International Journal of Reproductive BioMedicine
Volume:20 Issue: 4, Apr 2022

Sexual dysfunction has many factors in multiple sclerosis, but there is no reliable treatment for this challenge.

Determining effective sexual function or dysfunction interventions in individuals with multiple sclerosis.

To find the relevant published interventional studies that at least had an English abstract or in Persian, we searched International Statistical Institute, PubMed, Scopus, Cochrane, Medline, PsycINFO, EMBASE, CINAHL, and Google Scholar from January 1990 to June 2021. The results were analyzed using RevMan 5.3 software. The p < 0.05 was considered significant.

Out of 568 articles, 41 were included after deleting the duplicate and irrelevant articles. Studies were divided into 2 groups of sexual function (n = 27) and dysfunction (n = 14). Interventions in each category have 4 subgroups: psychoeducational, exercise and rehabilitation, and medical and multi-type interventions. For improving sexual function, more than half of psychoeducational interventions showed a significant improvement after interventions (p = 0.0003). In sexual dysfunction studies, most of the interventions (n = 13/14) had improved at least one subscale of sexual dysfunction. Medical interventions were effective on men’s sexual dysfunction, and psychoeducational interventions had been more effective in women’s sexual dysfunction.

Psychoeducational and medical interventions are the commonest effective interventions. The psychoeducational studies conducted specifically on women had a positive impact, and only 4 articles with medical interventions were specifically targeted at men, which had a positive effect.

Menopause is a normal physiological phenomenon, closely identified with a great deal of physical-psychological symptoms, including hot flashes (HFs) with a prevalence rate of 20-80%. Various pharmacological and non-pharmacological interventions have been thus far practiced to reduce this common symptom of the menopausal transition.

This systematic review was conducted to evaluate the effects of psychological interventions on menopausal HFs.

In this review, the databases of Google Scholar, Scopus, PubMed, Web of Science, Science Direct, the Cochrane Library, and Scientific Information Database were searched applying the Boolean searching operators as well as the keywords of ‘hot flashes’, ‘menopause’, ‘psychological intervention’, and ‘vasomotor symptoms’. Accordingly, a total number of 20,847 articles published from January 2000 to June 2019 were retrieved. After excluding the duplicate and irrelevant ones, the risk of bias of 19 clinical or quasi-experimental clinical trials was assessed using the Cochrane collaboration tool.

The interventions implemented in the studies on menopausal HFs included cognitive behavioral therapy, mindfulness-based stress reduction, hypnotherapy, and relaxation techniques. All of the articles reported improvements in HFs in postmenopausal women, except for 4 studies.

Based on the findings of this systematic review, psychological interventions, especially cognitive behavioral therapy and relaxation techniques, are potentially effective for vasomotor symptoms and HFs in healthy postmenopausal women, although the quality of published research on this topic is sometimes questionable.

Lysophosphatidic acid (LPA) contributes to follicular activation, oocyte maturation, in vitro fertilization, and embryo implantation.

This study was designed to evaluate the effects of LPA to improve the development of isolated follicles derived from whole mouse cultured vitrified ovaries.

In this experimental study, first, the 1-wk-old mouse ovaries in the non-vitrified and vitrified groups were cultured in the presence of 20 µM of LPA for 1 wk. Then, their isolated preantral follicles were cultured individually for 12 days in the presence or absence of 40 µM of LPA. The following evaluations were done for the cultured follicles: a viability test using Calcein AM staining, flow cytometry using annexin V/Pi, and analysis of the expression of genes by real-time reverse transcription polymerase chain reaction. The maturation rates of the oocytes were compared among groups and some of the released metaphase II oocytes were subjected to in vitro fertilization.

In all LPA treated groups, the rates of survival and follicular development were higher, and the incidence of cell death and expression of pro-apoptotic genes were lower, than in the non-LPA supplemented groups (p = 0.035). There was no significant difference between the vitrified and non-vitrified groups regarding follicular or oocyte development, but the expression of Bad and LPA receptors genes was significantly altered in the vitrified LPA supplemented group in comparison with the non-vitrified LPA supplemented group (p = 0.028).

LPA improved the survival and developmental potential of the isolated follicles. Despite some alterations in the expression of apoptosis-related genes in the vitrified ovaries, LPA had positive effects on the survival and development of these follicles.

Acupuncture is a nonpharmacological treatment which has been known to improve ovulatory function in polycystic ovary syndrome (PCOS) women. Acupuncture modulates the somatic and autonomic nervous systems, which regulate endocrine and metabolic functions to impact ovulatory functions.

To investigate the effectiveness of electroacupuncture (EA) and pharmacological combination therapy on improving insulin resistance in women with PCOS.

This double-blind, randomized clinical trial was performed on 44 participants from March to September 2018 at Cipto Mangunkusumo National hospital, Jakarta, Indonesia. Participants were randomly allocated to treatment (true EA + medication) and control group (sham EA + medication) in a 1:1 ratio using a web-based computer random-number generator. Randomization was carried out by an independent project manager. Both groups received 12 sessions of acupuncture therapy and metformin as pharmacological therapy.

This study showed a significant decrease in the Homeostatic Model Assessment for Insulin Resistance index in the true EA + medication group before and after therapy (p = 0.014).

The combination of EA and pharmacological therapy effectively improves insulin sensitivity in women with PCOS.

Methylenetetrahydrofolate reductase enzyme (MTHFR) plays a key role in regulating folate balance, converting homocysteine to methionine, and producing s-adenosylmethionine (SAM) that plays a role in the methylation process.

This study aimed to determine MTHFR activity and SAM level in men with normozoospermia and oligozoospermia.

30 oligozoospermic and 30 normozoospermic men as controls were enrolled in this case-control study. Semen analysis was conducted according to the world health organization criteria. All semen samples were collected after 3-5 days of sexual abstinence. The sperms were evaluated by sperm test video software. All subjects SAM level was measured by enzyme-linked immunosorbent assay kit, and MTHFR were measured manually.

2 groups had a significant difference in sperm morphology (p = 0.02), concentration (p = 0.02) and motility (p = 0.03). The MTHFR activity in normozoospermic and oligozoospermic groups had significantly differences (p = 0.01). The level of SAM in the semen of oligozoospermic men was statistically lower than normozoospermic men (p = 0.03). Also, there was a positive association between MTHFR enzyme activity and SAM level in the normozoospermia group (p = 0.02, β = 0.67) and oligozoospermia group (p = 0.03, β = 0.54).

MTHFR activity and SAM concentration were statistically lower in oligozoospermia men. It seems they can affect sperm concentration, morphology, and motility.

Sperm quality has an important role in the success of assisted reproductive techniques, by adding some bioactive agents with a positive impact on sperms, it can be improved.

This study aimed to evaluate the effects of kisspeptin on the sperm motility criteria, Lactate dehydrogenase-C (LDHC) activity, acrosomal reaction, and capacitation in the mouse testicular sperm in vitro.

Sperm samples were extracted from testes of 96 male Balb/C mice weighing 25-30 gr, aged 6-8 wk. Then, they were separated into 4 parts; 2 controls and 2 kisspeptin-treated aliquots; each one incubated for either 15 or 30 min. The sperm motility and the LDHC activity were evaluated, and also the frequency of the non-capacitated, intact, and acrosomal-reacted sperms were evaluated by staining with Wheat germ agglutinin, Peanut agglutinin, and Concanavalin A, respectively. The stained sperms were analyzed by flow cytometry and fluorescent microscope.

Our result showed that kisspeptin increased both the sperm motility (p = 0.04) and LDHC enzyme activity (p = 0.04) after 15 min of incubation. At the same time, it did not impact the frequency of the non-capacitated, intact and acrosomal-reacted sperms after incubation in the same period (p = 0.16).

A 15 min period of incubation with kisspeptin could be applicable for evaluating sperm motility and LDH activity.

Premature ovarian insufficiency (POI) affects about 1% of women of reproductive ages (15-45 yr), with no curative treatment.

We aimed to present a rat model of POI using a D-galactose enriched diet.

In a pilot study, 4 pregnant Wistar rats were divided into 4 groups; 3 groups were fed galactose-enriched diets at days 3-15 of pregnancy (G1); on the 3rd day of pregnancy to parturition (G2), and the 3rd day of pregnancy until the end of the weaning period (G3). Also, group 4, as the control group (G0), was fed standard pellets during the study. After confirming the lack of adverse effects of dieting with galactose in terms of offsprings' birth weight, we performed our study designed the same as the pilot study. A total of 40 pregnant Wistar rats were randomly divided into 4 groups. Ovarian histology, reproductive hormones, and immunological characteristics of the female offspring were examined in all experimental groups and compared.

The pilot study revealed no significant differences in the birth weight of the offspring of the 4 study groups (p = 0.96). The ovarian index in the female offspring of those with a gal-exposed diet was significantly lower than that of the control group offspring (p < 0.01).

As the birth weights of the offspring of our experimental and control groups were similar, it can be concluded that the reduction of ovarian follicles after prenatal exposure to           D-galactose is due to the ovotoxicity of galactose. The results of our final study will provide more information about the rat POI model induced by prenatal exposure to D-galactose.

The prevalence of vitamin D deficiency and male infertility is high in Iran.

The present research aimed to examine the association between serum vitamin D [25(OH)D], parameters of semen including semen volume, sperm count, motility and morphology, and reproductive hormones in infertile Iranian men.

This was a cross-sectional study on 119 infertile men conducted between September 2018 and May 2019. Subjects were divided into 3 groups based on serum vitamin D levels: deficient (< 10 ng/mL), insufficient (10 ng/mL ≤ 25(OH)D ≤ 30 ng/mL), and sufficient (> 30 ng/mL). Body mass index and waist circumference were measured. 25(OH)D, testosterone, sex hormone-binding globulin, luteinizing hormone (LH), follicle-stimulating hormone and estradiol levels, and semen parameters were assessed.

The semen volume, sperm counts, total and progressively motile sperm, normal sperm morphology, testosterone levels, and testosterone/estradiol ratio were substantially higher in the sufficient group compared to the other groups (p < 0.001). Also, in the sufficient group, serum LH (p < 0.001) and estradiol (p < 0.001, p = 0.01) were notably lower and serum sex hormone-binding globulin (p < 0.001) and the testosterone/LH ratio (p < 0.001) were considerably higher compared to the insufficient and deficient groups.

Our study showed a positive relationship between serum vitamin D levels, and seminal parameters and sex hormones in Iranian infertile males.