International Journal of Reproductive BioMedicine
Volume:22 Issue: 12, Dec 2024

  Polycystic ovary syndrome (PCOS) casts a wide shadow over the reproductive health of millions of women worldwide, emerging as one of the most complex and multifaceted endocrine disorders. In addition, nitric oxide (NO) stands out as a pivotal signaling molecule, orchestrating a symphony of physiological processes.

This meta-analysis aims to elucidate the association between NO levels and PCOS, investigate the potential of NO as a biomarker for PCOS diagnosis, and evaluate its clinical significance.

A systematic review was conducted in several electronic databases, including PubMed, Web of Science, Cochrane Library, Scopus, EMBASE, and Google Scholar, to identify relevant studies published up to January 2024. Standardized mean difference and 95% CI were calculated using a random effects model to assess the overall effect size. Meta-regressions and subgroup analysis were performed to investigate sources of heterogeneity.

A meta-analysis of 14 studies with 1171 participants showed that NO levels were significantly lower in the PCOS group than in the control group. The pooled analysis yielded a standardized mean difference of -0.482; 95% CI: -0.908 to -0.056; p = 0.027. Subgroup analyses further demonstrated variations in NO levels between different PCOS phenotypes and in relation to metabolic parameters.

This meta-analysis provides evidence for an association between PCOS and dysregulated NO levels and suggests a potential role of NO as a biomarker in the diagnosis and pathogenesis of PCOS.

Sexual performance anxiety is common among infertility treatments. Psychological interventions are options for couples who do not tolerate psychiatric medications or like psychotherapy with pharmacotherapy.

This study aimed to compare the effectiveness of relationship enhancement couple therapy program (RECT) vs. systematic desensitization (SD) on sexual anxiety.

A parallel randomized clinical trial was conducted on 68 women with infertility in Shahrekord, Iran, in January 2022. They were randomly allocated to 8 weekly online interventions RECT or SD (control). The main outcome variable, sexual performance anxiety, was assessed via Davis's questionnaire at baseline, completion of the intervention (week 8), and follow-up (week 12). The secondary outcome variable spouse's satisfaction was assessed (weeks 8 and 12, via visual analog scale). Data from 29 women were analyzed in each group.

Intra-group comparison RECT and SD showed a significant decrease of sexual anxiety baseline compared to week 12 (p = 0.001, 0.001 for RECT and SD, respectively). No significant difference was observed between the 2 groups in baseline compared to week 12 (RECT vs. SD, p = 0.149). Time-group interaction of spouse's satisfaction showed a significant difference between RECT and SD (p = 0.010).

Both RECT and SD were almost equally effective in decreasing sexual anxiety. RECT (couple relationship-centered) by empowering 10 interpersonal skills, and SD (personal-oriented) by learning step-by-step how fight-or-flight response is replaced by relaxation response, helping women perform more adaptive behaviors regarding sexual anxiety. RECT increased spouse satisfaction significantly compared to SD, indicating that males need to participate in positive relationship changes. The results may be applied by therapists and health policymakers.

Infertility is defined as the inability to conceive after 12 months of regular unprotected intercourse. Approximately 85% of infertile couples have an identifiable cause, one of the most common causes of infertility is polycystic ovary syndrome (PCOS). The reduction of antioxidant levels in serum and follicular fluid in infertile women compared to healthy women shows the importance of further studying these markers.

To study salivary and serum antioxidant levels in PCOS participants under assisted reproductive technology.

This case-control study was conducted on 80 women in 2 groups including normal participants as control and PCOS groups (n = 40/each). Serum and salivary antioxidant levels such as saliva superoxide dismutase (SOD), saliva anti-Müllerian hormone (AMH), serum SOD, serum total oxidant status, and serum AMH were measured.

The average age of participants was 31.6 ± 5.4 yr. In both the saliva and serum, antioxidant levels differed significantly between the PCOS and control groups. Key findings showed that the PCOS group had different antioxidant levels and higher serum AMH levels compared to the control group, with all differences being statistically significant (p < 0.05).

Our finding underscored that saliva antioxidant levels, especially SOD, are a good marker for PCOS diagnosis. It is noninvasive, can easily be performed by the participants, and can be collected in various settings without specialized equipment.

Disturbed self-esteem and self-image can be found in body dysmorphic individuals, and sexual dysfunction is also more frequent among these individuals. Body image concerns may also contribute to the tendency to undergo cosmetic procedures, including rhinoplasty.

This study aimed to compare sexual dysfunction in married women who were candidates for cosmetic rhinoplasty to a control group.

This case-control study was conducted among 342 married women in Shiraz, Iran, from December 2021-2022. The case group included 192 cosmetic rhinoplasty candidates, and the control group comprised 150 women who were not candidates for cosmetic procedures; they were selected from the ear, nose, and throat outpatient department. Data on demographic features, psycho-social history, and quality of marital life were collected by face-to-face interviews. To evaluate their sexual performance, the participants filled out the female sexual function index questionnaire.

No significant difference was observed between rhinoplasty subjects and the control group in the female sexual function index (23.63 ± 3.6 vs. 23.19 ± 4.28, p = 0.43). The prevalence of sexual dysfunction among cosmetic rhinoplasty candidates and the control group was 75% and 76%, respectively (p = 0.60). No significant difference was observed in the sexual dysfunction domains between the groups.

Our study indicated a significant sexual dysfunction among the studied population, but the difference was not statistically significant between the rhinoplasty and the control group.

Endometriosis is a chronic inflammatory condition associated with debilitating chronic pelvic pain that affects women's quality of life. Several drugs have been used to reduce pain and psychological distress associated with this disease. Currently, gonadotropin-releasing hormone (GnRH) agonists and dienogest are the most widely used medical therapies for endometriosis.

This study aimed to investigate the efficacy of dienogest and GnRH agonists in improving pelvic pain after laparoscopic surgery for endometriosis.

In this randomized clinical trial study, 104 women with endometriosis who were referred to the Department of Reproductive Medicine of Yas hospital, Tehran, Iran, between April 2022 and March 2023 were studied. After laparoscopic surgery, individuals were randomly assigned into 2 groups (n = 52/each): the dienogest-administered group and the GnRH agonist-administered group. Participants were followed up at 3 months and pelvic pain was measured using the visual analog scale. Pelvic pain and adverse effects of drugs were compared between the groups.

Pelvic pain significantly improved in both treatment groups (p < 0.0001). No significant difference was observed in hot flashes and joint pain between the dienogest and GnRH agonist groups. However, a significant difference was found in vaginal dryness (p = 0.03) and decreased libido (p = 0.02). GnRH agonists and dienogest reduced irregular vaginal bleeding.

Our results suggested that the effect of GnRH agonists and dienogest in improving pelvic pain for endometriosis is the same after a 3-month treatment period. However, these 2 drugs caused different adverse effects.

Endometriosis (EM) is a condition that causes infertility with decreasing uterine receptivity. It is reported that it affects about 20-25% of all infertile women. Some genetic markers play a crucial role in pathogenesis and infertility.

This study investigates the role of miR-200a and miR-223-3p in embryo implantation and their association with EM-related infertility.

In this case-control study, 36 women who referred to the Center for Research on Reproductive Health and Infertility of Babol University of Medical Sciences and Fatemeh Al-Zahra Infertility Specialized Treatment Center in Babol, Iran between June 2022 and July 2023 were evaluated. Participants were divided into 2 EM and control groups (n = 18/each). Endometrial samples were collected from participants between 17th and 24th days of their menstrual cycle. Histopathological examination (hematoxylin and eosin and periodic acid schiff) was performed to confirm the secretory stage, and miR-200a and miR-223-3p expressions were analyzed by quantitative reverse transcriptase-polymerase chain reaction.

Histological analysis confirmed that both groups were in the secretory stage. Additionally, miRNA expression results showed a significant decrease in the miR-200a and miR-223-3p expression levels in EM group compared to control group. The expression level of miR-223-3p and miR-200a in the eutopic endometrial tissue of women with EM was notably lower than those in the control group.

Our results suggest that miR-200a and miR-223-3p are involved in the EM pathogenesis, while other genes and signaling pathways are probably involved in the implantation failure.

Genetic predispositions have been identified as important factors in male infertility. Among the many genes related to male reproductive function, interleukin 6 (IL-6) has emerged as a key player. Despite the growing recognition of genetic factors in male infertility, the specific association between the IL-6-174 G/C genetic polymorphism and male infertility remains an area that needs further investigation.

This investigation explores the correlation between the IL-6-174 G/C transversion and male infertility.

In a case-control study, a total of 314 men who referred to the Kashan Infertility Centre, Shahid Beheshti hospital, Kashan, Iran, were enrolled for IL-6-174 G/C polymorphism analysis. The study comprised 163 infertile participants as the case group and 151 fertile men as the control group. Following the screening, 2 ml of whole blood was collected from each participant. Cases were categorized into 3 subgroups based on World Health Organization criteria: (i) nonobstructive azoospermia (n = 42), (ii) oligozoospermia (n = 61), and (iii) asthenozoospermia (n = 60). After DNA extraction, genotypes of the samples at the -174 G/C (rs1800795) locus were determined using the polymerase chain reaction-restriction fragment length polymorphism method.

Our genetic investigation demonstrated a significant association between the GC genotype and male infertility. Furthermore, a correlation was observed between the heterozygous GC genotype and reduced risk of oligozoospermia and asthenospermia. Additionally, the C allele was correlated with a decreased risk of infertility and specific subgroups such as oligozoospermia and asthenospermia.

Our findings suggest that the IL-6-174 G/C transversion could potentially serve as a protective genetic factor against male infertility.

With the increasing prevalence of infertility and its links to depression, anxiety, and stress, it is essential to compare these mental health levels between infertile men and a control group.

This study aimed to compare depression, anxiety, and stress among infertile and fertile men. Also, assessing demographic factors affecting these challenges among both groups.

This case-control study was conducted on 120 men at Milad Infertility Research Center, Mashhad, Iran from January 2023 to February 2023. Participants were divided into 2 groups: 60 infertile men and 60 healthy men who did not have fertility problems. Demographic information such as age, education, occupation, duration of the marriage, and duration of infertility was collected from their medical records, and they also completed the depression, anxiety, and stress scale 21 questionnaire through a telephonic interview. Finally, the findings were statistically analyzed.

Severe and very severe depression, anxiety, and stress were observed in 65%, 60%, and 43.4% of infertile men and 16.7%, 23.3%, and 11.7% of fertile men, respectively. Which was significantly more than the fertile group, and there was a significant relationship between depression (p ≤ 0.001), anxiety (p = 0.001), stress (p ≤ 0.001), and infertility. Also, a significant relationship was observed between the duration of infertility and depression (p = 0.031).

Our study found infertile men had higher stress, anxiety, and depression than the control group. Limitations included phone-based data collection and the depression, anxiety, and stress scale 21 questionnaire's screening nature. Future studies should involve larger populations and consider economic status as a variable related to mental health.