RESUMO
PURPOSE: Follicle stimulating hormone, sex hormone-binding globulin and cytochrome P450 aromatase play crucial roles in the regulation of mammalian reproduction. The synergistic effect of FSHR 307(T/A)/FSHR 680(N/S), SHBG(TAAAA) ( n ) and CYP19(TTTA) ( n ) genotypes on ovarian response to standard gonadotrophin stimulation of women undergoing medically assisted reproduction (IVF/ICSI) was explored. METHODS: The study population consisted of 300 women under IVF/ICSI treatment and 300 women with at least with at least one successful child birth as controls. The polymorphisms were genotyped while the follicular size, the follicle and oocyte numbers were recorded during oocyte retrieval. RESULTS: The genotype analysis, excluding heterozygotes for each particular polymorphism, revealed eight combined homozygotic FSHR/SHBG/CYP19 genotypes. A gradual reduction in the number of follicles and oocytes from FSHR 307Thr/680Asn allele/long SHBG allele/long CYP19 allele homozygotes to FSHR 307Ala/680Ser allele/short SHBG allele/short CYP19 allele homozygotes was observed (20.36 ± 6.74 vs. 8.05 ± 2.47, p < 0.008 and 13 ± 4.63 vs. 6.1 ± 2.32, p < 0.02, respectively). CONCLUSIONS: FSHR/SHBG/CYP19 combined genotypes are associated with ovarian response to standard gonadotrophin stimulation of women undergoing medically assisted reproduction.
Assuntos
Aromatase/genética , Gonadotropinas/farmacologia , Indução da Ovulação , Polimorfismo Genético , Receptores do FSH/genética , Globulina de Ligação a Hormônio Sexual/genética , Adulto , Aromatase/metabolismo , Feminino , Fertilização in vitro , Genótipo , Gonadotropinas/administração & dosagem , Humanos , Recuperação de Oócitos , Folículo Ovariano , Ovário/metabolismo , Indução da Ovulação/métodos , Receptores do FSH/metabolismo , Globulina de Ligação a Hormônio Sexual/metabolismo , Injeções de Esperma IntracitoplásmicasRESUMO
Tumor necrosis factor α (TNFα) is a multifunctional cytokine that regulates various cellular processes related to spermatogenesis. Two types of cell receptors, TNFR1 and TNFR2, mediate TNFα activity. In the present study, we sought to explore the association of TNFα -857CâT, TNFR1 36AâG, and TNFR2 676TâG polymorphisms with sperm concentration and motility. Two hundred ninety men were examined during infertility investigation; of those, 170 men were normozoospermic and 120 were oligospermic. Polymerase chain reaction analysis revealed significant differences in genotype distribution of the TNFR1 36AâG polymorphism between normozoospermic and oligospermic men. Men with oligozoospermia presented TNFR1 36A/A genotypes less frequently than normozoospermic men (P < .001). The presence of the TNFR1 36G allele was significantly increased in oligospermic men (P < .001). Furthermore, the presence of the TNFR1 36G allele was associated with lower sperm concentration in normozoospermic men (P < .03) and in the total study population (P < .001), and with lower sperm motility in normozoospermic men (P < .007) and in the total study population (P < .001). No significant associations were found between TNFα -857CâT and TNFR2 676TâG polymorphisms and semen quality. The TNFR1 36A allele is associated with increased sperm concentration and motility in our series, supporting the significance of TNFR1 gene in semen quality.
Assuntos
Polimorfismo Genético , Receptores Tipo II do Fator de Necrose Tumoral/genética , Receptores Tipo I de Fatores de Necrose Tumoral/genética , Contagem de Espermatozoides , Motilidade dos Espermatozoides/genética , Fator de Necrose Tumoral alfa/genética , Adulto , Sequência de Bases , Estudos de Casos e Controles , Primers do DNA , Humanos , Infertilidade Masculina/genética , Masculino , Reação em Cadeia da PolimeraseRESUMO
PURPOSE: The association of cytochrome P450 aromatase gene CYP19(TTTA) ( n ) polymorphism with ovarian response to FSH stimulation was explored. METHODS: Three hundred women undergoing medically assisted reproduction and 300 women with at least one spontaneous pregnancy participated in the study. CYP19(TTTA) ( n ) polymorphism was genotyped, while serum hormones were determined. During oocyte retrieval, the follicular size, the follicle and oocyte numbers were recorded. RESULTS: Six CYP19(TTTA) ( n ) alleles with 7 to 12 repeats were revealed. Women homozygous for long CYP19(TTTA) ( n ) alleles presented with lower serum FSH levels at the third day of the menstrual cycle (p < 0.001) and higher large follicle numbers (p < 0.01), compared to women homozygous for short CYP19(TTTA) ( n ) alleles. The CYP19(TTTA) ( 7 ) allele was associated with higher serum FSH levels (p < 0.003), with lower total follicle (p < 0.02) and large follicle numbers (p < 0.03), while CYP19(TTTA) ( 7 ) allele-carriers presented more frequently with small follicles than CYP19(TTTA) ( 7 ) allele-non carriers (p < 0.01). CONCLUSIONS: CYP19 genetic variants were associated with ovarian reserve and response to standard gonadotrophin stimulation of women undergoing in vitro fertilization.
Assuntos
Aromatase/genética , Gonadotropinas/administração & dosagem , Repetições de Microssatélites/genética , Adulto , Aromatase/sangue , Estradiol/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Frequência do Gene , Estudos de Associação Genética , Homozigoto , Humanos , Hormônio Luteinizante/sangue , Oócitos/citologia , Folículo Ovariano/citologia , Ovário/citologia , Ovário/metabolismo , Polimorfismo Genético , Técnicas de Reprodução AssistidaRESUMO
PURPOSE: Sperm flow cytometry (SFC) was used to evaluate the association of sperm chromatin condensation and ploidy with fertilization, embryo development, pregnancy and abortion rates following IVF. METHODS: Conventional semen analysis was performed in one hundred fifty men, as well as SFC analysis, after acridine orange and propidium iodide staining, for the evaluation of sperm maturity and ploidy respectively. Conventional IVF was performed in all couples. RESULTS: Couples with low percentages of mature spermatozoa presented with lower fertilization rates (p < 0.005), lower rates of grade A embryos (p < 0.003) and lower pregnancy rates (p < 0.006), compared to couples with high percentages of mature spermatozoa. Couples with low total aneuploidy rates presented with higher fertilization rates (p < 0.007), higher rates of grade A embryos (p < 0.004) and higher pregnancy rates (p < 0.003), compared to couples with high total aneuploidy rates. CONCLUSIONS: Sperm chromatin condensation and ploidy constitute critical parameters for the evaluation of semen samples before IVF and for the identification of cases in need of ICSI application.
Assuntos
Cromatina/fisiologia , Fertilização in vitro , Ploidias , Taxa de Gravidez , Análise do Sêmen/métodos , Espermatozoides/citologia , Aborto Espontâneo , Feminino , Fertilização/fisiologia , Citometria de Fluxo , Humanos , Masculino , Gravidez , Espermatozoides/ultraestruturaRESUMO
Paraoxonase (PON) is a high-density lipoprotein-associated enzyme that prevents low-density lipoprotein oxidation. PON proteins, localized in the seminiferous tubules and in spermatozoa, have been implicated in the pathogenesis of male infertility. In the present study, we sought to explore the contribution of the PON gene variants to sperm parameters. One hundred twenty oligospermic and 170 normozoospermic men were examined during infertility investigation. DNA was extracted from spermatozoa, and the PON1(L/M) 55, PON1(Q/R) 192, and PON2(S/C) 311 polymorphisms were genotyped by polymerase chain reaction and digestion with restriction enzymes. The analysis revealed that oligospermic men presented PON1 55L/L, PON1 192Q/Q, and PON2 311S/S genotypes less frequently than normozoospermic men (P < .01, P < .01, and P < .001, respectively), whereas the PON1 55M, PON1 192R, and PON2 311C alleles were significantly increased in oligospermic men (P < .004, P < .008, and P < .008, respectively). The presence of PON1 55L allele was associated with higher sperm motility in oligospermic men (P < .001), in normozoospermic men (P < .01), and in the total study population (P < .01), and the PON1 192Q allele was associated with higher sperm motility in oligospermic men (P < .01), in normozoospermic men (P < .04) and in the total study population (P < .03). On the other hand, the PON2 311S was associated with higher sperm concentration in oligospermic men (P < .03), in normozoospermic men (P < .008), and in the total study population (P < .001). In our series, the PON1 55M and PON1 192R alleles were associated with decreased sperm motility whereas the PON2 311C allele was associated with decreased concentration, supporting the significance of PON genes in semen quality.
Assuntos
Arildialquilfosfatase/genética , Oligospermia/genética , Adulto , Humanos , Masculino , Polimorfismo Genético , Contagem de Espermatozoides , Motilidade dos EspermatozoidesRESUMO
The role of estrogen receptor alpha (ER alpha) and estrogen receptor beta (ER beta) gene polymorphisms on semen quality is the aim of our study. One hundred fourteen men were examined in the In Vitro Fertilization Unit of Ioannina Medical School, and it was found that 85 men had normal sperm count and 29 were oligozoospermic. The genotype analysis, on DNA extracted from spermatozoa, revealed that in men with oligozoospermia (sperm concentration <20 x 10(6) spermatozoa/mL), those with ER alpha 397T/C and 397C/C genotypes had higher sperm motility whereas those with 397T/T genotype had lower sperm motility (P = .003). In addition, men with ER alpha 351A/A genotype had lower sperm motility compared with 351A/G and 351 G/G genotypes (P = .013). Furthermore, normal-sperm-count men with ER alpha 397T/T genotype had higher sperm concentration compared with 397T/C and 397C/C genotypes (P = .016), whereas men with ER alpha 351A/A genotype had higher sperm concentration than those with 351A/G and 351G/G genotypes (P = .05). In contrast, no significant associations were found between ER beta (1082G-->A and 1730A-->G) polymorphisms and sperm concentration or motility. In conclusion, ER alpha polymorphisms were found to be associated with sperm motility and concentration. supporting the significance of this gene in spermatogenesis and semen quality.
Assuntos
Receptor alfa de Estrogênio/genética , Receptor beta de Estrogênio/genética , Análise do Sêmen , Genótipo , Humanos , Masculino , Oligospermia/genética , Polimorfismo Genético , Motilidade dos Espermatozoides/genéticaRESUMO
The purpose of this study was to report on a 10-year experience in the treatment of subfertile women with intrauterine adhesions using the resectoscope or the Versapoint system. Forty-six subfertile women with stage I (n = 6), stage II (n = 25) and stage III (n = 15) intrauterine adhesions underwent adhesiolysis with the use of the resectoscope (n = 21) or the Versapoint system (n = 26). Synechiolysis was successful in 43 women (93.5%) after the first attempt. In 13 out of 14 women (92.9%) with oligo/amenorrhoea at presentation, restoration of menses was reported after adhesiolysis (Versapoint: 9/9, resectoscope: 4/5). Overall live delivery rates according to stage of intrauterine adhesions were 33.3, 44.4 and 46.7% for stages I, II and III respectively. Similar cumulative delivery rates were achieved in patients with no additional infertility factors who attempted to conceive naturally after adhesiolysis using the Versapoint (71.7%) or the resectoscope (60%). Ten gestations ended in preterm delivery (50%), while in two of the women who delivered, a hysterectomy was performed due to placenta accreta. In conclusion, hysteroscopic adhesiolysis offers a real chance of parenthood in a substantial proportion of infertile couples either by using the Versapoint system or the resectoscope.
Assuntos
Ginatresia/cirurgia , Histeroscopia , Infertilidade Feminina/cirurgia , Resultado da Gravidez , Adulto , Feminino , Humanos , Histeroscópios , Gravidez , Complicações na Gravidez , Aderências Teciduais/cirurgiaRESUMO
The aim of the present study was to assess the safety and efficacy of hysteroscopic septum resection by Versapoint. Forty-five subfertile patients who underwent hysteroscopic septum resection using the Versapoint system were analysed. A type Va and a type Vb septate uterus were present in 10 (22.2%) and 35 (77.8%) patients respectively. Complete septum excision was feasible in all patients. No complications occurred during septum resection. Repeat hysteroscopy 2 months after septum excision showed normal endometrial cavity in all patients. Hysteroscopic septum resection by Versapoint system is a safe and efficient method.