Unexplained Female Infertility Research Articles

Preconception Immunoglobulins and Complements as Potential Biomarkers in Unexplained Female Infertility in Saudi Arabia

Preconception Immunoglobulins and Complements as Potential Biomarkers in Unexplained Female Infertility in Saudi Arabia

Midkine can not be accepted as a new biomarker for unexplained female infertility

Abstract Objectives This study aimed to investigate whether a growth factor and a cytokine midkine (MK) can be a new biomarker for the diagnosis and treatment of unexplained female infertility (UFI) cases. Methods Serum (S), follicle fluid (FF), and cumulus cells (CCs) of the patients aged 20–42 years, diagnosed with male factor (MF) and UFI were used. Patients underwent Intracytoplasmic Sperm Injection (ICSI). The anti-Müllerian hormone (AMH) and MK levels with other hormone levels (FSH, LH, E2, PRL, INHB, TSH), the oocyte and embryo qualities, the fertilization and pregnancy rates, and cumulus cells (Cell number and ultrastructure, apoptosis rate) were evaluated. Student-T-test was performed and p<0.05 was considered statistically significant. Results The lowest numbers of CCs were found at UFI (p<0.05). The lowest apoptosis rate with the highest CC viability rate was evaluated at MF (p<0.05). The lowest AMH and MK levels (S, FF) were detected at UFI in comparison to MF (p<0.05). MK and AMH levels of non-pregnant subjects were much lower than pregnant subjects (p<0.05). In addition, these levels were lower in the subjects above 35 age (p<0.05). Structural analysis of CCs showed that the number of lytic cells with cell remnants and apoptotic bodies was higher in non-pregnant subjects. It seems that MK did not show any resistance to both AMH and apoptosis. Conclusions MK can not be accepted as a new biomarker for the diagnosis and treatment monitoring of UFI cases.

Effect of miRNA-99a along with TGF-?1(C/G +915) in female with secondary unexplained infertility

Background: Women infertility is a big health problem worldwide and the genetic disorders considered underling causes of unexplained female infertility. Objective: to find out the role of miR-99a and TGF-?1 SNP (G/C +915) in development of secondary unexplained infertility in women and prognostic of miR-99a. To achieve this goal, investigate the fold change of miR-99a and possibility to use them as biomarker. Also identification of TGF-?1(G/C +915)SNP by ARMS- PCR. Material and methods: case control study have been conducted, blood samples had been collected from population (patients 50) and (control 50) living in the north area of Thi-Qar province The samples collected during the period from November 2021 to July 2022. The genomic RNA and DNA were extracted from serum and blood respectively for molecular assay. Results: the mean of miR-99a fold change in patients group 3.70 ±1.18 versus 0.84 ±0.34 in control group and p< 0.001. TGF-?1 SNP +915(GC) genotype CC was more frequent significantly in patients group than in control group (p < 0.001) and the odds ratio was 19.06, and no significant difference in frequency rate of genotype GC between study groups p = 0.106. Genotype GG was less frequent significantly in patients group than in control group p = 0.046 and the odds ratio was 0.22. Conclusion: we can get a diagnostic and prognostic as biomarker, using the miR-99a which show high sensitivity 100%, specificity 98% and accuracy 100% in secondary unexplained infertility, also TGF? (+915 G/C) SNP as predisposing risk factor for developing of secondary unexplained infertility.

Characterization and risk factors for unexplained female infertility in Sudan: A case-control study.

Female infertility with unknown causes (unexplained) remains one of the mysteries in the reproductive health field, where the diagnostic evidence is still weak and the proposed treatments still work with unknown methods. However, several studies have proposed some possible causes and risk factors for unexplained female infertility. To characterize and identify factors associated with unexplained infertility in Sudanese women. A matched (age and body mass index) case-control study was conducted from March 2021 to February 2022. The study samples were 210 women with unexplained infertility (UI) and 190 fertile women of reproductive age who were attending the maternity hospitals and fertility clinics in Khartoum, Sudan. The risk factors of unexplained infertility were identified using a structured, pre-tested questionnaire containing information on socio-demographic variables, anthropometrics, clinical diagnosis of infertility, behavioral factors, physical activity assessment, diversity, and consumption of different food groups by the study participants. The results showed a higher proportion of women diagnosed with UI were residents of rural areas than controls (21.4% vs 11.1%, P < 0.05), and previous miscarriages and/or abortions were more common in fertile women compared with infertile women (13.16% vs 5.71%, P < 0.05). Additionally, infertile women had a significantly (P < 0.05) higher proportion of family history of infertility (explained and unexplained) compared with controls. Finally, after controlling for the effects of potentially confounding variables using multivariable logistic regression analysis, only marital status, family history of infertility, use of modern contraceptives, smoking, caffeine consumption, physical activity level, meals consumed, other vitamin-A-rich fruits and vegetables, and other vegetables were found to be significant (P < 0.05) factors associated with unexplained infertility among Sudanese women. Married women with a family history of infertility who smoke and consume a high amount of caffeine, who live a sedentary lifestyle, and who consume more than two meals free of vitamin-A-rich fruits and/or vegetables and/or other vegetables per day are at the highest risk of developing unexplained infertility.

Management of Unexplained Female Infertility through Ayurvedic treatment - A Case Study

Infertility is an emerging health issue in present scenario. The term ‘Unexplained infertility’ may be applied to a couple who has failed to establish pregnancy despite an evaluation uncovering no obvious reason for Infertility or correction of the factors identified as probably responsible for infertility. It is commonly accepted that approximately 15% of couples will be determined to have Unexplained infertility. Ayurveda explains female infertility as Vandhyatwa and Primary factors associated with Vandhyatwa are abnormalities in Garbha Sambhava Samagri. In this case study patient aged 29 years who was anxious to conceive since 10 years of married life seeking Ayurvedic treatment in SDM College of Ayurveda, Udupi was taken. Routine investigations of partners showed Normal Study. The line of treatment followed in this case was Vatanulomana, Shodhana, Rasayana, Vrishya, Garbhasthapana with psychological assurance which is most important for conception and the patient conceived.

Common Autoimmune Antibodies in Unexplained Infertile Female Patients in Saudi Arabia.

Unexplained female infertility is a devastating health problem that has become increasingly prevalent worldwide with no specific explanation despite comprehensive evaluations. Recent data suggestthat serum autoimmune antibodies are frequently found in patients with unexplained female infertility. This study aims to identify the prevalence of common autoantibody abnormalities in females with unexplained infertility in Saudi Arabia. A cross-sectional study was conducted on female patients with unexplained infertility sequentially referred to the allergy and immunology clinic at King Abdulaziz University Hospital (KAUH). Demographics, clinical characteristics, and 12 common autoantibody immunological tests were described as frequency and percentage. The chi-square test was applied to evaluate any associations. A total of 119 females with unexplained infertility were studied; of those, 97 (81.5%) had secondary infertility. Their average age was 33.9 ± 5.6 years ranging from 23 to 49 years. The overall prevalence of a high level of at least one autoantibody (above the normal range) was 84%. The predominant high autoantibodies were antithyroglobulin in 42 (35.3%), antithyroid microsomal in 41 (34.5%), beta 2 glycoprotein IgM in 40 (33.6%), antigliadin IgA in 32 (26.9%), antinuclear in 22 (18.5%), and anticardiolipin IgM in 18 (15.1%) of the participants. The following significant associations were found in our study: secondary infertility with beta 2 glycoprotein (p = 0.022), age with antithyroglobulin (p = 0.027), and the number of pregnancies with anti-tissue transglutaminase IgG and antigliadin IgA(p = 0.015 and p = 0.043, respectively). A high level of at least one autoantibody was detected in the majority of females with unexplained infertility. Antithyroid, antiphospholipid, antigliadin, and antinuclear autoantibodies were the most commonautoantibodies.These findings may encourage autoantibody screening in infertile females to discover any potential immunopathology in further clinical studies.

Unexplained female infertility and ART: clinic, embryology, genetic items

Unexplained female infertility and ART: clinic, embryology, genetic items

Methylene Tetra-Hydrofolate Reductase Gene Polymorphism and Endometrial Perfusion in Unexplained Female Infertility

Methylene Tetra-Hydrofolate Reductase Gene Polymorphism and Endometrial Perfusion in Unexplained Female Infertility

Periodontal and caries status in unexplained female infertility: A case-control study.

The aim of this study was to investigate the possible association between maternal periodontal disease and dental caries that affect oral health and unexplained infertility. This cross-sectional case-control study included 50 fertile women and 50 women with unexplained infertility aged 21 to 39 years. Dental and periodontal parameters were examined to evaluate the oral health of the participants. Accordingto the new periodontal disease classification, periodontitis severity was determined. In infertile women, the number of advanced caries lesions, the percentage of bleeding on probing (BOP), gingival index (GI), probing depth (PD), and clinical attachment level (CAL) were higher (P<0.05). The DMFT and mean plaque index (PI) were not statistically different between the two groups. The PISA and PESA values were higher in women with unexplained infertility than in fertile women (P=0.005 and P=0.002, respectively). In multivariate analysis showed that association of DMFT and BOP variables with periodontitis was found to be significant for all women included in the study and for infertile women only (P=0.000 and P=0.012 for DMFT, respectively; P=0.000 and P=0.016 for BOP, respectively). The chronic inflammatory environment caused by periodontitis and advanced carious lesions in women with unexplained infertility should be of great concern as it may have a role in the etiology of infertility.

N-acetyl-cysteine as adjuvant therapy in female infertility: a systematic review and meta-analysis.

The objective of this study is to explore the efficacy and safety of N-acetyl-cysteine (NAC) as adjuvant therapy in female infertility. We performed a systematic literature search of PubMed, Cochrane Library, Embase, and Ovid databases through April 2019 for Randomized Controlled Trials (RCTs) evaluating the effectiveness and safety of NAC as adjuvant therapy in female infertility. The outcomes assessed were rates of ovulation, pregnancy, miscarriage and multiple pregnancy, presented as pooled odds ratio with 95% confidence interval (CI) using the random-effects model. Heterogeneity and inconsistency of the measurements were identified through Cochrane's Q statistic and I2 statistic. We also performed a sensitivity analysis, publication bias (using funnel plot and Begg's test), and subgroup analysis. Fifteen RCTs recruiting 2330 female receiving NAC were included. The pooled estimate showed the statistically insignificant improvement in outcomes; clinical pregnancy rate 1.55 (95% CI 0.98-2.47; I2=68%; p<0.01), ovulation rate 1.77 (95% CI 0.76-4.14; I2=90%; p<0.01), multiple pregnancy rate 0.83 (95% CI 0.34-1.99; I2=10%; p=0.31) and miscarriage rate 0.76 (95% CI= 0.37, 1.53; I2=0%; p=0.69) . NAC was found less efficacious and safe than metformin in all outcomes. Overall, NAC showed statistically insignificant (OR=0.98-2.47). NAC can be an effective adjuvant in PCOS related and unexplained female infertility. The effect could be more profound in women with high BMI, insulin resistance, and oxidative stress. However, the findings need further confirmation in well-designed randomized controlled trials to examine clinical outcomes such as live birth rate in more extended follow-up periods.

A Shift in Glycerolipid Metabolism Defines the Follicular Fluid of IVF Patients with Unexplained Infertility.

Follicular fluid (FF) constitutes the microenvironment of the developing oocyte. We recently characterized its lipid composition and found lipid signatures of positive pregnancy outcome after in vitro fertilization (IVF). In the current study, we aimed to test the hypothesis that unexplained female infertility is related to lipid metabolism, given the lipid signature of positive-outcome IVF patients we previously found. Assuming that FF samples from IVF patients with male factor infertility can represent a non-hindered metabolic microenvironment, we compared them to FF taken from women with unexplained infertility. FF from patients undergoing IVF was examined for its lipid composition. We found highly increased triacylglycerol levels, with a lower abundance of monoacylglycerols, phospholipids and sphingolipids in the FF of patients with unexplained infertility. The alterations in the lipid class accumulation were independent of the body mass index (BMI) and were altogether kept across the age groups. Potential lipid biomarkers for pregnancy outcomes showed a highly discriminative abundance in the FF of unexplained infertility patients. Lipid abundance distinguished IVF patients with unrecognized infertility and provided a potential means for the evaluation of female fertility.

Aromatase Inhibitor Versus Clomiphene Citrate for Induction of Ovulation in Unexplained Infertility

Background: Infertility is the inability of a sexually active couple with no contraception to achieve natural pregnancy within one year. Unexplained female infertility should be a term used when the female reproductive system has been evaluated according to current agreed standards, and no abnormalities are detected. Clomiphene citrate (CC) has been used as a first-line ovulation induction agent. Aromatase inhibitors are new groups of drugs for fertility treatment. Letrozole is an orally-active aromatase inhibitor, with good potential for ovulation induction. Objective: This study compared the effect of clomiphene citrate and letrozole in induction of ovulation in the treatment of infertility. Patients and methods: This prospective randomized controlled study was conducted at Obstetrics and Gynecology Department, Al-AzharUniversityHospitals and Al-AhrarHospital (ministry of health) on 100 women between 20 - 35 years old having unexplained infertility. Patients were divided into two equal groups: Letrozole group received 5 mg of letrozole orally daily from day 3 to day 7 of menses, and CC group, women received 100 mg of clomiphene citrate orally once daily from day 3 to day 7 of the menses and for up to three menstrual cycles. Results: There was a significant increase of positive pregnancy test in letrozole group compared to clomiphene group.There was a significant difference in multiple pregnancy rate and high significant differences in Doppler flow indices between letrozole group and clomiphene group. Conclusion:Letrozole has a better ovulation rate with better follicular development and higher pregnancy rate, CC group has less effect on the endometrial thickness and side effects.

Evaluation of Hormones and Trace Elements in Women with Unexplained Infertility

This study aims to Evaluation of prolactin (PRL), thyroid stimulating hormone (TSH), luteinizing (LH)and Follicle stimulating hormone(FSH)and trace elements (iron and copper) in women with unexplained infertility (UI). 60 women with unexplained infertility as well as (40) women with polycystic ovarian syndrome (PCOS) aged (20-35) year were included in this study. The women were divided according the type of infertility into primary and secondary groups (1oUI, 2oUI, 1oPCO and 2oPCO) respectively. Fifty healthy fertile women with the same age were included in this study as a control group. The results showed a significant increase in serum of Prolactin, TSH, LH levels in the two groups of women with explained infertility (pcos) compared to control and the two groups of women with unexplained infertility. In contrast no significant differences in Prolactin, TSH, FSH and LH levels in women with unexplained infertility in comparison with the control.Serum levels of iron and copper significantly increase in unexplained infertility groups in comparison with women with explained infertility and control groups. This study concluded that is Prolactin, TSH and LH hormone are not associated statistically with unexplained female infertility. The increase in Cu and iron may have an important etiological role in the pathogenicity of unexplained infertility.

Fertility experiences in women reporting endometriosis: findings from the Understanding Fertility Management in Contemporary Australia survey

Purpose: To examine the fertility experiences of women reporting and not reporting endometriosis in a population-based survey.Materials and methods: A cross-sectional survey among a community sample of 1543 women in Australia. Data were analysed to compare fertility management between women who did and did not report endometriosis. Factors associated with unintended pregnancy, infertility diagnosis, time to conception and live birth were identified through multivariable analyses.Results: While individual contraceptive use did not differ by endometriosis status, avoiding pregnancy was less important to women reporting endometriosis (50.5%) than to others (68.7%; p < .001). Women reporting endometriosis were approximately three times more likely to report an infertility diagnosis—the majority (39.7%) of which were ‘unexplained female or male infertility’—(p < .001) and six times more likely to report taking longer than 12 months to conceive than those who did not report endometriosis (p < .001). Although more women reporting a diagnosis of endometriosis also reported never having been pregnant (11.9%) than those who did not report a diagnosis (6.0%), this difference was not statistically significant (p = .060). There were also no endometriosis-associated differences in women’s reports of unintended pregnancy, abortion, having been pregnant, or having had a live birth.Conclusions: Our findings counter the common assertion that women with endometriosis are unlikely to conceive, and support the need for health care and information that addresses all aspects of fertility management (not just infertility) for women with endometriosis.

Transcriptome analysis of rhesus monkey failed-to-mature oocytes: deficiencies in transcriptional regulation and cytoplasmic maturation of the oocyte mRNA population.

Which different pathways and functions are altered in rhesus monkey oocytes that fail to mature after an ovulatory stimulus? Failed to mature (FTM) oocytes complete a large portion of the transition in transcriptome composition associated with normal maturation, but also manifest numerous differences that indicate incomplete transcriptional repression and cytoplasmic maturation affecting multiple processes. Oocyte maturation defects contribute to unexplained female infertility. Failure of some oocytes to undergo germinal vesicle breakdown or progress to second meiotic metaphase in response to an ovulatory stimulus can limit the number of high quality oocytes available for ART. The transcriptome of rhesus monkey oocytes that failed to mature (FTM; n = 11, 5 donors) in response to an ovulatory stimulus in vivo was compared to those of normal germinal vesicle stage (GV, n = 7, 2 donors) and metaphase II stage (MII, n = 7, 5 donors) oocytes by RNA-sequencing (RNAseq). Female rhesus monkeys of normal breeding age (6-12 years old) and with regular menstrual cycles were used. Animals underwent a controlled ovarian stimulation protocol for the collection of oocytes by ultrasound-guided needle aspiration of follicles. We obtained a high quality RNAseq dataset consisting of n = 7, n = 7, and n = 11 libraries for normal GV, normal MII and FTM oocytes, respectively. Total reads acquired were an average of 34 million for each GV sample, 41 million for each FTM sample and 59 million for each MII oocyte sample. Approximately 44% of the total reads were exonic reads that successfully aligned to the rhesus monkey genome as unique non-rRNA gene transcript sequences, providing high depth of coverage. Approximately 44% of the mRNAs that undergo changes in abundance during normal maturation display partial modulations to intermediate abundances, and 9.2% fail to diverge significantly from GV stage oocytes. Additionally, a small group of mRNAs are grossly mis-regulated in the FTM oocyte. Differential expression was seen for mRNAs associated with mitochondrial functions, fatty acid beta oxidation, lipid accumulation, meiosis, zona pellucida formation, Hippo pathway signaling, and maternal mRNA regulation. A deficiency DNA methyltransferase one mRNA expression indicates a potential defect in transcriptional silencing. All RNAseq data are published in the Gene Expression Omnibus Database (GSE112536). These results do not establish cause of maturation failure but reveal novel correlates of incompetence to mature. Transcriptome studies likely do not capture all post-transcriptional or post-translational events that inhibit maturation, but do reveal mRNA expression changes that lie downstream of such events or that are related to effects on upstream regulators. The use of an animal model allows the study of oocyte maturation failure independent of covariates and confounders, such as pre-existing conditions of the female, which is a significant concern in human studies. Depending on the legislation, it may not be possible to collect and study oocytes from healthy women; and using surplus oocytes from patients undergoing ART may introduce confounders that vary from case to case. FTM oocytes were at various stages of meiotic progression, so correlates of specific times of arrest are not revealed. All the FTM oocytes failed to respond appropriately to an ovulatory stimulus in vivo. Therefore, this analysis informs us about common transcriptome features associated with meiotic incompetence. These results reveal that some diagnostic markers of oocyte quality may not reflect developmental competence because even meiotically incompetent oocytes display many normal gene expression features. The results also reveal potential mechanisms by which maternal and environmental factors may impact transcriptional repression and cytoplasmic maturation, and prevent oocyte maturation. This work was supported by grants from the National Institutes of Health Office of Research Infrastructure Programs Division of Comparative Medicine Grants R24 [OD012221 to K.E.L., OD011107/RR00169 (California National Primate Research Center), and OD010967/RR025880 to C.A.V.]; the Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health under the award number T32HD087166; MSU AgBioResearch, Michigan State University. Authors have nothing to disclose.

The use of aniline blue chromatin condensation test on prediction of pregnancy in mild male factor and unexplained male infertility

The aim of this study was to investigate the possibility of using sperm function tests (hypoosmotic swelling test [HOS], aniline blue [AB] staining test, and sperm chromatin dispersion [SCD]) to predict intrauterine insemination [IUI] success rate. A total of 243 couples with mild male factor or unexplained male infertility who underwent IUI were evaluated prospectively. The results of basic sperm analysis and sperm function tests were compared between pregnant or nonpregnant groups. The HOS (11.9±9.6% vs. 10.1±8.5%, p=0.35) and SCD tests (32.9±21.0% vs. 29.9±19.0%, p=0.48) were not significantly different between pregnant (n=22) and nonpregnant (n=221) groups. However, the AB staining negativity rate was significantly higher in the pregnant group compared to the nonpregnant group (35.2±20.8% and 24.4±18.0%, p=0.008). On ROC analysis, a cut-off value of 24% for AB negativity showed a sensitivity and a specificity value of 82.35% and 51.38% (AUC)=0.653; 95% confidence interval: 0.571-0.72 P (Area=0.5)=0.0267, respectively, for prediction of pregnancy. Our study showed that the sperm chromatin maturity, assessed by AB stain, may predict the pregnancy in couples with unexplained female infertility plus mild male factor or unexplained male infertility. The HOS and SCD failed to predict the pregnancy in this group of couples.

Utilisation de l’hydroxychloroquine et de la prednisone en présence d’une auto-immunité sérique dans l’infertilité féminine

ObjectivePresence of non-specific autoimmunity (antinuclear antibodies without antigenic specificities and/or antiphospholipid antibodies without criteria of antiphospholipid syndrome) seems to be associated with unexplained female infertility. The objective is to study the characteristics of patients who undergone treatment for non-specific antibodies in Medically Assisted Procreation (MAP). MethodsTen patients were prospectively followed at MAP center of Grenoble University Hospital. Patient characteristics were collected and evaluated. All patients had a consultation in internal medicine unit as well as an autoimmune assessment (antinuclear antibodies, APL especially) in search of defined autoimmune disease (exclusion criterion). The treatments undertaken were at clinician’ discretion. ResultsOne patient received quadritherapy (heparin, platelet antiaggregant, prednisone and hydroxychloroquine), 5 received triple therapy, 3 had dual therapy, and one patient had prednisone only. The 10 patients had a pregnancy under treatment, 8 of which were completed without complications. The control of autoimmunity under treatment appears to show a decrease in serum antibody levels. Tolerance was good (delayed hypersensitivity to hydrochloroquine resulted in discontinuation of therapy in only one patient). ConclusionThe presence of non-specific serum autoimmunity in a context of infertility appears to be pathogenic and immunomodulatory treatments are clinically and/or biologically effective. A prospective and interventional study with a larger number of patients is needed to assess the efficacy of such treatments in patients with unexplained infertility.

The effect of health-promoting lifestyle education on the treatment of unexplained female infertility

ObjectiveThis study aimed to reveal the 1) awareness, 2) improvements of a health-promoting lifestyle on women with unexplained infertility having at least one of the risk factors that have been indicated to negatively affect fertility (smoking, body mass index lower than 18.5kg/m2 and more than 25kg/m2, over-exercising or not exercising at all, alcohol consumption, caffeine consumption of more than 300mg/day, and high levels of stress) by means of health-promoting lifestyle education, 3) the effect of this improvement on the result of assisted-reproduction treatment in terms of clinical pregnancy. Study design64 women diagnosed with unexplained infertility were divided into a group receiving Health-Promoting Lifestyle (HPL) education and a control group. 1) Risk Factors Questionnaire (BMI, Smoking, Alcohol, Stress, Exercise, Caffeine), 2) Depression, Anxiety and Stress Scale, 3) Health-Promoting Lifestyle Profile II. The health promoting lifestyle was given to the education group. The Risk Factors Questionnaire; Depression, Anxiety, Stress Scale and Healthcare-Promoting Lifestyle Profile II were also administered after the first-second-third month of education but before ART treatment. ResultsA statistically significant decrease was found in the average levels of four variables as; BMI (p<0.001)-stress (p<0.001)-caffeine consumption (p<0.001)-lower exercise levels (p<0.001). Moreover, the total number of risk factors that females had between the first and third interview decreased significantly. Clinical pregnancy rate after ART was 12 (46.1%) and 5 (19.2%) in education and control group consequently (p=0.02). ConclusionHealth-promoting lifestyle education was found to be effective in reducing the lifestyle risk factors for infertility and increasing the success rates of assisted reproduction treatment by correcting these risk factors.

Endothelial Nitric Oxide Synthase Gene Polymorphisms (Promoter -786T/C, Exon 894 G/T and Intron G10T) in Unexplained Female Infertility

Background/Aims: Recent investigations in both males and females show that there may also be some genetic risk factors associated with infertility, and endothelial nitric oxide synthase (eNOS) has important functions in implantation. We aimed to investigate the association of three different polymorphisms of eNOS (promoter -786T/C, exon 894 G/T and intron G10T) with unexplained female infertility. Materials and Methods: Two groups of patients were included in the study: (1) women with unexplained infertility and (2) healthy, fertile women with normal menstrual cycles. eNOS polymorphisms were studied in genomic DNA of each patient by polymerase chain reaction-restriction fragment length polymorphism method. Results: Forty-one women with unexplained infertility and 40 fertile women were included. Baseline physical characteristics and hormonal parameters of the two groups were similar. For eNOS exon 894 G/T polymorphism, the GG homozygotes were significantly lower and the heterozygotes GT were significantly higher in the infertile group than in the control group (p < 0.05). eNOS gene polymorphism both for promoter and intron were similar in the two groups (p > 0.05). Conclusion: Altered eNOS protein caused by eNOS exon 894 G/T polymorphism might cause implantation failure, which may be a possible cause of unexplained female infertility.

Malondialdehyde and Homocysteine Levels in Patients with Unexplained Female Infertility

ABSTRACTObjectivesTo assess association in between malondialdehyde and homocysteine in females with unexplained infertility.MethodsA case control study.SettingHospital based.PatientsFifty females diagnosed with unexplained infertility were matched with fifty normal healthy controls.InterventionBlood samples for malondialdehyde, a lipid peroxidation product and homocysteine measurements.ResultsOur study suggests that females with unexplained infertility have increase in malondialdehyde along with hyperhomocysteinemia when compared with normal healthy controls.ConclusionDetermination of levels of malondialdehyde and homocysteine should be incorporated as one of the factors for ascertaining the cause of female unexplained infertility.How to cite this articleGupta MM, Chari S. Malondialdehyde and Homocysteine Levels in Patients with Unexplained Female Infertility. J South Asian Feder Obst Gynae 2014;6(1):18-20.