 cm, p = 0.033) but the mean operating time, operative blood loss, febrile morbidity, and length of hospitalization were not significantly different between the two groups. ConclusionThis preliminary series demonstrated the use of Tisseel in LC of endometriomas without any bipolar coagulation and/or suturing of ovarian tissue is clinically safe and feasible.

Functional analysis of microRNA pathway genes in the somatic gonad and germ cells during ovulation in C. elegans

MicroRNAs (miRNAs) are post-transcriptional regulators of gene expression that play critical roles in animal development and physiology, though functions for most miRNAs remain unknown. Worms with reduced miRNA biogenesis due to loss of Drosha or Pasha/DGCR8 activity are sterile and fail to ovulate, indicating that miRNAs are required for the process of oocyte maturation and ovulation. Starting with this penetrant sterile phenotype and using new strains created to perform tissue specific RNAi, we characterized the roles of the C. elegans Pasha, pash-1, and two miRNA-specific Argonautes, alg-1 and alg-2, in somatic gonad cells and in germ cells in the regulation of ovulation. Conditional loss of pash-1 activity resulted in a reduced rate of ovulation and in basal and ovulatory sheath contractions. Similarly, knockdown of miRNA-specific Argonautes in the cells of the somatic gonad by tissue-specific RNAi results in a reduction of the ovulation rate and in basal and ovulatory sheath contractions. Reduced miRNA pathway gene activity resulted in a range of defects, including oocytes that were pinched upon entry of the oocyte into the distal end of the spermatheca in about 42% of the ovulation events observed following alg-1 RNAi. This phenotype was not observed on worms exposed to control RNAi. In contrast, knockdown of alg-1 and alg-2 in germ cells results in few defects in oocyte maturation and ovulation. These data identify specific steps in the process of ovulation that require miRNA pathway gene activity in the somatic gonad cells.

CLARITY reveals dynamics of ovarian follicular architecture and vasculature in three-dimensions

Optimal distribution of heterogeneous organelles and cell types within an organ is essential for physiological processes. Unique for the ovary, hormonally regulated folliculogenesis, ovulation, luteal formation/regression and associated vasculature changes lead to tissue remodeling during each reproductive cycle. Using the CLARITY approach and marker immunostaining, we identified individual follicles and corpora lutea in intact ovaries. Monitoring lifetime changes in follicle populations showed age-dependent decreases in total follicles and percentages of advanced follicles. Follicle development from primordial to preovulatory stage was characterized by 3 × 105-fold increases in volume, decreases in roundness, and decreased clustering of same stage follicles. Construction of follicle-vasculature relationship maps indicated age- and gonadotropin-dependent increases in vasculature and branching surrounding follicles. Heterozygous mutant mice with deletion of hypoxia-response element in the vascular endothelial growth factor A (VEGFA) promoter showed defective ovarian vasculature and decreased ovulatory responses. Unilateral intrabursal injection of axitinib, an inhibitor of VEGF receptors, retarded neo-angiogenesis that was associated with defective ovulation in treated ovaries. Our approach uncovers unique features of ovarian architecture and essential roles of vasculature in organizing follicles to allow future studies on normal and diseased human ovaries. Similar approaches could also reveal roles of neo-angiogenesis during embryonic development and tumorigenesis.

An Overview on Functional Causes of Infertility in Cows

Although problems in animal breeding are innumerable, infertility is one of the major bottlenecks in livestock production. In this paper functional causes of infertility like luteal deficiency due to abnormal pattern of LH pulses, cystic ovarian disease, and ovulatory defects, persistent corpus luteum, infertility associated with anestrus, non-detected estrus and repeat breeder are presented with respect to cow. It has been documented that in the management of cow, there are many times when the manipulation of normal cyclic activity ensures optimum production or is convenient for the owner by use of hormones to manipulate ovarian cyclic activity. Epitomizing under the prevailing condition increased productivity of the cow can only be achieved through success in minimizing infertility problems associated with functional cause through early diagnosis and treatment in addition to improvement of animal nutrition, health and genetic makeup.

Evaluation of effects of artemether + lumefantrine (artemisinin-based combination therapy) on women's reproductive cycle using Creighton Model Fertilitycare System and NaProTECHNOLOGY

Background: Malaria is prevalent in Nigeria, and artemether + lumefantrine (artemisinin-based combination therapy [ACT]) is drug of choice in treatment of uncomplicated cases. ACT is contraindicated in early pregnancy. They release-free radicals that can compromise female fertility. Infertility and its associated complications such as miscarriages, abnormal gestation, and unstable marriages seem to be on the increase. This study aims at evaluating the effect of ACT on female fertility. The significance of this research is to draw the attention of fertility care givers to this possible cause of infertility and fertility challenges. Subjects and Methods: Creighton Model FertilityCare System and NaProTECHNOLOGY are simply technologies that can be used to assess female fertility. They are used in this study to assess the effect of ACT administered at different stages of menstrual cycles of three selected fertile adult females. The results are interpreted on the background of standard Creighton model chart. Results: This study has shown that ACT has a significant fertility deteriorating effect on the women. It caused ovulation defect and diagnosed as partial rupture syndrome in the very cycle of use and in the first cycle after use. It also significantly reduced cervical mucus production and significantly reduced luteal phase progesterone production with an associated significant increase of luteal phase estrogen production. Conclusion: ACT use as antimalarial may be a possible cause of infertility and fertility challenges in women.

Estrogen Hormone Biology.

The hormone estrogen is involved in both female and male reproduction, as well as numerous other biological systems including the neuroendocrine, vascular, skeletal, and immune systems. Therefore, it is also implicated in many different diseases and conditions such as infertility, obesity, osteoporosis, endometriosis, and a variety of cancers. Estrogen works through its two distinct nuclear receptors, estrogen receptor alpha (ERα) and estrogen receptor beta (ERβ). Various transcriptional regulation mechanisms have been identified as the mode of action for estrogen, mainly the classical mechanism with direct DNA binding but also a nongenomic mode of action and one using tethered or indirect binding. The expression profiles of ERα and ERβ are unique with the primary sites of ERα expression being the uterus and pituitary gland and the main site of ERβ expression being the granulosa cells of the ovary. Mouse models with knockout or mutation of Esr1 and Esr2 have furthered our understanding of the role of each individual receptor plays in physiology. From these studies, it is known that the primary roles for ERα are in the uterus and neuroendocrine system, as female mice lacking ERα are infertile due to impaired ovarian and uterine function, whereas female mice lacking ERβ are subfertile due to ovarian defects. The development of effective therapies for estrogen-related diseases has relied on an understanding of the physiological roles and mechanistic functionalities of ERα and ERβ in human health and disease.

INF2‐ and FHOD‐related formins promote ovulation in the somatic gonad of C. elegans

Formins are regulators of actin filament dynamics. We demonstrate here that two formins, FHOD‐1 and EXC‐6, are important in the nematode Caenorhabditis elegans for ovulation, during which actomyosin contractions push a maturing oocyte from the gonad arm into a distensible bag‐like organ, the spermatheca. EXC‐6, a homolog of the disease‐associated mammalian formin INF2, is highly expressed in the spermatheca, where it localizes to cell‐cell junctions and to circumferential actin filament bundles. Loss of EXC‐6 does not noticeably affect the organization the actin filament bundles, and causes only a very modest increase in the population of junction‐associated actin filaments. Despite absence of a strong cytoskeletal phenotype, approximately half of ovulations in exc‐6 mutants exhibit extreme defects, including failure of the oocyte to enter the spermatheca, or breakage of the oocyte as the distal spermatheca entrance constricts during ovulation. Loss of FHOD‐1 alone has little effect, and we cannot detect FHOD‐1 in the spermatheca. However, combined loss of these formins in double fhod‐1;exc‐6 mutants results in profound ovulation defects, with significant slowing of the entry of oocytes into the spermatheca, and failure of nearly 80% of ovulations. We suggest that EXC‐6 plays a role directly in the spermatheca, perhaps by modulating the ability of the spermatheca wall to rapidly accommodate an incoming oocyte, while FHOD‐1 may play an indirect role relating to its known importance in the growth and function of the egg‐laying muscles. © 2016 The Authors. Cytoskeleton Published by Wiley Periodicals, Inc.

Androgen Receptor in the Ovary Theca Cells Plays a Critical Role in Androgen-Induced Reproductive Dysfunction.

Androgen and its receptor (AR) play a critical role in reproductive function under both physiological and pathophysiological conditions. Female AR global knockout mice are subfertile due to both neuroendocrine and ovarian defects. Female offspring from prenatally androgenized heterozygous AR pregnant mice showed rescued estrous cyclicity and fertility. Ar is expressed in granulosa cells, theca interstitial cells, and oocytes in the ovary. We created mice with theca-specific deletion of Ar (ThARKO) by crossing Cyp17-iCre mice that express Cre recombinase under cytochrome P450 17A1 (Cyp17) promoter with Arfl/fl mice. ThARKO mice exhibited no significant differences in pubertal onset or fertility compared with control littermates, and neither estrogen or testosterone levels were different between these groups. Therefore, Ar expression in theca cells likely does not influence fertility nor androgen levels in female mice. We then tested the role of AR in theca cells under hyperandrogenemic condition. After treatment with a pathophysiological level of dihydrotestosterone (DHT), control mice (control-DHT) showed acyclicity and infertility. However, estrous cycles and fertility were altered to a significantly less degree in ThARKO-DHT mice than in control-DHT mice. Messenger RNA (mRNA) levels of Lhcgr (luteinizing hormone receptor) and Timp1 (tissue inhibitor of metalloproteinase 1, and inhibitor of matrix metalloproteinase) were significantly lower in control-DHT ovary compared with control-no DHT ovaries, whereas mRNA levels of Fshr (follicle-stimulating hormone receptor) were significantly higher. Timp1 gene expression was comparable in the ThARKO-DHT and the control-no DHT ovary. We speculate that the preserved level of Timp1 in ThARKO-DHT mice contributes to retained reproductive function.

INF2- and FHOD-related formins promote ovulation in the somatic gonad of C. elegans.

Formins are regulators of actin filament dynamics. We demonstrate here that two formins, FHOD‐1 and EXC‐6, are important in the nematode Caenorhabditis elegans for ovulation, during which actomyosin contractions push a maturing oocyte from the gonad arm into a distensible bag‐like organ, the spermatheca. EXC‐6, a homolog of the disease‐associated mammalian formin INF2, is highly expressed in the spermatheca, where it localizes to cell‐cell junctions and to circumferential actin filament bundles. Loss of EXC‐6 does not noticeably affect the organization the actin filament bundles, and causes only a very modest increase in the population of junction‐associated actin filaments. Despite absence of a strong cytoskeletal phenotype, approximately half of ovulations in exc‐6 mutants exhibit extreme defects, including failure of the oocyte to enter the spermatheca, or breakage of the oocyte as the distal spermatheca entrance constricts during ovulation. Loss of FHOD‐1 alone has little effect, and we cannot detect FHOD‐1 in the spermatheca. However, combined loss of these formins in double fhod‐1;exc‐6 mutants results in profound ovulation defects, with significant slowing of the entry of oocytes into the spermatheca, and failure of nearly 80% of ovulations. We suggest that EXC‐6 plays a role directly in the spermatheca, perhaps by modulating the ability of the spermatheca wall to rapidly accommodate an incoming oocyte, while FHOD‐1 may play an indirect role relating to its known importance in the growth and function of the egg‐laying muscles. © 2016 The Authors. Cytoskeleton Published by Wiley Periodicals, Inc.

Follicle tracking under ultrasound revealed ovulation defects in unexplained infertility during natural cycle

Unexplained infertility (UI) was thought to have normal ovulation. To investigate if this is true, ovulation status of UI women were monitored by transvaginal ultrasonography (TVU) during natural cycle. Prospective study. 567 UI women diagnosed with basic infertility evaluation were enrolled to have TVU follicle tracking at an academic fertility center. Their menstrual cycle lengths were 26 to 30 days. The entire follicle development was monitored from day 10 of the cycle to the time of follicle rupture or to day 20 of the cycle. Follicle size was measured and recorded. 421 out of 567 UI women finished 629 natural cycles follicle tracking. In addition to normal follicle size ovulation, three types of abnormal follicular development were observed: 1) no follicular growth in 28 cycles (4.5%); 2) ovulation with small follicles (OSF, follicle ovulate at the size ≤16 mm) in 65 cycles (10.3%); and 3) luteinized unruptured follicles (LUF) in 34 cycles (5.4%). A total of 127 abnormal ovulation cycles were observed in this study, accounting for 20.2% of 629 UI cycles. Based on follicle tracking and timed intercourse, in 502 normal follicle size ovulation cycles 74 women became pregnant while in 65 OSF cycles only 2 became pregnant. The pregnancy rate was 14.7% vs 3.1% (P < 0.01). There was no pregnancy in the 34 LUF and 28 no follicle growth cycle. This study shows ovulation dysfunction existed in UI patients. TVU Follicle tracking is a reliable way to monitor follicle development and ovulation. One cycle of TVU to evaluate ovulation status will make the UI diagnosis more precise.

Gene knockout of nuclear progesterone receptor provides insights into the regulation of ovulation by LH signaling in zebrafish.

It is well established that the luteinizing hormone surge triggers ovulation, a dynamic process leading to the release of the mature oocyte from the ovarian follicle. But how this process controlled by LH signaling remains largely unknown in non-mammalian species. In this study, we investigated the roles of nuclear progesterone receptor (npr) in LH-induced ovulation. Our results indicate that the nuclear progesterone receptor serves as an important mediator of LH action on ovulation. This conclusion is based on the following results: (1) the expression level of npr peaks at the full-grown stage of the follicles; (2) the expression of npr is stimulated by LH signaling in vitro and in vivo; and (3) the npr null females are infertile due to ovulation defects. Moreover, we further show that LH signaling could induce ptger4b expression in an npr-dependent manner, and blockage of Ptger4b could also block hCG-induced ovulation. Collectively, our results not only demonstrate that npr serves an indispensable role in mediating the action of LH on ovulation in zebrafish, but also provide insights into the molecular mechanisms of the regulation of ovulation in fish.

Amplification of R-spondin1 signaling induces granulosa cell fate defects and cancers in mouse adult ovary

R-spondin1 is a secreted regulator of WNT signaling, involved in both embryonic development and homeostasis of adult organs. It can have a dual role, acting either as a mitogen or as a tumor suppressor. During ovarian development, Rspo1 is a key factor required for sex determination and differentiation of the follicular cell progenitors, but is downregulated after birth. In human, increased RSPO1 expression is associated with ovarian carcinomas, but it is not clear whether it is a cause or a consequence of the tumorigenic process. To address the role of Rspo1 expression in adult ovaries, we generated an Rspo1 gain-of-function mouse model. Females were hypofertile and exhibited various ovarian defects, ranging from cysts to ovarian tumors. Detailed phenotypical characterization showed anomalies in the ovulation process. Although follicles responded to initial follicle-stimulating hormone stimulation and developed normally until the pre-ovulatory stage, they did not progress any further. Although non-ovulated oocytes degenerated, the surrounding follicular cells did not begin atresia. RSPO1-induced expression not only promotes canonical WNT signaling but also alters granulosa cell fate decisions by maintaining epithelial-like traits in these cells. This prevents follicle cells from undergoing apoptosis, leading to the accumulation of granulosa cell tumors that reactivates the epithelial program from their progenitors. Taken together, our data demonstrate that activation of RSPO1 is sufficient in promoting ovarian tumors and thus supports a direct involvement of this gene in the commencement of ovarian cancers.

Germ cell specific overactivation of WNT/βcatenin signalling has no effect on folliculogenesis but causes fertility defects due to abnormal foetal development

All the major components of the WNT signalling pathway are expressed in female germ cells and embryos. However, their functional relevance in oocyte biology is currently unclear. We examined ovaries collected from TCFGFP mice, a well-known Wnt reporter mouse model, and found dynamic changes in the Wnt/βcatenin signalling activity during different stages of oocyte development and maturation. To understand the functional importance of Wnt signalling in oocytes, we developed a mouse model with the germ cell-specific constitutive activation of βcatenin using cre recombinase driven by the DEAD (Asp-Glu-Ala-Asp) box protein 4 (Ddx4) gene promoter. Histopathological and functional analysis of ovaries from these mutant mice (Ctnnb1ex3cko) showed no defects in ovarian functions, oocytes, ovulation and early embryonic development. However, breeding of the Ctnnb1ex3cko female mice with males of known fertility never resulted in birth of mutant pups. Examination of uteri from time pregnant mutant females revealed defects in ectoderm differentiation leading to abnormal foetal development and premature death. Collectively, our work has established the role of active WNT/βcatenin signalling in oocyte biology and foetal development, and provides novel insights into the possible mechanisms of complications in human pregnancy such as repeated spontaneous abortion, sudden intrauterine unexpected foetal death syndrome and stillbirth.

Mouse Sox17 haploinsufficiency leads to female subfertility due to impaired implantation.

Embryonic implantation comprises a dynamic and complicated series of events, which takes place only when the maternal uterine endometrium is in a receptive state. Blastocysts reaching the uterus communicate with the uterine endometrium to implant within a narrow time window. Interplay among various signalling molecules and transcription factors under the control of ovarian hormones is necessary for successful establishment of pregnancy. However, the molecular mechanisms that allow embryonic implantation in the receptive endometrium are still largely unknown. Here, we show that Sry-related HMG box gene-17 (Sox17) heterozygous mutant female mice exhibit subfertility due to implantation failure. Sox17 was expressed in the oviduct, uterine luminal epithelium, and blood vessels. Sox17 heterozygosity caused no appreciable defects in ovulation, fertilisation, blastocyst formation, and gross morphology of the oviduct and uterus. Another group F Sox transcription factor, Sox7, was also expressed in the uterine luminal and glandular epithelium relatively weakly. Despite uterine Sox7 expression, a significant reduction in the number of implantation sites was observed in Sox17 heterozygous mutant females due to haploinsufficiency. Our findings revealed a novel role of Sox17 in uterine receptivity to embryo implantation.

Feasibility of the Use of Novel Hemostatic Sealant (Tisseel) in Laparoscopic Ovarian Cystectomy of Endometrioma

Objective: To evaluate the use of Tisseel, a two-component fibrin sealant agent, for the control of minor bleeding and repair of the ovarian defect at the end of laparoscopic cystectomy (LC) of endometriomas. Materials and Methods: From January 2014 to December 2014, an observational study of all patients who underwent LC of endometrioma using Tisseel was performed. The LC by the stripping technique is similar to that described earlier.1–3 The demographic and operative data, including age, body mass index, operative indications, operative time, estimated blood loss, complications, and postoperative hospital stay duration, were recorded. A matched cohort of patients, who underwent LC of endometrioma without Tisseel, was also retrospectively compared. Results: Thirteen women with symptomatic ovarian endometrioma were enrolled in the study (group A). A homogenous group of 26 patients (2 to 1 matched), with the same preoperative characteristics as the study group, were also selected as the control group (group B). Complete hemostasis was achieved in all patients. The median operating time (97 vs 106 minutes, respectively; p = 0.340), operative blood loss (50 vs 50 mL, respectively; p = 0.217), and length of hospitalization (2 vs 2 days, respectively; p = 0.582) were not significantly different between the two groups. No patients in either group had serious complications or required blood transfusion. Conclusions: This preliminary series demonstrated the use of Tisseel in LC of endometriomas without any bipolar coagulation and/or suturing of ovarian tissue is clinically safe and feasible. No competing financial interests exist. Runtime of video: 1 min 13 secs