Risk Factor For Infertility Research Articles

Abstract 1699: Protumoral role of trans fatty acid in colorectal cancer

Abstract Trans fatty acids (TFAs) is a recent focus of health problems. TFA is a definitive risk factor for cardiovascular diseases and the death. TFA is also possible risk factor for Alzheimer's disease, obesity, diabetes, fatty liver, and ovulation infertility. Relation of TFA with carcinogenic risk is controversy; however, TFA is reported to increase the risk of breast cancer and prostate cancer. Elaidic acid (EA), a trans form of oleic acid, enhances cancer cell growth, invasion, and anti-apoptotic survival. By animal models, EA promotes tumor growth and metastasis to the lung, liver, and peritoneum. EA induces stemness in cancer cells through transactivation of EFGR via SRC from GPR40/120 as receptors in EA-integrated cholesterol raft. Activated EGFR relays the signals to activate canonical and non-canonical wnt pathway and to inactivate notch1 pathways. EA also increases miR-494, which inhibits cell differentiation through decrease of target genes. Continuous EA feeding with dosage alteration increased cancer cell stemness. EA diminishes the efficiency of 5-fluorouracil by increase of residual cancer stem cells. These findings suggest that TFA is a relevant cancer promoting factor. Decision of removal of TFA from foods by FDA might provide an impact to cancer clinics. Citation Format: Hitoshi Ohmori, Toshio Kuwai, Yasuhiko Kitadai, Kiyomu Fujii, Rina Fujiwara, Yukiko Nishiguchi, Tomonori Sasahira, Hiroki Kuniyasu. Protumoral role of trans fatty acid in colorectal cancer. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 1699.

A population-based survey on family intentions and fertility awareness in women and men in the United Kingdom and Denmark

Background: Across several European countries family formation is increasingly postponed. The aims of the study were to investigate the desire for family building and fertility awareness in the UK and Denmark.Methods: A population-based internet survey was used among women (n = 1,000) and men (n = 237) from the UK (40%) and Denmark (60%). Data covered socio-demographics, family formation, and awareness of female age-related fertility. Data analysis used descriptive statistics and logistic regression analysis for studying associations between low fertility awareness and desired family formation.Results: The majority of all participants desired two or three children. Two-thirds of the childless participants desired a first child at 30+ years, and one-fifth of the women and one-third of the men desired a last child at age 40. Overall, 83% of women and 73% of men were aware that female fertility starts to decline around 25–30 years. Men had significantly lower fertility awareness. Women who underestimated the impact of age on female fertility were significantly more likely to have a desire or attempted their first child at a higher age.Conclusion: Even though the majority were aware of the age-related decrease in female fertility, most desired having children at an age when female fertility has declined. Women who were not sufficiently aware of the impact of advanced age were significantly more likely to have their first child at a higher age. There is a need for developing educational programs for women and men in order to increase the population’s knowledge of fertility and risk factors for infertility.

224 Cervical cancer screening results in a cohort of women with cystic fibrosis

223 Infertility among women with cystic fibrosis: prevalence and risk factors M. Shteinberg, A. Ben Lulu, Z. Blumenfeld, M. Gur, L. Bentur, H. Mussaffi, H. Blau, I. Sarouk, O. Efrati, M. Cohen-Cymberknoh, E. Kerem, M. Aviram, E. Pickard, G. Livnat. Carmel Medical Center, Pulmonology and CF Center, Haifa, Israel; Technion-Israel Institute of Technology, The B. Rappaport Faculty of Medicine, Haifa, Israel; Rambam Health Care Campus, Obstetrics & Gynecology, Haifa, Israel; Rambam Health Care Campus, Ruth Rappaport Children’s Hospital, Haifa, Israel; Schneider Children’s Medical Center, Kathy and Lee Graub Cystic Fibrosis Center, Petach Tikva, Israel; Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv, Israel; Sheba Medical Center, Cystic Fibrosis Center, Tel Aviv, Israel; Hadassah-Hebrew University Medical Center, Cystic Fibrosis Center, Jerusalem, Israel; Soroka Medical Center, Cystic Fibrosis Center, Beer Sheva, Israel; Shaare Zedek Medical Center, Cystic Fibrosis Center, Jerusalem, Israel; Carmel Medical Center, CF Center, Haifa, Israel Objectives: Women with cystic fibrosis frequently encounter difficulty conceiving; however, the incidence of subfertility among CF women has not been established. It is unknown whether CF severity is associated with subfertility. We aimed to determine the rate of subfertility in women with CF, and to explore risk factors for female subfertility. Methods: A retrospective study of all CF centers in Israel including women with CF aged 18 and older. Women were divided into four fertility categories: 1. Normal fertility (spontaneous pregnancy). 2. Subfertility (having required assisted reproduction after 1 year of infertility). 3. Infertile (remained infertile despite treatments). 4. Not attempted childbearing. Clinical characteristics were compared between the fertility groups. Chi or T-test were employed where appropriate. Results: 130 women were included. 32 women had normal fertility, 17 subfertility, 4 infertility, and 77 never attempted childbearing. For further analysis, groups 2 and 3 were combined. The following variables were associated with decreased fertility: presence of two class I–III mutations, 52% (groups 2&3) vs. 40% in group 1; Pancreatic insufficiency, 61% vs. 44% (p =0.196); and BMI, 22.2±3kg/m2 vs. 23.2±3kg/m2, respectively. Differences did not reach statistical significance. There were no differences in lung function, rate of exacerbations, or colonization with Pseudomonas between fertility groups. Conclusion: The rate of subfertility among CF women was 39.6%, much higher than in the general population (10–15%). No clear risk factors for infertility were identified, although a trend for pancreatic sufficiency was associated with less infertility.

Prevalence and Risk Factors of Infertility at a Rural Site of Northern China.

ObjectiveTo investigate and analyze prevalence and risk factors of infertility at a representative rural site of Northern China.MethodThis is a cross-sectional study. We conducted a face-to-face questionnaire survey from July 2014 to October 2014 involving 5,131 women who were at childbearing age in Suizhong, a medium-sized, representative county located in Northern China. Finally, data from 4,232 valid questionnaires were analyzed.DefinitionInfertility is defined as the failure to achieve a clinical pregnancy after 12 months or more of regularly unprotected sexual intercourse.ResultsInfertility prevalence in Suizhong County was 13.09% (95% CI, 12.09%-14.1%), of which the primary infertility incidence was 0.99% (95% CI, 0.72%-1.34%), and the secondary infertility incidence was 12.10% (95% CI, 11.13%-13.12%). For women, the infertility incidence of underweight women (Body Mass Index, BMI<18.5 kg/m2) was 1.5-fold higher than that of women with moderate BMI (18.5–24.9 kg/m2). The infertility incidence of women with little exercise was 4 times more than that of women with regular exercise, and 2 times more than that of women with heavy exercise. The group with moderate menstrual flow had the lowest prevalence of infertility, while both scant and excessive menstruation led to increased infertility incidence. Number of pregnancies (OR = 0.63; 95% CI, 0.51–0.79) was a protective factor for infertility, while the number of abortions (OR = 2.15; 95% CI, 1.58–2.93) was a risk factor for infertility. For men, those who stayed up late at night more than 3 times per week showed a significantly higher infertility incidence. Men who engaged in occupations with high-temperature working environment also suffered from an infertility incidence of about four times more than the others.ConclusionsWe found significant association between women's infertility incidence with their BMI, state of exercise, amount of menstrual flow, number of pregnancies and number of abortions. As for men, both staying up late and engaging in high-temperature occupations are independent factors affecting their fertility.

Endometriosis-related infertility: ovarian endometrioma per se is not associated with presentation for infertility.

Is there an association between the endometriosis phenotype and presentation with infertility? In a population of operated patients with histologically proven endometriosis, ovarian endometrioma (OMA) per se is not associated with an increased risk of presentation with infertility, while previous surgery for endometriosis was identified as a risk factor for infertility. The increased prevalence of endometriosis among subfertile women indicates that endometriosis impairs reproduction for reasons that are not completely understood. This was an observational, cross-sectional study using data prospectively collected in all non-pregnant patients aged between 18 and 42 years, who were surgically explored for benign gynaecological conditions at our institution between January 2004 and March 2013. For each patient, a standardized questionnaire was completed during a face-to-face interview conducted by the surgeon during the month preceding surgery. Surgery was performed in 2208 patients, of which 2066 signed their informed consent. Of the 1059 women with a visual diagnosis of endometriosis, 870 had histologically proven endometriosis and complete treatment for their endometriotic lesions, including 307 who presented with infertility. Univariate analysis and multiple logistic regression analysis were performed to determine factors associated with infertility. The following variables were identified as risk factors for endometriosis-related infertility: age >32 years (odds ratio [OR] = 1.9; 95% confidence interval [CI]: 1.4-2.4), previous surgery for endometriosis (OR = 1.9; 95% CI: 1.3-2.2), as well as peritoneal superficial endometriosis (OR = 3.1; 95% CI: 1.9-4.9); Conversely, previous pregnancy was associated with a lower rate of infertility (OR = 0.7; 95% CI: 0.6-0.9 and OR=0.6; 95% CI: 0.4-0.9, respectively). OMA is not selected as a significant risk factor for infertility. The selection of our study population was based on a surgical diagnosis. We cannot exclude that infertile women with OMA associated with a diminished ovarian reserve, as assessed during their infertility work-up, were referred less frequently to surgery and might therefore be underrepresented. In addition we cannot exclude that our group of infertile women present associated other causes of infertility. Identification of risk and preventive factors of endometriosis-related infertility can help improve clinical and surgical management of endometriosis in the setting of infertility. None. None.

Effect of growth differentiation factor‑9C447T and G546A polymorphisms on the outcomes of invitro fertilization.

Single nucleotide polymorphisms (SNPs) in the growth differentiation factor (GDF)‑9gene are associated with premature ovarian failure, insufficient ovarian stimulation and a poor invitro fertilization (IVF) score in women with diminished ovarian reserve. The aim of the present study was to assess the effect of C447T (rs254286) and G546A (rs10491279) SNPs on ovary stimulation response, oocyte quality, fertilization rate and outcome of clinical pregnancy in an infertile population of Polish females (n=86) treated with IVF. The present study also included a group of fertile women (n=202). The P‑trend value, calculated for the GDF‑9C447T transition in infertile women, was statistically significant and were equal to0.0195. A significant association of the GDF‑9C447T SNP was observed with infertility for the C/Cvs.T/T+C/T model (OR= 2.140; 95% CI=1.043‑4.393; P=0.0349). The GDF‑9G546A SNP was significantly associated with the G/Avs.G/G model with poor ovarian stimulation (OR=9.303; 95% CI=2.568‑33.745; P=0.0008) and poor fertilization rate (OR=2.981; 95% CI=1.033‑8.607; P=0.0385). For the GDF‑9C447T SNP, a significant association was observed between the C/C+C/Tvs.T/T model and a poor ovarian stimulation response (OR=15.309; 95% CI=0.875‑267.83; P=0.0078), and a poor fertilization rate (OR=4.842; 95% CI=1.310‑17.901; P=0.0121). The present genetic evaluation revealed associations between IVF outcomes and the GDF‑9A546G and C447T SNPs. Additionally, these results indicated that the GDF‑9C447T SNP is a possible candidate genetic risk factor for female infertility in the Polish population.

Evaluation of Iranian College Students’ Awareness about Infertility Risk Factors

Background: With technological developments, creation of new industries, and changing human behavior and lifestyles, several new infertility risk factors (IRFs) are discovered annually. Although many studies have been conducted on IRFs, no research has yet been carried out on the awareness of Iranian college students about the many IRFs. Objectives: Since prevention of infertility in a society is directly related to awareness about infertility, in the present study the awareness of male and female college students about IRFs was evaluated and compared at Jami institute of technology. PatientsandMethods: For this purpose, a survey questionnaire containing 24 factors related to IRFs was developed and 123 college students from Jami institute of technology completed it. All data was extracted from these questionnaires and was statistically analyzed. Results: The results showed that both male and female participants had moderate awareness (55.86%) about IRFs. Female partic- ipants had significantly more awareness about the eects of cell phone radiation, fast food, and stress in comparison with their male counterparts. However, significantly higher numbers of male participants knew that smoking has negative eects on fertility.

Methionine synthase A2756G transition might be a risk factor for male infertility: Evidences from seven case-control studies

Methionine synthase (MTR) has a crucial role in DNA synthesis and methylation reactions. The aim of this study was to investigate the association of the MTR-A2756G polymorphism with idiopathic male infertility. Blood samples were collected from 217 idiopathic infertile- and 233 healthy-men, and MTR-A2756G genotyping was performed by PCR-RFLP. Meta-analysis was conducted by pooling our data with the data obtained from 6 previous studies. Also, the effects of this substitution on protein structure were evaluated by bioinformatics tools. Our study revealed the association of AG-genotype, GG-genotype, and G-allele with male infertility. Meta-analysis showed a significant association between A2756G transition and male infertility. In addition, structural analysis of the transition effect on protein revealed a significant influence on MTR function (with score: 38; expected accuracy: 66%). These findings suggest that the A2756G substitution might be a genetic risk factor and a potential biomarker for idiopathic male infertility.

Female Infertility and “Emerging” Organic Pollutants of Concern

Modern chemical instrumentation has fostered a revolution of sorts, in which epidemiologic studies of female infertility can now devote attention to very low level, “background” exposures to “emerging” non-persistent organic pollutants, rather than on “legacy” persistent organic pollutants. Predicated on widespread and frequent contact, and substantial experimental evidence of estrogen-disruptive effects, concern for phthalate diesters, environmental phenols (bisphenol A and triclosan), and ultraviolet filters (benzophenones) as risk factors for female infertility has grown. We reviewed the contemporary epidemiologic evidence for these emerging environmental pollutants as risk factors for female infertility. We conclude that the epidemiologic evidence is insufficient to date, to substantiate background exposures as risk factors for female infertility. However, very few epidemiologic investigations have been published. To more definitively address concerns, additional epidemiologic investigations are needed, including longitudinal collection of multiple biospecimens, simultaneous consideration of couple-level exposures, and incorporating mixtures of these and additional emerging organic pollutants.

Fertility Preservation in Children and Adolescents With Cancer

Advancements in oncologic therapy have increased long-term survival rates for children with childhood cancers. As survival has increased, the secondary effects of treatment have come into focus for patients and family. Infertility preservation in prepubertal children is a particularly difficult task as options are limited compared to adult counterparts with mature gametes. A systematic review of the published literature was conducted using keywords relevant to fertility preservation in the pediatric population undergoing oncologic treatment. We review the impact of cancer therapy upon gonadal function and identify the risk factors for future infertility in the prepubertal population. Treatment modifications that could modify the degree of potential damage to reproductive organs yet maintain oncologic principles were highlighted. Pubertal males and females have the opportunity to donate mature sperm or oocytes as do their adult counterparts; however, for the prepubertal child this is not the case. The options for these patients are considered investigational at this point and center on testicular tissue cryopreservation in males and oophorectomy vs ovarian cortical tissue cryopreservation in females. Infertility is an unfortunate side effect of oncologic treatment. Options are limited in the prepubertal population but tissue preservation and potential fertility should be discussed with all at-risk patients and their parents.

Sociomedical risk factors for male infecundity

Subjects and methods. A total of 917 men from infertile couples with abnormal ejaculate indicators were examined. Their age was 34.1 ± 6.3 years; the infertility period was 4.6 ± 3.9 years. A retrospective analysis of their case histories, clinical examination, questioning to identify risk factors for infertility, and anthropometric measurements of weight and height were made. Weight was rated normal at a body mass index (BMI) of ≤ 24.9 kg/m2 ; overweight at 25.0–29.9 kg/m2 , and obesity at ≥ 30 kg/m2 . When identifying infertility risk factors, the investigators kept in mind 24 risk factors at the moment of examination or in the patient histories, which were grouped into 3 clusters: 1 – environmental factors and occupational hazards; 2 – evidence of congenital and acquired abnormalities; 3 – social and quality-of-life factors; this cluster also includes history and examination evidence of tuberculosis, sexually transmitted diseases, and other social diseases, such as hepatitis B and C, or human immunodeficiency infection. Then the men who did not show an exacerbation of somatic diseases, genetic anomalies associated with reproductive disorders, or an exacerbation of social diseases at the moment of examination were selected from the total sample. These were divided into 2 groups: normal weight and obese patients. The frequency of the above mentioned infertility risk factors and additionally the proportion of persons engaged in intellectual or manual labor were calculated in each group. Results and discussion. In the total sample, the frequency of infertility risk factors including occupational hazards and environmental factors was 40 %. Conclusion. The sociomedical risk factors of infertility make the most significant contribution to the development of male infecundity. Moreover, among the contemporary men there is a social group of persons at high risk of infertility; these are 30–40-year-old men who have constitutional prerequisites to the development of obesity accompanied by the high rate of chronic hepatitis, who are engaged in intellectual labor and experience frequent emotional stresses, for relief of which they regularly consume alcohol.

Use of Vaginal Hygiene Product, Physical Activity, Age at Marriage, Body Mass Index, and FemaleInfertility

Background: Various products are common in the market for vaginal hygiene purpose, such as povidone iodine vaginal douche, extract of betel leaf, and other herbal internal vaginal hygiene products. However, it is hypothesized that these hygiene products may hamper female fertility. This study aimed to examine the effect of vaginal hygiene product use on female fertility, while controlling for the level of physical activity, age at marriage, and body mass index.Subjects and Method: This study was analytical-observational with case control design, conducted at Dr. Moewardi Hospital, Surakarta, Indonesia. The study population were women aged 15-49 years old. A total of 55 infertile women and 55 pregnant or post-partum women were selected as cases and controls, respectively, by using fixed diseases sampling. The dependent variable was infertility. The independent variables were external and internal use of vaginal hygiene product, level of physical activity, age at marriage, and body mass index (BMI). The data were analyzed using multiple logistic regression.Results: External use of vaginal hygiene product decreased the risk of infertility, but it was statistically non-significant (OR=0.62; 95%CI= 0.22 to 1.74; p=0.366). Internal use of vaginal hygiene product (OR=14.97; 95%CI= 1.66 to 135.16; p=0.016), heavy physical activity (OR=7.95; 95%CI= 1.54 to 41.08; p=0.013), age at marriage>29 years (OR=3.66; 95%CI= 0.68 to 19.76; p=0.131), BMI 29 years, underweight, and overweight, are risk factors of infertility in women. Women who use vaginal hygiene product internally should be aware that this practice significantly increased the risk of infertility.Keywords:Female infertility, vaginal hygiene product, physical activities, age at marriage, body mass indexCorrespondence: Ayu Kusuma Puspasari Arifin. Masters Program in Public Health, Sebelas Maret University. Email: puspasari.arifin@yahoo.comJournal of Maternal and Child Health (2016), 1(1): 41-52https://doi.org/10.26911/thejmch.2016.01.01.07

Impaired endometrial receptivity in primary infertility in women with undifferentiated connective tissue dysplasia and hereditary thrombophilia

to investigate endometrial morphological and immunophenotypic features in patients with primary infertility in the presence of uCTD and HT. The pipelle endometrial biopsy specimens taken in the implantation window were examined in 81 patients, including 13 women with a clinical diagnosis of uCTD, 40 with HT, 19 with uCTD concurrent with HT, and in a control group of 9 heathy surrogate mothers. Morphological, immunohistochemical, and morphometric examinations were done to study the paraffin-embedded endometrial biopsy sections stained with hematoxylin and eosin, pikrofuksin by van Gieson, and with toluidine blue. Immunohistochemical tests were carried out using primary antibodies against ER, PgR, LIF, PAI-1, VEGF, Collagen I, Collagen III, fibronectin, laminin, MMP-2, and MMP-9. The uCTD, HT, and uCTD + HT groups were found to have signs of decreased endometrial receptivity as dramatically lower counts of mature pinopodes, slower endometrial maturation, reduced expression of the receptivity marker LIF, and deviations of the stromal progesterone-estrogen index from the normal value. Sclerotic foci with type III collagen accumulation were detected in the endometrial stroma. uCTD and HT and especially their concurrence are commonly a concomitant disease and risk factors for infertility in women due to impaired endometrial receptivity. In uCTD, connective tissue remodeling processes are substantially retarded, which ultimately leads to increased processes of endometrial stromal sclerosis, reduced endometrial receptivity, and infertility. The most pronounced morphological and immunophenotypical changes have been ascertained to develop in the uCTD + NT group. The findings may be used to predict and devise new infertility treatments in patients with uCTD + NT.

Glucose-6-phosphate dehydrogenase deficiency does not increase the susceptibility of sperm to oxidative stress induced by H2O2.

ObjectiveGlucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common human enzyme defect. G6PD plays a key role in the pentose phosphate pathway, which is a major source of nicotinamide adenine dinucleotide phosphate (NADPH). NADPH provides the reducing equivalents for oxidation-reduction reductions involved in protecting against the toxicity of reactive oxygen species such as H2O2. We hypothesized that G6PD deficiency may reduce the amount of NADPH in sperms, thereby inhibiting the detoxification of H2O2, which could potentially affect their motility and viability, resulting in an increased susceptibility to infertility.MethodsSemen samples were obtained from four males with G6PD deficiency and eight healthy males as a control. In both groups, motile sperms were isolated from the seminal fluid and incubated with 0, 10, 20, 40, 60, 80, and 120 µM concentrations of H2O2. After 1 hour incubation at 37℃, sperms were evaluated for motility and viability.ResultsIncubation of sperms with 10 and 20 µM H2O2 led to very little decrease in motility and viability, but motility decreased notably in both groups in 40, 60, and 80 µM H2O2, and viability decreased in both groups in 40, 60, 80, and 120 µM H2O2. However, no statistically significant differences were found between the G6PD-deficient group and controls.ConclusionG6PD deficiency does not increase the susceptibility of sperm to oxidative stress induced by H2O2, and the reducing equivalents necessary for protection against H2O2 are most likely produced by other pathways. Therefore, G6PD deficiency cannot be considered as major risk factor for male infertility.

Online Fertility Survey

Objective: To determine the level of knowledge on common fertility issues among the population studied. Outcome measures: Fifty percent or more of the respondents correctly answering a particular question was adjudged as sufficient knowledge of that particular fertility issue and less than 50% adjudged insufficient knowledge. Methodology: The study was conducted by the Nordica Fertility Centre Lagos in 2012. A simple multiple choice questionnaire with 20 questions about fertility was posted on the Nordica Fertility Centre Lagos website for visitors to the site to answer. Results were collated and analyzed using SPSS 17.0. Results: A total of 289 persons participated in the online survey. Majority of the respondents lived in the Lagos area but responses came in from virtually all over Nigeria. A few responses came from outside Nigeria. There was sufficient knowledge on such issues as definition of infertility, age at which woman's fertility is maximal, frequency of intercourse per week when trying to conceive, who to see after a year of tests with no success, basic infertility tests for men, normal sperm counts, most common sperm abnormality, strongest risk factor for infertility in women, how long to wait before seeking help in women less than 35 years of age, what is unexplained infertility, meaning of menopause and what was the most successful option for older women trying to conceive. There was insufficient knowledge on sex positions increasing the likelihood of conception, monthly chance of conception, gender that experiences infertility most, causes of infertility, fertile period and irregular cycles. Up to 65% of the respondents felt certain sex positions increase the likelihood of conception. Over 30% said that a woman's fertility begins to decline from 40 years and beyond. About forty seven percent felt mere change of dates of menses monthly meant cycles were irregular. Only 49.5% correctly knew the fertile period. About 61% thought monthly natural fertility/conception rates was 50-70%. Staphylococcus was considered the leading factor in the causation of infertility by 41% of respondents, scored higher than male, female and combined factors. Majority of the respondents, 42.9% felt women were the gender that experienced infertility most while 11.4% of them said it was the men. Conclusion: There is still a need to improve knowledge on fertility and infertility. The online portal is a good source for this.

Association of body mass index with primary and secondary infertility among infertile women in Mangalore: A cross-sectional study

Background: Studies have shown that overweight and underweight can contribute to fertility problems. There is a significant paucity of data in the Indian context regarding the effect of body mass index (BMI) on infertility in women. Aims and Objective: To find the association of BMI with primary and secondary infertility among infertile women in Mangalore. Materials and Methods: This cross-sectional study included 204 infertile women (18–45 years) from a tertiary care hospital in Mangalore. Primary and secondary infertility were classified based on the infertility definitions of the World Health Organization. Weight and height were used to calculate BMI (kg/m2). Result: This study showed that infertile women with overweight were maximum 87 (42.65%), followed by women with normal BMI 85 (41.67%), underweight 17 (8.33%), and obese 15 (7.35%). Of 204 infertile women, 137 (67.2%) had primary infertility and 67 (32.8%) had secondary infertility. Of 137 women with primary infertility, 12 (8.8%) were underweight, 55 (40.1%) were normal BMI, 62 (45.3%) were overweight, and 8 (5.8%) were obese. Of 67 women with secondary infertility, 5 (7.5%) were underweight, 30 (44.8%) were normal BMI, 25 (37.3%) were overweight, and 7 (10.4%) were obese. Deviation of weight from normal BMI was more in primary infertility (59.9%) than in secondary infertility (55.2%). Conclusion: Both overweight and underweight is a preventable risk factor for infertility and precautionary measures to manage them may be an effective means of reducing the risk of infertility and other associated disorders. Future studies are needed to understand if correction of weight improves fertility in these women.

Spontaneous pregnancy after pessary placement in a patient with infertility and advanced pelvic organ prolapse

To highlight possible association of advanced pelvic organ prolapse with infertility and its successful outcome following conservative management. We report herein a 38-year-old para 1, non-overweight woman who presented with secondary infertility without any factors for infertility except for an advanced POP. She had intrauterine insemination (IUI) performed twice at a local clinic and in vitro fertilization-embryo transfer (IVF-ET) program twice in our institute unsuccessfully. She conceived spontaneously after vaginal pessary placement and delivered, vaginally, a healthy female baby weighing 3,365 g at the 38th week of gestation. Advanced POP appears to be an important risk factor for infertility. After completing an infertility workup, pessary application can be the first-line treatment modality for women with unexplained infertility due to advanced POP.

Açıklanamayan infertilite etiyolojisinde olası risk faktörü olarak herediter trombofilinin yeri

Objective: Unexplained infertility represents one of the most common diagnoses among infertile couples. In this study we investigated the impact of inherited thrombophilia as a risk factor in unexplained infertility. Material and Methods: In this study, genetic mutations of prothrombin gene G20210A, Factor V Leiden and methylene tetrahydrofolate reductase (MTHFR) C677T, as well as D-Dimer levels were investigated in 25 women diagnosed with unexplained infertility and 25 healthy fertile women. Results: In the present study, among unexplained infertile women and the control group, MTHFR C677T, prothrombin G20210A mutations and D-Dimer levels did not have a statistically significant difference (p>0.05). Factor V Leiden mutation was not observed in either group. Conclusion: Currently, there still are unclear points in the etiopathogenesis of unexplained infertility. As a result of our findings, although we did not observe a significant association between hereditary thrombophilia and unexplained infertility, the presence of a number of studies with contradictory findings demands future research with large sample sizes to clarify this issue.

Relationship between risk factors for infertility in women and lead, cadmium, and arsenic blood levels: a cross-sectional study from Taiwan.

BackgroundThe World Health Organization reported that more than 10 % of women are severely affected by infertility, making the condition a major worldwide public health problem. Lead (Pb), cadmium (Cd), and arsenic (As) are environmental pollutants that may contribute to reproductive disorders. This cross-sectional study investigated the association between blood concentrations of Pb, Cd, and As and risk factors for infertility in women.MethodsWomen who were infertile (N = 310) or pregnant (N = 57) were recruited from the gynecology and obstetrics department of a hospital. The participants were interviewed to obtain their sociodemographic, reproductive, and lifestyle information. The concentrations of Pb, Cd, and As in their blood samples were measured using inductively coupled plasma mass spectrometry.ResultsOur findings suggested that the concentrations of Pb and As, but not Cd, were significantly higher in the blood of infertile women than in that of pregnant women. A higher percentage of the infertile women consumed more alcohol, used Chinese herbal medicine more frequently, and lacked physical activity compared with the pregnant women. After accounting for potentially relevant predictors, we observed that blood Pb levels might be elevated by using Chinese herbal medicine 1–6 times per week (aOR = 2.82, p = 0.05). In addition, engaging in physical activity 1–2 times per week (aOR = 0.37, p = 0.05) might assist in reducing Pb accumulation in infertile women, though the p value was borderline.ConclusionsLack of physical activity and frequent use of Chinese herbal medicine may be associated with elevated blood Pb levels in infertile women. Chinese herbal medicine use was observed to increase the Pb body burden of both infertile and pregnant women in this study. The risk–benefit for Chinese herbal medicine intake should be evaluated by women of childbearing age.

Role of genetic mutations in folate-related enzyme genes on Male Infertility.

Several studies showed that the genetic mutations in the folate-related enzyme genes might be associated with male infertility; however, the results were still inconsistent. We performed a meta-analysis with trial sequential analysis to investigate the associations between the MTHFR C677T, MTHFR A1298C, MTR A2756G, MTRR A66G mutations and the MTHFR haplotype with the risk of male infertility. Overall, a total of 37 studies were selected. Our meta-analysis showed that the MTHFR C677T mutation was a risk factor for male infertility in both azoospermia and oligoasthenoteratozoospermia patients, especially in Asian population. Men carrying the MTHFR TC haplotype were most liable to suffer infertility while those with CC haplotype had lowest risk. On the other hand, the MTHFR A1298C mutation was not related to male infertility. MTR A2756G and MTRR A66G were potential candidates in the pathogenesis of male infertility, but more case-control studies were required to avoid false-positive outcomes. All of these results were confirmed by the trial sequential analysis. Finally, our meta-analysis with trial sequential analysis proved that the genetic mutations in the folate-related enzyme genes played a significant role in male infertility.