Serum levels of phthalates and bisphenol-A in patients with primary ovarian insufficiency.

OBJECTIVES: Phthalates and bisphenol-A (BPA) may pose a risk for human reproduction. Adverse effects of endocrine disturbing chemicals on animal ovaries have been proposed previously. This study was designed to measure the concentrations of phthalate diesters or their metabolites in serum to evaluate their relevance with primary ovarian insufficiency (POI). METHODS: This study was designed as a cross sectional and case-control study. The study group consisted of 30 women diagnosed with POI whereas 30 healthy fertile women without any systemic diseases were recruited as a control group. The two groups were matched with respect to age and body mass index and tobacco smoking. Serum phthalate diesters and BPA levels were measured in both groups. RESULTS: The mean serum level of mono-buthyl phthalate (MBP) was statistically significantly higher in POI group than in control group (8.45 ± 4.2 vs. 5.0 ± 3.47 ng/mL, p < .001). Other serum phthalate metabolites and BPA concentrations were similar among the groups. CONCLUSIONS: Serum levels of BPA and phthalate metabolites are increased in women diagnosed with POI. However, MBP is the most significant one among them. MBP may be a contributing risk factor in the development of POI.

Age-stratified analysis of tumor markers and tumor characteristics in adolescents and young women with mature cystic teratoma.

BACKGROUND: Serum tumor markers are widely used for the preoperative evaluation of an adnexal mass. Elevations of cancer antigen (CA) 125 and CA 19-9 have been reported in patients with mature cystic teratoma (MCT). The aim of the study is to investigate the relation of serum tumor markers with tumor characteristics in young women with MCT. METHODS: We conducted a retrospective review of 157 patients under the age of 35 who underwent laparoscopic surgery for ovarian MCT. Patients were divided into two age groups: Group I (n = 80): adolescents/young adults (aged 13-25 years) and Group II (n = 77): women aged 26-35 years. Data were analyzed for serum tumor markers, tumor size, and bilaterality. RESULTS: The rates of elevated CA 125 and CA 19-9 were 10.7% and 31.5%, respectively, for Group I, and 13.9% and 26.5%, respectively, for Group II. The bilaterality rate was higher in Group II compared to Group I (19.5% vs. 8.8%, respectively, p = 0.04). Serum CA 125 and CA 19-9 elevations were not related to tumor size in Group I. In Group II, elevated levels of CA 125 were also unrelated to tumor size. However, significant elevation in CA 19-9 levels was observed when tumor size was larger than 4 cm in this age group (p = 0.004). Elevated CA 125 and CA 19-9 levels were not significantly associated with the presence of bilateral MCT in either group. CONCLUSION: The results of our study indicate that elevations of CA 19-9 are associated with larger tumor size in women aged 26-35 years, but not in adolescents/young adults. However, elevated serum CA 125 levels are not related to tumor size in either age group.

Sirtuin 1 Levels in Recurrent Implantation Failure / Níveis de sirtuína 1 em falhas recorrentes de implantação

Abstract Sirtuin 1 has an important role in cellular processes, including apoptosis and cellular stress. The purpose of this study was to assess serum sirtuin 1 levels in women with recurrent implantation failure (RIF). In this cross-sectional study, we included 28 women with RIF, 29 healthy women who had conceived by in vitro fertilization (IVF), and 30 women with a 1-cycle failure of IVF as controls. Human serum nicotinamide adenine dinucleotide (NAD)-dependent deacetylase sirtuin-1 (SIRT1/SIRT2L1) levels were detected using a commercial colorimetric kit. Recurrent implantation failure patients have higher sirtuin 1 levels than non-pregnant women and healthy pregnant women, but this difference did not reach statistical significance due to the low number of patients in our study. These higher sirtuin 1 levels may result from the inflammation imbalance of RIF patients. The only statistically significant correlation found was between age and sirtuin (r = 0.277, p = 0.009).

Resumo A sirtuína 1 tem importante função nos processos celulares, incluindo a apoptose e o estresse celular. O objetivo deste estudo é o de avaliar níveis de sirtuína 1 em mulheres com falhas recorrentes de implantação (FRI). Neste estudo cruzado, incluímos 28 mulheres com FRI, 29 mulheres saudáveis que deram à luz por fertilização in vitro (FIV) bem-sucedida, e 30 mulheres com 1 ciclo de FIV malsucedido como controle. Os níveis de sirtuína 1 em soro humano de desacetilase dependente de dinucleotídeo de nicotinamida adenina (DNA) (SIRT1/SIRT2L1) foram detectados usando um kit colorimétrico comercial. Pacientes com FRI tiveram níveis de sirtuína 1 superiores às pacientes grávidas e aos controles, mas esta diferença não atingiu significância estatística devido ao baixo número de pacientes envolvidos. Estes níveis mais altos de sirtuína 1 podem ser resultado da inflamação desigual em pacientes com FRI. A única correlação estatisticamente significante encontrada foi entre idade e sirtuína (r = 0,277, p = 0,009).

First trimester biochemical markers in twin pregnancies.

OBJECTIVE: Our aim was to investigate the first trimester serum markers and nuchal translucency (NT) measurements in twin pregnancies in our population. MATERIALS AND METHODS: We reviewed the results of all double tests that were performed in our hospital over a three-year period. Out of them, we selected all twins and compared them with a group of three times as many singleton controls. NT measurements and the first trimester serum markers from 49 twin pregnancies were compared to those of 147 pregnant women with normal singleton pregnancy RESULTS: There were no statistically significant differences in age, gestational age and maternal weight between the two groups (p > 0.05). We found similar NT measurements in the two groups. The median MoM of Pregnancy-Associated Plasma Protein A (PAPP-A) and fß-hCG levels in twins were statistically significantly higher than those in singleton pregnancies. Twelve percent of the twins (12.2%) were the result of assisted reproduction technologies. IVF versus naturally conceived pregnancies showed similar MoM of PAPP-A (2.2 vs. 1.2, respectively) and fß-hCG (Mann-Whitney U; p = 0.195 and p = 0.958). CONCLUSIONS: Our study revealed that median PAPP-A and fß-hCG levels for twins were less than twice those of singleton values.

Mid-trimester maternal serum and amniotic fluid biomarkers for the prediction of preterm delivery and intrauterine growth retardation.

AIM: Our purpose was to evaluate the predictive value of maternal serum and amniotic fluid biomarkers that were obtained at the time of genetic amniocentesis for preterm delivery and intrauterine growth retardation (IUGR). METHODS: A prospective cohort analysis was conducted in 107 singleton pregnancies that underwent amniocentesis at 16-22 weeks according to standard genetic indications. Maternal blood and amniotic fluid obtained from genetic amniocentesis were tested for glucose, alkaline phosphatase (ALP), lactate dehydrogenase (LDH), ceruloplasmin, ferritin, high-sensitivity C-reactive protein and interleukin-6 (IL-6). Ninety-four pregnancies were followed until delivery. RESULTS: Of the 94 patients, 16 (18.1%) delivered before 37 weeks and seven (7.5%) delivered a baby below the 10th percentile for gestational age. Amniotic fluid glucose levels were significantly lower in patients with preterm delivery than term deliveries (P = 0.01). Median amniotic fluid ferritin and IL-6 levels and mean amniotic fluid ALP levels were higher in the preterm group but this difference did not reach statistical significance. Mean maternal ALP and LDH levels tended to be insignificantly higher. Only median maternal blood ferritin levels in the IUGR group were found to be higher than patients who were appropriate for gestational age (P = 0.03). CONCLUSION: Low amniotic fluid glucose levels are associated with risk of preterm delivery, whereas high maternal blood ferritin levels increase the risk for IUGR. Although this result is significant and notable, there is not enough clinical evidence to recommend their use as a screening test for preterm delivery and IUGR in routine practice.