Reproductive Outcomes Research Articles

Male Fertility as a Proxy for Health.

Male fertility is affected by a wide range of medical conditions that directly and indirectly affect spermatogenesis. As such, it can be useful as both an indicator of current health and a predictive factor for future health outcomes. Herein, we discuss the current literature regarding the association between male fertility and systemic health conditions and exposures. We review the connection between male fertility and genetics, medications, diet, and environmental pollutants, as well as its effects on future oncologic, cardiovascular, and autoimmune conditions. Understanding this interplay will allow more health care providers to engage in health counseling that will not only improve men's reproductive outcomes but also their overall health.

Do self-help groups improve sexual and reproductive health and HIV outcomes among female sex workers in sub-Saharan Africa? A scoping review protocol

Introduction Self-help groups (SHGs) have been effective in improving the health and wellbeing of women yet there is a dearth of evidence on how they can improve female sex workers’ (FSWs) HIV and sexual and reproductive health (SRH) outcomes, particularly in sub-Saharan Africa (SSA). The proposed scoping review seeks to address this gap by identifying and analysing literature on SHGs for FSWs in SSA. Materials and methods This scoping review will employ the methodology developed by Arksey and O’Malley (2005), expanded on by Levac and colleagues (2010) and Colquhoun and colleagues (2014), and further outlined by Peters and colleagues (2020): (1) identifying the research question(s); (2) identifying relevant studies; (3) selecting the studies; (4) charting the data; and (5) collating, summarising, and reporting the results. Results We will report our findings in accordance with the guidance provided in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement. Discussion The review will generate the most up-to-date evidence and identify gaps in literature in addition to informing future research on how SHGs can help address SRH and HIV outcomes among FSWs in SSA. Additionally, the scoping review can potentially inform a subsequent systematic review.

Maternal obesity management: a narrative literature review of health policies

Maternal obesity rates are increasing significantly, posing substantial risks to both mothers and their children. This study aims to introduce health policies addressing maternal obesity, identify preventive interventions, and highlight scientific gaps necessitating further research.We identified documents through electronic searches in PubMed, CINAHL Plus, EMBASE, and grey literature sources (ministry of health websites, national gynecology and obstetrics associations) from January 2013 to August 2023, updated in June 2024. The inclusion criteria focused on English-language documents discussing interventions or health policies that promote weight loss through lifestyle changes during pregnancy.A total of 22 documents (10 studies and 12 guidelines) were included. 12 studies (N=1244) identified via databases; included two Clinical Practice Guidelines (CPGs) from Canada and Singapore. Other 10 CPGs sourced from governmental websites and national associations: England (1), Australia (1), New Zealand (1), combined Australia and New Zealand (1), Canada (3), USA (1), Ireland (1), Germany (1). 10 guidelines focused on obesity in pregnancy, two on weight management during pregnancy. Covered interventions across pre-pregnancy, pregnancy, and postpartum periods (9 guidelines); pre-pregnancy and pregnancy (2); exclusively postpartum (1). Seven guidelines offered evidence-based recommendations on maintaining healthy weight in mothers, largely based on expert opinions.Maternal obesity poses significant risks to both mothers and children, underscoring the need for effective health policies and systems. However, few countries have integrated adequate responses into their healthcare policies and guidelines for professionals. Limited evidence exists on optimal practices to improve reproductive health outcomes in obese women. Hence, the crucial need to developing comprehensive guidelines and proactive strategies to manage maternal obesity. These measures can improve outcomes and reduce healthcare costs. Increased focus on research and policymaking is essential to protect the health of mothers and their children.

HARNESSING PHYTOTHERAPY: EXPLORING ALTERNATIVE TREATMENTS FOR MALE INFERTILITY

Purpose: The multifaceted nature of male infertility requires innovative approaches, leading researchers to explore the potential of phytotherapy to improve reproductive health. Phytotherapy offers a promising prospect for individuals seeking alternative treatments for male infertility, harnessing the natural therapeutic properties of plant-based compounds. The aim of this work is to investigate the efficacy and mechanisms of action of phytotherapy as a promising alternative treatment for male infertility. Through a comprehensive review of existing literature and clinical trials, this research aims to elucidate the potential benefits of phytotherapeutic interventions in improving sperm quality, enhancing reproductive parameters and addressing the underlying causes of male infertility. Methodology. We conducted a comprehensive literature search using electronic databases including PubMed, Scopus, Web of Science and Google Scholar. The search was conducted from 1970 to 2024, with no language restrictions. The following keywords and combinations of keywords were used: “phytotherapy”, “male infertility”, “herbal medicine”, “plant extracts”, “natural remedies” and “herbal supplements”. In addition, relevant articles were identified through manual searches of the reference lists of the retrieved trials and review articles. Articles were included if they met the following criteria: (1) original research articles, systematic reviews, meta-analyses and clinical trials investigating the efficacy of phytotherapy in the treatment of male infertility; (2) studies reporting outcomes related to sperm quality, reproductive hormones, semen parameters or fertility outcomes; (3) human studies involving adult men diagnosed with infertility or subfertility; (4) studies published in peer-reviewed journals. Scientific novelty. While conventional treatments for male infertility often focus on hormonal therapies, surgery or assisted reproductive techniques, this manuscript highlights the potential of phytotherapy as an alternative approach. By exploring natural remedies derived from medicinal plants, this manuscript offers new insights into complementary strategies for the treatment of male infertility. The emphasis on alternative treatments reflects a growing interest in holistic and integrative approaches to reproductive medicine. In addition to discussing the broader concept of phytotherapy, this manuscript examines the efficacy of specific phytochemicals in the treatment of male infertility. By focusing on individual compounds and their pharmacological effects, this manuscript advances our understanding of the bioactive constituents responsible for the therapeutic effects of medicinal plants. This targeted approach allows for a more nuanced evaluation of phytotherapeutic interventions and facilitates the identification of potential drug candidates. Conclusions. The use of various medicinal plants with benefits for male reproductive health was discussed, including Tribulus terrestris, Apium graveolens, Withania somnifera, Cornus mas, Fumaria parviflora, Phoenix dactylifera and many others, was discussed. The mechanisms by which these herbal remedies may exert their effects on sperm quality, reproductive hormones and overall fertility were also demonstrated. The role of plants as adjunctive therapies to address underlying conditions associated with male infertility, such as oxidative stress, inflammation and hormonal imbalances, was discussed. Although promising, clinical evidence for the efficacy of herbal treatments for male infertility remains limited, highlighting the need for further well-designed clinical trials and studies. Nevertheless, the integration of medicinal plants into comprehensive fertility care protocols offers a promising avenue for improving male reproductive health outcomes and warrants further exploration.

Near-stop in spermatogonia progression and reduced sperm motility in two testis forms of captive North African catfish in Kalasin, Thailand

North African catfish (Clarias gariepinus) is integral to aquaculture, particularly in hybrid production with bighead catfish (Clarias macrocephalus). Recent declines in their production output have been linked to the quality of the parental sperm. This study aimed to evaluate the state of spermatogenesis in two morphological testis forms, normal white testes (CGA_A) and black-brown testes (CGA_B), in captive populations to understand their differences in the cytological processes of spermatogenesis and impact on sperm quality and fertility. We performed computer-assisted sperm analysis (CASA), meiotic chromosome analysis, gene expression profiling, histological examination, and identification of apoptotic cells using the terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL). Additionally, microsatellite genotyping was conducted to assess genetic diversity of the populations, showing that similar gene pool patterns were observed between the two populations with the CGA_A and the CGA_B testes. The average sperm motility was 11.15 %. Histologically, the CGA_A testes predominantly contained spermatozoa. By contrast, the CGA_B testes, characterized by black-brown color and harder texture, were composed mainly of spermatocytes and exhibited a higher incidence of apoptotic spermatogonia. Additionally, the CGA_B testes displayed reduced expression of genes essential for normal testicular development. Notably, the CGA_A testes showed significantly higher expression of GtH I, GtH II, Dazl, and Cxcr4b genes and lower levels of Caspase-3 and p53 (p < 0.05). The selective removal of deficient spermatogonia through early apoptosis in CGA_B testes suggest a mechanism contributing to male infertility due to imbalances between the number of germ cells and Sertoli cells. Despite the use of CGA_A testis for fertilization, a hatching rate in the captive populations was 36.43 % over the last three years (2021−2023), substantially lower than that previously reported, indicating the presence of genetic and environmental factors that influence reproductive success in North African catfish. Differences in spermatogenesis between testis forms highlight the need for genetic and environmental strategies to enhance reproductive outcomes in aquaculture.

Patient navigation in reproductive healthcare.

This review summarizes evidence about barriers to abortion care pre-Dobbs and post-Dobbs, inequities in abortion access, and approaches to improving access to abortion care with use of patient navigators. The Dobbs decision and resulting state-level restrictions exacerbated economic, knowledge, and logistic barriers to abortion care. Abortion funds and emotional support are two main resources to help address these barriers; however, only with coordination can patients and clinics fully benefit from the resources. Patient navigation provides that coordination. Evidence shows it improves reproductive outcomes, is acceptable to patients and providers, and engages community health workers and community-based organizations. Increasing legal restrictions and barriers to abortion care have motivated advocates to identify effective interventions to facilitate patient-centered and culturally competent care. Navigators have improved postpartum care by increasing attendance, education and helping coordinate overall care. They have improved referrals and access to abortion care in statewide programs.

Sexual and reproductive health service utilization and associated factors among youth workers at Kombolcha Industry Park, Kombolcha town, Northeast Ethiopia, 2023.

Youth is a decisive age that shapes the direction of their life and that of their family. However, due to the host of biological, social, and economic factors, youth Industry Park workers can be at high risk of adverse sexual and reproductive health outcomes. Therefore, assessing youth sexual and reproductive health service utilization and associated factors among youth workers is very crucial for timely intervention to their gaps. This study aimed to assess sexual and reproductive health service utilization and associated factors among youth workers working at Kombolcha Industry Park Kombolcha, Northeast Ethiopia, 2023. An institutional-based cross-sectional study was conducted at Kombolcha Industry Park, Kombolcha, among a total of 422 youth workers from 1 January to 30 January 2023. A simple random sampling technique was used to access a total of 422 youth workers in Kombolcha Industry Park. The data were collected using pre-test, structured, and interviewer-administered questionnaires. Data were entered into Epi Data version 3.1 and were exported to SPSS version 26 for analysis. Bi-variable and multivariable binary logistic regression analyses were performed. Adjusted odds ratio with 95% confidence interval was estimated to measure the strength of the association. The level of statistical significance was declared at a p value of less than 0.05. Overall utilization of reproductive health services was 45.50%. Being married [adjusted odds ratio (AOR) = 5.76, 95% CI (2.94, 11.25)], near distance of sexual and reproductive health (SRH) facility to home [AOR = 2.57, 95% CI (1.60, 4.14)], having good knowledge [AOR = 9.23 95%CI (4.88, 17.44)], and good attitude about SRH [AOR = 2.06 95% CI (1.29, 3.28)] were significantly associated with youth SRHs utilization. Youth sexual and reproductive health service utilization among youth workers of Kombolcha Industry Park was low. Ensuring SRHs availability and accessibility, empowering youth with knowledge of SRHs, and advocating sexual and reproductive health services to develop a good attitude might be important in improving reproductive health service utilization. Future researchers should address segments of the population other than Kombolcha Industry Park.

Mechanistic target of rapamycin (mTOR) pathway in Sertoli cells regulates age-dependent changes in sperm DNA methylation

Over the past several decades, a trend toward delayed childbirth has led to increases in parental age at the time of conception. Sperm epigenome undergoes age-dependent changes increasing risks of adverse conditions in offspring conceived by fathers of advanced age. The mechanism(s) linking paternal age with epigenetic changes in sperm remain unknown. The sperm epigenome is shaped in a compartment protected by the blood-testes barrier (BTB) known to deteriorate with age. Permeability of the BTB is regulated by the balance of two mTOR complexes in Sertoli cells where mTOR complex 1 (mTORC1) promotes the opening of the BTB and mTOR complex 2 (mTORC2) promotes its integrity. We hypothesized that this balance is also responsible for age-dependent changes in the sperm epigenome. To test this hypothesis, we analyzed reproductive outcomes, including sperm DNA methylation in transgenic mice with Sertoli cell-specific suppression of mTORC1 (Rptor KO) or mTORC2 (Rictor KO). mTORC2 suppression accelerated aging of the sperm DNA methylome and resulted in a reproductive phenotype concordant with older age, including decreased testes weight and sperm counts, and increased percent of morphologically abnormal spermatozoa and mitochondrial DNA copy number. Suppression of mTORC1 resulted in the shift of DNA methylome in sperm opposite to the shift associated with physiological aging – sperm DNA methylome rejuvenation and mild changes in sperm parameters. These results demonstrate for the first time that the balance of mTOR complexes in Sertoli cells regulates the rate of sperm epigenetic aging. Thus, mTOR pathway in Sertoli cells may be used as a novel target of therapeutic interventions to rejuvenate the sperm epigenome in advanced-age fathers.

Mechanistic target of rapamycin (mTOR) pathway in Sertoli cells regulates age-dependent changes in sperm DNA methylation.

Over the past several decades, a trend toward delayed childbirth has led to increases in parental age at the time of conception. Sperm epigenome undergoes age-dependent changes increasing risks of adverse conditions in offspring conceived by fathers of advanced age. The mechanism(s) linking paternal age with epigenetic changes in sperm remain unknown. The sperm epigenome is shaped in a compartment protected by the blood-testes barrier (BTB) known to deteriorate with age. Permeability of the BTB is regulated by the balance of two mTOR complexes in Sertoli cells where mTOR complex 1 (mTORC1) promotes the opening of the BTB and mTOR complex 2 (mTORC2) promotes its integrity. We hypothesized that this balance is also responsible for age-dependent changes in the sperm epigenome. To test this hypothesis, we analyzed reproductive outcomes, including sperm DNA methylation in transgenic mice with Sertoli cell-specific suppression of mTORC1 (Rptor KO) or mTORC2 (Rictor KO). mTORC2 suppression accelerated aging of the sperm DNA methylome and resulted in a reproductive phenotype concordant with older age, including decreased testes weight and sperm counts, and increased percent of morphologically abnormal spermatozoa and mitochondrial DNA copy number. Suppression of mTORC1 resulted in the shift of DNA methylome in sperm opposite to the shift associated with physiological aging - sperm DNA methylome rejuvenation and mild changes in sperm parameters. These results demonstrate for the first time that the balance of mTOR complexes in Sertoli cells regulates the rate of sperm epigenetic aging. Thus, mTOR pathway in Sertoli cells may be used as a novel target of therapeutic interventions to rejuvenate the sperm epigenome in advanced-age fathers.

Barbed suture in laparoscopic myomectomy.

Uterine myomas are the most common benign gynecological tumors among women of reproductive age. The laparoscopic approach, when feasible, is considered the most suitable and safe technique for intervention. Typically, uterine muscular wall defects are sutured with absorbable filaments. However, performing intra-corporeal knots during laparoscopic procedures demands significant surgical abilities and experience. While laparoscopic myomectomies are often recommended, they pose a high risk of hemorrhage. Barbed sutures may address the challenges of laparoscopic knotting due to their inherent barbs, leading to filament cohesion with tissues. This characteristic could potentially reduce the total operative time and blood loss during surgery. In consideration of the latest literature meta-analysis on the topic, published in 2018 and cited in the present work, six papers were included in this review, excluding case reports, reviews and articles without a control group. The objective of this narrative review is to explore the literature and establish the safety profile of barbed suture compared to conventional laparoscopic sutures. Additionally, given the potential for postoperative adhesion formation with the use of barbed sutures, the review also emphasizes reproductive outcomes. Consistent with previous literature, patients undergoing barbed suture laparoscopic myomectomy experienced significantly lower suturing time and blood loss. Regarding obstetric outcomes, all studies analyzing this aspect concluded that barbed sutures in myomectomy are as safe as, and represent an easier alternative to, conventional sutures. Importantly, these findings did not adversely affect pregnancy outcomes.

Analysis of assisted reproductive outcomes in patients with atypical endometrial hyperplasia and early-stage endometrial cancer after fertility-sparing treatment.

To explore the assisted reproductive outcomes of patients with atypical endometrial hyperplasia (AEH) and early-stage endometrial cancer (EEC) who achieved complete remission after conservative treatment and to provide reference for clinical selection of appropriate conservative treatment. This retrospective cohort study included seven patients with EEC and 62 patients with AEH who underwent invitro fertilization or intracytoplasmic sperm injection at the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University between August 2015 and October 2023. The authors divided the participants into two groups based on the type of fertility-sparing treatment received: the oral medication group and the levonorgestrel-releasing intrauterine system (LNG-IUS) group. The primary outcome was the cumulative clinical pregnancy rate. Secondary outcomes included clinical pregnancy rate per transfer cycle, embryo utilization rate, and high-quality embryo rate. The LNG-IUS group had a significantly higher rate of usable embryos compared with the oral medication group (80.8% vs 91.1%, P = 0.005) and also had a thinner endometrial thickness on the day of embryo transfer. The cumulative clinical pregnancy rate was higher in the LNG-IUS group compared with the medication group (46.7% vs 78.9%, P = 0.037), and the difference was statistically significant. For patients with AEH and EEC with fertility needs, the conservative treatment method of LNG-IUS can achieve better assisted reproductive outcomes.

Utilization of Assisted Reproductive Technologies in Breeding Auliekol Cattle: A Comparative Study.

This study evaluates the utilization of in vitro embryo production (IVEP) technology for the conservation and breeding of the Auliekol cattle breed, a primary beef breed in Kazakhstan facing population decline due to the cessation of breeding programs and the incursion of transboundary diseases. We assessed the effect of consecutive ovum pick-up (OPU) procedures on oocyte yield and embryo production in Auliekol and Aberdeen Angus cows. A total of 2232 and 3659 oocytes were aspirated from Auliekol and Aberdeen Angus donors, respectively, with significantly higher yields and embryo production observed in Aberdeen Angus cows. The application of a meiotic block using Butyrolactone I (BLI) and subsequent in vitro fertilization (IVF) protocols was employed, with embryo development monitored up to the morula/blastocyst stage. Results indicated that Auliekol cows exhibited lower oocyte recovery, cleavage, and blastocyst rates compared to Aberdeen Angus cows, likely due to genetic characteristics. Despite the challenges, IVEP presents a valuable tool for the preservation and future propagation of the Auliekol breed, highlighting the need for further research to enhance reproductive outcomes and conservation strategies.

The discriminatory capability of anthropometric measures in predicting reproductive outcomes in Chinese women with PCOS

ObjectiveObesity is a common feature in women with polycystic ovary syndrome (PCOS) and potentially significantly influences reproductive function. However, opinions are divided as to which factor is a more appropriate obesity predictor of reproductive outcomes. The aim of this study was to investigate the discriminatory capability of anthropometric measures in predicting reproductive outcomes in Chinese women with PCOS.MethodsA total of 998 women with PCOS from PCOSAct were included. Logistic regression models were used to compute the odds ratios (ORs) and 95% confidence interval (95% CIs) to assess the effect of anthropometric measures, including body mass index (BMI), waist circumference (WC), hip circumference (HC), the waist‒hip ratio (WHR) and the waist‒height ratio (WHtR), on reproductive outcomes. The discrimination abilities of the models were assessed and compared based on the area under the receiver operating characteristic curve (AUC), Akaike’s information criterion (AIC) and integrated discrimination improvement (IDI).ResultsAmong PCOS women, there was a graded association between anthropometric measures and predicted reproductive outcomes across quintiles of anthropometric measures, including a linear association among WHR, BMI and reproductive outcomes and among waist circumference, WHtR and live birth, pregnancy, and ovulation. However, only a linear association was noted between the hip and ovulation. C-statistic comparisons and IDI analyses revealed a trend towards a significant superiority of BMI for ovulation and WHR for live birth, pregnancy and conception in the models. Combining obesity variables improved discrimination in the multivariable models for reproductive outcomes.ConclusionsOur findings support that BMI is a better predictor of ovulation and that the WHR is a better predictor of live birth, pregnancy and conception, whereas the combination of obesity variables contributes to the discrimination of reproduction.

Exploring the benefits of astaxanthin as a functional food ingredient: Its effects on oxidative stress and reproductive outcomes in women with PCOS - A systematic review and single-arm meta-analysis of randomized clinical trials.

Polycystic ovary syndrome (PCOS) is a prevalent gynecological-endocrinological disorder characterized by hyperandrogenism, menstrual irregularities, and metabolic disturbances. Recent research has highlighted the role of oxidative stress and chronic inflammation in exacerbating PCOS symptoms and impeding reproductive outcomes. Astaxanthin, a potent antioxidant found in marine organisms, has been suggested as a potential therapeutic intervention due to its ability to reduce oxidative stress and inflammation. This meta-analysis systematically reviews randomized controlled trials assessing the impact of astaxanthin supplementation on oxidative stress and reproductive outcomes in women with PCOS. Data from four trials were analyzed, focusing on markers of oxidative stress and reproductive health metrics. The meta-analysis utilized fixed and random-effects models to synthesize results, with heterogeneity assessed using Chi-square and I2 statistics. The findings indicate that while astaxanthin significantly improves markers of total antioxidant capacity (TAC) in follicular fluid, it does not show a consistent effect on other oxidative stress biomarkers such as malondialdehyde (MDA), catalase (CAT), or superoxide dismutase (SOD). Reproductive outcomes, including oocyte quality and the number of high-quality embryos, showed moderate improvements, although effects on fertilization rates and pregnancy outcomes were insignificant. The analysis highlights variability in study designs and dosing, suggesting a need for further research with standardized protocols and larger sample sizes. Future studies should focus on determining optimal dosing, exploring mechanistic pathways, and investigating the combined effects of astaxanthin with other interventions. Longitudinal studies are needed to assess long-term benefits and safety, and personalized approaches could enhance treatment efficacy for individualswithPCOS.

420 Automated identification and behavioral estrus detection in freestall-housed dairy cows using computer vision and machine learning: A two-layered algorithm approach

Abstract A critical aspect of dairy management involves maintaining accurate records of individual animals and promptly detecting estrus behavior, which is vital for successful breeding and reproductive outcomes. Recent advancements in precision livestock management, utilizing computer vision and machine learning technologies, have paved the way for automated and precise solutions in these areas. The objective of this study is to investigate the application of computer vision and machine learning for animal identification and behavioral estrus detection in dairy cows housed in freestall settings, employing a two-layered algorithmic approach. The research was conducted at the Joe Bearden Dairy Research Center, where a total of 10 lactating Holstein-Friesian cows were assessed across a 7-d trial period. For synchronization efforts, cows were provided a single injection of Prostaglandin F2α at trial initiation with expected estrus behaviors to be exhibited within the following 56 h. Continuous video was captured in 4k resolution using a five-camera closed caption media recording system strategically placed in the pen corners and over the feed bunk alleyway to capture multiple perspectives. Video data extrapolated into frames and manual annotation was utilized to generate the machine learning algorithm’s training data. Frames were randomly selected from a scattering of 56 h of video across all five camera viewpoints and down sampled to 384 x 640 p for both layers. A two-layer approach was employed utilizing an algorithm for each aspect of the study with the first model detecting the behavior, and the second model using the detected region of interest to identify specific cows. The first layer was trained on 682 frames and validated against 123 manually annotated frames. The second layer was trained on 102 frames and validated against 16 frames manually annotated for individual animals. Results demonstrated that the model used for mounting behavior identification has high precision (0.819) and recall (0.89), achieving a 0.926 mAP at an IoU of 0.5. This model achieved an F1 score of 0.86 at a confidence threshold of 0.268. The results demonstrated that the model used for individual animal identification across different classes achieved high precision (0.861) and recall (0.842), with a mAP of 0.897 at an IoU of 0.5. The F1 score for all classes was 0.89 at a confidence threshold of 0.788. In conclusion, these promising findings underscore the potential of computer vision and machine learning technologies to revolutionize dairy cow management practices. This innovative approach not only has potential to enhance operational efficiency, but also contributes significantly to improved reproductive management, thereby advancing precision and productivity in dairy operations.

227 Moderate body weight loss reduces total antioxidant capacity in pregnant beef heifers and one-carbon metabolite supplementation does not mitigate this response

Abstract In beef heifers, body weight (BW) gain and physiological stress are important considerations for reproductive outcomes and whole herd production efficiencies. The objective of this study was to determine if dietary one-carbon metabolite (OCM) supplementation in moderate BW loss pregnant heifers alters circulating total antioxidant capacity, superoxide dismutase, and glutathione peroxidase activity. In a replicated 2 × 2 factorial, Angus-cross heifers (n = 81) were stratified by BW to gain 0.45 kg/d (CON) or lose 0.23 kg/d (RES) and receive corn carrier with OCM supplements (+OCM) or without (−OCM). The OCM supplements consisted of vitamin B12 (20 mg) and folate (320 mg) injections weekly and dietary rumen-protected methionine (7.4 g/d) and choline (44.4 g/d) from breeding (d 0) to d 63 of gestation. The four treatment groups were: CON−OCM (n = 20), CON+OCM (n = 21), RES−OCM (n = 21), and RES+OCM (n = 19). Heifers underwent estrus synchronization and were bred via artificial insemination using female sexed semen to a single sire. Pregnancy was diagnosed and fetal sex was verified on d 35 of gestation. Blood was collected and assayed for total antioxidant capacity, superoxide dismutase, and glutathione peroxidase activity on d −2 (baseline), 35, and 63 of gestation for all three replicates. Data were analyzed using the MIXED procedure of SAS with repeated measures to determine the effect of gain, supplement, day, and their two-way and three-way interactions. The gain × supplement interaction remained in all models, but other interactions were removed if P &amp;gt; 0.10. Replicate and heifer BW were included in the model as covariates and covariance structure was determined by lowest AIC and BIC. Statistical significance was considered at P ≤ 0.05 and tendencies at 0.05 &amp;lt; P ≤ 0.10. There was no BW gain × supplement interaction, or main effect of OCM supplements in total antioxidants. There was a gain × day effect (P ≤ 0.01), in which total antioxidants were increased on d 35 and further increased on d 63 in CON compared with RES treatments. There was no gain × supplement interaction, or main effect of gain or OCM supplements in superoxide dismutase and glutathione peroxidase. However, both superoxide dismutase and glutathione peroxidase were decreased (P ≤ 0.01) on d 63 compared with d 0 and 35. These data suggest that moderate BW loss reduces total antioxidant capacity in pregnant beef heifers, which could affect redox homeostasis. However, OCM supplements did not affect total antioxidant capacity, superoxide dismutase, or glutathione peroxidase. These findings are somewhat surprising considering oxidative stress has been well characterized in nutrient-restricted pregnancies, and given the interconnection between energy metabolism and one-carbon metabolism. Future research is warranted to fully elucidate the therapeutic effects of one-carbon metabolites.

Treatment outcomes of infertile women with endometrial hyperplasia undergoing their first IVF/ICSI cycle: A matched-pair study

ObjectiveThe aim was to analyze the clinical characteristics, controlled ovarian stimulation status, pregnancy outcomes, and major factors influencing live births in patients with endometrial hyperplasia (EH) undergoing IVF/ICSI for assisted reproduction, so as to identify potential intervention measures. Study designPatients with EH who achieved complete remission (CR) after conservative treatment and who were undergoing their first IVF/ICSI cycle were included in this matched-pair study. Patients with normal endometriums were matched at a 1:2 ratio with the control group for the first cycle of controlled ovarian stimulation. Matching was based on age, and reproductive outcomes were analyzed. ResultsAmong the 263 patients (including 51 cases with atypical endometrial hyperplasia) in the study group, the pregnancy rate after the first controlled ovarian stimulation cycle was 48.67 % (128/263), and the live birth rate was 34.98 % (92/263). Multiple logistic regression analysis revealed that maternal age, body mass index (BMI), and endometrial thickness were significantly associated with live births (P<0.001). Specifically, being aged ≥ 35 years (OR 0.450, 95 % CI 0.223–0.907) and having a BMI≥28 kg/m2 (OR 0.358, 95 % CI 0.161–0.798) were identified as unfavorable factors for a clinical live birth, while an endometrial thickness ≥ 10 mm was found to be a favorable factor. Conclusion(s)ART is effective in patients with EH who have achieved CR after conservative treatment. Avoiding unnecessary intrauterine procedures, controlling body weight appropriately, and choosing suitable ART methods as soon as possible may be beneficial for clinical outcomes.

Mortality risk predicts global, local, and individual patterns of human reproduction

BackgroundHuman reproductive dynamics in the post-industrial world are typically explained by economic, technological, and social factors including the prevalence of contraception and increasing numbers of women in higher education and the workforce. These factors have been targeted by multiple world governments as part of family policies, yet those policies have had limited success. The current work adopts a life history perspective from evolutionary biology: like most species, human populations may respond to safer environments marked by lower morbidity and mortality by slowing their reproduction and reducing their number of offspring. We test this association on three levels of analysis using global, local, and individual data from publicly available databases.ResultsData from over 200 world nations, 3,000 U.S. counties and 2,800 individuals confirm an association between human reproductive outcomes and local mortality risk. Lower local mortality risk predicts “slower” reproduction in humans (lower adolescent fertility, lower total fertility rates, later age of childbearing) on all levels of analyses, even while controlling for socioeconomic variables (female employment, education, contraception).ConclusionsThe association between extrinsic mortality risk and reproductive outcomes, suggested by life history theory and previously supported by both animal and human data, is now supported by novel evidence in humans. Social and health policies governing human reproduction, whether they seek to boost or constrain fertility, may benefit from incorporating a focus on mortality risk.

Reproductive outcomes of prepubertal Bos indicus beef heifers raised in a pasture-based feeding system submitted to ovulation induction strategies prior to a timed-artificial insemination protocol

Reproductive outcomes were evaluated in Nelore (Bos indicus) heifers submitted to one, two or no ovulation induction protocols based on progesterone (P4) and estradiol (E2) prior to a timed-artificial insemination (TAI) protocol. A total of 1,437 heifers (13.0 ± 0.8 mo old; 3.1 ± 0.1 of body condition score [BCS] and 279.9 ± 25.8 kg of body weight [BW]) were randomly assigned to 1 of 3 treatments: 0IND (n = 486): no ovulation induction protocol; 1IND (n = 481): one ovulation induction protocol; or 2IND (n = 470): two ovulation induction protocols. On Day −47, heifers from 2IND received a disinfected intravaginal P4 device (2 g, previously used for 21 d), kept until Day −40, when 0.5 mg of E2 cypionate (EC) was given. On Day −19, heifers from 2IND and 1IND underwent the same protocol. On Day 0, all heifers were submitted to the same TAI protocol, starting with a P4 device (0.5 g), 0.5 mg of cloprostenol sodium (PGF), and 1.5 mg of E2 benzoate. On Day 7, P4 device was removed, 0.5 mg of PGF, 0.5 mg of EC, and 200 IU of equine chorionic gonadotropin (eCG) were administered. The TAI was performed 2 d later (Day 9). Blood samples were collected on Days −47 and 0, to determine the presence of CL (circulating P4 concentrations ≥ 1.0 ng/mL). Ultrasound was performed on Days 40, 75 and between Day 150 and parturition to assess pregnancy per AI (P/AI) and pregnancy loss (PL). Statistical analyses were performed using SAS 9.4 (a-cP ≤ 0.05; A,B0.05 < P ≤ 0.10). The proportion of heifers with CL on Day −47 was similar among groups (3.4%). A greater proportion of heifers from 1IND had CL on Day 0, followed by 2IND, then 0IND (87.9a; 80.4b; 28.8c%). There was an effect of treatment on expression of estrus (2IND: 66.6a; 1IND: 67.2a; 0IND: 57.4b%), P/AI on Day 40 (2IND: 53.4a; 1IND: 43.9b; 0IND: 46.5b%), P/AI on Day 75 (2IND: 49.8a; 1IND: 40.5b; 0IND: 44.4ab%) and final P/AI (2IND: 45.5a; 1IND: 35.8b; 0IND: 40.5ab%). No differences were observed in PL (40–75 = 6.3%; 75-final = 9.6%; Total = 15.3%). Particularly within lighter heifers, there was an effect of treatment on P/AI on Day 40 (0IND: 39.2b; 1IND: 43.3ab; 2IND: 53.9a%) and on Day 75 (0IND: 36.6B; 1IND: 39.0AB; 2IND: 48.5A%). At the first pregnancy diagnosis, more nonpregnant heifers from 2IND had CL on Day 40 than 0IND, but 1IND did not differ from the other groups (85.4a; 74.8b; 80.8ab%). In conclusion, ovulation induction protocols performed prior to the TAI protocol increased the proportion of heifers with CL on Day 0. The use of two induction protocols resulted in greater fertility, particularly in lighter heifers, and increased cyclicity among nonpregnant heifers. These results indicate that this strategy may be an optimized method for inducing cyclicity and enhancing fertility of prepubertal Nelore heifers raised in pasture-based feeding systems.

When assisted reproductive technology (ART) opens the door for inclusivity in a highly charged cultural milieu: an exploration of news articles on the establishment of ART clinics in Zimbabwe

The study focuses on how infertility and assisted reproductive technology (ART) have been portrayed in the Zimbabwean print news media, specifically looking at articles related to the country’s two private fertility clinics established in 2016 and 2017 respectively. Through thematic analysis of 35 news articles, seven prominent themes were developed: infertility as an undesirable and stigmatised condition; stress and the feminisation of infertility; the impact of societal and familial pressure to have children; ART as a ray of hope for infertile couples; growing acceptance of ART; availability, accessibility and affordability of ART; and the use of alternative medicines to cure infertility. The research highlights the coexistence of traditional medicine and ART in Zimbabwe, as well as the impact of stigma, pressure, and gender dynamics on infertile couples. Study findings signal how costly ART treatments may drive individuals towards potentially harmful traditional remedies. They also underscore the need for increased awareness of infertility, efforts to reduce stigma, and addressing barriers to ART access, particularly for men. Overall, findings shed light on the complexities surrounding infertility in Zimbabwe and the importance of addressing these issues in pursuit of better reproductive healthcare outcomes.