Pakistan journal of pharmaceutical sciencesFaiza Alam, Rabiya Ali, Mukhtiar Baig, Ihsan Nazurah Zulkipli, Fatima Syed, Taseer Ahmed Khan, Rehana Rehman
BACKGROUND: Maintenance of a normal redox balance is essential for optimal ovarian function and fertility. Reduction in silent information regulator1 (SIRT1) can potentiate inflammatory pathways, mitochondrial dysfunction and ultimately programmed cell death via "hypothalamic-pituitary-ovarian axis", developing 'low-grade oocytes', potentiating obesity related problems. Current hypothesis that a reduction in antioxidant levels (measured by SIRT1, visfatin, Manganese Superoxide dismutase (MnSOD), and Glutathione reductase (GR) with increased BMI is associated with decreased fertility. OBJECTIVES: The study aimed to evaluate the relationship between obesity and OS markers and to compare their levels between fertile and infertile women, thereby elucidating the potential role of redox imbalance in obesity-associated subfertility. METHODS: A cross-sectional study comprised of 207 fertile and 135 infertile females were recruited. Body mass index (BMI) determines obesity with the formula: weight in kilograms (kg)/height in meters (m2). Women's stratification was according to the South-Asian criteria (normal=18-22; overweight =23-24; obese >25 kg/m2). The enzyme-linked immunosorbent assay (ELISA) kits measured serum levels of MnSOD, GR, visfatin and SIRT1. Pearson chi-square and ANOVA were used; study variable association was calculated by Spearman's correlation, where p<0.05 was significant. RESULTS: The mean BMI was 25.94 ± 5.1 kg/m2; normal weight females were 27.5%, overweight 22.8% and obese 40.9% and infertile females had significantly increased BMI (p<0.001). The antioxidant levels of MnSOD, GR, SIRT1 and visfatin were significantly lower in infertile females (p value =0.049, 0.027, 0.027 and 0.034, respectively). Infertile women had decreased MnSOD and visfatin, decreasing from normal weight to obese (p=0.00 and 0.04). BMI was inversely related to SIRT1 and studied antioxidant concentrations. CONCLUSION: Continuous reduction in antioxidant levels in association with increased BMI indicates that obesity contributes to oxidative stress attributed by reducing antioxidant levels, which may lead to female infertility.
Comprehensive PhysiologyTathiana A Alvarenga, Mariana Toricelli, Renata Mazaro-Costa, Matheus Brandão Vasco, Sergio Tufik, Monica L Andersen
BACKGROUND: Sleep disturbances, particularly obstructive sleep apnea (OSA) and sleep deprivation, are critical yet underrecognized contributors to male reproductive dysfunction. Both conditions disrupt endocrine homeostasis, reducing testosterone and luteinizing hormone levels, which are central regulators of spermatogenesis. OBJECTIVE: This review aimed to synthesize current evidence on the mechanisms linking OSA and sleep deprivation to impaired male fertility, with emphasis on endocrine, oxidative, and inflammatory pathways. METHODS: We conducted a structured, non-systematic narrative review using PubMed/MEDLINE, Scopus, and Web of Science databases, focusing on clinical and experimental studies evaluating the effects of sleep disturbances on male reproductive health. RESULTS: Disrupted sleep and OSA-related intermittent hypoxia trigger oxidative stress, systemic inflammation, and testicular dysfunction, leading to impaired sperm motility, abnormal morphology, and genomic instability. In OSA, the severity of reproductive disruption correlates with apnea-hypopnea index and nocturnal oxygen desaturation. Despite extensive evidence implicating metabolic and endocrine factors in male infertility, the role of sleep disturbances remains overlooked in clinical practice. CONCLUSIONS: Emerging evidence suggests that sleep disturbances may represent a relevant and potentially modifiable factor in male reproductive health. Interventions targeting sleep disorders and oxidative stress pathways have shown potential benefits on hormonal and physiological parameters; however, their direct impact on fertility outcomes remains to be established. Further longitudinal and interventional studies are needed to clarify causality and clinical applicability.
The aim of this paper is to present the current status, challenges, and development directions of obstetrics and gynecology residency training in the Southern Great Plain region, in the context of the ongoing transformation of the Hungarian healthcare system. Obstetrics and gynecology represent one of the most complex fields of clinical medicine, where decision-making, ethical sensitivity, psychological resilience, and technical proficiency together define professional competence. Over the past decade, Hungarian postgraduate medical education has undergone significant reforms: the introduction of the healthcare service relationship, the elimination of informal gratuities, and the implementation of a competency-based educational framework have resulted in a more transparent and objective system. This paper draws attention to regional residency data, presenting trends in trainee distribution, the main structural elements of the program, and key areas of modernization - including digitalization, simulation-based training, the strengthening of research activity, and international mobility. The authors emphasize that high-quality residency training program requires structured competency assessment, modern infrastructure, the integration of international experience, and adequate mental support for trainees. The obstetrician-gynecologist of the future should not only be technically proficient but also reflective, empathetic, and responsible - a physician whose training is built on both professional excellence and the preservation of humanistic values and vocation. Orv Hetil. 2026; 167(29): 1159-1163.
BACKGROUND: Male infertility is one of the most important side effects of chemotherapy that can seriously compromise the quality of life of cancer patients. Doxorubicin, a widely used chemotherapy drug in the treatment of cancer patients, is known to cause testicular toxicity. Nicotinamide mononucleotide (NMN) has recently received attention due to its potential role in improving mitochondrial function and cellular resistance to oxidative stress. The aim of the present study was to investigate the protective effects of NMN on testicular apoptosis, inflammatory changes, oxidative stress, and mitochondrial function in rats treated with doxorubicin. MATERIAL AND METHOD: Thirty-two male Wistar rats were randomly assigned into four groups: control, NMN, doxorubicin, and NMN + doxorubicin. NMN (100 mg/kg) was administered intraperitoneally for 28 days, whereas doxorubicin was injected intraperitoneally at a dose of 2 mg/kg every 48 h for 12 days (six injections; cumulative dose 12 mg/kg). Histopathological evaluation was performed using Johnson's scoring system and morphometric analysis of seminiferous tubules. Oxidative stress markers (MDA, SOD, and GPx), intracellular ROS levels, and mitochondrial membrane potential were assessed. In addition, Bax and Bcl-2 gene and protein expression were examined using RT-qPCR and Immunohistochemistry staining. RESULTS: Doxorubicin administration significantly decreased Johnson's score, seminiferous tubule diameter, epithelial thickness, antioxidant enzyme activity, and mitochondrial membrane potential, while markedly increasing ROS levels, lipid peroxidation, and Bax expression (p < 0.05). NMN treatment significantly attenuated these alterations by reducing oxidative stress and apoptosis while improving mitochondrial function and histological architecture of the testes. CONCLUSION: NMN exerts significant protective impact against testicular damages related to doxorubicin via antioxidant, anti-apoptotic, and mitochondrial-protective mechanisms. These findings indicate that NMN attenuates structural and molecular indices of testicular injury induced by doxorubicin, although preservation of endocrine function and fertility potential remains to be established.
Molecular biology reportsFaraz Khakshour, Melika Hadad Tehran, Fahimeh Lavi Arab
Azoospermia, particularly non-obstructive azoospermia (NOA), is a major cause of male infertility and remains difficult to treat due to its complex hormonal, genetic, and immunological etiologies. The purpose of this review is to examine the biological, hormonal, genetic, and immunological mechanisms underlying azoospermia, with a specific focus on recent advances in regenerative and genetic therapies aimed at restoring spermatogenesis and fertility.This narrative review summarizes and analyzes published experimental, preclinical, and clinical studies focusing on the biological, hormonal, genetic, and immunological aspects of azoospermia, with particular emphasis on emerging regenerative and genetic therapeutic approaches.The reviewed highlights that non-obstructive azoospermia results from multifactorial disturbances involving hormonal imbalance, genetic defects, immune dysregulation, and disruption of the testicular microenvironment. The literature discussed in this review indicates that regenerative strategies such as platelet-rich plasma, stem cell-based approaches, and extracellular vesicles may contribute to testicular repair and support spermatogenic processes through modulation of cellular signaling and inflammatory pathways. In parallel, advances in genetic technologies, particularly CRISPR-based gene-editing tools, are presented as emerging strategies for targeting genes essential for spermatogenesis.Although clinical application remains early, these strategies show strong potential in reversing testicular damage. Continued research and clinical trials are essential to confirm safety, optimize protocols, and expand therapeutic use.
OBJECTIVES: This study examines heterogeneity in women's use of reproductive healthcare services before and after receiving an infertility diagnosis and its association with pregnancy identified without recorded loss within one year following the first infertility diagnosis. Reproductive healthcare use was operationalised as care-seeking history, utilisation intensity and subsequent engagement with assisted reproductive technology (ART) and financial support. DESIGN: Population-based retrospective cohort study. Multivariate logistic regression analyses were performed. SETTING: Korean National Health Insurance Service nationwide claims database. PARTICIPANTS: Women aged 20-49 years with a first recorded infertility diagnosis in 2019-2020 (n=151 570). OUTCOME MEASURES: Pregnancy identified without recorded loss within 1 year after infertility diagnosis. RESULTS: Differences between women who did and did not have a pregnancy identified without recorded loss were more pronounced in pregnancy-related diagnostic codes recorded prior to infertility diagnosis than in classical genitourinary disorders. ART use (OR: 1.66; 95% CI 1.60 to 1.72) and financial support (OR: 1.60; 95% CI 1.54 to 1.67) were positively associated with pregnancy; however, these associations were modest relative to age and socioeconomic gradients. Greater postdiagnostic healthcare utilisation was associated with lower odds of pregnancy identification. CONCLUSIONS: Women diagnosed with infertility exhibit heterogeneous patterns of prediagnostic and postdiagnostic healthcare engagement. Our findings suggest that infertility diagnosis is situated within women's broader reproductive healthcare engagement, highlighting the need for a patient-centred monitoring and evaluation system for women's health.
Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and GynaecologyCihan Karadağ, Gökçenur Karakelleoğlu, Levent Çelik, Kazibe Koyuncu
BACKGROUND: T-shaped uterus is associated with impaired reproductive outcomes, and the role of hysteroscopic metroplasty remains unclear. This study aimed to evaluate the impact of hysteroscopic metroplasty on in vitro fertilisation (IVF) outcomes in women with T-shaped uterus and unexplained infertility. METHODS: This retrospective cohort study included 105 women with unexplained infertility and hysteroscopically confirmed T-shaped uterus who underwent IVF between 2021 and 2024. The primary outcome was live birth rate (LBR). Unexplained infertility was defined as failure to conceive despite normal ovulation, tubal patency, and semen parameters. Fifty-six patients underwent hysteroscopic metroplasty prior to IVF, while 49 proceeded directly to IVF without surgical correction. All patients were treated using a standardised antagonist protocol with frozen embryo transfer. Implantation, biochemical pregnancy, clinical pregnancy, miscarriage, and live birth rates were compared between groups. RESULTS: Baseline demographic characteristics, ovarian reserve parameters, and IVF cycle features were comparable between groups. Implantation rates did not differ significantly (46.4% vs. 42.8%, p = 0.122). The biochemical pregnancy rate was lower in the metroplasty group (5% vs. 16%, p = 0.012). However, clinical pregnancy rate (41% vs. 26.5%, p = 0.024) and live birth rate (33.9% vs. 18.3%, p = 0.016) were significantly higher in women who underwent metroplasty. Miscarriage rates were similar between groups. CONCLUSIONS: Hysteroscopic metroplasty was associated with improved clinical pregnancy and live birth rates in women with T-shaped uterus undergoing IVF. Prospective randomised studies are warranted to confirm these findings. However, the observed improvement may reflect a combined effect of anatomical cavity restoration and endometrial injury associated with the surgical procedure.
Male fertility is increasingly recognized as a reflection of systemic health, closely linked to endocrine, metabolic, and musculoskeletal functions. Accumulating evidence indicates that obesity, insulin resistance, chronic inflammation, and sarcopenia adversely affect reproductive health through hormonal imbalance, oxidative stress, and impaired cellular homeostasis. Testosterone deficiency, reduced muscle strength, and altered myokine signaling contribute synergistically to compromised spermatogenesis and declining semen quality. This review examines the interplay between male reproductive health and musculoskeletal integrity, emphasizing the pathophysiological roles of metabolic dysfunction, inflammation, endocrine disfunction, and sarcopenia. Literature searches were conducted via Medline/PubMed, Scopus, and the Directory of Open Access Journals (DOAJ) to identify studies related to male fertility, sarcopenia, muscle strength, physical activity, rehabilitation, testosterone, oxidative stress, and inflammation. Particular attention is given to the emerging role of sarcopenia and physical performance as determinants of reproductive outcomes, including their implications for rheumatic and musculoskeletal diseases. Resistance exercise, structured physical activity, nutritional optimization, and lifestyle modifications demonstrate promising effects on hormonal regulation, inflammatory status, and reproductive function. Available evidence supports a multidisciplinary framework in which male fertility is interpreted within the broader context of systemic and functional health. Integrating reproductive evaluation with metabolic and musculoskeletal assessment may improve early risk stratification and facilitate more targeted therapeutic strategies.
MedicineCheng Fan, Shiyuan Huang, Chunhua Xiang, Yi Song
Insulin resistance and impaired glucose metabolism are critical factors influencing female reproductive health. This study aimed to evaluate the association between estimated glucose disposal rate (eGDR), a surrogate marker of insulin resistance, and female infertility in the general population. We conducted a cross-sectional analysis of women aged 20 to 45 years from the National Health and Nutrition Examination Survey 2013 to 2020. Multivariable logistic regression, restricted cubic spline analysis, threshold analysis, and subgroup analyses were used to assess the association between eGDR and infertility. A total of 2430 women were included, and the prevalence of infertility was 14.9%. After adjustment for potential confounders, eGDR was negatively associated with the risk of female infertility (odds ratio [OR] = 0.80, 95% confidence interval [CI]: 0.70-0.92; P = .001). In tertile analyses, women in the highest eGDR tertile had a lower risk of infertility than those in the lowest tertile (OR = 0.51, 95% CI: 0.31-0.84; P = .009), with a significant trend across tertiles. Threshold analysis identified an inflection point at an eGDR value of 4.96. Subgroup analyses showed a significant interaction between eGDR and age. Higher eGDR was significantly associated with a lower risk of female infertility among U.S. women. These findings suggest that eGDR may be a useful marker for evaluating infertility risk related to insulin resistance.
Polycystic ovarian syndrome (PCOS) is a prevalent metabolic and neuroendocrine disease affecting females of childbearing age. Irregular ovulation, elevated androgen levels, and the presence of multiple ovarian cysts characterize it. This study aimed to investigate the prolonged impact of RA on female fertility during three oestrus cycles, utilizing biochemical, histopathological, and immunohistochemical analyses. Twelve female mice were classified into two groups of 6 animals each: (1) the negative control group that received DMSO diluted with sunflower oil, and (2) the positive control group that received a 10 mg/kg dose of retinoic acid. For 15 days, intraperitoneal injections were given daily. The animals were physically euthanized by slaughter on day 16 after treatment. Histopathological and immunohistochemical expression of EGFR, as well as hormonal level investigations, including FSH and LH, were performed on day 16. A 10 mg/kg RA daily dose for 15 days significantly induces FSH and reduces LH. In addition, we revealed that exogenous excess RA leads to PCOS, which causes an increase in cystic follicles and a reduction in antral follicles and corpus luteum. Immunohistochemically, excessive RA suppresses the expression of EGFR, which is localized in granulosa cells. Our investigation concluded that inhibition of epidermal growth factor receptor (EGFR) signaling resulting from long-term high-dose treatment with retinoic acid (RA) affects cumulus granulosa cell proliferation and oocyte maturation. So, vitamin A may harm female fertility.
Biological researchEman I Hassanen, Sara S Elbagwry, Zienab E Eldin, Rehab A Azouz, Marwa A Ibrahim, Rawhia Doghaim
Mancozeb (MZ) is an extensively used fungicide with well-documented reproductive toxicity induced by oxidative stress and hormonal disruption. Antioxidants such as naringin (NAR) have been studied as protective agents, but their therapeutic application is limited by poor bioavailability. Nano-formulated approaches, including chitosan-coated nanoparticles (NARNPs), offer a promising strategy to enhance delivery and efficacy. The present study explores this concept by evaluating the protective effects of NAR and NARNPs against MZ-induced testicular damage and infertility in rats. 42 adult male albino Wistar rats were divided into six groups (n = 7) as follows: (1) control, (2) NAR (20 mg/kg bwt), (3) NARNPs (20 mg/kg bwt), (4) MZ (250 mg/kg bwt), (5) NAR + MZ, and (6) NARNPs + MZ. Data revealed that the exposure of rats to MZ caused a significant decrease in the body weight gain, sperm viability and motility, serum testosterone level, and testicular antioxidant enzyme activities, along with an increase in the lipid peroxidation. MZ also inhibited the expression of steroidogenic genes and proliferating markers in testes. The administration of NAR with MZ partially restored oxidative homeostasis and the reproductive biomarkers. Otherwise, NARNPs were more effective than NAR, which substantially improved the testicular morphology and function, as well as partially returned the gene expression back to normal with higher immunoexpression of proliferating markers in testicular tissues. The study highlights the potential of nano-formulated NAR as a promising strategy to counteract MZ-induced reproductive damage and improve testicular health via enhancing steroidogenic gene expression.
Background/Objectives: Infertility is a multifactorial condition influenced by both medical factors and lifestyle-related determinants, including diet quality and nutritional supplementation. However, it is unclear which dietary patterns are optimal for women requiring assisted reproductive technology (ART). This study had two main objectives: (1) to assess dietary habits and the prevalence of nutritional supplementation among women with fertility disorders preparing for in vitro fertilization (IVF); (2) to develop, based primarily on a review of the scientific literature, a nutritional protocol to support women undergoing assisted reproductive procedures. Methods: A cross-sectional study was conducted among 61 women undergoing IVF treatment. Diet quality was assessed using the original ProFertiMed score (food-based score). Data regarding supplementation practices, anthropometric characteristics, and the number of IVF attempts were collected using a structured questionnaire. Statistical analyses (Chi-square test) were performed to evaluate associations between diet quality, supplementation practices, and clinical outcomes. Results: Only 8% of the respondents demonstrated a high level of dietary adherence according to the ProFertiMed score, suggesting that nutritional intervention should be implemented in the remaining 92% of women. Dietary supplement use was highly prevalent (95%), with participants taking a mean of 7 ± 4 supplements (range: 1-17). No statistically significant association was observed between diet quality assessed using the ProFertiMed score and the number of IVF attempts (Chi-square test, p = 0.85). Conclusions: The ProFertiMed score appears to be a promising tool for assessing diet-related factors in the context of assisted reproduction and may be particularly valuable when applied at the time of female infertility diagnosis, allowing for the early identification and modification of dietary factors that may affect reproductive outcomes. The proposed protocol, which is primarily based on the scientific literature, outlines key aspects of supportive nutritional management that may contribute to preconception preparation; however, its potential impact on IVF outcomes has not yet been empirically confirmed and should be evaluated in future studies. Therefore, further refinement and validation are required before its implementation in clinical practice.
Non-obstructive azoospermia represents one of the most intractable forms of male infertility, with its onset frequently associated with meiotic abnormalities. To date, the pivotal molecular mechanisms governing meiosis remain incompletely understood. This study demonstrates that CMTR2 (Cap methyltransferase 2) exerts a critical regulatory function in male germ cell meiosis through a mechanism independent of its methyltransferase activity. Germ cell-specific Cmtr2 knockout mice (Ddx4-GcKO) exhibited meiotic prophase I zygotene arrest and male sterility. Ddx4-GcKO spermatocytes displayed phenotypic abnormalities, including defective DNA double-strand break repair and compromised crossover formation and recombination. Subsequent investigations revealed a marked reduction in the messenger RNA (mRNA) stability of key meiotic genes, Speedy/RINGO cell cycle regulator family member A (Spdya) and moloney leukemia virus 10 Like 1 (Mov10l1), in Ddx4-GcKO testes. Mechanistic studies indicated that CMTR2 directly interacts with the 5' untranslated regions of these genes. Importantly, CMTR2 selectively mediates 2'-O-methylation of Spdya mRNA, whereas its regulation of Mov10l1 mRNA stability is independent of its enzymatic activity. This study is the first to uncover the non-canonical role of CMTR2 in meiotic regulation, enhancing our comprehension of meiotic molecular mechanisms and offering novel insights into the etiology of male sterility.
The journal of sexual medicineNatalie O Rosen, Kaylee Jabbour, Gabrielle Marcotte-Beaumier, Meghan Rossi, Sophie Bergeron, Audrey Brassard, Katherine Péloquin
BACKGROUND: Sexual desire is important for sustaining relationships during periods of vulnerability such as when undergoing medically assisted reproduction (MAR). Desire problems are the most common sexual issue experienced by couples during MAR and while there is evidence of variability, distinct classes and predictors of dyadic trajectories have not been established. AIMS: To establish distinct classes of sexual desire trajectories among couples undergoing MAR over 2-years and to examine biopsychosocial predictors of classes. METHODS: Couples (N = 217) seeking MAR completed an online survey assessing their demographics (age, education), biological (eg, infertility duration, type of MAR treatments), and psychosocial factors (partner support, relationship satisfaction, and perceived financial burden) at baseline. Hypotheses and analyses were pre-registered. Data were analyzed with dyadic latent class growth analysis and with multinomial logistic regression to examine predictors. OUTCOMES: Sexual desire was assessed at baseline, 6-, 12-, 18-, and 24-months with two items from the Female Sexual Function Index and two nearly identical items from the International Index of Erectile Function, for female and male participants, respectively. RESULTS: We identified four distinct classes of dyadic trajectories of (mostly declining) sexual desire: Steep Decline with Low Sexual Desire (10%), Moderate Sexual Desire (27%), Discrepant Sexual Desire (37%), and High Sexual Desire (26%). In univariable models, six predictors were significantly associated with class membership: male-factor infertility, relationship satisfaction (both partners), MAR receiver's perception of partner support, MAR receiver's age and education. In the multivariable model, education and relationship satisfaction remained significant predictors. CLINICAL IMPLICATIONS: Trajectories of sexual desire during MAR are not uniform; clinical practice should take this heterogeneity into account in psychoeducation, assessment, and intervention. By emphasizing the potential protective nature of relationship satisfaction, findings may inform couple-based interventions to promote sexual desire during MAR. STRENGTHS AND LIMITATIONS: This study is a large dyadic, longitudinal investigation of couples' patterns of change in sexual desire during MAR. The sample excluded those with social infertility, was characterized by high education and employment and was predominantly White and heterosexual, limiting generalizability. Absence of a control group not undergoing MAR limits our ability to determine whether patterns are unique to MAR. CONCLUSION: We identified four distinct dyadic trajectories of sexual desire across 2 years of MAR; membership in some classes were predicted by education and relationship satisfaction. Findings provide more nuanced information about couples' sexual desire during this vulnerable period, which may facilitate early assessment and intervention.
Gynecological endocrinology : the official journal of the International Society of Gynecological EndocrinologyCamil Castelo-Branco, Svetlana Vujovic, Alessandro D Genazzani, Mark Brincat, Blazej Meczekalski, Petra Stute, Andrea R Genazzani, Geraldine Brichant, Raoul Or…
BACKGROUND: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder whose terminology inadequately reflects its systemic nature. The proposed renaming to polyendocrine metabolic ovary syndrome (PMOS) aims to better represent its pathophysiology. OBJECTIVE: To present the European Society of Gynaecology (ESG) position regarding the proposed terminology change and its implementation. METHODS: Expert consensus and narrative synthesis of current scientific evidence and international recommendations. RESULTS: ESG supports a structured, patient-centered transition strategy. Recommendations include prioritizing patient communication, implementing a gradual transition with prolonged dual terminology use, and integrating the new terminology systematically into scientific and educational frameworks. The importance of interdisciplinary clarity and the central role of gynecological endocrinology are emphasized. CONCLUSION: A phased and clearly communicated transition will enhance conceptual accuracy while preserving patient understanding, continuity of care, and clinical coordination.
Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and GynaecologyPedro Belchín Fernández, Virginia Calvente, Maria Jose Gómez Roso, Eva González Expósito, Ana Silván Bueno, Maya Aparicio Fluge, Daniel Ordoñez Pérez
BACKGROUND: PCOS is frequently associated with metabolic disturbances, including a high prevalence of insulin resistance and compensatory hyperinsulinemia, which can impair reproductive outcomes. Previous evidence indicates that combining myo-inositol and D-chiro-inositol in a specific 3.6:1 ratio may support ovarian physiology and reproductive performance in women with PCOS. This study aimed to evaluate whether taking a 3.6:1 MYO:DCI inositol-based supplement enriched with antioxidants for at least 1 month prior to controlled ovarian stimulation could improve IVF-ICSI outcomes. METHODS: A retrospective observational cohort study was conducted, including 92 women diagnosed with PCOS according to the Rotterdam criteria. Patients were allocated to 2 groups: those who used the MYO:DCI 3.6:1 antioxidant-containing supplement (Group 1) and those who followed conventional supplementation (Group 2). Outcomes assessed included ovarian response, fertilization rates, blastocyst development and pregnancy results. RESULTS: The number of retrieved oocytes (21.5 in Group 1 vs. 20.7 in Group 2; p = 0.56) and the metaphase II oocyte rate (72.06% in Group 1 vs. 71.23% in Group 2; p = 0.68) were comparable between both groups. Notably, Group 1 achieved higher fertilization rates (77.66% vs. 71.61%; p = 0.0314) and a lower proportion of cycles without at least one good-quality blastocyst to transfer (4.35% vs. 17.39%; p = 0.0450). In addition, both clinical and ongoing pregnancy rates were significantly improved in the supplemented group (54.39% vs. 42.65%; p = 0.0203; 45.61% vs. 36.76%; p = 0.0033). CONCLUSION: This observational pilot study suggests that a pre-treatment with 3.6:1 MYO:DCI ratio and antioxidant-based supplement taken for at least 1 month prior to ovarian stimulation may improve oocyte quality and increase pregnancy rates. These findings, while promising, require confirmation in larger prospective trials.
Human fertility (Cambridge, England)Haowen Zou, Kelli Peirce, Vincent Chapple, Jay Natalwala, Rui Wang, Yanhe Liu
The objective was to investigate whether there are differences in cumulative live birth rate, cumulative clinical pregnancy rate, or perinatal outcomes after delaying ICSI timing. The design was a retrospective cohort study at Fertility North in Australia using 1,969 ICSI cycles with different ICSI timings among 1,078 patients from 2017 to 2022. Cumulative outcomes included cumulative live birth and cumulative clinical pregnancy rates per oocyte retrieval cycle. Perinatal outcomes included preterm birth, low/high birthweight, and small/large for gestational age. Binomial logistic regression and multinomial logistic regression were used. Generalised estimating equation (GEE) was incorporated into the logistic regression analyses to account for the cluster effect from patients undergoing multiple retrieval cycles. ICSI timing was grouped into quartiles: Q1(37.1-41.1h, n = 498), Q2(41.2-42.4h, n = 510), Q3(42.5-43.3h, n = 483), and Q4(43.4-46.8h, n = 478). No significant difference was found in cumulative live birth in Q2 (aOR: 0.79, 95%CI: 0.55-1.14), Q3 (0.87, 0.61-1.25), and Q4 (0.86, 0.58-1.27), compared with Q1, respectively. Similarly, there was no significant difference in cumulative clinical pregnancy rate between the four groups. Furthermore, no significant differences were found in preterm birth, low birth weight, high birth weight, small for gestational age, and large for gestational age in Q4, compared to Q1. Delaying ICSI until 46.8 hours post-trigger does not compromise cumulative clinical pregnancy or live birth rates, or increase adverse perinatal risks.
European journal of obstetrics, gynecology, and reproductive biologyLena Ottou, S Mebroukine, L Ferretti, L Chansel-Debordeaux, M Lambert, V Bernard, C Hocke, G Robert, C Depuydt, A Buffeteau, E Begon, A Boulenger de Hauteclocq…
This retrospective observational cohort study was designed to evaluate the cumulative live birth rates achieved through testicular sperm extraction (TESE) followed by intracytoplasmic sperm injection (ICSI) in couples affected by isolated non-obstructive male infertility, to better estimate their chances of achieving biological fatherhood. We also aimed to estimate their time to live birth, and identify predictive factors of successful TESE. We included all couples undergoing a first TESE procedure for isolated non-obstructive male infertility at a tertiary university hospital between January 2014 and December 2024. Our main outcomes were : Sperm retrieval rate, live birth rate per ICSI cycle, cumulative live birth rate, and time to live birth. Among 168 included couples, sperm retrieval was successful for 99 patients (58.9 %). Forty men (23.8 % of the couples included) achieved biological fatherhood. The mean live birth rate per ICSI cycle was 32.8 %, with a cumulative live birth rate of 45 % after four ICSI cycles. Median time to live birth was 19.5 months from the first TESE and 10 months from the first ICSI attempt. Thirty-eight men achieved fatherhood through sperm donation (22.6 % of the cohort). Median time to live birth was 3 years from the first consultation, irrespective of TESE or sperm donation. TESE-ICSI provides a substantial probability of achieving biological fatherhood in couples with non-obstructive male infertility, with clinically relevant cumulative live birth rates and time to live birth, supporting informed counseling and decision-making.
Biochemical and biophysical research communicationsGourab Das, Byapti Ghosh, Zhumur Ghosh
Male infertility has emerged as a significant concern in modern society, with genetic defects as one of the major underlying cause behind it. This impairment negatively impacts sperm motility and morphology, leading to conditions such as Asthenozoospermia (reduced sperm motility), Teratozoospermia (abnormal sperm morphology) and sometimes Asthenoteratozoospermia (both motility and morphology defects). Assisted reproductive technologies (ART), such as in-vitro fertilization (IVF), offer a potential solution for such cases but with a low success rate. Classical semen analysis provides only a phenotypic snapshot without revealing the fertilizing potential of the sperms. Hence, in order to screen the functional sperm population as well as to get a deeper insight into the reasons underlying the aberrant sperm population, it is important to study their genetic profile. In this work, we have performed a meta analysis of the transcriptomic data of infertile sperms from Asthenozoospermia and Teratozoospermia patients with that from fertile sperms of normal individuals. Thereafter we have screened a signature gene set which has been used to develop a prediction model named Explainable Infertility Test (E-InfertilityTest) to classify between fertile versus infertile sperm at the preliminary level. For each prediction, it will also provide the set of genes which are playing a dominant role towards such prediction. Thus, it will provide patient specific dominant gene expression profile responsible for the aberration. Overall, this AI based framework will serve as a proof-of-concept towards predicting the genetic basis associated with male infertility. User can access the tool named E-InfertilityTest as a standalone version on GitHub. Github Link: https://github.com/zglabDIB/einfertility.git.
Zhongguo zhen jiu = Chinese acupuncture & moxibustionLiyan Geng, Pengchao Li, Zixue Sun
OBJECTIVE: To compare the clinical efficacy between herbal cake-separated governor vessel moxibustion combined with conventional medication and conventional medication alone in treating asthenozoospermia infertility of kidney yang deficiency. METHODS: A total of 126 patients with asthenozoospermia infertility of kidney yang deficiency were randomized into a herbal cake-separated governor vessel moxibustion group (moxibustion group, 63 cases, 3 cases dropped out) and a medication group (63 cases, 2 cases dropped out, 2 cases were eliminated). The medication group was treated with levocarnitine oral solution and Yougui capsules orally. On the basis of the treatment in the medication group, herbal cake-separated governor vessel moxibustion was applied in the moxibustion group, once every 6 days. Both groups were treated for 90 days. Before and after treatment, the sperm progressive mobility (PR), sperm progressive and non-progressive mobility (PR+NP), sperm deoxyribonucleic acid (DNA) fragmentation index (DFI), seminal plasma levels of malondialdehyde (MDA) and superoxide dismutase (SOD), and TCM syndrome score were observed; the natural pregnancy rate of spouses was recorded during treatment and follow-up of 6 weeks after treatment completion; and the clinical efficacy was evaluated after treatment in the two groups. RESULTS: After treatment, the sperm PR and PR+NP, and seminal plasma SOD levels were increased compared with those before treatment (P<0.05), while the sperm DFI, seminal plasma MDA levels, and TCM syndrome scores were decreased compared with those before treatment (P<0.05) in the two groups. After treatment, the sperm PR and PR+NP, and seminal plasma SOD level in the moxibustion group were higher than those in the medication group (P<0.05), the sperm DFI, seminal plasma MDA level, and TCM syndrome score were lower than those in the medication group (P<0.05). During the treatment and follow-up periods, there were no statistically significant differences in the natural pregnancy rates of spouses in the two groups (P>0.05). The total effective rate in the moxibustion group was 75.0% (45/60), which was higher than 47.5% (28/59) in the medication group (P<0.05). CONCLUSION: On the basis of conventional medication treatment, herbal cake-separated governor vessel moxibustion can improve the sperm motility, sperm DFI, and seminal plasma SOD and MDA levels, and alleviate TCM clinical symptoms in patients with asthenospermia infertility of kidney yang deficiency. Its clinical efficacy is superior to that of medication treatment alone.