Genetic variants in fibrinolytic system-related genes in infertile women with and without endometriosis.

AIMS: The aim of this study was to evaluate urokinase-type plasminogen activator gene (uPA) and thrombin-activatable fibrinolysis inhibitor gene (TAFI) genotypes in a group of infertile women with and/or without endometriosis and controls. METHODS: A case-control study comprising 180 infertile women with endometriosis, 68 women with idiopathic infertility, and 152 fertile women as controls was carried out. Detection of uPA (C422T/rs2227564) and TAFI (G438A/rs2146881) polymorphisms was performed by TaqMan polymerase chain reaction. The results were statistically analyzed and a p-value of <0.05 was considered significant. RESULTS: We found no association among both uPA or TAFI polymorphisms and endometriosis-related infertility (p=0.920 and p=0.356, respectively) or idiopathic infertility (p=0.502 and p=0.392, respectively) comparing to controls, even considering minimal/mild and moderate/severe endometriosis separately. Both uPA and TAFI polymorphisms were in Hardy-Weinberg equilibrium for all studied groups. The combinatory analysis of both uPA and TAFI polymorphisms to endometriosis-related infertility, idiopathic infertility, and control group showed no statistical difference to any combination. CONCLUSION: The data suggest that, in the Brazilian population, genetic variations in both uPA and TAFI were not relevant to endometriosis and/or infertility.

[Analysis of codon 72 polymorphism of the TP53 gene in infertile women with and without endometriosis]. / Análise do polimorfismo no códon 72 do gene TP53 em mulheres inférteis com e sem endometriose.

PURPOSE: to evaluate the frequency of TP53 codon 72 polymorphism in infertile women with endometriosis, women with idiopathic infertility, controls and its relation to the disease. METHODS: a case-control study that included 198 infertile women with endometriosis, 70 women with idiopathic infertility and 169 fertile women without endometriosis as control. Detection of TP53 codon 72 gene polymorphism (rs1042522, Arg/C:Pro/G), that promotes a C/G exchange in the coding region of the gene, was performed by real time Polymerase Chain Reaction (PCR), using the TaqMan system of primers, that flank the implicated region and probes labeled with different fluorescent dyes, one for allele C and other for allele G. When two dyes were observed, the patient was considered to be heterozygous CG. In the presence of only one dye, the individual was considered to be homozygous CC or GG. The χ2 test was used to compare allele and genotype frequencies between groups. All p-values were two-tailed and a p-value <0.05 was considered to be statistically significant. RESULTS: we found no statistically significant difference in the distribution of TP53 codon 72 polymorphism genotypes CC, CG or GG (p=0.7) and alleles C or G (p=0.4) between infertile patients with endometriosis and controls (p=0.4), regardless of the stage of the disease. In relation to infertility, no statistically significant difference in the genotype or allele distribution (p=1.0 and p=0.9, respectively) was observed between idiopathic infertile women and controls. Considering the dominant inheritance model, again, no statistically significant difference was found even in the endometriosis (p=0.5) or the idiopathic infertility group (p=0.9) when compared to controls. Regarding the recessive inheritance model no statistically significant difference was found, with p=0.6 and p=1.0, respectively, for the endometriosis and idiopathic infertility groups. CONCLUSION: the results suggest that the TP53 codon 72 polymorphism does not confer genetic susceptibility to endometriosis and/or infertility in the Brazilian population, not even the severe form of the disease.

Plasminogen activator inhibitor-1 4G/5G polymorphism in infertile women with and without endometriosis.

OBJECTIVE: To evaluate PAI-1 genotypes in a group of infertile women with or without endometriosis and control subjects. DESIGN: Case-control study. SETTING: Human Reproduction Center of Medicina do ABC Faculty. POPULATION: One hundred and forty infertile women with endometriosis, 64 women with idiopathic infertility and 148 fertile women as control subjects. METHODS: The PAI-1 4G/5G polymorphism was identified by restriction fragment length polymorphism-polymerase chain reaction. MAIN OUTCOME MEASURES: Genotype distribution and allele frequency of the 4G/5G polymorphism of the PAI-1 gene. RESULTS: The frequencies of genotypes 4G/4G, 4G/5G and 5G/5G of the PAI-1 gene in the infertile women with endometriosis were 38.6, 37.1 and 24.3%, respectively, and in the control group 24.3, 33.8 and 41.9%, respectively (p=0.003). When the infertile women with endometriosis were divided according to their endometriosis stage, genotypes 4G/4G, 4G/5G and 5G/5G were identified, respectively, in 36.7, 32.9 and 30.4% of the patients with minimal/mild endometriosis (p=0.102) and in 41.0, 42.6 and 16.4% of the patients with moderate/severe endometriosis (p=0.001); in the women with idiopathic infertility, these genotypes were found at a frequency of 29.7, 34.3 and 36%, respectively (p=0.637). CONCLUSION: The data suggest that, in Brazilian women, the PAI-1 4G/5G polymorphism may be associated with a risk of endometriosis-associated infertility.

Análise do polimorfismo no códon 72 do gene TP53 em mulheres inférteis com e sem endometriose / Analysis of codon 72 polymorphism of the TP53 gene in infertile women with and without endometriosis

OBJETIVO: avaliar a frequência do polimorfismo no códon 72 do gene TP53 em mulheres inférteis com endometriose, mulheres com infertilidade idiopática, Grupo Controle e sua associação com a doença. MÉTODOS: estudo caso-controle que incluiu 198 mulheres inférteis com endometriose, 70 mulheres com infertilidade idiopática e 169 mulheres férteis sem endometriose como controles. O polimorfismo no códon 72 do gene TP53 (rs1042522, Arg/C:Pro/G), que promove uma troca de C/G na sequência codante, foi identificado pela reação em cadeia da polimerase (PCR) em tempo real, por meio da utilização de sistema TaqMan de primers, flanqueando a região em questão e sondas marcadas com fluoróforos diferentes, uma para o alelo C, outra para o alelo G. Na observação de dois fluoróforos, o paciente foi considerado heterozigoto para o polimorfismo. Na presença de apenas um fluoróforo, o paciente foi considerado homozigoto CC ou GG. O teste do χ2 foi utilizado para comparar as frequências dos genótipos e alelos entre os grupos. Todos os valores de p foram bicaudais, e o nível de significância considerado foi 0,05 (α <0,05). RESULTADOS: não foi encontrada diferença significativa na frequência dos genótipos CC, CG e GG (p=0,7) e alelos C e G (p=0,4) do polimorfismo no códon 72 do gene TP53 entre pacientes inférteis com endometriose em relação aos controles, independentemente do estágio da doença. Em relação à infertilidade, não houve diferença significativa quanto às mulheres inférteis sem endometriose em relação aos controles na distribuição dos genótipos e alelos (p=1,0 e p=0,8, respectivamente). Considerando o modelo de herança dominante, não houve diferença estatística significante tanto no grupo de endometriose (p=0,5) como no grupo de infertilidade idiopática (p=0,9) em relação aos controles. Observando o modelo recessivo, também não houve diferença significante (p=0,6 e p=1,0, respectivamente) para os grupos de endometriose e infertilidade idiopática ...

PURPOSE: to evaluate the frequency of TP53 codon 72 polymorphism in infertile women with endometriosis, women with idiopathic infertility, controls and its relation to the disease. METHODS: a case-control study that included 198 infertile women with endometriosis, 70 women with idiopathic infertility and 169 fertile women without endometriosis as control. Detection of TP53 codon 72 gene polymorphism (rs1042522, Arg/C:Pro/G), that promotes a C/G exchange in the coding region of the gene, was performed by real time Polymerase Chain Reaction (PCR), using the TaqMan system of primers, that flank the implicated region and probes labeled with different fluorescent dyes, one for allele C and other for allele G. When two dyes were observed, the patient was considered to be heterozygous CG. In the presence of only one dye, the individual was considered to be homozygous CC or GG. The χ2 test was used to compare allele and genotype frequencies between groups. All p-values were two-tailed and a p-value <0.05 was considered to be statistically significant. RESULTS: we found no statistically significant difference in the distribution of TP53 codon 72 polymorphism genotypes CC, CG or GG (p=0.7) and alleles C or G (p=0.4) between infertile patients with endometriosis and controls (p=0.4), regardless of the stage of the disease. In relation to infertility, no statistically significant difference in the genotype or allele distribution (p=1.0 and p=0.9, respectively) was observed between idiopathic infertile women and controls. Considering the dominant inheritance model, again, no statistically significant difference was found even in the endometriosis (p=0.5) or the idiopathic infertility group (p=0.9) when compared to controls. Regarding the recessive inheritance model no statistically significant difference was found, with p=0.6 and p=1.0, respectively, for the endometriosis and idiopathic infertility groups...

+1730 G/A polymorphism of the estrogen receptor beta gene (ERbeta) may be an important genetic factor predisposing to endometriosis.

OBJECTIVE: To determine the frequency of the estrogen receptor gene (ERbeta) +1730 G/A polymorphism in Brazilian women with endometriosis. DESIGN: Case-control study. SETTING: Endometriosis Outpatient Clinic and Family Planning Outpatient Clinic of ABC Faculty of Medicine. POPULATION: A total of 108 patients with endometriosis and a control group consisting of 210 fertile women. METHODS: The ERbeta gene +1730 G/A polymorphism was identified by restriction fragment length polymorphism-polymerase chain reaction. MAIN OUTCOME MEASURE(S): Genotype distribution and allele frequency of the +1730 G/A polymorphism in the ERbeta gene. RESULTS: Genotypes GG, GA and AA of the ERbeta gene presented frequencies of 50.9%, 47.2% and 1.9%, respectively, in the women with endometriosis. Among the patients with stage I/II endometriosis, 47% presented the normal homozygous genotype GG; 51% had a GA heterozygous genotype and 2% had a homozygous mutated genotype AA. Among the patients with stage III/IV endometriosis, genotypes GG, GA and AA were present in 54.3%, 44% and 1.7%, respectively. In the control group, 74.3% presented the normal homozygous genotype GG, 24.3% the heterozygous genotype GA and 1.4% the homozygous mutated genotype AA. CONCLUSION: The data suggest that the ERbeta gene +1730 G/A polymorphism can be associated with the risk of endometriosis development, regardless of the stage of the disease.

Insuficiência ovariana precoce em mulheres submetidas a tratamento contra câncer de mama: alternativas para preservação da fertilidade / Precoce ovarian insuficience in women submitted to breast cancer treatment: alternatives for fertility preservation

O câncer de mama é o segu ndo tipo de câncer mais frequente no mundo e o mais comum entre as mulheres, sendo responsável, a cada ano, por 22% dos casos novos de câncer em mulheres, além de representar 30% dos tumores malignos que ocorrem na idade reprodutiva. Nas últimas décadas, houve uma melhora nas taxas de sobrevida devido ao aumento de consciência sobre doenças da mama e programas de triagem bem estabelecidos, o que levou à detecção precoce e ao melhor tratamento, que inclui o uso liberal de quimioterapia citotóxica adjuvante. Entretanto, o uso de regimes quimioterápicos adjuvantes, juntamente com o aumento do número de mulheres que retardam o primeiro filho para além dos 35 anos, tem resultado numa ampla proporção de pacientes com câncer de mama enfrentando infertilidade, levando à maior procura de ajuda para preservação da fertilidade. Isso se reflete na proliferação de técnicas de reprodução assistida, as quais vão desde as bem estabelecidas clinicamente, como a criopreservação de embriões, até as mais experimentais, como a criopreservação de oócitos e de tecido ovariano. O objetivo do presente estudo foi realizar uma revisão sobre as técnicas disponíveis para preservação da fertilidade nas mulheres submetidas ao tratamento contra câncer de mama.

Breast cancer is the second most frequent type of cancer world wide and most common among women, accounting for each year by 22% of newcases of cancer in women, and it represents 30% of malignant tumors in women of reproductive age. In recent decades, there was an improvementin survival rates due to increased of knowledge about breast diseases and well-established screening programs, that lead to early detection and better treatment, which includes the liberal use of adjuvant cytotoxic chemotherapy. However, the use of adjuvant chemotherapy regimens, with the increasing number of women who delay the first child beyond 35 years, has resulted in a large proportion of patients in reproductive age with breast cancer experiencing infertility. This resulted in an increased demand for assistance for preservation of fertility, which is reflected in theproliferation of techniques to preserve fertility through techniques of assisted reproduction, ranging from well established clinically technique, asembryo cryopreservation, to the most experimental, such as oocytes and ovarian tissue cryopreservation. The aim of this study was to make a review of the available techniques for fertility preservation in women under breast cancer chemotherapy.