International Journal of Reproductive BioMedicine
Volume:18 Issue: 2, Feb 2020

Vitamin D deficiency and infertility are two important health problems in Iran. Some studies suggest that vitamin D may influence Anti-Müllerian hormone (AMH) and antral follicle count (AFC) as an ovarian reserve.

The present study aimed to investigate the impact of vitamin D on AMH serum concentrations/AFC.

three hundred and five infertile women referred to the IVF Unit of Yas hospital, between July and December 2017, were enrolled in this cross-sectional study. The demographic characteristics of the participants, as well as the serum levels of vitamin D, AMH, and ultrasonic examination of AFC were recorded.

Finally, 287 infertile women were included in the analysis with a mean age of 29.95 ± 4.73 yr (18-45 yr) and a mean Body mass indexof 25.11 ± 4.41 kg/m2. The median AMH and vitamin D levels were 3.20 and 22.82 ng/ml, respectively. Considering the cut-off level of 20 ng/ml, 58.7% were vitamin D deficient. Regression analysis showed no association between AMH and vitamin D levels (p = 0.161), even after adjusting for baseline variables (p = 0.182). A total of 120 patients had an AFC < 6 and 164 ≥ 6, which was not statistically different between the groups with normal level or deficient vitamin D (p = 0.133).

The present cross-sectional study showed no significant association between serum levels of vitamin D and AMH or AFC in infertile women, even after adjusting for baseline variables.

Diabetes mellitus is a metabolic disorder characterized by impaired insulin secretion or the inability of tissues to respond to insulin. This disease can damage the testis and reduce semen quality. Therefore, it can impair the potential for male fertility. Different herbal therapeutic treatments have been used to control diabetes and its complications.

This study aimed to evaluate the effects of streptozotocin-induced diabetes on sperm and in vitro fertilization (IVF) potential and investigate the protective effects of Equisetum arvense methanolic extract on diabetic mice.

Twenty-four adult male mice were divided into four groups: control-sham, diabetic, diabetic + Equisetum extract (250 mg/kg), and diabetic + Equisetum extract (500 mg/kg). After 45 days, sperm samples were collected from the cauda epididymis to evaluate the characteristics of sperm (including viability, count, motility, morphology and chromatin/DNA integrity of sperm) and the IVF potential.

Sperm motility and viability were increased remarkably (p≤ 0.001) in the treated groups compared with the non-treated diabetic group. The decrease in sperm count in the diabetic group compared with the treated groups was not significant. Moreover, the percentage of sperm with DNA damage, nuclear immaturity, and abnormal morphology was decreased significantly (p≤ 0.001) in the treated groups compared with the diabetic group. The treated animals exhibited remarkably higher fertilization rates and a higher percentage of fertilized oocytes that developed toward the blastocyst stage compared with the non-treated diabetic group (p≤ 0.001).

The methanolic extract of the Equisetum arvense inhibited diabetes-induced detrimental effects on sperm quality and fertilization rate, which may have been associated with hypoglycemic and antioxidative activities in this plant.

The use of frozen embryo transfer (FET) is increasing worldwide in the treatment of infertility by in vitro fertilization. Different methods of endometrial preparation for FET have been suggested.

The aim of this study was to compare the pregnancy outcomes after treatment with letrozole and those after treatment with the combination of gonadotropin-releasing hormone (GnRH) agonist and estradiol in FET.

This randomized controlled trial study was conducted on 142 infertile women with a history of previous FET failure. Participants were randomly assigned to two groups (n = 71 each). The GnRH group received 500 µg of buserelin plus 4mg estradiol (which increased to 8 mg if endometrial thickness was less than 5 mm), and the letrozole group received 5 mg of letrozole plus 75 IU of recombinant human follicle-stimulating hormone). At least two high-quality embryos were transferred to each subject in both groups. The outcome measures were clinical pregnancy rate and fetal heart rate detection.

Subjects in the study groups had similar demographic characteristics and baseline clinical condition. Mean endometrial thickness in the letrozole and GnRH agonist groups were 8.90 ± 0.88 mm and 8.99 ± 0.85 mm, respectively (p = 0.57). The number of positive results of the beta human chorionic gonadotropin test and detection of fetal heartbeat were not significantly different between the groups (p > 0.05).

The administration of letrozole and GnRH may produce similar pregnancy outcomes in FET.

Asherman’s syndrome (AS) is a rare reproductive abnormality, resulting in endometrial collapse due to aggressive or recurrent endometritis and/or curettage.

We aimed to assess the effectiveness of using platelet-rich plasma (PRP) to lower the recurrence rate of intrauterine adhesions (IUAs) following hysteroscopy.

In this non-randomized clinical trial, women aged 20-45 years with AS diagnosed by sonohysterography, 3D sonography, hysteroscopy, or uterosalpingography between May 2018 and September 2018 were included. Participants (n = 30) were divided into case and control groups. Following hysteroscopic adhesiolysis, a Foley catheter was placed into the uterine cavity in all women. After two days, the catheter was removed, and 1-mL PRP was injected into the uterine cavity of women in the PRP (case) group, while the control received no PRP. All controls and subjects underwent diagnostic hysteroscopy 8-10 weeks following the intervention to assess the IUAs according to the American Society for Reproductive Medicine scoring system.

Our results did not reveal any significant difference in the menstrual pattern of either the control or test groups before or after treatment (p = 0.2). Moreover, the IUA stage in both studied groups before and after treatment was similar (p = 0.2). The duration of menstrual bleeding in both studied groups before and after treatment was also similar.

PRP cannot change the menstrual pattern or development of postsurgical AS, as evaluated by follow-up hysteroscopy.

Infertility is a common condition affecting at least 15% of couples worldwide, and male factors are involved in about half of this prevalence rate. In Cameroon, about 20%-40% of couples are the victims. However, the sperm characteristics of infertile men are yet to be described in the health districts in Cameroon for better management of male infertility.

The present study was designed to assess the sperm profile and related sociodemographic factors of men attending the urology services at the Dschang Health District.

It consisted of a 10 yr retrospective study carried out in the Dschang Health District. The results of patients’ semen analysis (SA) were computed using Epi Info software and expressed as qualitative and quantitative spermogram state as described by the clinician and sociodemographic features of those patients.

Out of the 379 patients studied, 83.91% had abnormal spermogram. Patients older than 50 yr were the most affected when grouped into age categories. With regard to patient’s profession, 52.51% had specified their profession and from that group, although farmers (9.31%) represented the lowest size category, they were the most affected with 94.74% having abnormal spermogram.

This study indicates that the sperm damage is the major cause of male infertility in the Dschang Health District. It also shows that farmers are the most affected category and it could be linked to the long-term exposure to pesticides. These results call for the assessment of the reproductive toxicity of locally used pesticides.

The role of human papillomavirus (HPV) as single or multiple infections in pregnant women would be relevant to determine the time to progression and/or the time to regression of cervical lesions.

In this preliminary study, we determined the prevalence of HPV as single or multiple infections in pregnant women from Northeastern Mexico.

Samples from 31 pregnant and 62 nonpregnant women were examined between January 2015 and November 2015 at UMAE-23 of the Instituto Mexicano del Seguro Social (IMSS). The samples of cervicovaginal exudate were obtained for HPV DNA detection using the INNO-LiPA test, and HPV infections were analyzed as single or multiple infections. Participants completed a questionnaire on sociodemographic, gynecological, obstetric, and sexual behavior characteristics.

The mean age of the pregnant women was 25.7 ± 4.8 yr, with an average time of pregnancy of 6 ± 1 months at the time of the study. With respect to age, parity, smoking history, or oral contraceptive use no statistically significant differences between the two studied groups was observed. The HPV infection was 2.7 times higher in pregnant women (35%) than in the control group (13%). In total, 78% of the pregnant women who were HPV-positive presented with single infections compared with 28% of the nonpregnant women.

A higher prevalence of HPV as a single infection was found in this sample of pregnant Mexican women. Follow-up is necessary to evaluate the persistence or regression of the infection.

A huge cervical myoma (rare) in a young woman is a nightmare of every gynecologist owing to the associated technical challenges in performing a myomectomy. Moreover, the 2014 US Food and Drug Administration prohibited power morcellation during laparoscopic myomectomy due to the inadvertent spread of occult malignancy and an increased risk of iatrogenic parasitic leiomyoma negatively affected the overall rate of a minimally invasive surgery.

Case: 

This report described our experience with a case of a huge anterior cervical myoma (473 gr) in a young nulligravida woman who successfully underwent laparotomic myomectomy. After an initial diagnosis by Magnetic resonance imaging (MRI), we performed preoperative ureteric catheterization. The myoma was enucleated following the footsteps of Victor Bonney, the pioneer of myomectomy, combined with simple additional steps. We did not use preoperative gonadotropin-releasing hormone analog, intraoperative vasopressin injection, or uterine artery ligation. A 6-month follow-up MRI revealed an intact cervical canal in midline position with no evidence of residual fibroid.

Based on our experience, the review of the relevant literature, and the US Food and Drug Administration's prohibition of power morcellation during laparoscopic myomectomy, a laparotomic myomectomy for a huge cervical myoma still plays a vital role in fertility preservation. We propose the mnemonic "MUSIC" as a helpful guide for a consistent strategy: M (preoperative MRI), U (prophylactic ureteric catheterization), S (shell out the myoma following Bonney's principles i.e. start-up and stay intracapsular), I (immediate suction to clarify dead space) and C (close the cavity by spiraling stitch).