Uterine Vascularization Research Articles

Description of the features of blood supply of intramural and intramural-subserous myomatous nodes of various sizes using the Virtual Organ Computer-aided Analysis (VOCAL)

Background: Uterine fibroids are a common benign tumor that negatively affects reproductive function. The criteria for tumor evolution have not yet been determined. It is assumed that tumor growth and the number of growth points are associated with the transformation of blood circulation in the uterus and myomatous node. Recently, data have appeared on the prospects for three-dimensional ultrasound to be used with a specialized program that allows for describing the characteristics of blood supply throughout the entire tumor volume at the level of the microvasculature, which has low speed parameters, namely Virtual Organ Computer-aided Analysis (VOCAL). Aim: The aim of this study was to assess the characteristics of the blood supply to intramural and intramural-subserous myomatous nodes of various sizes using ultrasound and power Doppler in three-dimensional mode using specialized VOCAL software. Materials and methods: This study included 40 patients with uterine fibroids with a single myomatous node of intramural-subserous or intramural localization (International Federation of Gynecology and Obstetrics types 4–6). Four study groups were formed. Group I consisted of ten patients with uterine fibroids with a node diameter of up to 4.0 cm inclusive. Group II comprised ten patients with a node diameter from 4.0 to 5.0 cm inclusive. Group III included ten patients with a node diameter from 5.0 to 8.0 cm inclusive. And Group IV included ten patients with a node diameter of more than 8.0 cm. Ultrasound examination was carried out using a W10-RUS ultrasound scanner (Samsung Medison Co., Ltd., South Korea) on days 5–7 of the menstrual cycle. Results: We found that the most vascularized were myomatous nodes with a diameter of up to 4.0 cm. With an increase in the diameter of myomatous nodes, vascular resistance increased, which in turn indicates a decrease in vascularization. In addition, a decrease in resistance in the central vessels of the tumor compared to its peripheral vessels indicates the characteristic development of the vascular network of the myoma. This is characterized by the formation of new blood vessels mainly from the periphery of the tumor, which form a highly vascularized vascular capsule, while the center of the myomatous node is a hypovascular core. Conclusions: Evaluation of uterine vascularization and uterine fibroids using the specialized VOCAL program allows us to describe the features of blood supply and re-evaluate the mechanisms of tumor development. The use of power Doppler in 3D mode with the use of the specialized VOCAL program makes it possible to further study the vascularization of tumor tissue and establish “hemodynamic variants” of the intramural form of uterine myoma to search for the relationship between tumor growth and the transformation of the associated myometrium.

Effects of altrenogest supplementation in late lactation on reproductive performance of primiparous sows

Genetic selection for hyperprolific sows resulted in higher proportion of low birthweight piglets and greater birthweight variation within the litter, increasing preweaning mortality. There is evidence that altrenogest supplementation improves post-weaning reproductive performance through higher ovulation rates, and increased embryo survival. This study aimed to evaluate the impacts of altrenogest supplementation during the last week of lactation in primiparous sows on subsequent reproductive performance. Ninety-six primiparous females were randomly assigned to two treatments: ALT-sows supplemented orally with 20mg of altrenogest (n=46) during the last six days of lactation up to 24h before weaning; and CON- non-supplemented sows (n=50). Ten sows from each experimental group were randomly selected to evaluate plasma progesterone concentrations on days 1 and 3 of treatment, at weaning and at 48, 72 and 96h after estrus onset. Farrowings were monitored and piglets' individual birthweight, total number of piglets born, born alive, stillborn and mummified were recorded. Stillborn piglets were necropsied to assess organ weight. A subgroup of five females per treatment was euthanized on the day of estrus onset for morphological analysis of the reproductive tract. ALT females showed higher progesterone levels 72h after estrus onset (P<0.05). Moreover, piglets' birthweight, total number of piglets born, liveborn, stillborn, and mummified were similar between experimental groups. Data collected from stillborn necropsies showed that birthweight was the main factor affecting organ weights (P<0.05). Correlation analysis revealed that piglets weighing 600-800g presented higher brain:liver weight ratio, a determinant factor of intrauterine growth restriction, which was predominant in males (P<0.05), and ALT females showed fewer piglets within that birthweight range (P<0.05). Interestingly, ALT sows showed higher number, but smaller endometrial glands (P<0.05). Taken together, short-term altrenogest supplementation in the last week of lactation increased progesterone levels after estrus onset, improving uterine vascularization and endometrial glands hyperplasia in the pre-implantation period, which benefit embryo development, leading to a decrease in the proportion of low birthweight piglets.

Is platelet-rich plasma effective in treating uterine inflammation in jennies inseminated with cryopreserved donkey semen?

Despite frozen donkey semen demonstrating high quality after thawing and achieving suitable pregnancy rates in mares, it yields unsatisfactory results in jennies, likely due to a stronger uterine inflammatory response. This study assessed the effects of platelet-rich plasma (PRP) on uterine inflammation and pregnancy rates in jennies inseminated with frozen donkey semen. Estrous cycles from 11 jennies were assigned to three groups: Control (CTR, n=22) with no treatment; Single PRP infusion (S-PRP, n=22) administered 30h after ovulation induction, prior to artificial insemination (AI); and Double PRP infusion (D-PRP, n=21) with the first infusion at 30h after ovulation induction and the second 4h after AI. Insemination was performed with frozen donkey semen (1 billion sperm) deposited deeply in the uterine horn immediately after ovulation. Endometrial edema, intrauterine fluid (IUF), uterine vascularization, and endometrial cytology were evaluated pre-AI (TCt) and post-AI (6, 24, and 48h). Uterine biopsies were taken at T48 for histopathological and collagen evaluation. Peripheral blood samples were collected on D5 for serum progesterone measurement, and pregnancy was evaluated via ultrasonography on D14. Data were analyzed using GLMMs, ANOVA, Friedman, and Kruskal-Wallis tests in SAS and GraphPad Prism, with significance set at p<0.05. The S-PRP group showed less IUF accumulation than the CTR group at T6. Other parameters showed no significant differences among the groups. Cytology revealed a high percentage of inflammatory cells at T6 in all groups, which decreased in subsequent evaluations. In the CTR group, neutrophil percentages were similar to TCt at T24, while treated groups reached this similarity only by T48. Eosinophil percentages increased over time only in the treated groups. Pregnancy rates showed no differences among the groups (CTR: 0%, S-PRP: 0%, D-PRP: 10%). Results indicate that PRP treatments were ineffective in modulating uterine inflammation and did not enhance pregnancy rates in jennies inseminated with frozen donkey semen.

Effect of Curcuma longa maceration treatment on ovarian follicular development, serum oestradiol, uterine growth and vascularisation in female albino rats.

Curcuma longa is a well-known medicinal plant with various health benefits. This study was designed to evaluate the administration of Indonesian C. longa maceration for its effect on promoting growth and development of the ovary and uterus before mating in female albino rats. A total of 15 female Sprague Dawley rats in their dioestrous phase were assigned into three different groups: the Control group (mineral water); the Cur-Low group (mineral water with 1% C. longa maceration) and the Cur-High group (mineral water with 5% C. longa maceration). The treatments were given for 20 days. Serum concentrations of follicle-stimulating hormone, oestradiol and progesterone were determined. After the sacrifice of the rats, ovary and uterine relative weight, uterine cornua diameter and length, uterine gland diameter (by histology), the number of primary, secondary, tertiary, and Graafian follicles, the number of corpora lutea and vascular endothelial growth factor (VEGF) expression in the ovary were measured. Uterine vascularisation was also evaluated. Administration of C. longa maceration significantly improved the relative weights of the uterus and ovary; uterine cornua diameter, length and vascularisation; uterine gland diameter; and expression of VEGF in the ovary. It also increased the number of tertiary follicles and corpora lutea, albeit not significantly. Follicle-stimulating hormone serum concentrations were lower in the administered rats. Oestradiol and progesterone levels rose with C. longa maceration treatment. The maceration improved the reproductive organs of unmated rats and had potential to optimise the uterine environment for supporting pregnancy in order to produce high-quality offspring.

Methodology of ICG marking technique in modern pelvic surgery: applied aspects (Literature review)

The article is devoted to a review of scientific publications on the use of the Indocyanine green (ICG) labeling technique in modern pelvic surgery. This dye was developed by Kodak Research Laboratories in 1955 and approved for clinical use in 1959, but has only recently come into widespread use. ICG-enhanced near-infrared fluorescence is introduced to improve visualization and provide more detailed anatomical localization during surgery.The dye binds to blood plasma proteins, it is quickly excreted from the organism and is non-toxic and has no found complications after its administration. Many studies have been conducted on the use of this technique: visualization of sentinel lymph nodes (SLN) in various oncogynecological diseases; visualization of ureters, lymphatic drainage, tissue perfusion, vessels of various sizes, colorectal blood circulation, etc. The high detection rate of SLN (unilateral and bilateral) with ICG compared with other dyes such as radiocolloid and patent blue suggests its effectiveness.The condition of SLN has an important prognostic and therapeutic value, based on the obtained results, a more correct further adjuvant treatment can be prescribed. A sentinel lymph node labeling procedure was performed as an alternative to systemic lymphadenectomy to assess the status of lymphovascular invasion. The use of ICG-marking allows to reduce the risk of intraoperative and postoperative complications. Many experimental studies have been conducted in relation to the assessment of uterine vascularization, preservation of individual vessels, their identification and measurement of blood flow.The article provides data from scientists on the use of the ICG-marking technique in endometrial, cervical, vulva, vaginal, ovarian cancer, as well as in endometriosis and for visualization of the ureters. This technique causes active discussions in the scientific community, requires further research and should be more widely used in various directions of surgical interventions.

Artificial insemination of all ejaculated sperm fractions accelerates embryo development and increases the uterine vascularity in the pig

The semen of boar is characterized by ejaculation in well-differentiated fractions with specific concentration, composition, and volume. The 'sperm-rich fraction' (SRF), the most concentrated seminal fraction, is habitually collected in insemination centers to make artificial insemination (AI) doses. The absence of the other fractions in AI doses could alter the uterine reaction to AI and not trigger essential responses that could maximize fertility. Thus, there is an urge to ascertain the impact of different ejaculate fractions on the uterus after AI to optimize the semen doses. This work analyzed specific parameters related to fertility in pregnant artificially inseminated sows (n=15) with ac-cumulative fractions of the semen of boars (n=6): F1, composed of the sperm-rich fraction (SRF); F2, composed of F1 plus the intermediate fraction; F3, composed of F2 plus the post-SRF. Non-inseminated sows (n=5) were included as control (C). The different types of seminal dose did not affect the number of ovulated follicles (CL; corpora lutea, p>0.05) but did affect the embryo development (p<0.05). The proportion of embryos in morula stages was significantly higher in AI-F1 sows (84.4%, p<0.05). Morulas and blastocysts were balanced in AI-F2 or AI-F3 (p>0.05). Independently of the type of seminal dose (F1, F2, or F3), we observed by immunohistochemistry that AI significantly increased uterine vascularization, although with some anatomical differences. The cranial region of the uterine horns was significantly more vascularized in AI-F1 or AI-F2 sows (26.7±2.3 and 28.6±2.0%, respectively), and AI-F3 showed significantly less vascularization at that point (17.8±1.6%, p<0.05). To summarize, the synergistic effect of all ejaculate fractions accelerates embryo development, at least during the preimplantation period, and increases the uterine reaction to AI in certain parts of the uterus.

Perfusion magnetic resonance imaging in Asherman syndrome.

Microvascular scarring compromises the functionality of the endometrium, and vascular flow at the junctional zone (JZ) may be the key to understanding poor reproductive outcomes in women with Asherman syndrome (AS). To investigate whether vascular perfusion of the uterus, measured by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is impaired in women with intrauterine adhesions (IUA) and AS. A prospective observational cohort pilot study of 23 women with IUA treated with hysteroscopic synecholysis and a control group of two patients with cervix cancer were subject to DCE-MRI with gadolinium to assess uterine vascularity. Twelve regions of interest (ROIs) were allocated on the DCE-MRI image incorporating the JZ, with control ROI placed at the psoas muscle. Individual ROIs were compared to the mean total perfusion (TP) in the same uterus. Pre- and post-operative perfusion analyses were performed on five women. Receiver operator curves (ROC) were used to analyse MRI as a predictor of IUA. There was no significant difference in perfusion; a trend toward reduced perfusion was observed in women with IUA compared to the controls. The ROC was predictive of higher-grade and inoperable IUA. Reduced perfusion on DCE-MRI as assessed by ROC predicted higher-stage AS. The results of this study support further investigation of DCE-MRI as a prognostic tool for AS prior to surgical intervention to assist in providing prognostic guidance for women suffering from AS.

Evaluation of Uterine Fibroid Vascularity Using Contrast-Enhanced Ultrasound in Comparison with Contrast-Enhanced Magnetic Resonance Imaging

The aim of the work described here was to assess uterine fibroid vascularity using contrast-enhanced ultrasound (CEUS) as compared with magnetic resonance imaging (MRI). Forty women diagnosed with symptomatic uterine fibroids scheduled for uterine artery embolization (UAE) were enrolled in this institutional review board-approved study. Before UAE, participants underwent CEUS examination with an Aplio i800 scanner (Canon Medical Systems, Tustin, CA, USA) with curvilinear array (8C1). CEUS was performed using 2.0 mL of the ultrasound contrast agent Lumason (Bracco, Milan, Italy) administered intravenously. Digital CEUS clips were acquired and randomized offline, and fibroids were characterized as hyper- or hypovascular. MRI was used as reference standard for fibroid vascularity and compared with CEUS. Results were analyzed using McNemar's test. Forty participants were enrolled in the trial. One patient did not proceed with the UAE procedure and one patient refused pre-procedure MRI because of claustrophobia. Therefore, 38 participants underwent CEUS and MRI examinations before UAE. Hypervascular fibroids were seen on MRI and CEUS in 24 and 26 participants, respectively. Hypovascular fibroids were seen with MRI and CEUS in 14 and 12 participants, respectively. Fibroids characterized as hypovascular in two participants by MRI were characterized as hypervascular by CEUS. CEUS and MRI findings were similar in 36 of 38 participants, corresponding to an accuracy of 95% (p=0.62). Contrast-enhanced ultrasound can accurately assess uterine fibroid vascularity, serving as a potential alternative to MRI in determination of the vascularity of uterine fibroids.

Vascularisation of Endometrium In Primary Dysmenorrhea wsr to Kha-Vaigunya

Painful menstruation can be correlated with Udavartini Yonivyapad in Charaka Samhita or Udavarta Yonivyapad in Susruta Samhita. Deregulation of endometrial blood flow has been associated with several menstrual disorders including primary dysmenorrhoea, menorrhagia, inter-menstrual bleeding and endometriosis. Doppler assessment of uterine artery is essential to reflect endometrial vascularisation. It is identified that pain in primary dysmenorrhea is caused by excessive endometrial prostaglandin production leading to abnormal uterine activity and consequent changes in blood flow within the uterus. Kha vaigunya is a process with a general cause for abnormalities in the Srothas (vasculature). It is a gradually progressing chronic phenomenon which may lead to an interruption in circulation of materials causing the physiological arrest of metabolism and the elimination of metabolic wastes. Therefore excessive production of the metabolic materials leads to excessive amounts of prostaglandin. The aim of this study was to explore the relationship between pain and uterine vascularity and the study suggests that primary dysmenorrheaic patients tend to have moderately positive correlation with pain intensity.

Common mechanisms of placental dysfunction in preeclampsia, gestational diabetes, and COVID-19 in pregnant women

COVID-19 infection, preeclampsia and gestational diabetes mellitus in pregnancy cause similar changes in the placenta and influence development of the fetus between conception and birth in gestation. Proper uterine and placental vascularization is essential for normal fetal development. The transplacental exchange is regulated and maintained by the placental endothelium. During placental implantation, the trophoblast differentiates into two distinct layers, the inner cytotrophoblast and outer syncytiotrophoblast, which are key elements of the human placental barrier. Proinflammatory cytokines exacerbate ischemic events and create an upward spiral of an inflammatory reaction in the placenta. Placental pathology in gestational COVID-19 shows desquamation and damage of trophoblast and chronic histiocytic intervillositis. Similar lesions also occur in gestational diabetes mellitus and preeclampsia. The systemic inflammatory response of the mother, the increased inflammation in the placenta and cytokine production by placental trophoblasts should be monitored throughout pregnancy. Placental angiogenesis can be evaluated by serum vascular endothelial growth factor, Annexin A2, placental growth factor or sclerostin. Tissue damage can be assessed by measuring levels of serum lactate dehydrogenase and myeloperoxidase. Blood flow can be monitored with three-dimensional Doppler and pathological changes can be documented with paraffin-embedded tissue sections stained with hematoxylin and eosin, and electron microscope images as well as immunohistochemistry tests for vascular endothelial growth factor, placental growth factor, sclerostin and Annexin A2. The damage of maternal and fetal vascular perfusion (villitis and fibrin deposition) is a common mechanism of gestational diseases. The placenta lesions liberate anti-endothelial factors that lead to anti-angiogenic conditions and are the common mechanism of maternal placental vascular malperfusion in gestational diseases. Keywords: dysfunction, inflammation, pathology, placenta, pregnancy, vascularization

Persistent cornual pregnancy mimicking uterine arteriovenous malformation: a case report

BackgroundUterine arteriovenous malformation(AVM) refers to the abnormal direct traffic between uterine arteries and veins, which can be characterized by the imaging examination, showing increased uterine vascularity and arteriovenous shunting. However, similar imaging manifestations can also be seen in a variety of conditions including retained production of conception, gestational trophoblastic disease, placental polyp, and vascular neoplasm.Case presentationHere we present a case of a 42-year-old woman who was suspected of suffering uterine AVM indicated by Doppler sonography and magnetic resonance imaging but was finally diagnosed with a persistent ectopic pregnancy located on the right uterine corner by pathology after laparoscopy. She recovered well after surgery.ConclusionUterine AVM is a rare and serious condition. In general, it presents special radiological manifestations. However, when complicated with other diseases it can also be distorting. Standardized diagnosis and management are important.

Does the uterine inflammatory response differ between mares and donkey jennies inseminated with frozen donkey semen?

Frozen donkey semen produces poor fertility rates in jennies (0-11%) while showing normal fertility in mares (33-53%). This may be related to interspecific differences in the interaction of the uterus with frozen semen. This study aimed to evaluate and compare the inflammatory process in the endometrium of donkey jennies and mares inseminated with cryopreserved donkey semen. A total of 36 estrous cycles from 12 Pega donkey jennies and 36 estrous cycles from 12 mares (Breton and Mangalarga), aged between 3 and 14 years old were used. Once ovulation was detected, the animals were inseminated deeply in the horn ipsilateral to ovulation with thawed donkey semen containing 1 billion sperm. The following parameters were evaluated in both species at ovulation/before insemination (time 0h) and after insemination (times 6h, 12h, 24h, 48h, 72h, 96h and 120h): uterine vascularization, endometrial cytology, serum progesterone levels and pregnancy rate. Normally distributed data were analyzed using a mixed-model ANOVA and a Wilcoxon test for non-normally distributed data, using R software. Donkey jennies showed a higher percentage of colored pixels in the uterine body region at T6 compared to mares. Also, the percentage of inflammatory cells was higher in the donkey jenniescompared to the equine cytology at T12 (52.75 versus 37.44) and T48 (16.00 versus 3.98). The inflammatory peak was reached at T6 in both species (55.77 versus 57.31) but remained elevated until T12 only in donkeys. Although a complete resolution of the inflammation occurred within 48 hours after AI in both species, the percentage of inflammatory cells remained higher in jennies than in mares. An eosinophilic uterine infiltrate was present in donkeys, while it was not observed in mares. In addition, donkey jennies showed a significant increase in monocytes at T12, compared to the other times. Also, jennies showed a higher mean P4 level (13 ng/ml), compared to the mares (6 ng/ml), both species had progesterone concentrations compatible with the maintenance of pregnancy. The pregnancy rate 14 days after AI was higher in mares than in donkeys, reaching a rate of 54.55% (6/11) versus 0% (0/12), respectively. In conclusion, the inflammatory uterine response in the presence of frozen donkey semen differs between mares and jennies. Jennies have a later inflammatory resolution, marked by the presence of intense polymorphonuclear and eosinophilic infiltrates. These differences may contribute to the lower fertility rates in this species.

Successful management of vascular invasive mole by uterine artery embolization and hysterectomy - A case report

Gestational Trophoblastic Neoplasia (GTN) is a rare disease originating from pregnancy events that have varied incidences and clinical manifestations based on regional variation. We are reporting a case of a 36-year-old woman with Invasive mole from Central India who presented with abnormal uterine bleeding with severe anemia. She had three full-term vaginal deliveries and 2 spontaneous abortions, the last conception being an abortion around 7 years back. MRI pelvis demonstrated a hypervascular uterine mass suggestive of an Invasive Mole, supported by increased serum β-hCG levels of 31.8 IU/ml. There was no evidence of any metastases on adjunct radiological investigations. After a thorough counselling, the enlarged vascular uterine mass was managed by uterine artery embolization (UAE) followed by simple hysterectomy. Histopathology report confirmed the diagnosis of invasive mole with villi lying in the fibrinous blood clot sheath of the syncytial, and cytotrophoblasts were seen invading the myometrium foci. The patient being in the low risk FIGO scoring, calculated was 5, chemotherapy was not deemed necessary for the patient. Serial post operative β-hCG along with ultrasound pelvis and chest radiogram surveillance showed favourable results with no evidence of metastases even on 6 months follow up. Being a very rare condition, a high index of suspicion with prompt timely management ensures optimum care.

Laparoscopic treatment of advanced interstitial pregnancy: key steps for a successful management

To describe a conservative laparoscopic treatment of an advanced case of interstitial pregnancy diagnosed in a woman at 14 weeks of gestational age. Video case report with demonstration of diagnostic work-up and laparoscopic management of rare subtypes of ectopic pregnancy SETTING: University tertiary care hospital. A 32-year-old nulliparous woman at 14 weeks of gestational age, presented with moderate abdominal pain. She reported an history of irregular periods however, no risk factor for ectopic pregnancy were identified. HCG levels was 7345 mIU/mL. Transvaginal ultrasound revealed an empty uterine cavity and a complex heterogeneous mass of 6 cm on the left cornual region. Myometrial thickness surrounding the gestational sac was 4 mm. There were several critical strategies for this laparoscopic approach. To reduce intraoperative bleeding, the peritoneum was opened, the ureters were identified, and bulldog clamps were used to temporarily reduce uterine vascularization. An intramyometrial injection of vasopressin was performed. After a first cornuostomy attempt, we had to get on a cornual resection to achieve a complete removal of the ectopic mass. Multilayer uterine suture and anatomical restoration to prevent adhesion was then accomplished. Institutional review board approval was not required for this case report as per our institution's policy; patient consent was obtained for publication of the case. Description of a laparoscopic management of huge interstitial pregnancy RESULTS: The overall operation time was 55 minutes, and the estimated blood loss was 55cl. A successfully conservative treatment was achieved with no short-term complications. Postoperative ultrasound showed a normal uterus and complete regression of hCG was obtained two weeks after surgery. Interstitial ectopic pregnancy presents a high risk of maternal mortality considering that the interstitial part of the tube, because of its thickness, has a great capacity to expand before rupture.

Expression profile of genes related to pregnancy maintenance in Dromedary Camel during the first trimester

So far, few signals involved in embryo-maternal dialogue have been identified in pregnant she-camel. Our objective was to investigate expression profiles of genes relevant to uterine extracellular matrix remodeling (ITGB4, SLCO2A1, FOS, and JUN), uterine tissue vascularization, and placental formation (VEGFA, PGF, and PDGFA), embryonic growth and development (IGF1 and PTEN), plus cell death of uterine tissue (BCL2) in early pregnant versus non-pregnant she-camels. Forty genital tracts (20 pregnant and 20 non-pregnant) and blood samples were collected from abattoirs. Total RNA was extracted from uterine tissues and qRT-PCR was conducted for candidate genes. Serum concentrations of progesterone (P4) and estradiol17-β (E2) were measured. Expression of ITGB4, FOS, and PGF genes increased (P<0.001) in the right uterine horn of pregnant versus non-pregnant she-camels. Moreover, JUN, SLCO2A1, VEGFA, and PTEN mRNAs were up-regulated (P<0.001) in various segments of uterine tissues in pregnant groups. The PDGFA transcript was over-expressed (P<0.001) in both uterine horns of pregnant groups. Additionally, IGF1 was higher (P<0.001) in the right horn and the uterine body of pregnant groups, and expression of BCL2 was increased (P<0.001) in the pregnant uterine body. Moreover, serum concentrations of P4 were higher (P<0.001) and E2 lower (P<0.05) in pregnant she-camels. Taken together, the fine-tuning of genes related to implantation, matrix formation, vascularization, and placental formation is highly required for successful pregnancy in she-camels.

Gene profiling reveals the role of inflammation, abnormal uterine muscle contraction and vascularity in recurrent implantation failure.

Objective: Recurrent implantation failure (RIF) is now disturbing numerous infertile couples accepting assisted reproductive technology (ART). And the endometrial factors are crucial causes of recurrent implantation failure. However, its mechanism is still unclear. Thus, the aim of this study is to identify altered biologic processes in endometrium that may contribute to recurrent implantation failure. Methods: We recruited two microarray datasets (GSE103465, GSE111974) from Gene Expression Omnibus database (GEO), which contain endometrium from RIF and normal women during implantation period. Using the online tools GEO2R and Venny, we identified Differentially Expressed Genes (DEGs) of selected datasets, and obtained common DEGs. Gene Ontology (GO) terms, Kyoto Encyclopedia of Genes and Genomes (KEGG) and BioCatar pathway enrichment were conducted with Enrichr platform, "ssgsea" and "ggplot2" package of RStudio. PPI networks and hub gene related TF-gene interaction and TF-miRNA co-regulation networks were built via online tools STRING and NetworkAnalyst. Immune infiltration analysis was performed by CIBERSORT platform. Recurrent implantation failure subgroup identification was achieved through "ConsensusClusterPlus," "tsne," "ssgsea", and "ggpubr" package in RStudio. Diagnostic characteristic ROC curves were constructed via "pROC" and "ggplot2" package of RStudio. Enrichr platform was utilized to find drugs targeting hub genes. Results: 26 common DEGs were confirmed. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes/BioCarta analysis determined common DEGs were mainly enriched in inflammation associated pathways including TNF, NF-κB, IL-4, IL-10, IL-6, and TGF-β signaling pathways. Five hub genes (PTGS2, VCAM1, EDNRB, ACTA2, and LIF) and related TF-gene and TF-miRNA interactions were identified. Immune infiltration analysis indicated the importance of macrophage M2 in recurrent implantation failure patients. Importantly, subgroup identification analysis highlighted that recurrent implantation failure patients can be divided into two subgroups with different phenotypes. Moreover, the ROC curves and drugs may provide new diagnostic and therapeutic thought for recurrent implantation failure.

Effect of Disulfiram on the Reproductive Capacity of Female Mice.

In the process of assisted reproduction, the high-oxygen in vitro environment can easily cause oxidative damage to oocytes. Disulfiram (DSF) can play an anti-oxidant or pro-oxidant role in different cells, and the effect of DSF on oocytes remains unclear. Moreover, it remains unclear whether the use of DSF in the early stages of pregnancy has a negative impact on the fetus. In this study, we found that DSF increased serum FSH levels and increased the ovulation rate in mice. Moreover, DSF enhanced the antioxidant capacity of oocytes and contributed to the success rate of in vitro fertilization. Moreover, the use of DSF in early pregnancy in mice increased the uterine horn volume and the degree of vascularization, which contributed to a successful pregnancy. In addition, it was found that DSF regulated the mRNA expression of angiogenesis-related genes (VEGF), follicular development-related genes (C1QTNF3, mTOR and PI3K), ovulation-related genes (MAPK1, MAPK3 and p38 MAPK) and antioxidant-related genes (GPX4 and CAT). These results indicate that DSF is helpful for increasing the antioxidant capacity of oocytes and the ovulation rate. In early pregnancy in mice, DSF promotes pregnancy by increasing the degree and volume of uterine vascularization.

Doppler ultrasound investigation of female infertility.

This study reviewed recent advances in the use of Doppler ultrasonography for the management and prediction of female infertility outcomes of assisted reproductive technology (ART). Color or power Doppler and three-dimensional power Doppler ultrasound can be used to measure vessels near the ovaries, uterus, and endometrium to assess blood flow. Increased blood flow and reduced resistance to the ovaries, uterus, and endometrium are associated with improved pregnancy outcomes, and their measurement has been suggested as a key factor in ART procedural outcomes. Perifollicular vascularity indices can help predict oocyte quality and maturity. Likewise, endometrial and uterine vascularity could be associated with endometrial receptivity and may assist with embryo transfer timing and pregnancy outcome predictions. With the advancement of Doppler ultrasound technology, this highly potent examination will be used more widely in routine clinical settings for the treatment of female infertility.

Amniocentesis-When It Is Clear That It Is Not Clear.

The current study aims to identify correlations between blood contamination of samples collected during amniocentesis and certain factors dependent on the instruments used (thickness of the needle used to aspirate the fluid), the location of the placenta, and uterine vascularity (more pronounced in multiparous patients). The study included 190 patients in the second trimester of pregnancy who met one of the criteria for invasive prenatal diagnosis (age over 35 years, high risk in first trimester screening, history of pregnancies with genetic abnormalities, etc.). The amniotic fluid samples collected from these patients were analyzed in terms of blood contamination of the amniotic fluid aspirated with maternal cells Results: Of the patients in whom the procedure was performed using 21 G size needles, 16 samples (13.33% of the total) were contaminated. None of the samples collected from patients where a 20 G needle was used were contaminated. There was a statistically significant association between the lack of contamination and the use of Doppler ultrasound in multiparous patients with anterior placenta in whom a 21-gauge needle was used for amniocentesis. There is an increased rate of sample contamination (statistically significant) when using 21 G needle sizes and a significant difference in contamination between primiparous and multiparous patients, with contamination being more frequent in multiparous patients. The use of Doppler ultrasonography may benefit the procedure, as the contamination rate was significantly reduced when used during amniocentesis.

Saving The Uterus; Our Experience In Uterine Artery Embolization For Acquired Uterine Vascular Abnormalities.

Acquired uterine vascular abnormalities are a rare cause of potentially life threatening bleeding. These include uterine artery pseudoaneurysms (UAP)and acquired arteriovenous malformations. The objective of this study was to describe our experience with the diagnosis of acquired uterine vascular abnormalities and its treatment with uterine preservation. It was a retrospective cohort study. Eight patients were enrolled from the hospital database who presented to our Interventional Radiology department from April 2017 to March 2021 for uterine artery embolisation (UAE) with a history of iatrogenic/acquired uterine vascular abnormalities confirmed on imaging. These included two patients with uterine artery pseudoaneurysm (PA) concurrently with arteriovenous malformation (AVM), one with uterine artery PA and five having uterine AVMs. Embolisation agents used were histoacryl glue, lipiodol, PVA particles, and gelfoam slurry. Medical records, imaging studies, and telephonic contact with patients were assessed for patient presentation, intraprocedural details, and follow up to record treatment success. Statistical analysis was performed using descriptive statistics. Bilateral UAE was performed in six patients, while two patients underwent unilateral UAE. Three of the patients presented with life-threatening bleeds requiring multiple transfusions. Clinical as well as angiographic success was achieved in all patients with immediate control of haemorrhage. No complications were observed during follow-up. Two of the patients were able to conceive normally within one year, though it resulted in a miscarriage. Acquired/iatrogenic uterine vascular abnormalities are a rare but important cause of life-threatening haemorrhage that can be expertly managed and successfully treated using UAE, which is rapid, safe, and minimally invasive, with the added advantage fertility preservation.