Reason For Infertility Research Articles

Infertility and risk of ovarian cancer in the women's health initiative.

There is a consistent relationship with greater ovulation frequency and increased risk of ovarian cancer. However, prior research on infertility, which may be associated with ovulation frequency through multiple mechanisms, and ovarian cancer has yielded conflicting results, possibly due to prior research conflating fertility treatment with infertility and restricting follow-up to premenopausal cases. Our objective was to determine the association between infertility and risk of postmenopausal ovarian cancer, overall and by histotype, in a population that had not received treatment with IVF. We utilized data from the Women's Health Initiative (n = 112,925 postmenopausal participants) with over 25years of follow-up. At baseline, participants were asked whether they had ever tried to become pregnant for more than one year without becoming pregnant and whether a reason was found. Cox proportional hazards models were used to calculate hazard ratios (HRs) of incident adjudicated ovarian cancer comparing participants with a history of infertility to fertile participants overall and by histotype. 17% of participants reported a history of infertility at baseline and 1,109 ovarian cancer cases were diagnosed during follow-up. No statistically significant association was observed between infertility and risk of any ovarian cancer (HR: 1.09, 95% CI 0.92-1.29), but those reporting infertility had a 90% higher risk of endometrioid and clear cell ovarian cancers (HR: 1.90 95% CI 1.09-3.34) compared to fertile participants. The reported reason(s) for infertility had no discernable impact on these associations. Infertility may be associated with clear cell and endometrioid ovarian cancer but not other ovarian tumor histotypes.

Association between iron deficiency and fertility.

This retrospective, observational cohort study investigated the association between treatment of iron deficiency with conception results and pregnancy outcomes in women with infertility and iron deficiency, before and after intravenous ferric carboxymaltose infusion. Data were collected from electronic health records from the Dextra Fertility Clinic (Helsinki, Finland) between 2015 and 2020. The cohort included 292 women (<43 years) with infertility and iron deficiency (s-ferritin ≤30 μg/L), treated with a ferric carboxymaltose infusion (Ferinject®, 500 mg i.v.). The main outcomes were live birth and miscarriage rates before and after treatment of iron deficiency. The main explanatory variable studied was the administered iron infusion. Mean s-ferritin levels increased from 16.2 ± 7.0 μg/L before to 81.5 ± 49.8 μg/L after iron infusion. The proportion of patients who conceived increased from 65% before to 77% after treatment of iron deficiency (p < 0.001). Of the study population, 28% of patients experienced miscarriages and 26% gave a live birth before iron infusion, and 13% and 51% after treatment of iron deficiency (p < 0.001). In the model adjusted for age, use of preimplantation genetic testing for aneuploidy, and repeated iron infusions, treatment of iron deficiency with iron infusion was associated with a higher live birth rate (OR = 3.19; 95% CI = 2.21-4.66; p < 0.001). In the model adjusted for age, reason for infertility, and total number of pregnancies, treatment of iron deficiency was associated with lower miscarriage rates (OR = 0.32; 95% Cl = 0.20-0.52; p < 0.001). Filling of depleted iron stores was positively associated with conception results (higher number of pregnancies) and pregnancy outcomes (higher live birth rates and lower miscarriage rates), regardless of the assisted reproductive technology method used. Screening of iron status seems to be important in patients seeking help for infertility problems.

Oxidative stress indicators during peripartum uterine infection of buffaloes: A review

The transition of dairy animals from the period of pregnancy to next lactation considerably enhances the need for source of carbohydrates, proteins, lipids and other nutrients for various metabolic activities. At the same time, the dry matter intake is generally decreased resulting to negative energy balance ultimately compromising the immunity, which leads to oxidative stress as a result of enhanced free radicals in body and makes the animal vulnerable to metabolic as well as infectious diseases. Diseases related to reproductive system especially uterine infections viz. endometritis, metritis during the peri partum period is the most widespread reason of infertility in dairy sector leading to enhancing the interval for uterine involution, occurrence of first oestrus, number of services/ conception and service period. The adverse effects on fertility of animal, health status and the treatment cost prove that uterine infections are considered as one of the most serious and expensive conditions, challenging the buffalo sector. Hence, current researchers aim to find some indicator molecules which will predict the diseases before their onset so that by managemental and nutritional interventions it can be minimised, further animal will suffer less, and better management and welfare will be achieved. The objective of this review article is to discuss about the occurrence of oxidative stress during peripartum period and the physical status of Murrah buffaloes during the said period by assessing the Nitric oxide (NO), Malondialdehyde (MDA) and Total antioxidant capacity (TAC) status.

Hormonal status of patients with infertility and post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) is a mental disorder that occurs after a psychologically or physically traumatic event, and characterized by three main clusters of posttraumatic symptoms, as well as chronic and significant disturbances in emotion regulation, identity, and relationships. PTSD is more common in women, which suggests a role for the regulation of female sex hormones in its development.The objective: to study the hormonal status of women with infertility and PTSD.Materials and methods. 112 women with infertility were examined, who were divided into groups depending on the PTSD criteria. The I group included 36 women with PTSD criteria, who were diagnosed with infertility before the onset of the traumatic factor, the II group – 31 patients with fertility disorders which were diagnosed on the background of PTSD, the III group – 45 women with infertility and without signs of PTSD, the control group consisted of 50 healthy women who applied for a routine preventive examination.In all patients, on the 3rd–5th day of the menstrual cycle, the concentrations of prolactin, estradiol, follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone were determined in the blood serum, in the saliva – cortisol, on the 21st day of the cycle – in the blood serum progesterone.Results. It was established that in women with infertility that was developed after the traumatic factor, the prolactin content is significantly higher (59.5±18.9 ng/ml) than in other groups of patients with fertility disorders (36.9±12.3 ng/ml in I group, 34.3±17.9 ng/ml – in the III group) and in the group of healthy women (13.5±5.6 ng/ml). The concentration of estradiol in the I group was within the reference values for the follicular phase of the cycle, but significantly lower (23.4±3.6 pg/ml) than in women of the other groups (from 87.6±14.6 pg/ml in the III group to 103.5±27.8 pg/ml in the group of healthy women). The average concentration of progesterone in the I (3.4±2.7 pg/ml) and II (4.1±2.9 pg/ml) groups was within the reference values, but was probably lower than that of healthy women (23.6±4.9 pg/ml), as well as women with infertility without signs of PTSD (19.4±5.1 pg/ml).In this study the patients with infertility which has developed on the background of PTSD had LH values within the reference normal range (2.0±0.5 U/L), but several times lower than in women with other reasons of infertility (12.0±3.6 U/l – in women with infertility before the development of PTSD, 6.0±1.9 U/l – in women with infertility without PTSD criteria) and in healthy women (9.2±3.4 U/l).An increased level of testosterone beyond the reference values was found only in women of the II group (3.3±1.9 nmol/l), in the other groups the average testosterone concentration ranged from 1.3±0.6 nmol/l in healthy women to 1.5±0.9 nmol/l in the I group and 1.8±0.7 nmol/l in women with infertility without signs of PTSD. Patients with PTSD are characterized by an increased level of cortisol in saliva, which indicates a prolonged reaction of the body to the trauma (8.8±0.3 ng/ml – in the I group, 10.3±0.4 ng/ml – in the II group), in groups without PTSD the level of this hormone in saliva was almost twice as low (5.4±0.2 ng/ml – in the III group and 5.9±0.3 ng/ml – in healthy women).Conclusions. 1. The patients with PTSD and infertility are characterized by high concentrations of cortisol in saliva and a decreased progesterone level in blood serum.2. In patients who had fertility disorders before a stressful event, a decreased estrogen concentration and an increased luteinizing hormone level were found in blood serum, which indicates endocrine disorders as a cause of infertility.3. Prolactin and testosterone levels were found to be higher in the patients with infertility that was developed after a traumatic event than in other women with reproductive function disorders. Both factors are pathogenetically related to the pathological reaction to stress.

ROLE OF UTTARBASTI IN STRI VANDHYATVA W.S.R. FEMALE INFERTILITY IN DIFFERENT RESPONSIBLE FACTORS

Failure to conceive after one or more years of regular, unprotected coitus is known as vandhyatva. The female component accounts for 40–55% of the cases, making it a significant problem in the modern day, given the rising number of occurrences brought on by a confluence of unhealthy environmental, social, psychological, and nutritional variables. The most frequent reasons for infertility in women are uterine, tubal, and ovulatory factors, among others. According to Ayurveda, Vata is the primary cause of all illnesses about the female reproductive system, including Vandhyatva. A key component of treating female vandhyatva is panchakarma. In the old literature of Ayurveda, Basti Karma is regarded as the most significant treatment for Vataja diseases; consequently, Uttarbasti is highlighted here.

Permanently infertile couples and family building-a cross-sectional survey in Denmark.

Which decision-making factors influence family building among permanently infertile couples? Ethical, legal, and financial considerations outweigh genetic relatedness in decision-making, favouring domestic gestational surrogacy, if this were possible, over international options. Permanent infertility affects 4-5% of people in the fertile age. Their family-building options include adoption, surrogacy, uterus transplantation, foster care, and intentional multiple parenthood. However, in most countries, including Denmark, legal barriers constrain these methods due to surrogacy restrictions, suspended international adoptions, and the experimental status of uterus transplantation. Despite existing research on surrogacy, adoption, and specific causes of permanent infertility, a significant gap remains in our understanding of how couples with permanent infertility make family-building decisions within these limited frameworks. This cross-sectional study with 150 permanently infertile Danish participants was conducted from June to November 2023 using an online questionnaire. Multiple strategies, such as online forums, fertility clinics, hospital departments, and snowballing, were used to recruit a diverse sample. The study included couples aged 26-50 years facing permanent infertility due to the following primary causes: women without a uterus (15%), women with a non-functional uterus (47%) or women for whom pregnancy would be life-threatening (9%), male couples (16%), transgender partner couples (2%), and other causes (11%). The survey collected data on demographics, reproductive history, family-building choices, and communication strategies. Closed questions were analysed using descriptive statistics. Among 150 respondents, 41% had used transnational surrogacy, 27% adoption, 14% chose to remain childless, and 19% were undecided. Critical factors on family-building decisions were ethical, legal, and financial concerns which ranked higher than genetic relatedness. Despite the complexity of family building, most participants were open about their child's origin and received social support. If all family-building methods were legal and available in Denmark, domestic gestational surrogacy would be the preferred method, with uterus transplantation and remaining childless being least popular. The sample size is relatively small, despite the use of a variety of recruitment strategies. Nevertheless, this has ensured a diverse cohort representing the different reasons for infertility and family-building choices. It is important to note that the strategies may have favoured individuals achieving parenthood. The finding of our study reveals a notable gap between available family-building options in Denmark and the preferences of couples facing permanent infertility. These insights could be instrumental for organizations reviewing and developing family-building frameworks. Furthermore, for healthcare professionals guiding couples experiencing infertility issues in their attempts to build a family, an understanding of these preferences is essential to facilitate informed decisions about their future family plans. The project was financed by the Independent Research Fund Denmark. The authors have no conflict of interest to declare. N/A.

Evaluation of serum Vitamin D and ferritin level and their correlation with insulin resistance and adiposity in women with polycystic ovarian syndrome: A hospital-based study in Maharashtra, India

INTRODUCTION: Polycystic ovarian syndrome (PCOS) is the utmost prevailing, complex endocrinopathy of reproductive-aged women and one of the fundamental reasons for female infertility. It has been acclaimed as a metabolic syndrome variant in women and comprises a crucial segment of the female population at risk of cardiovascular diseases and type 2 diabetes mellitus. Vitamin D deficiency is connected with deleterious metabolic outcomes in PCOS and may be responsible for exacerbating PCOS symptoms. This hormonal deficiency is linked with insulin resistance (IR), adiposity, impaired glucose and lipid metabolism, and systemic pro-inflammatory milieu in PCOS women. Ferritin, a regulator of iron homeostasis, is linked with IR and obesity. There is an absolute interrelation of even slightly raised body iron stores with aggravated risk of IR, diabetes, cardiovascular events, and metabolic syndrome in PCOS. AIMS: This study was designed to assess and compare Vitamin D and ferritin status in PCOS and control group women. We also aimed to analyze the association of Vitamin D and body iron stores with IR and adiposity in PCOS women. MATERIAL AND METHODS: Women with a diagnosis of PCOS, between 18 and 40 years of age, were recruited and compared with healthy controls. Baseline information was obtained from all the participants, and biochemical parameters such as Vitamin D and ferritin were analyzed. RESULTS: This study demonstrated that women with PCOS have significantly decreased Vitamin D levels compared to controls. A compromised Vitamin D status in PCOS women is associated with higher IR, body mass index (BMI), waist/hip ratio, and lipid accumulation product (LAP). PCOS women showed increased serum ferritin concentration that correlated with IR and BMI. CONCLUSION: An inadequate Vitamin D and raised ferritin status in PCOS women are associated with IR and adiposity. These biochemical markers might be the hallmark of metabolic aberrations in PCOS and their assessment would be worthwhile for evaluating cardiovascular and diabetes risks in these women. Furthermore, the correlation of the LAP index with the IR index suggests that obesity has a strong impact on IR.

Evaluation of Knowledge and Assessment of Polycystic Ovarian Syndrome (PCOS) Among Healthcare Providers in Medical Institutes of Bahawalpur

Polycystic ovarian syndrome (PCOS) is an endocrine disorder (an imbalance of sex hormones) in which water-filled sacs called cysts form in ovaries. Hormone imbalances in PCOS can lead to problems like irregular periods, troubled ovulation, diabetes, and cardiovascular disorders. PCOS is the main reason for ovulation issues and infertility among females. This study aims to check how many female healthcare providers in the medical institutes of Bahawalpur know about PCOS. In Pakistan, around 52% of reproductive-age women deal with PCOS versus 20–25% in the UK. The study surveyed 341 participants to assess their knowledge. Findings showed that nearly all participants had good knowledge about PCOS (94.4%), and over one-fifth showed possible symptoms (23%). Many of them were undergraduates. The research highlights the need for better education and awareness of PCOS for the general population through these healthcare providers and care to enhance affected women’s quality of life. Based on signs and symptoms, 78 respondents (22.9%) are suspected to have PCOS but are living unknowingly with a low quality of life. They should take medical action as early diagnosis of PCOS is beneficial for improving their quality of life. Hence, community-based awareness programs are needed to address the risk factors, problems, and clinical manifestations for healthcare providers and the general population.

Assessment of socio-demographic factors associated with depression among couples attending a tertiary-care infertility clinic

Background: Infertility rates vary amongst countries from 5%-30%. Data extrapolated from WHO by the Indian council of medical research suggest that approximately 13-19 million couples are likely to be infertile in India at any given time. Many studies give evidence that depression is highly prevalent among infertile couples, especially women. Demographic and social factors are expected to impact the fertility behaviours. It is estimated that psychological factors have an important role in the pathogenesis of infertility. Aim of this study was to assess socio-demographic factors associated with depression among couples attending a tertiary-care infertility clinic. Methods: This cross-sectional study was conducted among 126 infertile couples attending the infertility clinic of government medical college, Thiruvananthapuram, Kerala, India. We used descriptive design as the research design and purposive sampling as sampling technique. PHQ9 depression tool and an interviewer administered semi-structured questionnaire were used in study. Qualitative variables were expressed as frequency and percentages. Chi-square test of independence and Fisher's exact test used to test association between categorical variables as applicable. Results: Among the infertile couples the prevalence of depression was 51.6% (n=65). Depression was more prevalent in females (48.4%, n=61) than in males (33.3%, n=42) and when the reason for infertility was female related. The differences were not statistically significant (p&gt;0.05). The risk of development of depression was significantly high when the other partner had depression (p=0.001, odds ratio=25.196). Presence of children in the family had a significant association with development of depression in infertile couples who belonged to joint or extended family (p=0.020). Depression was significantly associated with social pressure (p=0.021) in female participants and with impaired concentration in both females (p=0.013) and males (p=0.001). Causal relationships could not be established between depression and socio demographic as well as fertility variables due to cross sectional design. Conclusions: Prevalence of depression is comparatively high among infertile females. Support from spouse, family, friends and society have been estimated to have an impact on prevalence of depression. Interventions like counseling and supportive psychotherapy to decrease and prevent development of severe depression among these patients should be considered.

Efficacy of Vamana Karma in the Management of Kshetra Dushti Janya Bandhyatva (Uterine Fibroid)

Fibroids, one of the major reason for infertility are present in 5- 10% of infertile patient. Depending on the location in the uterus, fibroid prevent conception by causing difficulty in sperm ascent, impaired sperm transport and hindering the nidation of fertilized ovum. Thus, fibroids have been implicated in infertility as well as pregnancy loss. Hereby, we are reporting a case of a 31year-old married female who visited the OPD of the National Institute of Ayurveda, Jaipur. She came with complaints of being unable to conceive for 1 year. Ultrasonography dated July 13, 2022, suggested a bulky uterus with intramural fibroid (85 × 65 mm). On the basis of these clinical presentations and USG findings, the patient was diagnosed with infertility due to a uterine fibroid correlated with Kshetra dushti janya Bandhyatva. Vamana karma was conducted for the elimination of Kapha Dosha. After Vamana karma, she missed her period. Her UPT was performed on March 22, 2023, which was found positive. Uneventfully, the patient had delivered a live female child weighing 2.5 kg on 1/11/2023 by LSCS under SA. Vamana karma is beneficial in the management of Kshetra dushti janya Bandhyatva (infertility due to a uterine fibroid).

NO MORE SUFFERING IN SILENCE-MANAGING ENDOMETRIOSIS WITH PHYSICAL THERAPY

In a developing country like Pakistan, health issues, especially those related to women’s health, always need prime focus, particularly in the far away and distant areas of the country where even basic medical facilities are hardly available. Endometriosis is one of the rarely addressed diseases, mainly because of two reasons, lack of proper education and socio-economic conditions. Endometriosis is becoming a more challenging disease for the medical community, observed primarily in females 15 to 45 years of age. The prevalence of endometriosis in females is approximately 8–11% of the reproductive period (with or without a medical diagnosis)1 . Despite the fact that patients do not show clinical symptoms but the majority of them mainly suffer from pain during menstruation (dysmenorrhea) and pain during intercourse (dyspareunia) is also common. Other conditions associated with endometriosis are chronic pelvic pain (CPP), irritable bowel syndrome (IBS), loss of quality of life and fatigue2, 3. Even though endometriosis is the primary reason for infertility, and it affects the quality of life badly, but endometriosis cannot be cured in a definite manner. The focus on managing of endometriosis is either hormonal suppression of disease, analgesic, or surgical excision. Several qualitative types of research have been undertaken on endometriosis to improve our understanding of its effects on the general quality of life, social relationships, and intimate life4 . Despite many studies, physiotherapy has been the most neglected treatment for the management of endometriosis.

O-162 Ethnic disparity in the use of treatment with assisted reproductive technologies in Denmark

Abstract Study question Is ethnic background among 18-45-year-old women associated with initiating ART-treatment in Denmark? Summary answer Results indicate ethnic disparity in the use of ART-treatment, with immigrants and descendants having lower odds of initiating ART-treatment compared to women with Danish origin. What is known already The use of fertility treatment has increased over the past decades. Ethnic disparity exists in the use of health care, but there is limited knowledge about the association between ethnicity and use of fertility treatment. Previous studies have shown that women with lower socioeconomic position (SEP) have lower odds of initiating ART-treatment compared to women with higher SEP. Immigrants and descendants often have lower SEP compared to the general population, but specific mechanisms might be at play when residing and navigating in a new country and healthcare system. Study design, size, duration This is a national, register-based study based on the DANAC II cohort. Women initiating ART-treatment (IVF or ICSI) aged 18–45 were identified in the Danish IVF Register from 1994-2017. According to the time of ART-treatment women were included in the study and randomly age-matched with 10 untreated women in the background population. The study population consisted of 676.355 women. Participants/materials, setting, methods The probability of initiating ART-treatment was compared across ethnic groups and examined in logistic regression analysis. Migration status and country of origin were used as proxies for ethnic group in separate analysis. Age was accounted for by matching, and additional factors of interest such as SEP measures were classified as potential mediators and thus not included in the main analyses. The effect of duration of residence in Denmark was analysed separately among immigrants. Main results and the role of chance The study population consisted of 526.507 (78 %) women of Danish origin, 142.656 (21 %) were immigrants and 7.192 (1 %) descendants of immigrants. Among women of Danish origin 11 % had initiated ART-treatment compared to 5 % of immigrants and 9 % of descendants. Immigrants had 56 % lower odds of receiving first ART-treatment compared to women of Danish origin (OR 0,44, CI 95 % 0,43-0,45), while descendants had 22 % lower odds compared to women of Danish origin (OR 0,78, CI 95 % 0,72-0,84). Regarding the analysis looking at country of origin results showed that 3-4 % of women originating from western countries had received first ART-treatment, compared to 6-8 % of women originating from non-western countries. Women originating from western countries had between 65-78% lower odds for receiving first ART-treatment compared to women of Danish origin. Odds of receiving ART-treatment among women of non-western origin was between 34-47 % lower compared to women of Danish origin. This indicates that disparity in first ART-treatment is particularly distinctive among women of western origin, possibly explained by differences in reasons for migrating. Limitations, reasons for caution Information on the reason for infertility and desire to have children could have provided more insight into the disparity. Data about basis for residence could have provided information on reasons for immigration and duration of residence. Wider implications of the findings Infertility and childlessness can have severe consequences for individuals and society, and equal access to fertility treatment is important, not least in a universal welfare society. The results of this study indicate ethnic disparity in ART-treatment, and we encourage further research regarding the possible causes and barriers to initiate treatment. Trial registration number not applicable

P-205 Exploring the influence of platelet rich plasma (PRP) versus PRP with hyaluronic acid on endometrial thickness (ET) and IVF outcome: a pilot study

Abstract Study question What is the impact of sub-endometrial instillation of PRP versus PRP with hyaluronic acid on ET and IVF outcome defined by positive and clinical pregnancy Summary answer PRP with hyaluronic acid group had more endometrial thickness with better vascularity and better pregnancy outcomes as compared to normal PRP What is known already Receptive endometrium is the end result of an interplay of a myriad of cytokines, adhesion molecules growth factors etc. Defect in these can result in thin endometrium. Sub endometrial PRP instillation has been attempted in such cases with promising results and acts by stimulating cell growth and angiogenesis These actions are enhanced by hyaluronic acid along with its antiadhesive effect. PRP with hyaluronic acid has been used previously in orthopedics, dermatology but not documented in thin endometrium. Most of previous studies have focused on endometrial thickness and no comparison has been done between PRP and PRP with hyaluronic acid. Study design, size, duration A retrospective observational study was conducted at Gunjan IVF WORLD Ghaziabad, from January 2022 to Dec 2023. Total 215 patients between the age group of 21-50 years with thin endometrium (ET &amp;lt; 7mm) with zone 2 or less vascularity with at least 1 good quality blastocyst for transfer were selected. They were subjected to hysteroscopic sub endometrial PRP instillation or instillation of PRP with hyaluronic acid Participants/materials, setting, methods Women with diverse reasons for infertility were divided into 2 groups - those receiving PRP (87 subjects) vs PRP with hyaluronic acid (128 subjects). PRP was activated by adding 0.1 ml of Calcium Chloride in 0.9 ml of PRP. Hyaluronic acid (80IU/ML) was added to PRP in the ratio of 1:5. The two groups were compared for positive pregnancy defined as βhCG &amp;gt;100 mIU/ml, clinical pregnancy defined as visualization of gestational sac and endometrial thickness Main results and the role of chance 112 of 215 (52.09%) women had positive pregnancy outcomes (βhCG &amp;gt;100 mIU/ml). Of the 112 subjects having positive outcomes, 40 (35.71%) belonged to normal PRP group and 72 (64.28%) belonged to PRP with hyaluronic acid group. Clinical pregnancy was seen in 37 (33.03%) in normal PRP group and 70(62.5%) in PRP with hyaluronic acid group. Mean βhCG was significantly higher in PRP with hyaluronic acid group (p = 0.013). Mean endometrial thickness was also higher in PRP with hyaluronic acid group (p = 0.05). The findings of the study suggest that PRP with hyaluronic acid has much better results in patients with thin endometrium in terms of not only the endometrial thickness but it also translates into better pregnancy rates. Limitations, reasons for caution 1. Patient pool from limited geographical area. 2. More Randomized controlled trials with larger sample size required to assess efficacy of Platelet rich plasma with hyaluronic acid. 3. The results were analyzed only up to clinical pregnancy and not ongoing pregnancy or live birth rates Wider implications of the findings 1. PRP with hyaluronic acid can be a boon to patients having thin endometrium who otherwise would have sub optimal IVF outcomes 2. Study can encourage larger randomized controlled trials in this direction especially in cases of intrauterine adhesions. Trial registration number not applicable

P-456 Sexual attitudes in men undergoing Infertility treatment:Turkish sample

Abstract Study question 1. What are the sexual attitudes in men undergoing Infertility treatment ? Summary answer When the infertility reason arises from their spouse, men tend to display a more self-centred sexual attitude. What is known already Men experiencing infertility often hesitate to seeking information or ask questions about sexuality due to prevailing societal norms.Health professionals predominantly focus on addressing women’s issues, leaving the male partner feeling like an outsider who observes the treatment process from a distance. Study design, size, duration This research was conducted in cross-sectional type.,September and December 2017. 141 participant. Participants/materials, setting, methods 141 men who applied to an infertility clinic in Istanbul on Tuesdays and Thursdays between September 2017 and December 2017. The participants’ inclusion criteria were as follows: being men between the ages of 18-49, literate, accepting to participate, and having no diagnosed psychiatric illness.. All men meeting the sampling criteria were invited to participate, and there were no refusals. This setting accepts couples who have been married for at least one year and infertility problems. Main results and the role of chance The mean score of Hendrick Sexual Attitude Scale (HSAS) was 69.78 ± 9.46. Among its subscales, Birth Control had the highest mean score (11.95 ± 2.81), while Instrumentality had the lowest mean score (10.43 ± 4.34). Men whose spouse was over 30, whose marriage age was over 27, and the cause of infertility was unexplained had higher HSAS mean scores. Additionally, men with male-factor infertility scored higher in HSAS than female-factor infertility. Healthcare professionals involved in infertility treatment must prioritise addressing the sexuality of both partners. Male partners may struggle in this aspect, leading to potential misunderstandings or incomplete understanding of sexual information. By addressing and dispelling erroneous cognitive schemas, false beliefs, and self-centred attitudes, healthcare professionals can play a significant role in supporting both partners in their sexual well-being throughout the infertility treatment process. Providing sexual counselling for couples, both jointly and individually, can have a positive impact. However, it is essential to recognise that male partners may be reluctant to engage in such counselling, resulting in suppressed problems and thoughts. Healthcare providers must actively involve male partners and encourage them to share their feelings and concerns professionally and openly. Limitations, reasons for caution The participants included from a single outpatient clinic and little sample size which may limit the generalizability of the findings. Due to the topic’s taboo in Turkish society, some men might not feel openly expressing their thoughts and feelings while answering the questions, potentially affecting the accuracy of the responses. Wider implications of the findings The findings of this research highlight the significance of further investigations into men facing infertility issues from various cultural backgrounds. Qualitative and quantitative research can offer valuable insights into the complexities of sexual attitudes in diverse cultural settings. Collobaration between infertility clinics and liaison psychiatry may be advantageous. Trial registration number not applicable

Effect of intra-uterine administration of Lactobacillus bacteria on the steroid hormone profile in sub-clinical endometritis affected cows

Infertility in bovines is a major cause of serious economic loss to the dairy farmers. A major reason for infertility is sub-clinical, retrograde uterine infections. Sub-clinical endometritis is endometrial inflammation without apparent clinical manifestation and usually without signs of infection. This condition may be due to uterine infections or an extended inflammatory period that exists after elimination of bacteria. At present, infertility treatment is mainly done with intrauterine antibacterials, antiseptics and less commonly by hormones. These days, the major problem faced by animal reproductive health workers is the multiple drug resistance pathogens because of the indiscriminate use of antibiotics.Therefore, a different approach for more effective treatment of subclinical endometritis with Lactobacilli and its role on the steroid hormone profile was studied. In the present study, estradiol-17 β values were lower in the sub-clinical endometritis affected cows. Whereas, intra-uterine administration of Lactobacillus bacteria caused significant increase in estradiol level in a cycle after treatment in cross- bred cows. Similarly, the circulating serum progesterone concentration was also found to be low in subclinical endometritis affected cows. These findings could be used for clinical and experimental interpretations. Further, the information on pulsatile release of gonadotropins and steroid hormones status, receptors and its control, the close relationship among hormones could be necessary for better understanding of the role of steroid hormones in sub-clinical uterine infections.

Infertility and risk of postmenopausal breast cancer in the women's health initiative.

Although infertility (i.e., failure to conceive after ≥ 12months of trying) is strongly correlated with established breast cancer risk factors (e.g., nulliparity, number of pregnancies, and age at first pregnancy), its association with breast cancer incidence is not fully understood. Previous studies were primarily small clinic-based or registry studies with short follow-up and predominantly focused on premenopausal breast cancer. The objective of this study was to assess the relationship between infertility and postmenopausal breast cancer risk among participants in the Women's Health Initiative (analytic sample = 131,784; > 25years of follow-up). At study entry, participants were asked about their pregnancy history, infertility history, and diagnosed reasons for infertility. Incident breast cancers were self-reported with adjudication by trained physicians reviewing medical records. Cox proportional hazards models were used to estimate risk of incident postmenopausal breast cancer for women with infertility (overall and specific infertility diagnoses) compared to parous women with no history of infertility. We examined mediation of these associations by parity, age at first term pregnancy, postmenopausal hormone therapy use at baseline, age at menopause, breastfeeding, and oophorectomy. We observed a modest association between infertility (n = 23,406) and risk of postmenopausal breast cancer (HR = 1.07; 95% CI 1.02-1.13). The association was largely mediated by age at first term pregnancy (natural indirect effect: 46.4% mediated, CI 12.2-84.3%). These findings suggest that infertility may be modestly associated with future risk of postmenopausal breast cancer due to age at first pregnancy and highlight the importance of incorporating reproductive history across the life course into breast cancer analyses.

Bushenhuoluo Decoction improves polycystic ovary syndrome by regulating exosomal miR-30a-5p/ SOCS3/mTOR/NLRP3 signaling-mediated autophagy and pyroptosis

BackgroundPolycystic ovary syndrome (PCOS) is a frequent and complicated endocrine disease that remains a major reason for infertility. Bushenhuoluo Decotion (BSHLD) has been validated to exhibit curative effects on PCOS. This study was aimed to explore the potential mechanism underlying the therapeutic action of BSHLD.MethodsPCOS rat model was induced by dehydroepiandrosterone (DHEA). Serum hormone and cytokines levels and ovarian pathological alterations were measured to assess ovarian function. Exosomes (Exos) were identified by Transmission electron microscopy and Nanoparticle Tracking Analysis. RT-qPCR, Western blotting, immunohistochemical staining, and immunofluorescence staining were performed to detect molecule expressions. Proliferation and pyroptosis of granulosa cells (GCs) were evaluated by CCK-8 and flow cytometry, respectively. The binding relationship between miR-30a-5p and suppressor of cytokine signaling 3 (SOCS3) was verified by dual luciferase reporter and RIP assays.ResultsBSHLD treatment improved serum hormone abnormality, insulin sensitivity, and ovarian morphologic changes of PCOS rats. Moreover, BSHLD treatment restrained the excessive autophagy and pyroptosis in ovarian tissues of PCOS rats. Moreover, BSHLD reduced the expression of miR-30a-5p in serum, serum-derived Exos, and ovarian tissues, thus inhibiting autophagy and NLRP3-mediated pyroptosis in GCs. Mechanistically, SOCS3 was proved as a target of miR-30a-5p and could activate mTOR/P70S6K pathway to repress autophagy. The inhibitory effect of miR-30a-5p deficiency on autophagy and pyroptosis of GCs was attenuated by rapamycin.ConclusionCollectively, BSHLD suppressed autophagy and pyroptosis to improve POCS by regulating exosomal miR-30a-5p/SOCS3/mTOR signaling.

Efficacy of &lt;i&gt;Chatuprasrutik Basti&lt;/i&gt; in Management Of Oligospermia – A Pilot Study

Oligospermia is one of the most common reasons for infertility in day-to-day life. Infertility is a widespread issue that affects 8-12 % of couples globally on average and is getting worse day by day. It was observed that the pathology is found in approximately incidence of 60% males alone in infertile couples. In Ayurveda, Oligospermia can be correlated with Shukra-Alpta. Bastikarma is considered to be having particular action on Shukra Dhatu and Chatuprasrutik Basti is explained as Shukrakrut Basti in Charak Samhita, So in this study, Chatuprasrutik Basti was selected in the management of Oligospermia. Aim: This clinical investigation looked into how Chatuprasrutik Basti affected the number of sperm in patients with infertility. Study Design: This was interventional clinical research with one arm. Materials and Methods: Chatuprasrutik Basti was administered for two cycles of Basti of 6 days each with a month gap in Seven newly diagnosed cases of Oligospermia from the outpatient Department of Panchakarma at SST’s Ayurved Mahavidyalaya in, Sangamner, Ahmednagar, Maharashtra, India. Statistical Analysis: The “Student paired t-test” was used statistically to analyze the data. Results: At the conclusion of therapy, a significant (p&lt;0.05) result was found in the evaluation of an objective parameter, specifically sperm count, and a significant result was not found in the evaluation of the factor sperm motility as p&gt;0.05. Conclusion: Chatuprasrutik Basti is effective in the management of Oligospermia considering the factor of sperm count.

Association between follicular fluid bacteria with inflammatory markers of the complete blood count and the outcomes of assisted reproductive technology in women with endometriosis: A case-control study.

Endometriosis is a common reason for infertility and poor outcomes of assisted reproductive technology (ART). Inflammation is involved in the pathogenesis of this disease. The presence of microorganisms in women with endometriosis may increase levels of inflammatory markers. The purpose of this study is to determine the relationship between the presence of bacteria in the follicular fluid with the inflammatory markers of the complete blood count (CBC) and the outcomes of in vitro fertilization(IVF) in women with endometriosis. This case-control study was conducted on 74 patients undergoing IVF, referred to Al-Zahra Hospital in Rasht (Iran) in 2021. The patients were divided into two case groups including 37 women with endometrioma and the control group, including 37 infertile women with a male factor and normal ultrasound. In total, 74 follicular fluids were collected from the case and control groups and were cultured in the laboratory. The relationship between culture results with IVF outcomes and the levels of CBC inflammatory markers including the number of white blood cells (WBCs), lymphocytes, neutrophils, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR), erythrocyte sedimentation rate (ESR), and c-reactive protein (CRP) was analyzed. There was no significant statistical difference between the frequency of bacteria present in the follicular fluid (p = 0.861), the mean rate of fertilization (p = 0.363), the frequency of CRP (p = 0.999), and the mean WBCs, lymphocytes, neutrophils, NLR, LMR, and PLR in the two groups. There was a significant statistical difference between the mean number of oocytes of metaphase II (p = 0.034) and the mean ESR (p = 0.018) in the two groups. It seems necessary to evaluate follicular fluid as a biological substance that is considered an optimal factor for predicting oocyte quality, fertilization rate, embryo quality, and the success rate of ART.

Kliničke karakteristike i analiza semene tečnosti bolesnika sa primarnim infertilitetom koji se javljaju urologu prvi put - studija preseka

Introduction/Aim. Seminal fluid analysis (SFA) plays a crucial role in helping infertility clinics diagnose the underlying reason of male infertility. The aim of the study was to investigate seminal fluid patterns of male partners of an infertile couple with apparently fertile female partners. Materials and methods. A cross-sectional study was conducted between January 2019 and December 2022. Patients were attending consultations for delayed conception for more than 12 months with apparently fertile female partner. Results. Four hundred fifty-three patients were included in the study. The distribution of patients according to age groups showed that 277 patients were young, aged 21 - 30 years (61%). Two hundred sixty-two (58%) patients complained of infertility for 12 - 24 months duration. Four hundred twenty-nine (94.7%) patients had normal semen volume. In terms of sperm count, 174 patients had below the normal sperm count. Sperm concentrations also showed a great decline with advancing age. Motility parameters were shown to be poor. Sperm morphology findings were relatively good. Results of the current study reflects the impact of infertility on young age groups (21-30 years) as 277 (61%) cases of infertility manifests in this age. One hundred fifty-eight (34.8%) patients were suffering from low sperm count which tend to get lower with increasing age. Motility is known to have a stronger impact on fertility rate compared to morphology. Conclusion. Low motility is caused by several factors which are highly prevalent in society as compared to abnormal morphology factors, including: smoking, drinking alcohol, low exercise, stress, obesity, while morphology on the other hand is affected by other factors which are less prevalent in society.