International Journal of Reproductive BioMedicine
Volume:21 Issue: 2, Feb 2023

Increased levels of kisspeptin are associated with hypothalamus-pituitary-ovary axis dysfunction. It may lead to the development of polycystic ovary syndrome (PCOS).

We aimed to investigate the effect of prenatal kisspeptin antagonist exposure on the development of PCOS in prenatally androgenized rats in adulthood.

In this experimental study, pregnant rats were injected with free testosterone (T, 5 mg/day) or T+P271 (kisspeptin antagonist) on the 20th day of the pregnancy period (n = 5 in each group), while rats in the control group received solvent. Female offspring were examined in terms of anogenital distance (AGD), anovaginal distance (AVD), vaginal opening, serum total testosterone (TT) levels, ovarian follicles, and the regularity of estrous cycles in adulthood. AGD and AVD were measured using a vernier caliper. TT levels were measured using the enzyme-linked immunosorbent assay method. Ovaries were fixed in 10% formalin, tissue processing was done by a standard protocol, and then ovaries embedded in paraffin. 5 μm-thickness ovarian sections mounted on a glass slide, deparaffinized, and stained using Harris’s Hematoxylin and Eosin Y.

AGD, AVD (p < 0.001), TT levels (p = 0.02), and the numbers of preantral and antral follicles (p < 0.001) in the ovaries were significantly decreased in prenatally T-P271-exposed rats compared to prenatally T-exposed rats. The age of vaginal opening was early in T-P271-exposed rats compared to prenatally T-exposed rats (p < 0.001). The number of corpora lutea was significantly increased in T-P271-exposed rats (p < 0.001). No cystic follicles were observed in the ovaries of prenatally T-P271-exposed rats. Prenatally T-P271-exposed rats had regular estrous cycles compared to prenatally T-exposed rats.

Prenatal exposure to kisspeptin antagonist can prevent PCOS development in prenatally androgenized rats in adulthood.

Infertility affects individual’s and couples’ adjustment. The defense mechanism and marital adjustment are mental processes that play a key role in infertile couples’ life.

This study aims to investigate the role of defense mechanisms on marital adjustment in infertile couples based on the cause of infertility.

This cross-sectional study was conducted on 400 infertile couples at Royan Institute (A referral center for infertility, Tehran, Iran). Infertile couples were divided into 4 groups based on the cause of infertility (female, male, both, and unknown). Demographic questionnaire, revised dyadic adjustment scale, and defense styles questionnaire were used for data collection.

Results showed that the mean score of marital adjustment of men based on the cause of infertility (female, male, and both) was significantly higher in comparison with their wives (p = 0.04, p ≤ 0.001, p ≤ 0.001, respectively). However, no difference was observed between the mean score of women, men, and couples (women and husbands) in defense mechanisms. But marital adjustment has a significant positive correlation with mature defense mechanisms and a negative correlation with immature ones (p < 0.05).

The mean score of marital adjustment is higher in men than in their wives in all groups. So, counseling infertile couples in the field of marital adjustment and training in the use of mature defense mechanisms is recommended especially in women.

Oxidative stress is a major contributor to diabetes mellitus (DM), which leads to testicular damage and infertility.

The aim of this study was to investigate the effects of glibenclamide (GL) as a chemical medicine and troxerutin (TR) as an herbal agent on sperm parameters and histopathological changes of testis in diabetic male rats.

40 male Wistar rats (230-260 gr) were randomly divided into 5 groups (n = 8/each), including control, diabetic (D), GL, TR, and GL+TR. DM was induced by the administration of 60 mg/kg streptozotocin intraperitoneally. The groups were treated with 5 mg/kg/day of GL or 150 mg/kg/day of TR via oral gavage for 4 wk. In the final stage of the treatment, blood sampling was done for biochemical analysis. The rats were then sacrificed and their left testis and epididymis were dissected for sperm analysis, histopathology, and morphometric assessment.

A significant decrease in the number, motility, viability, maturity and chromatin quality of sperm was found in diabetic rats compared to control group. (p < 0.001). DM also increased the malondialdehyde level and decreased the level of the serum’s total antioxidant capacity compared to the control group (p < 0.001). Furthermore, we observed significant difference in seminiferous tubule diameter, germinal epithelium height, and testicular histological abnormalities in diabetic rats compared to control group (p < 0.001). Administration of GL, TR and their combination improved the above-mentioned parameters, and treatment with TR provided a higher improvement (p < 0.001).

According to these findings, it can be concluded that TR plays a more influential role than GL to treat diabetic-induced infertility.

Individualized assisted reproductive techniques (ART) can improve ART outcomes. Some studies suggested using insulin-like growth factor-1 (IGF-1) level on cycle day 2 for individualized ART.

To investigate the relationship between serum levels of IGF-1 on day 2 of the cycle and ART outcomes.

In this cross-sectional study, cycle day 2 serum levels of IGF-1 were measured in 175 women aged between 18-44 yr as candidates for in vitro fertilization or intracytoplasmic sperm injection. All participants received antagonist protocol, and the relationship between serum levels of IGF-1 and ART outcomes according to the number of oocytes were investigated; poor responders (oocytes < 5), normal responders (oocytes 5-15), and hyper responders (oocytes > 15).

Poor responders had higher serum level of IGF-1 when compared with normal and hyper-responders; however, this difference was not statistically significant (p = 0.41). The serum levels of IGF-1 in women with zero retrieved oocytes and those cycles that were canceled for the inappropriate ovarian response were not significantly different compared to other women in the group of poor responders. An inverse relationship was observed between the serum level of IGF-1 and anti-Mullerian hormone. Furthermore, no significant relationship between serum level of IGF-1 with age, body mass index, number of 2 pronucleus, and number of embryos was observed.

According to our results, the serum levels of IGF-1 may not be able to predict ART outcomes. It seems necessary to conduct more studies with larger sample size.

The infertility phenomenon affects physiological and psychosocial aspects. Sexual counseling can improve sexual and marital satisfaction.

This study aimed to determine the effectiveness of sexual health counseling based on the mindfulness approach on sexual satisfaction of women suffering from infertility.

This randomized clinical trial study was conducted on 44 women suffering from infertility referred to the Yazd Reproductive Science Institute, Yazd, Iran. Women were randomly divided into 2 groups. The intervention group (n = 22) received 8 sessions of sexual counseling, while control group (n = 22) received routine care. The data collection tool was the sexual satisfaction questionnaire.

The mean age of women was 30.05 ± 4.9 yr, infertility duration was 6.83 ± 4.27 yr, and the mean duration of marriage was 8.3 ± 4.01 yr. The mean score of sexual satisfaction of women suffering from infertility in the intervention group was 62.9 ± 7.32, 71.6 ± 5.95, and 70.9 ± 6.26, before the intervention (baseline), after intervention (8th wk), and follow-up (12th wk) respectively. The mean score of sexual satisfaction of women suffering from infertility in the control group was 63.3 ± 6.82, 64.2 ± 7.93, and 62.25 ± 7.99, at baseline, 8th wk later, and after follow-up (12th wk), respectively. Sexual satisfaction scores increased before and one month after the intervention in the counseling group, and this difference was statistically significant (p < 0.001).

Mindfulness-based sexual health counseling programs may improve sexual satisfaction in women suffering from infertility in the intervention group.

The Coronavirus disease-2019 (COVID-19) pandemic may profoundly impact on maternal and neonatal health worldwide. However, a few studies have investigated this topic.

This study aimed to investigate the impact of the COVID-19 pandemic on maternal and neonatal health.

This retrospective cohort study analyzed collected data from March to May 2020, and the same period in 2019, involving 5711 pregnant women referring to comprehensive healthcare centers in Isfahan province health facilities, Iran. Pregnant women and neonates were followed-up until 40 days after the delivery. Demographic characteristics, pre-pregnancy, antenatal care, and post-pregnancy variables were collected.

A total of 5711 pregnant women were studied, of whom 3477 (61%) were referred in 2019 (before the COVID-19 pandemic as nonexposed) and 2234 (39%) during the COVID-19 pandemic (as exposed group) in 2020. For those living in cities with a population of > 20,000, the number of antenatal care were lower about 2% compared to nonexposed group (p = 0.01). The number of mothers with a history of the underlying disease who referred to a comprehensive healthcare center during the COVID-19 pandemic (47%) was lower about 6% compared to nonexposed group (41%) (p < 0.001). During the COVID-19 pandemic, the prevalence of hypertension and gestational diabetes mellitus was 5% (n = 109) and 20% (n = 445), which were higher about 2% and 4%, respectively, compared to nonexposed group. The COVID-19 pandemic had no other significant effect on mothers' and neonates' other characteristics than nonexposed group.

The COVID-19 pandemic imposes no significant effect on mothers' and neonates' health compared to nonexposed group.

 One of the reproductive medicine challenges is to determine the role of hyperhomocysteinemia in the pathogenesis of polycystic ovary syndrome (PCOS), especially in women with recurrent pregnancy loss (RPL).

 Determine the correlation between hyperhomocysteinemia and pregnancy outcome in women with PCOS.

 This case-control study involved 245 women (20-30 yr) and was conducted in Georgia, Tbilisi from 2019-2022. Of these, 175 were women with PCOS (study group) and 70 were healthy women (control group). Women with PCOS were divided into- group I with RPL (n = 90), and group II with live births (n = 85). Group I was divided into subgroups A and B with and without insulin resistance. The investigation measured homocysteine (Hcy), follicle-stimulating, luteinizing, anti-Mullerian hormones, total and free testosterone were determined. To determine the ovarian volume and antral follicle count, participants also underwent an ultrasound examination.

 In women with PCOS, the average Hcy level was significantly higher than in the controls, p < 0.05. In group I, the average Hcy level was significantly higher than in group II and controls, p < 0.05. There was no significant difference in average Hcy level between group II and controls. The average Hcy level in group I, subgroup A was significantly higher than in subgroup B, p < 0.05. The average total, free testosterone levels, and homeostatic model assessment-insulin resistance levels (HOMA-IR) in group I was significantly higher than in group II and controls. HOMA-IR in group II and controls did not differ significantly. The average anti-Mullerian hormone levels in women with PCOS were significantly higher than controls, p < 0.05. No significant difference was observed in average anti-Mullerian hormone level, ovarian volume, antral follicle count, and body mass index between the comparison groups of PCOS. In group I, a positive correlation between Hcy with HOMA-IR was detected.

 Serum Hcy levels are elevated in women with PCOS and RPL, which correlates with their insulin resistance status.

 Methamphetamine abuse during pregnancy is associated with maternal and fetal adverse outcomes. Methamphetamine induces reproductive damage in adults; however, its effect has not been studied during pregnancy.

 To investigate the effects of methamphetamine exposure during pregnancy on the reproductive system.

 15 pregnant Wistar rats were divided into 3 groups (n = 5/group), and received daily intraperitoneal injections of saline or methamphetamine (5, and 10 mg/kg) from day 10 until the end of pregnancy. One adult male offspring was selected from each dam. Subjects were euthanized, and their testis was removed. Sperm samples from cauda epididymis were analyzed for sperm concentration, morphology, and motility. Terminal deoxynucleotidyl transferase dUTP nick-end labeling assay was used to detect apoptotic cells. Levels of B-cell lymphoma 2 protein (Bcl-2) and Bcl-2 associated X-protein were measured using Western blot.

 Methamphetamine significantly decreased sperm concentration (5 mg vs. saline: p = 0.001, 10 mg vs. saline: p < 0.001), normal sperm morphology (saline vs. 10 mg: p = 0.001), and motility (p: saline vs. 5 mg = 0.004, 5 mg vs. 10 mg = 0.011, saline vs. 10 mg < 0.001) in a dose-dependent manner. There was a significantly higher number of terminal deoxynucleotidyl transferase dUTP nick-end labeling -positive cells and higher exposure. Moreover, Bcl-2 associated X-protein was increased, and Bcl-2 was decreased in these rats.

 The present study shows that chronic methamphetamine exposure during intrauterine period can induce apoptosis of seminiferous tubules and decrease sperm quality in adult rats. Moreover, we showed that the intrinsic apoptotic pathway is involved in this process. Further studies are required to identify the complete molecular pathway of these results.