Treatment Of Infertile Women Research Articles

Age specific reference intervals of serum anti-Müllerian hormone concentration of 1,253 women with healthy females in infertility center

Objective: To investigate the age specific reference intervals of serum anti-Müllerian hormone (AMH) concentration of healthy women in infertility center. Materials and Methods: After exclusion of 642 participator who did not meet the inclusion criteria, a total of 1,253 healthy women aged 17 to 49 years were enrolled in the study between January and August 2016. This study population was divided to five age groups, The samples of this study collected from each participants and aliquoted and stored at -80℃ refrigeratory until assayed, The authors used AMH enzyme-linked immunosorbent assay (ELISA) kit for the assessment of AMH levels. Results: The serum AMH levels varied inversely correlation with patient age. The AMH concentration can be roughly calculated by formula (AMH =-0.327*age+15.98). This downward trend was significant among these women whom 40 years age. The coefficient of variation was larger even in the same age groups, The 2.5-97.5th percentile of AMH level of each age group was 2.30-16.7 ng/mL, 0.96-16.4ng/mL, 0.44-15.1ng/ mL, 0.14-12.5ng/mL, and 0.08-6.56ng/mL, respectively. Conclusions: This study determined reference values of serum AMH in China women with regular menstruation. These values can be applied to clinical evaluation and treatment of infertile women. It suggested that AMH is an individual medical index that women should establish their own baseline date for longitudinal axis comparison.

A Randomized Controlled Trial of Combination Letrozole and Clomiphene Citrate or Letrozole Alone for Ovulation Induction in Women With Polycystic Ovary Syndrome

(Abstracted from Fertil Steril 2019;111(3):571–578) Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age and the most common cause of anovulatory infertility. Treatment for infertility in women with PCOS centers around ovulation induction (OI).

Współpraca lekarza i farmaceuty w zakresie optymalizacji farmakoterapii w trakcie doustnego leczenia niepłodności u kobiet. Stan badań klinicznych oceniających skuteczności składników suplementów diety stosowanych w trakcie leczenia niepłodności

Współpraca lekarza i farmaceuty w zakresie optymalizacji farmakoterapii w trakcie doustnego leczenia niepłodności u kobiet. Stan badań klinicznych oceniających skuteczności składników suplementów diety stosowanych w trakcie leczenia niepłodności

LABORATORY PREDATORS OF SPONTANEOUS PREGNANCY OCCURRENCE IN WOMEN WITH OVARIAN CYSTS AFTER LAPAROSCOPIC TREATMENT OF INFERTILITY

The main goal of treating couples with infertility is achieving pregnancy and successful delivery of the newborn. Laparoscopy is used worldwide for treating patients with infertility due to endometriosis or recurrent functional uni- or bilateral ovarian cysts. In our prospective study we examined 258 women with the diagnosis of benign mass of the ovaries who underwent treatment for infertility at Samara State Clinical Hospital n.a. V.D. Seredavin within the period from November 2015 to December 2017. 54 women with infertility were enrolled in the current study. We divided them into two groups: the first group included patients with endometrioid cysts (n = 20) and the second one included patients diagnosed with functionalovarian cysts (n = 34). Exclusion criteria comprised the tubal factor of infertility, male factor, BMI > 25 of female and other metabolic disorders. Anti-Mullerian hormone (AMH) ng/ml and CA-125 were determined preoperatively. Patients were compatible with age, parity, and duration of infertility. Post-operative levels of AMH were measured on the first cycle after surgery. Postoperatively the patients were followed up for 6 monthsin order to confirm the presence/absence of pregnancy by ultrasound examination and the level of human chorionic gonadotropin in blood. 42,6% of total women enrolled in this study became pregnant within 6 months after surgery. The proportion of pregnancies in the group with treated endometriomas was significantly lower in comparison with the group of functional cysts: 7 patients (35%)in the first groupand 16 patients (47,05%) in the second one, p < 0.007 respectively. We consider post-operative AMH level to be more accurate prognostic tool for predicting results of laparoscopic infertility treatment in women both with ovarian cysts and endometriomas.

Laparoscopic surgery: Any role in patients with unexplained infertility and failed in vitro fertilization cycles?

Patients who undergo several in-vitro fertilization (IVF) treatment cycles and fail to conceive present a frustrating problem to the clinician. When 1 cycle of IVF treatment fails, should we offer the couples to choose additional cycle of IVF instead of evaluation of the potential peritoneal factor? In cases of otherwise unexplained infertility, the investigation cannot be considered to be complete until laparoscopy has been performed. The aim of the study is to investigate the fertility outcome of laparoscopic treatment in infertile women with repeated IVF failures.This is a retrospective case-control study conducted in a tertiary care, academic teaching hospital from January 2012 to December 2015. Patients recruited in this study were classified into 2 groups. Study group (n = 45) were offered laparoscopy for evaluation of infertility, control group (n = 45) elected to proceed to IVF without laparoscopy. Diagnostic laparoscopy and subsequent excision of suspected endometriotic lesions, lysis of adhesion and treatment of tubal pathology were performed when indicated.Forty-four (97.8%) patients in study had pelvic pathologies and the treatment was performed at the same time. Twenty-four patients in study group conceived including 16 patients conceived spontaneously and 14 patients conceived with additional IVF following laparoscopy management. There was a significant difference in the ongoing pregnancy rates between patients conceived through IVF in study group and control group (41.9% vs 19.6%, P < .05).Laparoscopy in women with normal hysterosalpingography but recurrent IVF failures can detect unrecognized pelvic pathologies. Laparoscopy evaluation prior to additional cycle of IVF seems to improve the subsequent pregnancy rate.

Osteoprotegerin (OPG) Interacts with Syndecan-1 to Mediate Human Endometrial Stromal Decidualization &lt;i&gt;via&lt;/i&gt; Decreasing Akt Phosphorylation

Methods: Human endometrial tissues from proliferative stage to secretory stage of normal menstrual cycle, and decidua tissues from normal pregnancy and recurrent pregnancy loss patients were collected to analyze the expression of OPG. Human endometrial stromal cells (HESCs) and primary human endometrial stromal cells (ESCs) were performed to explore the function and mechanism of OPG during decidualization. Findings: OPG expressed in human endometrium across menstrual cycle and during the human endometrial stromal cell decidualization. Knockdown experiments revealed that decrease of OPG impaired the expression of decidual markers prolactin (PRL) and insulin-like growth factor binding protein-1 (IGFBP-1) without interference with the cell proliferation. Knockdown of OPG increased the phosphorylation of Akt and ERK1/2 during HESCs decidualization. Inhibition of PI3K signaling can rescue the impaired expression of decidual markers PRL and IGFBP-1 in response to OPG knockdown, but the ERK1/2 inhibition cannot. Further experiments revealed that OPG mediates human endometrial stromal decidualization by interacting with Syndecan-1 via decreasing Akt phosphorylation. Finally, endometrial expression of OPG was significantly lower in recurrent pregnancy loss (RPL) endometrial samples than that in normal pregnancy samples during the first trimester. Interpretation: OPG is required for decidualization, and the decrease of OPG is associated with recurrent pregnancy loss. These findings would provide a new candidate for diagnosis and treatment of infertility in women. Funding: This work was supported by the National Natural Science Foundation of China. Declaration of Interest: The authors declare that there is no conflict of interests. Ethical Approval: This study was approved by the Medical Ethics Committee of The First Affiliated Hospital of Xiamen University and written informed consent was obtained from all participants in accordance with the guidelines in The Declaration of Helsinki 2000.

In vitro fertilization as a method of infertility treatment in women with type 1 diabetes mellitus

Some patients with type 1 diabetes have anovulation, tubal occlusion, male factor and other causes of infertility which require IVF procedure.&#x0D; We examined 20 women with type 1 diabetes, in which pregnancy occurred as a result of ART, at the stage IVF protocol planning, during pregnancy course and delivery. One of the patients underwent IVF procedure twice. Mean age of the patients who applied to the Department of assisted reproductive technologies was 336 years, duration of infertility varied from 3 to 15 years. Two patients were performed donor oocytes transfer (patients with Turner Syndrome and Swyer Syndrome). In 70% of patients the method of CSII was used. Assessment of carbohydrate metabolism was based on the level of glycated hemoglobin A1c (HbA1c), plasma glucose level measured at least 8 times a day and results of continuous glucose monitoring (CGM).&#x0D; 18 singleton pregnancies and three multiple gestations (dichorionic diamniotic twins) occurred as a result of IVF. In 12 women delivery occurred on the 3739th weeks of gestation, in 9 patients pregnancy was terminated on the 3436th weeks. In all the cases it was live birth. Birth weight above the 90th percentile had 6 newborns.

198 Superovulatory response in cows undergoing aromatase inhibitor treatment

The aromatase inhibitor letrozole has been used in the treatment of infertility in women by inducing mild ovarian superstimulation or augmenting the ovarian response to FSH treatment. The effect has been attributed to an apparent up-regulation of FSH receptors on granulosa cells as a result of increased androgens (Weil et al. 1999 J. Clin. Endocrinol. Metab. 84, 2951-2956). The objective of this study was to determine whether letrozole will augment the superstimulatory response in FSH-treated cattle. Mature, non-lactating Holstein cows (n=30) were given 2 luteolytic doses of PGF2α 12h apart and scanned daily by transrectal ultrasonography to detect ovulation. Transvaginal ultrasound-guided ablation of follicles ≥5mm was performed in all cows as a group, at 5 to 8 days after ovulation. On the day of ablation, cows were assigned randomly to 2 groups (n=15 per group) and given either an intravaginal letrozole-releasing device or a blank device for 5 days. Coinciding with expected wave emergence (Day 0), cows in both groups were given 8 doses of 50mg of pFSH (Folltropin; Vetoquinol, Lure, France) IM at 12-h intervals, and PGF2α on Days 3 and 3.5. At the time of the second PGF2α, vaginal devices were removed and paint was applied to the tailhead to facilitate detection of oestrus. On Day 5, cows were given gonadotropin-releasing hormone (100mg gonadorelin) IM and artificially inseminated 12 and 24h later. Ova/embryos were collected by transcervical uterine flush on Day 12. The ovaries were examined by ultrasonography on Day 0, 3.5, 5, 6.5, and 12 to record the follicular and luteal response. Nominal data were compared between groups by t-test and by ANOVA for repeated-measures and are expressed as mean±s.e.m. Binomial data were compared by chi-squared test. The number of follicles at wave emergence did not differ between letrozole and control groups (24.6±3.1 and 26.5±3.3 respectively; P=0.68). There was no treatment effect or treatment×day interaction in the number of follicles &amp;gt;8mm on Day 3.5, 5, and 6.5. Letrozole-treated cows exhibited oestrus later than controls (50.3±1.1h v. 40.7±2.0h after first PGF2α; P&amp;lt;0.001) and had less variance in interval to oestrus (residuals, 3.1±0.48h v. 6.7±0.87 h; P&amp;lt;0.01). The number of CL on Day 6.5 was lower in the letrozole group than in the control group (9.1±1.1v. 12.3±1.1; P=0.05). The proportion of ovulations (number of CL on Day 12 over number of follicles ≥3mm on Day 0) was lower in the letrozole group than in the control group (0.65±0.05v. 0.82±0.08; P=0.02). The total number of ova/embryos collected per cow did not differ between letrozole and control groups (5.0±1.9v. 5.4±1.8; P=0.75), nor did the number of transferable embryos differ (3.0±1.2v. 4.3±1.5; P=0.56). In conclusion, treatment with a letrozole-releasing device during ovarian superstimulation did not improve the superovulatory response or embryo collection rate in mature Holstein cows, but letrozole treatment resulted in more synchronous oestrus, which may be used in the design of a fixed-time AI protocol following superstimulatory treatment in cattle. This research was supported by the Alberta Livestock and Meat Agency.

Automatic texture and intensity based ovarian classification

Detection of ovarian follicle/cysts and monitoring its growth is vital in infertility treatment in women. Ultrasound imaging technique is used for recognition of ovarian follicles and cysts. Profound variation in location, shape, size and color is seen in follicles. Human interpretation of follicles gives a chance for misinterpretation and false diagnosis. Follicle recognition becomes a challenging task due to the non-homogenous nature of the follicles and presence of speckle noise. To overcome this problem, computer assisted recognition of ovarian follicle and cysts followed by ovarian classification were proposed. Discrete wavelet transform (dwt) was used for despeckling. Texture and intensity based segmentation methods were used for automatic recognition. Classification of ovary was done based on ovarian morphology. This novel method serves as a decision support system for the medical expert. The efficiency of the proposed texture and intensity based ovarian classification (TIOC) method was demonstrated using various performance indices like sensitivity, specificity, accuracy, precision, Mathew’s correlation coefficient and receiver operating characteristic curve. The resultant images obtained from the TIOC method was compared with the control images and existing methods for validation.

Autotransplantation of fragmented ovarian cortical tissue: a laparoscopic demonstration

To describe and demonstrate a simple and secure procedure for laparoscopic autotransplantation of fragmented ovarian cortical tissue in women with diminished ovarian reserve as part of invitro activation (IVA) of ovarian follicles. Step-by-step video explanation of the surgical procedure with still pictures and surgical video clips to demonstrate the detailed technique. Fertility clinic and obstetrics and gynecology department at a university hospital. Women with idiopathic diminished ovarian reserve and indication for invitro fertilization (IVF), aged 25 to 39years with an antral follicle count bilaterally of ≤5, antimüllerian hormone level of ≤5 pmol/L, and two ovaries. The laparoscopic autotransplantation consists of six steps: [1] obtaining ovarian cortical biopsy samples, [2] preparing the peritoneal pocket, [3] fragmenting the ovarian cortical tissue into pieces of approximately 1mm3, [4] installing the tissue fragments into a catheter, [5] transplanting the tissue fragments into the peritoneal pocket, and [6] closing the peritoneal pocket with a surgical clip. After the procedure, the patients are evaluated with blood samples and ultrasound scans followed by controlled ovarian stimulation. Ethics committee approval was obtained. Feasibility of a six-step laparoscopic autotransplantation procedure using fragmented ovarian cortical tissue. A simple, fast laparoscopic procedure for taking biopsy samples and autotransplanting cortical tissue fragments in an all-in-one procedure ensures the rapid handling and correct placement of the small tissue fragments. The procedure is performed in an outpatient setting with an operation time of 1hour. We have performed this procedure on 20 patients with no complications. Invitro activation is a new, developing option for women in fertility treatment who have diminished ovarian reserve. Fragmentation of murine ovarian tissue has shown to suppress the Hippo pathway, thereby initiating proliferation and growth. This surgical procedure resembles that used when transplanting pieces of frozen-thawed ovarian tissue for fertility restoration, but the fragmented ovarian tissue is only 1mm3, which makes it difficult to transplant. Until now no surgical procedures for transplanting small IVA fragments of cortical tissue has been published. With this video we report in detail a simple way of autotransplanting small fragments of IVA cortical tissue using what is already accessible in the operating theater. Among the many advantages of this procedure are its short duration (1hour) and outpatient setting, which enable fast recovery and minimal postoperative pain. The procedure also allows fast handling and minimal manipulation of the tissue (limited to the fragmentation). The effect of autotransplantation of fragmented tissue in women with diminished ovarian reserve is currently being studied in ongoing trials. If the technique is combined with chemical IVA, a better outcome may be seen.

Клинико-экономический анализ применения фоллитропина-альфа+лутропина-альфа (лекарственный препарат Перговерис) в лечении бесплодия у женщин с субоптимальным ответом яичников в Российской Федерации

Клинико-экономический анализ применения фоллитропина-альфа+лутропина-альфа (лекарственный препарат Перговерис) в лечении бесплодия у женщин с субоптимальным ответом яичников в Российской Федерации

Levothyroxine supplementation on assisted reproduction technology (ART) outcomes in women with subtle hypothyroidism: a retrospective study

The need for treating subclinical hypothyroidism (SCH) in women undergoing assisted reproduction technology (ART) is under debate. Moreover, it is known that controlled ovarian hyperstimulation (COH) protocols may impair the thyroidal axis. Therefore, we evaluated if levothyroxine (L-T4) supplementation in SCH women before undergoing ART positively affects the main reproductive outcomes. We retrospectively analyzed in vitro fertilization (IVF) data of 4147 women submitted to 6545 cycles in a tertiary care IVF Center (January 2009–December 2014). L-T4 (1.4–2.0 mcg/kg) treatment was offered to all women with a pre-cycle TSH >2.5 mIU/L before starting COH and main ART outcomes were compared in euthyroid and L-T4-treated women undergoing ART. Among 4147 women, 1074 (26%) were affected by SCH and were treated with L-T4 before COH was started. No statistically significant differences among L-T4-treated and euthyroid women group were observed regarding pregnancy rate, respectively, per cycle (27.67% vs 26.37%; p = .314) and per embryo transfer (30.13% vs 29.17%; p = .489), live birth rate, respectively, per cycle (21.58% vs 20.38%; p = .304) and per embryo transfer (23.49 vs 22.54%; p = .449) and the rest of primary and secondary efficacy endpoints. Early L-T4 treatment for infertile women with a subtle thyroid dysfunction may mitigate and protect from the negative effects of SCH in the setting of ART, and may preventively overcome also the negative impact of COH on thyroidal axis.

Фармакоэконо­мический анализ лечения бесплодия у женщин с субоптимальным ответом яичников

Фармакоэконо­мический анализ лечения бесплодия у женщин с субоптимальным ответом яичников

Uterus Transplantation: A Rapidly Expanding Field.

Uterus transplantation (UTx) has been successfully introduced as a treatment option for women with absolute uterine factor infertility (AUFI). AUFI representing approximately 3% to 5% of the female general population is linked to either congenital uterine agenesis (Mayer-Rokitansky-Küster-Hauser syndrome), major congenital uterine malformation (hypoplastic uterus, fraction of bicornuate/unicornuate uterus), a surgically absent uterus, or an acquired condition (intrauterine adhesions, leiomyoma) linked to uterine malfunction that causes implantation failure or defect placentation. The world's first clinical uterus transplant was performed in 2000. However, a hysterectomy became necessary shortly after the surgery due to uterine necrosis. In 2011, a group in Turkey reported on a surgically successful deceased donor transplant; however, this procedure has, to date, not resulted in a healthy live birth, the ultimate goal of UTx. Building on an extensive experimental background in various animal models, including primates, the Gothenburg group led by Brännström reported on the first delivery of a healthy baby in a recipient of a live donor UTx in 2014. This event did not only show the feasibility of UTx, it also helped defining relevant areas of clinical and basic research. Use of a gestational surrogate carrier, is, at least in theory, an alternative for a woman with AUFI seeking genetic motherhood. However, in the clear majority of countries worldwide, gestational surrogacy is not practiced based on legal, ethical, or religious concerns. Of note, the overwhelming majority of surveyed women in the United Kingdom, a country which permits surrogacy, preferred UTx over gestational surrogacy and adoption. Moreover, randomly selected women of fertile age in Sweden preferred UTx over gestational surrogacy. A recent large survey in Japan with more than 3000 participants revealed that UTx had a twofold higher acceptance rate compared with gestational surrogacy. In a recent US survey exploring the potential of donating vascularized composite allografts, uterus donation achieved the highest priority. Thus, the acceptance of UTx as infertility treatment for women with AUFI is high, although the procedure remains in its infancy. Here, we provide an update of clinical activities, summarize achievements and challenges, and submit areas of research interests.

Follicle Stimulating Hormone Receptor Signaling is Regulated by Lipid Raft Residency

Infertility affects 7.4 million women and their partners in the United States. One cause for infertility in women is human follicle stimulating hormone (hFSH) dysfunction. hFSH is involved in follicle maturation and estrogen production in females and spermatogenesis in males. Lack of normal hFSH function in either the ligand or receptor leads to infertility in women, however does not fully inhibit fertility in males. hFSH is secreted from the pituitary gland and binds to its g protein‐coupled receptor (hFSHR) located in the ovaries or the testis. Previous research in our lab has shown that hFSHR resides in cholesterol, sphingolipid, and caveolin enriched microdomains called lipid rafts. It has been previously shown that hFSHR interacts with caveolin although the specific mechanism of this interaction is unknown. One possibility is that the interaction is through a specific amino acid sequence in hFSHR consistent with caveolin interaction motifs identified in other proteins. The current study investigated how lipid rafts regulate hFSHR signaling. It was hypothesized that disruption of lipid rafts or interference with the caveolin interaction motif would alter hFSHR signaling. Lipid rafts in human granulosa cells (the hGrC1 cell line) were disrupted through cholesterol depletion with methyl‐β‐cyclodextrin (MβCD) and FSH signaling differences were observed by western blot. It was observed that MβCD treatment resulted in an increase of cAMP signaling compared to control cells. In parallel, mutations in the hFSHR caveolin interaction motif were made and expression plasmids were transiently transfected into HEK 293 cells. Western blot analysis revealed that some of the mutants showed increased basal signaling relative to the wild type receptor. Taken together, these results suggest that lipid rafts may be acting act as an inhibitory mechanism for hFSHR and that caveolin may play a role in receptor recruitment to the lipid raft. Researching hFSH signaling after lipid raft manipulation can provide a better understanding of the cellular mechanisms of hFSHR, which could lead to innovative ideas in infertility treatment for women.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

The role of combining medroxyprogesterone 17-acetate with human menopausal gonadotropin in mouse ovarian follicular development

Medroxyprogesterone 17-acetate (MPA) combined with human menopausal gonadotropin (hMG) has been effectively used for ovarian stimulation in clinical practice. However, the molecular mechanism of MPA + hMG treatment in follicular development is poorly described. Here we performed a study to investigate the impact of MPA + hMG on ovarian stimulation utilizing a mouse model in vivo. Forty female BALB/C mice were randomly divided into four groups of 10 each and treated during ciestrus stage and continued for 5 days: control group, MPA group, hMG group, and MPA + hMG group. Morphological and molecular biology methods were used for detecting serum hormones and ovarian function. MPA + hMG group exhibited increasing follicle stimulating hormone (FSH), antral follicle, FSH receptor (FSHR) and phosphorylated mammal target of rapamycin (p-mTOR), and decreasing luteinizing hormone (LH), estradiol (E2), progesterone (P), corpus luteum, phosphoinositide 3-kinase (PI3K), Akt and mTOR compared with control group. In contrast, MPA + hMG group showed reduced FSH, LH, E2, P, corpus luteum, LH receptor (LHR), and activated PI3K,/Akt/mTOR pathway compared with hMG group (P < 0.05). Collectively, these data definitively established that MPA plus hMG may modulate the hormone, hormone receptor and PI3K/Akt/mTOR signaling pathway to influence follicular development in the mouse ovary. Our study provides overwhelming support for MPA + hMG as an effective treatment for infertility in women.

INTERRELATIONSHIP OF THYROID HORMONES, OBESITY, AND PROLACTIN IN INFERTILE WOMEN

Objective: The aim of the study was to evaluate and compare the level of thyroid hormones, namely, triidothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH), and prolactin in blood serum of infertile women with normal healthy subjects in Amritsar region of Punjab, India. A number of complications arise from the dysfunction of hypothalamic-pituitary-ovarian axis, which leads to the hormonal disturbances in female reproductive system. Certain disorders such as obesity and thyroid hormone imbalance are highly prevalent and lead to various complications in pregnancy such as polycystic ovary syndrome. These disorders lead to the infertility and ultimately constitute a major physiological stress. A multidimensional diagnostic approach is imperative in evaluating these disorders. In the present study, the association between thyroid hormones and prolactin has been reviewed in infertile women which is a prerequisite to work up for infertility in Punjab.Methods: Hemoglobin levels were estimated in the blood serum of healthy controls and infertile women by the method of Sahli. The levels of serum T3, T4, TSH, and prolactin were determined by electrochemiluminescence immunoassay using Cobas e 411 analyzer according to the instruction manual.Results: Majority of infertile women were found to have hypothyroidism and hyperprolactinemia which can be correlated with infertility. This condition might respond to the treatment for their hormonal and prolactin levels, and fertility can be restored.Conclusion: The measurement of TSH and prolactin should be done at an early stage of infertility rather than more invasive procedures involved in the treatment of infertility in women.

INTERRELATIONSHIP OF THYROID HORMONES, OBESITY, AND PROLACTIN IN INFERTILE WOMEN

Objective: The aim of the study was to evaluate and compare the level of thyroid hormones, namely, triidothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH), and prolactin in blood serum of infertile women with normal healthy subjects in Amritsar region of Punjab, India. A number of complications arise from the dysfunction of hypothalamic-pituitary-ovarian axis, which leads to the hormonal disturbances in female reproductive system. Certain disorders such as obesity and thyroid hormone imbalance are highly prevalent and lead to various complications in pregnancy such as polycystic ovary syndrome. These disorders lead to the infertility and ultimately constitute a major physiological stress. A multidimensional diagnostic approach is imperative in evaluating these disorders. In the present study, the association between thyroid hormones and prolactin has been reviewed in infertile women which is a prerequisite to work up for infertility in Punjab.Methods: Hemoglobin levels were estimated in the blood serum of healthy controls and infertile women by the method of Sahli. The levels of serum T3, T4, TSH, and prolactin were determined by electrochemiluminescence immunoassay using Cobas e 411 analyzer according to the instruction manual.Results: Majority of infertile women were found to have hypothyroidism and hyperprolactinemia which can be correlated with infertility. This condition might respond to the treatment for their hormonal and prolactin levels, and fertility can be restored.Conclusion: The measurement of TSH and prolactin should be done at an early stage of infertility rather than more invasive procedures involved in the treatment of infertility in women.

Оценка эффективности экстракорпорального оплодотворения при селективном переносе одного эмбриона

Оценка эффективности экстракорпорального оплодотворения при селективном переносе одного эмбриона

Is M235T polymorphism of the angiotensinogen gene involved in the development of endometriosis?

The aim of the study was to analyze the M235T polymorphism of the angiotensinogen (AGT) gene in women with endometriosis and to identify correlations between identified genotypes and the disease progression, its stage and clinical course as well as to evaluate the prognostic value of the investigated polymorphism in patients with endometriosis treated for infertility. The study group consisted of 241 women with minimal to severe stage of endometriosis, the control group (without endometriosis) - 127. The molecular analysis was performed by PCR-RFLP technique. The analysis of the frequency of genotypes and alleles of M235T polymorphism showed no significant differences between the study and the control groups and between the severity grades of the disease (p > 0.05). No such differences were reported in the case of different localizations of the disease lesions, either. Evaluation of the correlations related to pain accompanying endometriosis did not demonstrate association with any genotypes of the analyzed AGT gene poly-morphism. Comparison of the results obtained in the group in which infertility treatment was successful (n = 54) and in those who failed to conceive (n = 73) did not show the correlation between the investigated polymorphism and the effect of infertility treatment. M235T polymorphism of the AGT gene seems unrelated to the development or the clinical course of en-dometriosis. No prognostic value has been found of the investigated polymorphism in predicting the effects of infertility treatment in women with endometriosis.