Follicular microenvironment: Oxidative stress and adiponectin correlated with steroids hormones in women undergoing in vitro fertilization.

Research has been focused on determining the follicular microenviroment produced by the theca and granulosa cells since the molecular characterisation of this body fluid could lead to the understanding of several fertility problems. Oxidative stress may be one of the factors involved in female infertility since it plays a key role in the modulation of oocyte maturation and finally pregnancy. An increase in oxidative stress is correlated with inflammation and intense research was developed to understand the interaction between inflammation and adiponectin, based on the fact that many adipokines are inflammation related proteins linked to reactive oxygen species production. The aim of this study is to investigate the correlation between total adiponectin levels and oxidative stress amount in the serum and follicular fluid (FF) of women who undergone in vitro fertilization. Moreover we verified the expression of adiponectin in granulosa and cumulus cells. To clarify the predictive value of steroid hormones in human assisted reproduction, twelve steroid hormones in FF and serum, were quantified in a single run liquid chromatography/mass spectrometry, by using a multiple reaction monitoring mode and we related the serum and follicular fluids adiponectin levels with the concentration of the investigated steroid hormones.

Outcomes of Ovulation Induction Aimed to Pregnancy in Eight Hypopituitarism Patients.

BACKGROUND: Female sex hormones work in concert. Gonadotropin-releasing hormone and ovulation-inducing agents are required in female patients with infertility owing to hormone dysregulation. Although drug-induced follicular development can be expected in patients with endogenous female hormone deficiency, data are lacking on the protocols and drugs used. METHODS: We retrospectively examined the success rates of ovulation induction, assisted reproductive technology, and pregnancy outcomes in 66 cycles of eight patients with pituitary insufficiency at our hospital. RESULTS: Ovulation occurred in 75.4% (49/66); 82.6% (38/46) of patients <40 years and 57.9% (11/19) of patients ≥40 years of age. Five of the eight patients became pregnant, and three delivered babies. The fertilization rate was 78% with in vitro fertilization, and the recombinant follicle-stimulating hormone usage was 3,717.1 ± 1,528.9 International Unit in hypopituitarism patients. CONCLUSION: Hypopituitarism patients can achieve ovulation, pregnancy, and delivery after optimal gonadotropin administration. Further studies are needed to determine the effects of gonadotropins on other pituitary hormones, such as growth hormones.

Chlamydia trachomatis Infection Could Be a Risk Factor for Infertility in Women: A Prospective Descriptive Study.

OBJECTIVE: To determine whether previous Chlamydia trachomatis (CT) infection among sexually active women is significantly associated with a diagnosis of infertility. METHODS: A prospective descriptive study was conducted in Lleida Health Region (Spain). Women who attended medical consultations for infertility at a public university hospital in 2021 were included in the study. Data were collected during January and February 2022 using the hospital's electronic records and clinical interviews. RESULTS:  The study revealed that having immunoglobulin (Ig)G antibodies for CT was associated with an increased rate of infertility compared to patients with negative titers(p-value < 0.05). Age was also associated with infertility. There was no statistically significant difference among the other characteristics studied, such as previous sexually transmitted infections (STI), previous miscarriages, preliminary cervical lesions, and levels of follicle-stimulating hormone (FSH), estradiol, thyroid-stimulating hormone (TSH), prolactin, and anti-mullerian hormone (p-value > 0.05). CONCLUSION: The study showed a high prevalence of infertility among women who had IgG CT antibodies. Although more studies should be conducted, promoting strategies among young women to control this infection may help reduce infertility.

Premature Ovarian Failure Related to SARS-CoV-2 Infection.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is known to have a wide spectrum of effects on the respiratory, cardiac, neurological, hematopoietic, gastrointestinal, ocular and urological systems, but there is very little information on its effects on the human ovary. Our aims are to describe a unique case that developed amenorrhea during and after SARS-CoV-2 infection and to push researchers to do more researches to understand the effects of SARS-CoV-2 infection on the ovaries. A 27-year-old female patient presented with amenorrhea. She had fever on the second day of the menstrual cycle, and her cycle had been interrupted on the same day. The patient had a sub-febrile temperature, myalgia, fatigue, sweating, loss of appetite, and mild sleep disorder. Based on clinical, laboratory, and reverse transcription polymerase chain reaction (RT-PCR) data of a nasopharyngeal swab sample, she had a positive result for SARS-CoV-2 infection. Till now there are limited publications on the effect of SARS-CoV-2 infection on the ovaries. In particular, the potential adverse effects of SARS-CoV-2 infection on fertility are unclear. Coronavirus disease 2019 (COVID-19) patients need to be followed up for a long time, and clinicians need to pay attention to menstrual disturbances, especially in young female patients. More evidence, through both epidemiologic and clinical studies, as well as long-term follow-up studies, is needed to understand the impact of this infection on the human ovary, especially in reproductive-aged women.

Oxidative Stress and Human Ovarian Response-From Somatic Ovarian Cells to Oocytes Damage: A Clinical Comprehensive Narrative Review.

Basic scientific research on human reproduction and oxidative damage has been extensively performed; however, a more clinical view is still lacking. As a result, exhaustive data on the influence of oxidative stress on human ovarian response and, consequently, on fertility are still lacking. This narrative review aims at summarizing the role of oxidative stress in different conditions associated to female infertility and to list some of the main antioxidant agents. A systematic literature search was performed in May 2022 to retrieve studies regarding the oxidative stress and the human ovarian response from somatic ovarian cells to oocytes damage. Only human studies were included and the authors focused their review, in particular, on clinical implications in order to define a new research perspective on the assessment of any eventual strategy to preserve women's fertility. Thereby, the authors evaluated the contribution of DNA repair pathways in improving women's fertility by reducing the DNA damage associated with aging or diseases, such as endometriosis or polycystic ovary syndrome, and eventually, in prolonging the reproductive lifespan after cancer treatment.

Association of exposure to ambient air pollution with ovarian reserve among women in Shanxi province of north China.

Air pollution has been an important risk factor for female reproductive health. However, epidemiological evidence of ambient air pollution on the predictor for ovarian reserve (antral follicle count, AFC) is deficient. We aim to comprehensively evaluate the association of long-term exposure to ambient air pollution with AFC among women of reproductive age in Shanxi of north China. 600 women with spontaneous menstrual cycle, not using controlled ovarian stimulation, were enrolled in the retrospective study. Two distinct periods of antral follicle development were designed as exposure windows. Generalized linear model was employed to estimate the change of AFC associated with exposure of atmospheric pollutants (SO2, NO2, PM10, PM2.5, CO and O3). Stratification analysis based on age (<30, ≥30 years), university degree (yes, no), years of exposure (2013-2016, 2017-2019) and duration of infertility (<2, 2-5, >5 years) along with two pollutants model were employed to further illustrate the association. We found every 10 µg/m3 increase in SO2 concentration level during the entire development stage of antral follicle was associated with a -0.01 change in AFC (95% confidence interval: -0.016, -0.002) adjusting for the confounders including age, BMI, parity and infertility diagnosis factors. The significant association of increased SO2 level with decreased AFC was particularly observed during the early transition from primary follicle to preantral follicle stage by 10 µg/m3 increase in SO2 exposure level with a -0.01 change (95% CI: -0.015, -0.002) in AFC. The negative association was pronounced among women aged ≥30 years old, and also significant in two pollutants model after adjusting the confounders. No significant associations between other air pollutants and AFC were observed. Our finding suggests that long-term exposure to air pollutant SO2 is associated with lower AFC, raising our concern that atmospheric SO2 exposure may have potential adverse impact on women ovarian reserve.

Investigating the role of stigma on fertility desire among HIV-positive women in Bangkok, Thailand: a qualitative study.

OBJECTIVES: The Thai Ministry of Public Health is committed to reaching the United Nations' goal of zero new HIV infections, zero AIDS-related deaths, and zero discrimination towards people living with HIV by 2030. While significant progress has been made towards the first two targets, stigma against women living with HIV (WLHIV), particularly in the context of their desire to have and raise children, remains an issue. METHODS: We conducted interviews with WLHIV (n=10) who expressed a desire to have a child or delivered an infant within 2 years of the study date, and key informants (KI) involved in their medical care and social support. We asked women about their HIV diagnosis, thoughts about pregnancy, desires to have children, and perceived stigma. KIs were asked about their perceptions of stigma towards WLHIV and policies or recommended actions to reduce discrimination towards this population. RESULTS: While the WLHIV reported that their healthcare providers had generally been supportive of them having children, internalised stigma and the perceived risk of or actual discrimination by community members negatively impacted fertility desire and peripartum experiences among the study participants. KIs confirmed similar sources of discrimination, emphasising more internalised and community-based stigma rather than from healthcare providers. Both groups highlighted the importance of increasing community education and awareness about HIV to reduce stigma. CONCLUSIONS: Complex issues around stigma and discrimination specific to women with HIV should be addressed at the community level in order to reach the goal of zero discrimination against all people living with HIV in Thailand.