International Journal of Reproductive BioMedicine
Volume:12 Issue: 10, Oct 2014

We often see patients with a thin endometrium in ART cycles, in spite of standard and adjuvant treatments. Improving endometrial growth in patients with a thin endometrium is very difficult. Without adequate endometrial thickness these patients, likely, would not have reached embryo transfer.

We planned this study to investigate the efficacy of intrauterine granulocyte colony-stimulating factor (G-CSF) perfusion in improving endometrium, and possibly pregnancy rates in frozen-thawed embryo transfer cycles.

This is a non-randomized intervention clinical trial. Among 68 infertile patients with thin endometrium (-7 mm) at the 12th-13th cycle day, 34 patients received G-CSF. G-CSF (300 microgram/1mL) to improve endometrial thickness was direct administered by slow intrauterine infusion using IUI catheter. If the endometrium had not reached at least a 7-mm within 48-72 h, a second infusion was given. Endometrial thickness was assessed by serial vaginal ultrasound at the most expanded area of the endometrial stripe.

The cycle was cancelled in the patients with thin endometrium (endometrial thickness below 7mm) until 19th cycle day ultimately The cycle cancelation rate owing to thin endometrium was similar in G-CSF group (15.20%), followed by (15.20%) in the control group (p=1.00). The endometrial growth was not different within 2 groups, an improvement was shown between controlled and G-CSF cotreated groups, with chemical (39.30% vs. 14.30%) and clinical pregnancy rates (32.10% vs. 12.00%) although were not significant.

Our study fails to demonstrate that G-CSF has the potential to improve endometrial thickness but has the potential to improve chemical and clinical pregnancy rate of the infertile women with thin endometrium in frozen-thawed embryo transfer cycle.

Despite extensive progress in IVF techniques, one of the most difficult problems is the variability in the response to controlled ovarian hyperstimulation (COH). Recent studies show the effects of individual genetic variability on COH outcome.

To evaluate the correlation between LHβ G1502A polymorphisms in exon 3 of the LH gene and ovarian response to COH.

A total of 220 women treated with a long protocol for ovarian stimulation were studied. Three genotypes of GG, GA and AA were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis.

In total, 34 (17%) patients were poor responders, 154 (77%) were normal responders and 12 (6%) were hyper responders. The most frequent genotype was GA (55.5%) whereas 44.5% of patients showed GG genotype and there was no patient with AA genotype. In total 54.5% of normal responders, 61.8% of poor responders and 50% of hyper responders showed GA genotype.

Our results did not establish a significant relationship between this polymorphism and the ovarian response. Therefore it is still very difficult to use the genotype of patients for prediction of the ovarian response to stimulation.

Previous researches about the effects of epididymal obstruction on the testes are contradictory, and the mechanism harmful effect of male duct system obstruction on seminiferous tubules still remains unclear.

The aim of this study was to investigate the effects of epididymal obstruction in prepubertal rats on the testis.

15 days of age, the young rats were divided at random in two groups for epididymal ligation (n=25) or sham operation (n=15). Both groups were sacrificed at 21, 35, 56, 90, 120 days. The testis were removed, fixed in Bouin’s fixative and embedded in paraffin wax. The tissues were sectioned at 5 μm and stained with haematoxylin-eosin and triple stain.

In ligated rats the first histological alterations were detected at 56 days. These degenerative changes included increase at the seminiferous tubule diameter and basal membrane thickness, decrease at the germinal epithelium thickness, depletion of spermatids and presence of multinucleated spermatids. In 90 and 120 days ligation groups; germ cells greatly reduced in number.

progressive degenerative alterations occurred in the seminiferous tubules after prepubertal epididymal obstruction but these degenerative alterations are not observed until puberta and in the seminiferous tubules that showed extensive degeneration, seminiferous epithelium was composed mainly of Sertoli cells

MicroRNA (miRNA) is small endogenous, single strand RNA molecules that regulate gene expression at post-transcriptional level through several mechanisms to affect key cellular event including male germ cells differentiation, proliferation, development and apoptosis. Mutation and/or aberrant expression of miRNAs have been associated with progression of various disorders, including infertility.

The purpose of this research was to study the estrogen receptor beta (ERβ), hsa-mir-21 and, hsa-mir-22 expression level in oligospermic infertile andcontrol fertile men and correlation between them.

In this study, the change in mir-21, mir-22 expression and their common target gene (ERβ) expression levels were evaluated in oligospermic infertile men (n= 43) compared with 43 age matched healthy control by Real-Time PCR methods.

Expression analysis by qRT-PCR test on miRNA have identified that mir-21, mir-22 levels were significantly higher than those in normal controls (p<0.0001) and ERβ expression level significantly decreased in comparison with the normal group (p<0.0001).

Our study showed that mir-21 and mir-22 are indirectly involved in spermatogenesis by regulating of the estrogen receptor and might have a diagnostic and prognostic value in men infertility

Endometrial integrin expression changes might be a reason for implantation failure in polycystic ovarian syndromes (PCOS).

Assessment of integrin genes and proteins expression upon endometrium in the PCOS experimental mouse model was the main goal of this study.

30 NMRI female mice were equally divided into control, experimental (PCOS; received estradiol valerate (40 mg/kg)) and sham group (received; olive oil). After 8 weeks, each group was hyper stimulated by 7 IU PMSG and then, after 48hrs, 7 IU HCG was injected. Vaginal plaque was checked. After 5 days, Progesterone and estradiol levels and endometrial tissues were investigated to evaluate of α4, αv, β1 and β3 integrins gene and protein by qPCR method and immunohistochemistry, respectively.

Tissue samples were assessed and showed that level of progesterone was significantly decreased in PCOS group. Results of molecular part in the amount of αv, β3, β1 and α4 gene expressions showed a great difference in β3 and αv genes expressions between experimental groups. αv, β3, α4 and β1 proteins in the endometrial stroma in the control group were expressed, but they were not detected in PCOS group.

According to the results, integrins had different expression patterns in different areas of the endometrium; such as epithelial and stromal. It seems that in PCOS, this pattern has changed and the results might have a great influence on implantation failure. Therefore, this study suggests that a great attention to this problem may be essential in patients who are involved

Momordica charantia (M. charantia) seed has been supposed to have an antifertility property but mechanisms underlying the infertility effect have not been investigated.

We investigated the antifertility effect of M. charantia ethanol seed extracts on reproductive toxicology and seminal and plasma testosterone in male Wistar rats.

The control group (I) was provided daily 1 ml dimethylsulfoxide (DMSO) and the experimental groups II and III were given daily 400 and 800 mg dry matter/kg body weight of the extracts dissolved in 1 ml DMSO via the esophageal route. All groups were administered for 42 days (day 42). Changes in body weight, fertility, reproductive characteristics, testicular histopathology and levels of seminal and plasma testosterone among three groups were compared.

On day 42, the extracts caused antifertility (p=0.001). The extracts demonstrated significant reductions in diameters of seminiferous tubules and epididymides, spermatid density, daily sperm production and caudal epididymal spermatozoa, sperm motility and viability (p=0.046). Pathological changes in seminiferous tubules revealed atrophy, desquamation, pyknosis nucleus and multinucleated giant cell. Plasma cells were evident in three parts of epididymides of rats treated with high dose of the extract. Furthermore, the high dose of the extract suppressed seminal testosterone level (p=0.001) and plasma testosterone level (p=0.002).

Our data showed that high dose of M. Charantia seed extracts caused infertility in male rats. The interruption in their fertility was probably attributed to the direct toxic to seminiferous tubules, epididymis and the lowered testosterone level which might impact on sperm parameters.

Date Palm Pollen (DPP) and Astragalus genus are used in some countries for the treatment of infertility.

This study was designed to investigate effects of DPP and Astragalus ovinus (A.Ovinus) on fertility in healthy adult male rats.

Thirty-six rats were divided into six groups (n=6) including control and five treatment groups. DPP (120, 240 and 360 mg/kg) and A.ovinus (100, 500 mg/ kg) were orally given to the treatment groups. After thirty-five days, blood samples were taken to determine serum levels of FSH, LH, testosterone and estradiol. Weight of testis and epididymis, sperm count, sperm motility, seminiferous tubules diameter (STD), germinal cell layer thickness (GCLT), sertoli, leydig and spermatogonia cells were also evaluated.

DPP at the of 120 and 240 mg/kg doses significantly raised the ratio oftestis or epididymis to body weight, sperm count, sperm motility, and estradiollevel compared to the control group (p<0.05). LH and testosterone levels onlynoticeably increased at 120 mg/kg of DPP (p<0.01 and p<0.001 respectively). STDincreased in the three applied doses (p=0.001). A. ovinus extract at the indicateddoses produced a significant reduction in the ratio of testis or epididymis to bodyweight and sperm motility (p<0.05). Sperm count, spermatogonia, leydig cells andFSH level decreased at dose of 500 mg/kg. Furthermore, GCLT, spermatogoniacells, and serum estradiol level increased at 100 mg/kg dose of A. ovinus.

Our findings indicate that DPP could improve fertility factors, while A.ovinus can exhibit deleterious effects on gonad and sperm parameters in rats.

The beneficial role of cabergoline as a prophylactic agent to prevent ovarian hyper stimulation syndrome (OHSS) among high-risk patients has been demonstrated in previous studies. But data for its role as a treatment for established severe OHSS is still limited. We represent the treatment results of high dose oral cabergoline in management of six patients after the syndrome is established.

High-dose oral cabergoline (1 mg daily for eight days) was prescribed as an adjuvant to symptomatic treatment for six hospitalized patients with established severe OHSS following infertility treatment cycles. In two cases OHSS resolved rapidly despite the occurrence of ongoing pregnancy.

Considering the treatment outcomes of our patients, high dose cabergoline did not eliminate the need for traditional treatments, but it was a relatively effective and safe therapy in management of established severe OHSS, and prevented the increase in its severity following the occurrence of pregnancy