International Journal of Reproductive BioMedicine
Volume:20 Issue: 9, Sep 2022

Infertility negatively impacts the overall health and social life of affected individuals and couples. Female infertility is their inability to perceive pregnancy. To date, polycystic ovary syndrome, primary ovarian insufficiency, fallopian tube obstruction, endometriosis, and intrauterine synechiae have been identified as the primary causes of infertility in women. However, despite the mutual efforts of clinicians and research scientists, the development of an effective treatment modality has met little success in combating female infertility. Intriguingly, significant research has demonstrated mesenchymal stem cells as an optimal source for treating infertility disorders. Therefore, here we attempted to capsulize to date available studies to summarize the therapeutic potential of mesenchymal stem cells in combating infertility in women by focusing on the underlying mechanism through which stem cells can reduce the effects of ovarian disorders. Furthermore, we also discussed the preclinical and clinical application of stem cell therapy, their limitation, and the future perspective to minimize these limitations.

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women worldwide, affecting their sexual and reproductive health (SRH).

This integrative review aimed to identify SRH aspects in women with PCOS by consolidating the findings from previous studies.

The present integrative review was conducted through an electronic systematic review search of 1052 manuscripts published from April 2000 to March 2020 using PubMed, SCOPUS, Web of Science, Embase, Google Scholar, MEDLINE, Science Direct, Ovid, and the Cochrane Library. After at least 2 researchers evaluated the articles based on the inclusion and exclusion criteria, 27 papers were accepted. The data were analyzed by thematic analysis.

9 main themes of SRH were obtained: 1) the impact of PCOS-related complications on reproductive health; 2) the lifelong effect of PCOS on reproductive patterns; 3) PCOS and adverse reproductive and pregnancy outcomes; 4) women's need for understanding complications; 5) the financial burden of the disease; 6) women's life experiences and quality of life; 7) sexual disorders; 8) psychological concerns and issues; and 9) femininity feelings and roles.

We were able to identify and categorize various aspects of SRH needs for women with PCOS. These categories can facilitate a more comprehensive assessment of SRH, including previously neglected areas. We suggest that these aspects should be considered in the health plans of women with PCOS.

Placenta accreta spectrum (PAS) is a major cause of obstetric bleeding in third trimester of pregnancy.

This study aimed to compare the outcomes of uterine preservation surgery vs. hysterectomy in women with PAS.

In this retrospective cross-sectional study, the records of 68 women with PAS referred to the Imam Khomeini hospital in Ahvaz, Iran, between March 2015 and February 2020 were included. The women divided into 2 groups according to surgical approach: hysterectomy vs. uterine preservation (including just removing the lower segment, removing the lower segment with uterine artery ligation or removing the lower segment with hypogastric artery ligation during cesarean section). The need for blood components transfusion (whole blood, packed cells, and fresh frozen plasma), maternal mortality, duration of surgery, and length of hospitalization was compared between groups.

In total, we investigated 68 women between the ages of 24-45 yr (mean age of 32.88 ± 5.08 yr). All participants were multiparous and underwent cesarean section. Furthermore, 28 women (41.2%) had a history of curettage. In total, 24 women (35.3%) underwent hysterectomy, and 44 (64.7%) underwent uterine preservative surgeries. There were no significant differences between groups of hysterectomy and uterine preservative surgeries in terms of need for blood components transfusion, maternal mortality, duration of surgery, and length of hospitalization.

The results of this study showed no significant difference between groups regarding the studied outcomes. Therefore, conservative surgeries could be used to preserve the uterus instead of hysterectomy in women with PAS.

Luteal phase deficiency is common in assisted reproductive technology and is characterized by inadequate progesterone production. Various studies have shown that administration of progesterone in fresh embryo transfer cycles increases the rate of clinical pregnancy and live birth rate. Progesterone administration has variable types: oral, vaginal, oil-based intramuscular, and subcutaneous.

This study aims to compare the effect of adding intramuscular progesterone to the vaginal progesterone for luteal phase support in the fresh embryo transfer cycle.

This study reviewed the information related to 355 women who had a fresh embryo transfer between March 2020 and February 2021 at the Yazd Reproductive Sciences Institute, Yazd, Iran. The participants population were divided into 2 groups based on the type of luteal phase support regime: group I (n = 173) received 400 mg vaginal progesterone alone twice a day from the day of ovum pick up; and group II (n = 182) received 50 mg IM of progesterone in addition to vaginal progesterone 400 mg twice a day from the day of ovum pick up. Chemical and clinical pregnancy rates were compared between groups.

The basic characteristics of groups were statistically similar. The rates of chemical and clinical pregnancy were higher in the vaginal plus IM progesterone group than in the vaginal progesterone group. Moreover, chemical pregnancy showed a significant difference between the groups (p = 0.011).

Our findings demonstrated that the addition of IM progesterone to the vaginal progesterone improves the chemical pregnancy rate in fresh embryo transfer.

The success rate of infertility treatment depends on many different factors.

This study aimed to determine the effect of platelet-rich plasma (PRP) on the improvement of pregnancy outcomes in participants with repeated implantation failure.

The study is a randomized triple-blind clinical trial. The study population was 118 women with repeated implantation failure during assisted reproductive technology treatment at Tabriz Jihad-e Daneshgahi ART Center from May 2017 to December 2019. Intervention: Intrauterine injection of autologous PRP. Standard treatment of fetal transfer to the uterine cavity was performed without intrauterine PRP injection in the control group: After 4 wk, the level of β-human chorionic gonadotropin hormone in participants' blood was measured.

Comparing the effect of intrauterine injection of PRP in 2 groups showed the level of β-human chorionic gonadotropin positive in the intervention group was 21 (43.8%), in the control group was 12 (26.1%), odds ratio = 2.20 (0.92-5.26) and p = 0.073.

The therapeutic effect in the intervention group compared to the control regarding the outcome of a successful pregnancy showed that intrauterine injection of PRP can be effective in improving pregnancy outcomes, although this improvement is not significant.

Infertility is one of the issues affecting sexual function (SF). Infertility is also one of the complications of polycystic ovary syndrome (PCOS) and endometriosis.

This research seeks to assess and compare SF and the prevalence of sexual dysfunction in infertile women with PCOS and endometriosis.

A cross-sectional study was carried out with a sample of 630 (210 infertile women with endometriosis, 210 infertile women with PCOS, and 210 healthy women of childbearing age as the control group). SF was assessed by the female sexual function index (FSFI). Descriptive statistics and inferential statistics were used to analyze the data. The primary outcome measured was FSFI score. Secondary outcome was hospital anxiety and depression scale score.

The results showed that the mean score of the total FSFI in the 2 groups of PCOS and endometriosis was lower than the control group (p < 0.001). In addition, women with higher education (university education) had a higher total FSFI.

Sexual dysfunction rates are high in infertile women with endometriosis and PCOS. Infertility service providers in infertility centers need to pay attention to this issue.

The social and cultural challenges facing surrogate mothers have been explored in several studies. However, few studies have discussed the motivations of surrogate mothers, their expressions and interpretations of their lived experiences, and their feelings of personal and spiritual satisfaction.

This study aims to present the positive experiences of surrogate mothers from a phenomenological perspective.

Using a phenomenological approach, this study was conducted from September 2020 to January 2021 in the city of Yazd, Iran. Participant observation and semi-structured interviews were used to collect the data among 12 participants with at least 1 experience of surrogate motherhood.

Our findings showed that, despite having had harsh physical and socio-cultural experiences such as fear of social labeling and stigma, participants felt a kind of inner satisfaction and a positive view of their actions. A core theme found in the study was mothers' satisfaction. The main categories included feminine self-sacrifice and positive rewards. Feminine self-sacrifice included 2 sub-categories: creating happiness and conveying motherly feelings, while positive rewards included good childbirth, family acceptance, and halal income.

This study showed that surrogate mothers experience conflicting feelings of inner satisfaction and social stigma during surrogacy. Some of those interviewed were willing to go through surrogacy again, but they feared social labeling and stigma, being misunderstood by others who are not fully informed about surrogacy, and being subjected to family and social disapproval.

Spinal muscular atrophy (SMA) is characterized by the homozygous deletion of the survival motor neuron-1 gene. Pre-implantation genetic testing for monogenic diseases through in-vitro fertilization program was developed to provide a reliable genetic diagnostic method for SMA.

The couple who was confirmed as carriers of SMA visited the Morula IVF Clinic, Jakarta, Indenesia seeking for an in-vitro fertilization expert opinion in relation to the pre-implantation genetic testing for SMA. Utilizing polymerase chain reaction-restriction fragment length polymorphism, we have successfully screened for unaffected embryos that were characterized by a normal presence of the survival motor neuron-1 exon 7-8 and survival motor neuron-2 exon 7-8. The frozen embryo was subsequently transferred and a healthy unaffected female baby was born with undetected deletion of the survival motor neuron-1 gene.

This successful embryo pre-implantation screening case could potentially accommodate the demands of genetically at-risk couples who are apprehensive about conceiving a child who might inherit monogenic disorders such as SMA.