International Journal of Reproductive BioMedicine
Volume:20 Issue: 3, Mar 2022

Polycystic ovary syndrome (PCOS) is known to be associated with metabolic syndrome (MS). It is characterised by Insulin Resistance, hyperinsulinemia, dyslipidemia, obesity and hypertension. Data related to MS in infertile women with PCOS are limited in Indian populations.

This study aims to compare the prevalence of MS in infertile women with and without PCOS in a rural population in South India.

130 women with PCOS and 130 women without PCOS were enrolled in this cross-sectional study. A detailed history was taken and a physical examination was done for all women. Anthropometric parameters, a glucose tolerance test, fasting glucose/ insulin levels, trigylcerides, high-density lipoprotein cholesterol and blood pressure were assessed in all participants. The International Diabetes Federation criteria were applied for assessment of MS.

MS was more prevalent in infertile women with PCOS (42.3%) compared to women without PCOS (19.3%). 56.9% of women with PCOS had low high-density lipoprotein cholesterol levels, 46.2% had high triglycerides, 71.5% had a high waist circumference, 31.5% had high blood pressure and 37.7% had high blood glucose levels. 26.0% of the women with PCOS had a healthy weight, and MS was seen in 6.9% of these women.

The prevalence of MS was higher in women with PCOS in comparison to women without PCOS. Among the women with PCOS, the prevalence of MS increased with age (> 27 yrs), body mass index and waist circumference (71.5%), and even healthy women with PCOS contributed to 7% of MS. Hence it becomes necessary to screen all women with PCOS for metabolic profile risk factors at young age itself to prevent long term cardiovascular complications.

Infertility is an important problem that affects many couples worldwide. Assisted reproductive technology (ART) helps infertile couples to have offspring. One of the critical parts of ART is embryo transfer (ET).

To compare the effect of transvaginal and transabdominal ultrasonography-guided ET on ART outcomes.

In this randomized clinical trial study, 90 women who were candidates for in vitro fertilization (IVF) referred to Mahdiyeh hospital of Tehran, Iran during the year 2020 were randomly divided into two groups (n = 45/each) of transvaginal and transabdominal ultrasonography-guided ET. The embryos were transferred two-three days after oocyte retrieval. The patient pain, duration and difficulty of the procedure, three-dimensional vision quality and successful pregnancy rate were measured.

In this study, 63.2% of the 45 women who underwent IVF under the guidance of the transvaginal guidance and 36.8% of the 45 women who underwent IVF under the transabdominal guidance had a successful pregnancy, that was not significantly different (p = 0.19). Also, based on other results there was no difference between the two groups in terms of patient pain (p = 0.53), duration (p ≥ 0.5) and difficulty of procedures (p ≥ 0.5) and ultrasonography vision; however, the three-dimensional vision quality in the transvaginal ultrasonography was better than that in the transabdominal ultrasonography (p = 0.005).

Overall, the ART outcomes in the transvaginal and transabdominal ultrasonography-guided ET were similar, so we suggest that physicians evaluate the patient’s situation, the hospital equipment, and their ability before selecting the type of ultrasonography.

Ectopic pregnancy (EP) is one of the major causes of maternal mortality during the first trimester of pregnancy.

Four treatment methods for EP including single-dose methotrexate (SD-MTX), double-dose methotrexate, expectant and surgical management were considered.

In this cross-sectional study, the clinical characteristics of 365 women aged 15-44 yr who had been diagnosed with EP were reviewed from March 2017 to March 2019 in hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. Receiver operating characteristics curves were plotted to determine the cut-off points for size of ectopic mass and beta-human chorionic gonadotropin (β-hCG) that suitably discriminated between double-dose methotrexate and surgery management.

The most common site of EP was adnexa. According to the receiver operating characteristics analysis, surgery was the best plan for the women with an ectopic mass > 34.50 mm in diameter or with an initial β-hCG level > 6419 mIU/ml. The β-hCG levels in the women successfully treated with SD-MTX were significantly lower than in those with failed treatment (p = 0.02). The SD-MTX group had a higher success rate and significantly shorter duration of hospitalization, and so this was a more effective medical treatment in comparison with the DD protocol.

Surgery is proposed as the best option for the cases with large ectopic mass or high β-hCG level. SD-MTX had a higher success rate and shorter hospital stay than the DD protocol, and so was found to be an efficient and safe alternative. Further randomized clinical trials with larger sample sizes are recommended to validate the current results.

Ureaplasma urealyticum (U. urealyticum) and Mycoplasma genitalium (M. genitalium) may colonize the male genital tract. However, the negative effects of these bacteria on overall sperm quality, including semen pH, sperm concentration, motility, morphology, and total sperm count remain unclear.

This study aimed to determine the presence of genital U. urealyticum and M. genitalium in semen and evaluate the effect of these organisms on sperm quality.

A cross-sectional study was conducted on 380 men from infertile couples at a tertiary university hospital from July 2017 to June 2018. Semen quality was analyzed according to the World Health Organization 2010 standard, and U. urealyticum and M. genitalium were detected in the semen samples using polymerase chain reaction.

338 men (88.9%) presented with at least one abnormal semen parameter. The detection rates of U. urealyticum and M. genitalium were 16.05% and 0.79%, respectively. There was no significant difference between the Ureaplasma-positive group and the Ureaplasma-negative group in terms of sperm characteristics. Sperm motility and sperm vitality in the Mycoplasma-positive group were much lower than those in the Mycoplasma-negative group (p = 0.02 and p < 0.001, respectively).

The presence of U. urealyticum in the semen of infertile men did not affect the sperm characteristics. Although the positive rate of M. genitalium was low, colonization by these bacteria was more likely to negatively affect sperm quality.

Polycystic ovary syndrome (PCOS) is a heterogeneous disorder, which affects about 15-20% of women of reproductive age. The most important etiopathogenesis factor in its incidence is hyperandrogenism; over 70 candidate genes are known to be associated with this syndrome, such as the androgen receptor (AR) gene which encodes a steroid receptor and is located on the Xq11-12 chromosome. The N-terminus of exon 1 of AR contains a polymorphic trinucleotide repeat (CAG)n region that encodes glutamine tract. There are some studies showing that shorter AR CAG repeats are significantly related to enhanced AR sensitivity.

This study investigated the frequency of the polymorphic expansion of the trinucleotide CAG repeats of AR in PCOS.

160 Iranian women aged 17-40 yr were participated in this case-control study: 80 women as PCOS patients and 80 women as healthy control according to the Rotterdam criteria. Other similar phenotypes factors such as hyperandrogenism were not considered as PCOS. The frequency of polymorphic expansion of CAG trinucleotide repeats in PCOS patients was compared with the frequency in non-PCOS controls in using two primer sets for nested polymerase chain reaction. The polymerase chain reaction products were visualized on polyacrylamide gel and then were confirmed by a sequencing process.

The results did not show a significant correlation between the frequency of CAG repeats in AR and PCOS incidence.

In contrast to some previous reports, the present data showed that the CAG length in PCOS cases did not significantly differ from that of controls. So, the AR (CAG)n does not appear to be a major factor for PCOS in Iranian women.

The role of genital Ureaplasma speices, genital Mycoplasma (M) speices, and Chlamydia (C.) trachomatis, the most prevalent sexually transmitted bacteria, in male infertility are still not clear. Different reports about the impact of these bacteria on semen quality are controversial.

This study was proposed to determine the frequency of bacteriospermia in men and investigate the relationship between the presence of these bacteria and semen quality using molecular assay.

In this cross-sectional study, 200 semen samples obtained from men attending the research and clinical centers for fertility in Kerman, Iran, between July and December 2019 were analyzed for semen volume, progressive motility, non-progressive motility, total progressive motility, and viability according to the World Health Organization guidelines. The polymerase chain reaction was used for the detection of related bacteria.

The mean values of volume, progressive motility, non-progressive motility, total progressive motility, and viability were significantly lower in infertile men (p < 0.001). Statistically significant correlations were observed between the presence of M. genitalium and progressive sperm motility, M. hominis and semen volume, Ureaplasma parvum and the sperm normal form, and C. trachomatis and the sperm progressive motility and viability. Logistic regression analysis showed that M. genitalium (OR = 8.06, p < 0.001) and C. trachomatis (OR = 16, p = 0.01) were significantly associated with male infertility.

During the infertility assessment, clinicians should consider of role C. trachomatis and M. genitalium in male infertility. Screening test particularly for asymptomatic individuals is recommended.

Endometriosis is associated with abnormal immunologic responses and combined inflammatory and anti-inflammatory conditions.

This study aims to investigate follicular fluid (FF) concentration of interleukin (IL)-3, IL-5, and IL-6 in women with and without endometriosis.

In this a cross-sectional study 68 women who were referred to the in vitro fertilization center of Imam Reza hospital in Mashhad during 2018 was selected randomly. Leaves of cytokines in the FF samples were evaluated in the endometriosis and the control group (n = 34/each). The diagnostic accuracy of cytokines and clinical characteristics were evaluated.

IL-3 and IL-6 were significantly changed in FF of the women with endometriosis compared with control group (p = 0.04, and p = 0.003, respectively), the mean concentration of IL-5 in the endometriosis group was lower than the control group (p = 0.5). But it was not significant. There were significant differences in the menstrual cycle, dyspareunia, and dysmenorrhea between the groups (p = 0.003, p = 0.04, and p = 0.02, respectively). The diagnostic accuracy of IL-3 and IL-6 in the FF was low, with the area under the curve of 0.614 and 0.645, respectively.

Although none of the cytokines had a predictive value for endometriosis, the decreased levels of IL-3 and increased levels of IL-6 in the FF samples of women with endometriosis, and risk factors, including irregular menstrual cycle, dyspareunia, and dysmenorrhea, could be associated with the pathogenesis of this painful disease.

Vitamin D and glucose play an important role in the female reproductive system.

The aim of this study was to assess the effect of serum and follicular fluid vitamin D on assisted reproductive technique (ART) outcomes.

102 infertile women were enrolled in the study. All cases received the routine in vitro fertilization protocol. On the oocyte retrieval day, a sample of their peripheral blood and follicular fluid was obtained to determine the level of vitamin D and glucose. We also evaluated ART outcomes including oocytes, 2 pronucleus and embryo number, implantation, chemical and clinical pregnancy, and abortion rate. Finally, the effect of serum and follicular fluid vitamin D and glucose on the ART outcomes was assessed.

There was no difference in the characteristics, serum vitamin D, follicular fluid vitamin D, fasting blood sugar (FBS), or follicular fluid glucose between the women with vs. without a positive clinical pregnancy. There was no significant difference between the ART outcomes based on vitamin D level. The mean follicular fluid glucose levels in women who were deficient, insufficient and sufficient in vitamin D were 65.20 ± 14.65, 63.47 ± 14.90 and 55.97 ± 15.64, respectively. Follicular fluid glucose was lower in women with sufficient vitamin D levels and this difference was statistically significant (p = 0.01). There was no relationship between the three follicular fluid vitamin D levels and ART outcomes. In women with normal FBS levels, the level of follicular fluid vitamin D was significantly lower than in the women with pre-diabetic FBS status (p < 0.001).

The present study showed that serum vitamin D level, follicular fluid vitamin D level, FBS, and follicular fluid sugar were not predictive parameters for ART outcomes.

The authors of article entitled "The effect of endometrial injury on pregnancy rate in frozen-thawed embryo transfer: A randomized control trial " requested some corrections in their article due to re-analyze their data. The authors reviewed the data and confirmed the critical but inadvertent statistical analysis errors which had occurred during research. As the authors explain in their letter to the editor, the errors are listed as: The recruitment end date has been changed from January 2016 to December 2015. The Fisher exact test has been added in statistical analysis section. A typographical error has occurred in eligible woman which mistyped 210 instead of 120. Also, in the first group, 45 women were analyzed at the end, of which 48 were incorrectly stated. Some numbers in tables has been changed and statistical tests has been revised.