Immune system cells modulation in patients with reproductive issues: A systematic review approach.

The aim of this study was to carry out a systematic literature review to investigate the main immune cells responsible for implantation failures. We selected papers from PubMed, Embase and Virtual Health Library databases. Eligible articles included publications between January 1, 2010 and April 24, 2022. Inclusion criteria were: observational and case-control studies; and the exclusion criteria were: review papers, letters to the editor, abstracts, animal studies and case reports. We extracted the following information: day of collection, number of patients, control group, age of patients, type of sample used, immune cells and cytokines. As main findings in our mapping, we found that in peripheral blood, CD3+, CD4+, CD8+, CD16+, CD56+, CD57+, CD69+, CD154+, CD158a+, NKp46 cells were increased and the CD4+, CD45+, Foxp3 and NKp46 markers were reduced. From the endometrial biopsies, there was an increase in CD3+, CD4+, CD5+, CD8+, CD16+, CD25+, CD45+, CD56+, CD57+, CD68+, CD127+ and a reduction in CD45+, CD56+, NKp46 and FoxP3 cells. Cytokines found increased in peripheral blood included IL-6, IL-10, IL-17, INF-γ, TGF-ß, TNF-α; while IL-4, IL-6, IL-10, IL-35, FoxP3, TGF-ß, SOCS3 were reduced. As for the biopsies, there was an increase in IL-2, IL-6, IL-17, IL-22, IL-23, INF-A1, INF-B1, INF-γ, TNF-R and a reduction in IL-6, IL-10, INF-γ, TGFß, TNF-α. We concluded that immune cells can be modulated during pregnancy failure, but further studies are needed to elucidate the modulating effect of the immune system on the endometrium of these patients.

Assessment of differentially expressed genes from in vitro matured human oocytes: A bioinformatics approach.

OBJECTIVE: One of the techniques that has gained much attention is the in vitro maturation of oocytes for patients who use assisted reproduction techniques. However, its results are still inferior to controlled ovarian stimulation methodologies. Understanding the maturation mechanisms based on analyses can help improve this methodology's results. The work aims to identify the central genes differentially expressed in oocytes after in vitro maturation in the germinal vesicle and metaphase II stages. METHODS: This work is a computational analysis. The entire search will be conducted using the Gene Expression Omnibus (GEO) database. To carry out and obtain the data present in the work, an advanced research search was carried out in the GEO database within the period from January 1, 2013, to January 1, 2023. A total of 27 genomic data were available in the GEO database, of which only two were used. RESULTS: Two datasets were identified on the Gene Expression Omnibus database platform: registration data GSE158802 and GSE95477. From the analysis, we identified five downregulated and thirty-six upregulated genes; the central genes that correlated with the main gene proteins found were CLTA and PANK1. CONCLUSIONS: There was a differential regulation of gene expression. The most central ones are related to energy capture.

Impact of sperm DNA fragmentation on the clinical outcome of assisted reproduction techniques: a systematic review of the last five years.

OBJECTIVE: To elucidate through a systematic literature review the impact sperm DNA fragmentation has on embryos from assisted reproduction techniques. DATA SOURCE: Studies from the "PubMed", "Embase", and "BVS" databases were analyzed. STUDIES SELECTION: The articles selected in the review included: cohort and case-control studies that addressed the proposed theme, published between January 1, 2017, and January 31, 2022, in English, Portuguese, and Spanish. As inclusion criteria: cohort and case-control articles. As exclusion criteria: articles outside the scope of the research, review articles, case reports, articles using animal models, abstracts, letters to the editor, and articles found duplicates in the databases. DATA COLLECTION: Number of couples or cycles; age (men/women); collection type; DNA damage (%); assisted reproduction activity and techniques. DATA SYNTHESIS: In in vitro fertilization, a reduction in fertilization rate, blastocyst rate, and embryo quality was observed. In addition to implantation and increased abortion rates in patients with high sperm DNA fragmentation. High rates of sperm DNA fragmentation in intracytoplasmic sperm injection led to reduced blastocyst production rate, embryo quality, implantation, and live birth rate, and in intrauterine insemination, a reduction in pregnancy rate. CONCLUSION: Sperm DNA fragmentation was a potential limiting factor for assisted reproduction techniques.

The impact of thyroid disorders on the clinical outcome of assisted reproductive techniques: a systematic approach over the last 10 years.

OBJECTIVE: To verify from a systematic literature review the possible effects of thyroid diseases on assisted reproduction techniques. DATA SOURCES: The studies were analyzed from the PubMed, Cochrane Library, LILACS databases. SELECTION OF STUDIES: The articles selected for the review included: cross-sectional studies, cohort studies, and clinical trials that addressed the proposed theme and which were published within the period stipulated from January 1, 2012, to March 5, 2022, in English, Portuguese and Spanish. These would later have to go through stages of inclusion as a framework of the type of study and exclusion criteria that were review articles, case reports, abstracts, articles with animal models, and duplicate articles and letters to the editor. DATA COLLECTION: Author's name; Number of patients; Clinical outcome; Use of drugs; Control group (in case it had); Clinical outcome. DATA SYNTHESIS: In in vitro fertilization and intracytoplasmic sperm injection it was verified that thyroid diseases can lead to effects such as a reduction in the rate of recovered oocytes, a decrease in the number of embryos, lower pregnancy rates, and increased chances of congenital anomalies in these patients and a reduction in the rate of implantation. Levothyroxine can increase the number of cycle cancellations. CONCLUSIONS: Thyroid diseases may have deleterious effects on the clinical outcome of in vitro fertilization and intracytoplasmic sperm injection.

Vaginal microbioma and the presence of Lactobacillus spp. as interferences in female fertility: A review system.

The vaginal microbiome is dominated by Lactobacillus spp. and the depletion of these microorganisms have been associated with adverse conditions that can affect women's health. Disturbance of the vaginal niche with a non-lactobacillary microbiota is associated with susceptibility to some diseases, such as obstetric alterations and infertility, resulting in failure in natural pregnancies and increased demand for assisted reproduction treatments. The present study sought to understand the influence of Lactobacillus spp. and fertility female. A systematic search was performed in the following databases: PubMed, MEDLINE, SciELO and LILACS, using the keywords: "Microbiome"; "Lactobacillus" and "Female Infertility", published in the last five years. The search resulted in 92 articles; however, 38 articles were excluded due to duplicity, 23 articles were excluded in the selection title/abstract, leaving 31 articles for full reading. In the end, 18 articles were analyzed. The studies encompassed a total of 2,011 women, using 27 types of samples to verify the composition of the microbiome. The eighteen articles that reported the microbiome of fertile women were constituted by a dominance of Lactobacillus spp. who joined to positive predictive outcomes in reproduction, while infertile women showed a dysbiotic profile. Therefore, analyzing bacterial patterns would allow a personalized diagnosis, which could favor personalized therapy for prevention and treatment of certain diseases.

Microbiota and seminal quality: A systematic review.

The microbiota is composed of numerous resident microorganisms, which contribute to the health and illness of the individual. When the microbiota is in dysbiosis, it can cause some pathological processes and in men it can be correlated with male infertility, so the present study does a systematic review, identifying whether there is a correlation between the microbiota and seminal quality. We analyzed 7 papers published in PubMed, Medline and the Cochrane library databases, in English and published between 2012 and 2022. In men with normal semen parameters, a higher prevalence of Lactobacillus. There was a higher prevalence of Prevotella in patients who had some seminal alteration. We conclude that the microbiota is correlated with seminal quality, since the decrease in Lactobacillus and the increase in other species is seen in infertile men.

Cytotoxic Activity of Antineoplastic Agents on Fertility: A Systematic Review.

OBJECTIVE: To analyze the long-term effects of antineoplastic treatments on patient fertility. SELECTION OF STUDIES: The studies were selected through the New PubMed, Scielo and Lilacs databases along with references used for the creation of the present work. For the selection of studies, articles published between the periods from January 1, 2015 to April 6, 2020 in the English, Portuguese and Spanish languages were used. As inclusion criteria: cohort studies and studies conducted in vitro. As exclusion criteria: review articles, reported cases, studies that do not address thematic reproduction, studies that do not address the cancer theme, articles that used animals, articles that address the preservation of fertility and articles in duplicate in the bases. DATA COLLECTION: The collected data included: age of the patient at the beginning of treatment, type of neoplasm, type of antineoplastic treatment, chemotherapy used, radiotherapy dosage, radiotherapy site, effect of antineoplastic agents on fertility and number of patients in the study. DATA SYNTHESIS: Thirty studies were evaluated, antineoplastic chemotherapy agents and radiotherapy modulate serum hormone levels, reduces germ cell quantities and correlated with an increase in sterility rates. The effects mentioned occur in patients in the prepubertal and postpubertal age. CONCLUSION: Antineoplastic treatments have cytotoxic effects on the germ cells leading to hormonal modulation, and pubertal status does not interfere with the cytotoxic action of therapies.

OBJETIVO: Analisar os efeitos a longo prazo dos tratamentos antineoplásicos na fertilidade de pacientes. FONTES DE DADOS: Os estudos foram selecionados através das bases de dados New PubMed, Scielo e Lilacs, junto com as referências utilizadas para a confecção do trabalho. SELEçãO DOS ESTUDOS: Para a seleção dos estudos, foram utilizados artigos publicados entre os períodos de 01 de janeiro de 2015 a 06 de abril de 2020 nos idiomas inglês, português e espanhol. Como critérios de inclusão: estudos de coorte e estudos realizados in vitro. Como critérios de exclusão: artigos de revisão, relatos de caso, estudos que não abordavam a temática reprodução, estudos que não abordavam a temática câncer, artigos utilizando animais, artigos que abordavam preservação da fertilidade e artigos em duplicidade nas bases. COLETA DE DADOS: Os dados coletados incluíram: idade do paciente ao início do tratamento, tipo de neoplasia, tipo de tratamento antineoplásico, quimioterápicos utilizados, dosagem da radioterapia, local da radioterapia, efeito dos agentes antineoplásicos na fertilidade e número de pacientes dentro do estudo. SíNTESE DE DADOS: Trinta estudos foram avaliados. Os agentes quimioterápicos antineoplásicos e a radioterapia modulam níveis séricos hormonais de marcadores de fertilidade, reduzem a quantidade de células germinativas e estão correlacionados com um aumento da taxa de esterilidade. Os efeitos citados anteriormente ocorreram em pacientes com idade pré-púbere e pós-púbere. CONCLUSãO: Os tratamentos antineoplásicos possuem efeitos citotóxicos em células germinativas, levando a modulação hormonal, e o status puberal não interfere diretamente na ação citotóxica das terapias.

Cytotoxic activity of antineoplastic agents on fertility: a systematic review / Atividade citotóxica dos tratamentos antineoplásicos na fertilidade: Uma revisão sistemática

Abstract Objective: To analyze the long-term effects of antineoplastic treatments on patient fertility. Selection of Studies: The studies were selected through the New PubMed, Scielo and Lilacs databases along with references used for the creation of the present work. For the selection of studies, articles published between the periods from January 1, 2015 to April 6, 2020 in the English, Portuguese and Spanish languages were used. As inclusion criteria: cohort studies and studies conducted in vitro. As exclusion criteria: review articles, reported cases, studies that do not address thematic reproduction, studies that do not address the cancer theme, articles that used animals, articles that address the preservation of fertility and articles in duplicate in the bases. Data Collection: The collected data included: age of the patient at the beginning of treatment, type of neoplasm, type of antineoplastic treatment, chemotherapy used, radiotherapy dosage, radiotherapy site, effect of antineoplastic agents on fertility and number of patients in the study. Data Synthesis: Thirty studies were evaluated, antineoplastic chemotherapy agents and radiotherapy modulate serum hormone levels, reduces germ cell quantities and correlated with an increase in sterility rates. The effects mentioned occur in patients in the prepubertal and postpubertal age. Conclusion: Antineoplastic treatments have cytotoxic effects on the germ cells leading to hormonal modulation, and pubertal status does not interfere with the cytotoxic action of therapies.

Resumo Objetivo: Analisar os efeitos a longo prazo dos tratamentos antineoplásicos na fertilidade de pacientes. Fontes de dados: Os estudos foram selecionados através das bases de dados New PubMed, Scielo e Lilacs, junto com as referências utilizadas para a confecção do trabalho. Seleção dos estudos: Para a seleção dos estudos, foram utilizados artigos publicados entre os períodos de 01 de janeiro de 2015 a 06 de abril de 2020 nos idiomas inglês, português e espanhol. Como critérios de inclusão: estudos de coorte e estudos realizados in vitro. Como critérios de exclusão: artigos de revisão, relatos de caso, estudos que não abordavam a temática reprodução, estudos que não abordavam a temática câncer, artigos utilizando animais, artigos que abordavam preservação da fertilidade e artigos em duplicidade nas bases. Coleta de dados: Os dados coletados incluíram: idade do paciente ao início do tratamento, tipo de neoplasia, tipo de tratamento antineoplásico, quimioterápicos utilizados, dosagem da radioterapia, local da radioterapia, efeito dos agentes antineoplásicos na fertilidade e número de pacientes dentro do estudo. Síntese de dados: Trinta estudos foram avaliados. Os agentes quimioterápicos antineoplásicos e a radioterapia modulam níveis séricos hormonais de marcadores de fertilidade, reduzem a quantidade de células germinativas e estão correlacionados com um aumento da taxa de esterilidade. Os efeitos citados anteriormente ocorreram em pacientes com idade pré-púbere e pós-púbere. Conclusão: Os tratamentos antineoplásicos possuem efeitos citotóxicos em células germinativas, levando a modulação hormonal, e o status puberal não interfere diretamente na ação citotóxica das terapias.