The vaginal microbiota composition of women undergoing assisted reproduction: a prospective cohort study.

OBJECTIVE: To evaluate the impact of vaginal microbiota on pregnancy outcomes in women undergoing assisted reproduction. DESIGN: A prospective cohort study. SETTING: A university-based assisted reproductive technology (ART) centre. POPULATION: 223 women undergoing ART treatment. METHODS: Prior to embryo transfer, vaginal samples were collected from the posterior fornix. Vaginal microbiota identification was carried out using next-generation sequencing and categorised according to the V3-V4 hypervariable region in the 16S rRNA gene region. MAIN OUTCOME MEASURES: ART clinical outcomes (implantation, clinical pregnancy rates and live birth rates). RESULTS: The live birth rate in women with community state type (CST)-I (39%) was higher than that in women with CST-III (21.5%) but the difference was not statistically significant (P = 0.052). The relative abundance of Lactobacillus was lower in women who failed to become pregnant (NP group) (67.71%) than in women who became pregnant (PR group) (79.72%). However, this difference was not statistically significant (P = 0.06). In the NP group, the relative abundance of Streptococcus (7.81%) and Gardnerella (9.40%) was higher than that in the PR group (relative abundance of Streptococcus and Gardnerella was 2.28% and 5.56%, respectively). The abundance of Streptococcus was found to be statistically significantly different between the two study groups (P = 0.014). Linear discriminant analysis (LDA) further validated that Streptococcus had the highest contribution (LDA score >4.0) to the difference between these two groups. CONCLUSIONS: Streptococcus has the highest contribution to the distinction between the PR and NP groups. TWEETABLE ABSTRACT: A relatively high abundance of Streptococcus in the vaginal microbiota may be associated with a lower ART success rate.

High-resolution 1H-NMR spectroscopy indicates variations in metabolomics profile of follicular fluid from women with advanced maternal age.

AIM: To reveal whether there are differences in follicular fluid metabolomics profile of women with advanced maternal age (AMA). METHOD: The group with advanced maternal age includes 23 patients above the age of 40, and the control group includes 31 patients aged between 25 and 35 years and AMH values above 1.1 ng/mL with no low ovarian response history. A single follicular fluid sample from a MII oocyte obtained during the oocyte pick-up procedure was analyzed with high-resolution 1H-NMR (nuclear magnetic resonance) spectroscopy. The results were evaluated using advanced bioinformatics analysis methods. RESULTS: Statistical analysis of the NMR spectroscopy data from two groups showed that α-glucose and ß-glucose levels of follicular fluid were decreased in the patients with AMA, while in contrast, lactate and trimethylamine N-oxide (TMAO) levels were increased in these patients compared with the controls. In addition to these, there was an increase in alanine levels and a decrease in acetoacetate levels in patients with AMA. However, these changes were not statistically significant. CONCLUSION: Obtained results suggest that the follicular cell metabolism of patients with AMA is different from controls. These environmental changes could be associated with the low success rates of IVF treatment seen in these patients.

Metabolomics analysis of seminal plasma in patients with idiopathic Oligoasthenoteratozoospermia using high-resolution NMR spectroscopy.

BACKGROUND: Male infertility is a global health issue caused by a combination of different factors. Specialists generally rely on semen analysis to diagnose male infertility. However, it is known that diagnostic semen analysis fails to identify about 50% of male infertility disorders. Recently, metabolomics has been proven to be a powerful technique for the diagnosis of different diseases. OBJECTIVE: To determine whether metabolites could be used as potential biomarkers for the diagnosis of male factor infertility through comparing seminal plasma samples from infertile men with oligoasthenoteratozospermia (OAT) and samples from normozoospermic controls. MATERIALS AND METHODS: This study utilized high-resolution 1 H NMR spectroscopy to reveal whether the metabolomic changes of seminal plasma obtained from 31 patients with oligoasthenoteratozospermia (OAT) are different from the ones obtained from 28 normozoospermic controls. RESULTS: Multivariate statistical analysis of NMR data concluded that the metabolomic profile of samples from patients with OAT exhibits statistically significant differences when compared to the controls. The differences were based on the metabolites lactate, citrate, lysine, arginine, valine, glutamine, creatinine, α-ketoglutaric acid, spermine, putrescine, and tyrosine. Except the tyrosine, levels of the above metabolites were significantly decreased in patients with OAT compared to the controls. The levels of citrate, choline, spermine, putrescine, α-ketoglutaric acid, valine, and tyrosine were significantly different (p < 5 × 10-4 ) between two groups. On the other hand, levels of lactate, creatinine, lysine, arginine, and glutamine were also statistically significant (0.001 < p < 0.05). However, considering the p-values, the physiological relevance of these metabolites may be lower when compared to the others. A PLS-DA model built on the NMR data achieved 89.29% sensitivity and 93.55% specificity results in a leave-one-out cross-validation process. DISCUSSION AND CONCLUSION: 1 H NMR spectroscopy-based metabolomic analysis could be used as a diagnostic tool for the diagnosis of oligoasthenoteratozospermia.

Role of endometrial concentrations of heavy metals (cadmium, lead, mercury and arsenic) in the aetiology of unexplained infertility.

OBJECTIVE: To determine the role of endometrial concentrations of heavy metals (cadmium, lead, mercury and arsenic) in the aetiology of unexplained infertility. STUDY DESIGN: Thirty-three women with unexplained infertility and 32 fertile women were recruited. Endometrial biopsies were collected during the putative window of implantation (cycle days 20-24). The concentrations of cadmium, lead, mercury and arsenic were measured in endometrial biopsy specimens using atomic absorption spectrometry. RESULTS: Cadmium was detected in 91% (30/33) of women with unexplained infertility, compared with 34% (11/32) of fertile women. The median endometrial cadmium concentration was 19.58 (interquartile range 1.46-30.23)µg/l in women with unexplained infertility, compared with 0.00 (interquartile range 0.00-0.40)µg/l in fertile women. Lead was detected in 15% (5/33) of women with unexplained infertility and 3% (1/32) of fertile women. Mercury and arsenic were not detected in any endometrial samples from either group. CONCLUSION: A significant difference in endometrial cadmium concentration was found between women with unexplained infertility and fertile women. This suggests that cadmium may be a contributing factor in the aetiology of unexplained infertility.

XPD and XRCC1 gene polymorphism in patients with normal and abnormal cervical cytology by pap smear.

AIM: The purpose of the present study was to identify the role of abnormalities in DNA repair pathways by measuring the XPD and XRCC1 gene polymorphisms. MATERIALS AND METHODS: Thirty-five patients with abnormal cervical cytology (study group) and 10 women with normal cytology (control group) were included in the study. The polymorphisms of XRCC1 Arg194Trp, XRCC1 Arg399Gln and XPD Lys751Gln genes were investigated from the blood samples. RESULTS: There was no statistically significant difference in allele frequencies of XPD gene among the groups (p = 0.097), while XRCC1R399Q gene polymorphism was strikingly more frequent in the study group than that of control cases (p = 0.029). The prevalence of XRCC1R194W gene polymorphism on the other hand, was similar between the groups (p = 0.579). CONCLUSIONS: Patients with abnormal and normal cervical cytology have similar XPD gene polymorphism. However, the frequency of gene polymorphism in XRCC1 Arg 399 Gln codon was significantly higher in abnormal cervical cytology group.

Cardiovascular risk factors in polycystic ovary syndrome.

A total of 31 women with polycystic ovary syndrome (PCOS) and 31 healthy age/body mass index matched controls were compared for serum hormones, basal and oral-glucose stimulated glucose, insulin, homocysteine, high sensitive C-reactive protein (hsCRP) and lipid levels. The women with PCOS had significantly higher serum fasting insulin, homocysteine, total cholesterol and LDL cholesterol level than controls, whereas no differences were detected in serum fasting or OGTT 60th- and 120th-minute glucose concentrations, hsCRP, HDL cholesterol, VLDL cholesterol and triglyceride levels between PCOS and control women. Insulin resistance was found in 54.8% (17/31) of PCOS patients by glucose: insulin (G/I) ratio, whereas only 29.0% (9/31) of control women (p = 0.04). Multivariate linear regression analysis revealed that only waist/hip ratio was independent determinants of G/I ratio. PCOS is associated with some biochemical and clinical risk factors for cardiovascular disease. Therefore, patients with PCOS should undergo comprehensive evaluation for recognised cardiovascular risk factors.

Vaginitis in Turkish women: symptoms, epidemiologic - microbiologic association.

OBJECTIVE: To determine the relationship between clinical-epidemiologic findings and microbiologic results in vaginitis. METHODS: A prospective study of 212 women with vaginal symptoms was undertaken. Each patient underwent an evaluation that included standardized history, interview after pelvic examination and vaginal culture. RESULTS: Only 45% of patients received diagnosis. Only two symptoms were more frequently noted with diagnosis. Itching was more frequent in vulvovaginal candidiasis (VCC) whereas odor was more frequent in Bacterial vaginosis (BV). BV was associated with a history of spontaneous and induced abortion, increased number of pregnancy, vaginal douching practice and intrauterine contraceptive device usage. VVC was found to be associated with no contraceptive usage and previous vaginitis history. CONCLUSION: Presenting symptoms alone or with microbiologic studies has limited value, and that of the women with vaginal symptoms may lack a microbiologic diagnosis. Evidence-based approaches that produce highly accurate diagnostic and effective treatment regimens would be expected in the future.