Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 73
Filtrar
1.
PLoS One ; 15(8): e0237808, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32866209

RESUMO

In this study, we performed an analysis of the impact of performance enhancing polymorphisms (PEPs) on gymnastic aptitude while considering epistatic effects. Seven PEPs (rs1815739, rs8192678, rs4253778, rs6265, rs5443, rs1076560, rs362584) were considered in a case (gymnasts)-control (sedentary individuals) setting. The study sample comprised of two athletes' sets: 27 elite (aged 24.8 ± 2.1 years) and 46 sub-elite (aged 19.7 ± 2.4 years) sportsmen as well as a control group of 245 sedentary individuals (aged 22.5 ± 2.1 years). The DNA was derived from saliva and PEP alleles were determined by PCR, RT-PCR. Following Multifactor Dimensionality Reduction, logistic regression models were built. The synergistic effect for rs1815739 x rs362584 reached 5.43%. The rs1815739 x rs362584 epistatic regression model exhibited a good fit to the data (Chi-squared = 33.758, p ≈ 0) achieving a significant improvement in sportsmen identification over naïve guessing. The area under the receiver operating characteristic curve was 0.715 (Z-score = 38.917, p ≈ 0). In contrast, the additive ACTN3 -SNAP-25 logistic regression model has been verified as non-significant. We demonstrate that a gene involved in the differentiation of muscle architecture-ACTN3 and a gene, which plays an important role in the nervous system-SNAP-25 interact. From the perspective originally established by the Berlin Academy of Science in 1751, the matter of communication between the brain and muscles via nerves adopts molecular manifestations. Further in-vitro investigations are required to explain the molecular details of the rs1815739 -rs362584 interaction.


Assuntos
Actinina/genética , Aptidão , Epistasia Genética , Ginástica/fisiologia , Proteína 25 Associada a Sinaptossoma/genética , Adulto , Alelos , Área Sob a Curva , Bases de Dados Genéticas , Entropia , Feminino , Marcadores Genéticos , Humanos , Modelos Logísticos , Masculino , Modelos Genéticos , Redução Dimensional com Múltiplos Fatores , Polimorfismo de Nucleotídeo Único/genética , Adulto Jovem
2.
Reprod Biol Endocrinol ; 18(1): 40, 2020 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-32393337

RESUMO

The role of prostaglandin E2 (PGE2) in the successful resumption of oocyte meiosis and cumulus expansion has been well-documented. However, there remains very little information available on the influence of PGE2 on other processes that occur during oocyte maturation. In this study, we supplemented a maturation medium with PGE2 and monitored oocyte quality markers, glucose metabolism, mitochondrial status, oxidative stress, and apoptosis in the cumulus-oocyte complexes (COCs), using a well-established in vitro model of embryo production in cattle. We found that this increased availability of PGE2 during maturation led to an increase in the expression of genes associated with oocyte competence and improved the quality of blastocysts produced. Prostaglandin E2 also appeared to stimulate glucose uptake and lactate production in the COCs, both influencing the expression of enzymes involved in glycolysis and the hexosamine biosynthetic pathway. We found that PGE2 reduced intracellular reactive oxygen species levels, and simultaneously increased glutathione concentration and stimulated antioxidant gene expression in the oocyte. These results indicate that PGE2 has an important role in the protection of oocytes against oxidative stress. Mitochondrial membrane potential was also improved in PGE2-treated oocytes, and there was a reduction in the occurrence of apoptosis in the COCs. Promotion of an anti-apoptotic balance in transcription of genes involved in apoptosis was present in both oocytes and the cumulus cells. In summary, PGE2 could represent a novel autocrine/paracrine player in the mechanisms that can facilitate successful oocyte maturation and oocyte survival in the cow.

3.
Ginekol Pol ; 91(1): 45-48, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32039468

RESUMO

Low biomass microbiome has an increasing importance in today's fertility studies. There are more and more indications for incorporating upper gynecological tract microbiome content in patients diagnostic and in vitro fertilization process, as doing so may help to evaluate chances for a positive outcome. An abnormal endometrial microbiota has been associated with implantation failure, pregnancy loss, and other gynecological and obstetrical conditions. Furthermore it has been shown, that using molecular methods in addition to routine diagnostics may help diagnose chronic endometritis or even indicate cancerogenic changes. Understanding the significance of microbiome in endometrium may completely change therapeutic approach in treatment of this part of reproductive tract. Next generation sequencing (NGS) has allowed to isolate culturable and unculturable bacteria from female reproductive tract and is a cheaper and quicker alternative for other widely known and used methods.


Assuntos
Endometrite/complicações , Endometrite/microbiologia , Endométrio/microbiologia , Infertilidade Feminina/etiologia , Infertilidade Feminina/microbiologia , Microbiota , Adulto , Feminino , Humanos
4.
Syst Biol Reprod Med ; 66(2): 112-121, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32057251

RESUMO

The main aim of this prospective study was to investigate the effect of the concentration of fat-soluble vitamins A, D, E and K in individual follicles on oocyte quality and developmental competence. The analysis was performed on 313 follicular fluid (FF) samples from 50 patients undergoing ovarian stimulation with intracytoplasmic sperm injection. We demonstrated that the mean concentration of individual vitamins in FF correlated with their level in serum (p < 0.0001). The levels of vitamin D in FF were higher than in serum, while the opposite was observed for other analyzed vitamins. We did not observe a correlation between FF vitamin D concentration with fertilization success. However, we observed its association with embryo development status on day 3. Moreover, we showed a statistically significant negative correlation between the mean day 5 embryo score and the concentration of vitamin D in serum (rS = -0.68 p = 0.01) and follicular fluid (rS = -0.71 p = 0.01). Our study showed that FF concentration of vitamin A and E was helpful in the prediction of fertilization success of each individual oocyte. Moreover, vitamin A and E concentrations in FF were associated with status of embryo development on the third day of culture. Vitamin A was also associated with the embryo quality on day 2 and the embryo development status on day 5 after fertilization. In conclusion, a combination of FF vitamin analysis and routine morphological assessment could allow for a more accurate and sensitive method of determining embryonic developmental competence and enable the selection of a better embryo to transfer and perhaps translating into an increased chance of pregnancy.Abbreviations: in vitro fertilization: IVF; anti-Mullerian hormone: AMH; follicular fluid: FF; intracytoplasmic sperm injection: ICSI; top quality: TQ; vitamin D binding globulin level: VDBP; assisted reproductive technology: ART.

5.
Science ; 365(6460): 1466-1469, 2019 09 27.
Artigo em Inglês | MEDLINE | ID: mdl-31604276

RESUMO

Chromosome errors, or aneuploidy, affect an exceptionally high number of human conceptions, causing pregnancy loss and congenital disorders. Here, we have followed chromosome segregation in human oocytes from females aged 9 to 43 years and report that aneuploidy follows a U-curve. Specific segregation error types show different age dependencies, providing a quantitative explanation for the U-curve. Whole-chromosome nondisjunction events are preferentially associated with increased aneuploidy in young girls, whereas centromeric and more extensive cohesion loss limit fertility as women age. Our findings suggest that chromosomal errors originating in oocytes determine the curve of natural fertility in humans.


Assuntos
Envelhecimento , Aneuploidia , Segregação de Cromossomos , Fertilidade , Oócitos/citologia , Adolescente , Adulto , Criança , Feminino , Humanos , Meiose , Não Disjunção Genética , Adulto Jovem
6.
Syst Biol Reprod Med ; 65(4): 281-287, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30994373

RESUMO

The aim of the study was to determine if serum testosterone (T) and dehydroepiandrosterone (DHEAS) levels are a factor in determining increased risk for embryonic aneuploidy in karyotypically normal women undergoing in vitro fertilization (IVF) and preimplantation genetic testing screening for aneuploidy (PGT-A). This is a retrospective cohort study of IVF cycles with PGT-A performed during 2015-2016. A total of 256 cycles with 725 embryos were initially considered for inclusion. A total of 208 cycles and 595 embryos determined to be either euploid or aneuploid were included in the analysis. The mean age of women was 37.4 ± 4.4 years. There were 193 (32.44%) euploid, and 338 (56.81%) aneuploid blastocysts. Sixty-four (10.76%) had 'no diagnosis' after PGT-A. The 32 embryos with 'no diagnosis' after first PGT-A were biopsied again and after the second analysis, 7 were found to be euploid and 3 aneuploid. The remaining 32 embryos were not reanalyzed due to the lack of patients' consent for the second biopsy. The relationship between embryo ploidy and levels of serum testosterone and dehydroepiandrosterone sulfate was assessed using ordinal multivariable regression analysis. The model, adjusted for both anti-Mullerian hormone (AMH) and age, showed no association between ploidy status and serum levels of the two hormones. We concluded that the serum levels of testosterone and DHEAS do not influence embryo ploidy in karyotypically normal women undergoing IVF. Abbreviations: T: testosterone; DHEAS: dehydroepiandrosterone; IVF: in vitro fertilization; PGT-A: preimplantation genetic testing screening for aneuploidy; AMH: anti-Mullerian hormone; FSH: follicle-stimulating hormone; LH: luteinizing hormone; E2: oestradiol; P: progesterone.


Assuntos
Androgênios/fisiologia , Blastocisto/ultraestrutura , Ploidias , Adulto , Androgênios/sangue , Desidroepiandrosterona/sangue , Feminino , Fertilização In Vitro , Humanos , Cariótipo , Masculino , Gravidez , Fatores de Risco , Testosterona/sangue
7.
Gynecol Endocrinol ; 35(6): 473-477, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30632825

RESUMO

This is a preliminary report of the first cases of successful simultaneous use of ulipristal acetate (UPA) and vitamin D3 in uterine fibroid (UF) oral treatment in humans. We present two cases of 37- and 49-year-old females with clinically symptomatic UFs and vitamin D deficiency. Both patients were treated with a standard 3 months of UPA scheme (5 mg daily) with the additional use of vitamin D3 (7000 IU daily orally). In the 37-year-old female all the symptoms (pain, pressure, frequent urination) decreased, total tumor volume after the treatment changed by 47.8%. In the 49-year-old female most symptoms perished, total tumor volume was reduced by 63.3%. UPA and vitamin D share synergistic anti-fibroid properties. Further studies are necessary to show the exact effect of UPA and vitamin D as co-drugs.


Assuntos
Antineoplásicos Hormonais/uso terapêutico , Colecalciferol/uso terapêutico , Leiomiomatose/tratamento farmacológico , Norpregnadienos/uso terapêutico , Neoplasias Uterinas/tratamento farmacológico , Adulto , Sinergismo Farmacológico , Quimioterapia Combinada , Feminino , Humanos , Pessoa de Meia-Idade , Resultado do Tratamento
8.
Nurse Educ Pract ; 35: 42-47, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30665059

RESUMO

Evidence based midwifery education and practice are fundamental to assure high quality care of childbearing women, also with complications. In Poland, midwifery education includes aspects of participation in the abortion. A cross-sectional study was designed to describe the attitudes towards abortion at the beginning and at the end of students' university education. The study was aimed to verify change of attitudes throughout the course of the university education. Most of the students approved abortion if the pregnancy constitutes a threat to woman's health or life, results from a rape, or whenever the fetus presents with a lethal defect. More than a half did not approve participation in the abortion if the fetus presents with a non-lethal defect. Generally, the acceptance rates were significantly higher among the final year students, but more than a half of them stated, that the abortion-related topics were inadequately addressed in their study curriculum. That bring to the conclusion that higher rates of abortion acceptance among the final year students, were not necessarily a manifestation of informed approval for this procedure, but rather a form of a "systemic" adjustment. Midwifery program need to be revised to support students in developing informed and evidence-based attitudes toward abortion.


Assuntos
Aborto Induzido/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Tocologia/educação , Estudantes de Enfermagem/psicologia , Aborto Induzido/educação , Estudos Transversais , Bacharelado em Enfermagem , Humanos , Polônia , Inquéritos e Questionários , Adulto Jovem
9.
J Proteomics ; 191: 131-142, 2019 01 16.
Artigo em Inglês | MEDLINE | ID: mdl-29530678

RESUMO

Analysis of proteomic composition of human follicular fluid (hFF) has been previously proposed as a potential tool of oocyte quality evaluation. In order to develop an efficient method to investigate the hFF proteome and peptidome components, we applied and tested a few prefractionation schemes of hFF material consisting of ultrafiltration, optional immunodepletion, and high pH RP-HPLC separation by building spectral libraries and comparing their quantification capabilities of unfractionated samples. Low Molecular-Weight Fraction peptides (LMWF, <10 kDa) and High Molecular-Weight Fraction proteins (HMWF, >10 kDa) resulting from ultrafiltration were analyzed separately. We identified 302 proteins in HMWF and 161 proteins in LMWF in all qualitative experiments. All LMWF peptidomic libraries turned out to be of poor quantification quality, however they enabled measurement of higher numbers of peptides with increasing input of experiment data, in contrast to HMWF proteomic libraries. We were able to quantify a total of 108 HMWF proteins and 250 LMWF peptides (from 84 proteins) in all experiments. Employment of high RP-HPLC fractionation allowed for identification of a much broader set of proteins, however did not significantly improve the quantification capabilities of the applied method. Data are available via ProteomeXchange with identifier PXD008073. SIGNIFICANCE: In the search of biomarkers for assessment of oocyte quality in assisted reproductive technology, many studies are devoted to analysis of follicular fluid composition. Candidates for such biomarkers can be located in both the proteome and the recently investigated peptidome of hFF. Reliable qualitative and especially quantitative analysis of complex mixtures such as hFF, requires development of a fast and preferably inexpensive analytical procedure. The powerful SWATH-MS technique is well suited for quantitative label-free analysis of complex protein and peptide mixtures. However, for efficient usage it needs well designed and constructed MS-spectral libraries as well as a proper protocol for sample preparation. We investigated the influence of the size and quality of MS-spectral libraries (different spectral libraries are constructed using various sample prefractionation protocols) on SWATH experiments on hFF proteome and peptidome. In the case of peptidome investigation, increasing the size of spectral libraries led to quantification of more peptides in a single experiment. For the proteome, increasing the size of spectral libraries improved quantification only to a limited extend, and further extension of spectral libraries even worsened results. Nevertheless, using the best selected prefractionation schemes and spectral libraries we were able to quantify as many as 79 proteins of hFF proteome and 106 peptides (from 53 proteins) of hFF peptidome in single experiments. The spectral libraries and prefractionation protocols we developed allow for a large scale fast scan of hundreds of clinical hFF samples in the search for biomarkers for evaluation of oocyte quality.


Assuntos
Líquido Folicular/química , Espectrometria de Massas/métodos , Proteoma/metabolismo , Proteômica/métodos , Fracionamento Químico , Cromatografia de Fase Reversa/métodos , Feminino , Humanos , Peso Molecular , Oócitos , Peptídeos/análise
10.
Int J Mol Sci ; 19(12)2018 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-30518097

RESUMO

Uterine fibroids (UFs) are the most common benign tumors of the female genital tract. The incidence of UFs has been estimated at 25⁻80% depending on selected population. The pathophysiology of UFs remains poorly understood. The transformation of smooth muscle cells of the uterus into abnormal, immortal cells, capable of clonal division, is the main component of all pathways leading to UF tumor formation and tumor necrosis factor α (TNF-α) is believed to be one of the key factors in this field. TNF-α is a cell signaling protein involved in systemic inflammation and is one of the cytokines responsible for the acute phase reaction. This publication presents current data about the role of tumor necrosis factor α in the biology of UFs and the related symptoms. TNF-α is an extremely important cytokine associated with the biology of UFs, UF-related symptoms and complaints. Its concentration has been proven to be elevated in women with clinically symptomatic UFs. The presented data suggest the presence of an "inflammation-like" state in women with UFs where TNF-α is a potent inflammation inducer. The origin of numerous symptoms reported by women with UFs can be traced back to the TNF-α influence. Nevertheless, our knowledge on this subject remains limited and TNF-α dependent pathways in UF pathophysiology should be investigated further.


Assuntos
Leiomioma/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Neoplasias Uterinas/metabolismo , Matriz Extracelular/metabolismo , Feminino , Humanos , Inflamação/patologia , Leiomioma/patologia , Neoplasias Uterinas/patologia
11.
Int J Mol Sci ; 19(7)2018 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-30011902

RESUMO

This article provides a detailed review of current knowledge on the role of vitamin D and its receptor in the biology and management of uterine fibroids (UFs). Authors present ideas for future steps in this area. A literature search was conducted in PubMed using the following key words: "uterine fibroid" and "vitamin D". The results of the available studies, published in English from January 2002 up to April 2018, have been discussed. Vitamin D is a group of steroid compounds with a powerful impact on many parts of the human body. This vitamin is believed to regulate cell proliferation and differentiation, inhibit angiogenesis, and stimulate apoptosis. Nowadays, hypovitaminosis D is believed to be a major risk factor in the development of UFs. In many studies vitamin D appears to be a powerful factor against UFs, resulting in inhibition of tumor cell division and a significant reduction in its size, however, the exact role of this compound and its receptor in the pathophysiology of UFs is not fully understood. According to available studies, vitamin D and its analogs seem to be promising, effective, and low-cost compounds in the management of UFs and their clinical symptoms, and the anti-tumor activities of vitamin D play an important role in UF biology. The synergy between vitamin D and selected anti-UF drugs is a very interesting issue which requires further research. Further studies about the biological effect of vitamin D on UF biology are essential. Vitamin D preparations (alone or as a co-drugs) could become new tools in the fight with UFs, with the additional beneficial pleiotropic effect.


Assuntos
Leiomioma/tratamento farmacológico , Neoplasias Uterinas/tratamento farmacológico , Deficiência de Vitamina D/tratamento farmacológico , Vitamina D/uso terapêutico , Apoptose/efeitos dos fármacos , Diferenciação Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Feminino , Humanos , Leiomioma/patologia , Neoplasias Uterinas/patologia , Vitamina D/administração & dosagem , Vitamina D/farmacologia , Vitaminas/administração & dosagem , Vitaminas/farmacologia , Vitaminas/uso terapêutico
12.
Reprod Fertil Dev ; 30(12): 1720-1727, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29929575

RESUMO

The present study analysed live birth ratios in frozen embryo transfer (FET) cycles where embryo ploidy status was determined with preimplantation genetic testing (PGT) using next-generation sequencing (NGS). PGT was performed on trophectoderm cells biopsied at the blastocyst stage. The present prospective cohort study included 112 women undergoing frozen embryo transfer, with NGS PGT. The control group consisted of 85 patients who underwent the IVF procedure with FET planned for a subsequent cycle. The live birth rate per cycle was higher by ~18.5 percentage points in the investigated compared with control group (42.0% vs 23.5% respectively; P=0.012). The differences between the study and control groups were also significant for clinical pregnancy (42.0% vs 23.5% respectively; P=0.012), implantation (41.2% vs 22.2% respectively; P=0.001) and pregnancy loss rates (9.6% vs 28.6% respectively; P=0.027). The results show that PGT NGS is a useful method for embryo selection and it may be implemented in routine clinical practice with propitious results.


Assuntos
Transferência Embrionária/métodos , Testes Genéticos , Sequenciamento de Nucleotídeos em Larga Escala , Nascimento Vivo , Diagnóstico Pré-Implantação , Adulto , Implantação do Embrião , Feminino , Humanos , Gravidez , Resultado da Gravidez , Taxa de Gravidez
13.
Int J Immunopathol Pharmacol ; 32: 2058738418779461, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29809057

RESUMO

Uterine fibroids (UFs) are one of the most common pathologies of the female genital tract. The incidence of UFs has been estimated at 25-80%. Tumor necrosis factor (TNF)-α is a cell-signaling protein involved in systemic inflammation and is one of the cytokines responsible for the acute phase reaction. The aim of the study was to evaluate the impact of clinically symptomatic UFs on TNF-α serum levels. A total of 149 Caucasian women were included: 85 patients admitted for surgery due to clinically symptomatic UFs (n = 85; study group) and 64 age-matched UF-free controls (n = 64). TNF-α serum concentrations between the groups were compared. Receiver operating characteristic (ROC) curves were also used as a statistical model to evaluate TNF-α as a marker for UFs. Mean TNF-α serum concentration in the study group was 0.34 ± 0.14 pg/mL; (in half of the subjects, the level did not exceed 0.39 pg/mL. Mean TNF-α serum concentration in the control group was 0.17 ± 0.09 pg/mL; in half of the subjects, the level did not exceed 0.14 pg/mL. The difference was statistically significant. Using the area under the ROC curve, we found that TNF-α serum concentration of 0.34 pg/mL can be used as a predictor for UFs in selected populations. In our study, we confirmed higher TNF-α serum concentrations in women with clinically symptomatic UFs.


Assuntos
Biomarcadores Tumorais/sangue , Leiomioma/sangue , Fator de Necrose Tumoral alfa/sangue , Neoplasias Uterinas/sangue , Adulto , Área Sob a Curva , Estudos de Casos e Controles , Feminino , Humanos , Leiomioma/complicações , Leiomioma/diagnóstico , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Curva ROC , Reprodutibilidade dos Testes , Regulação para Cima , Neoplasias Uterinas/complicações , Neoplasias Uterinas/diagnóstico , Adulto Jovem
14.
Anim Reprod Sci ; 192: 242-250, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29573844

RESUMO

Cumulus-oocyte complexes (COCs) release factors potentially involved in follicular growth and development, such as growth and differentiation factor 9 (GDF9), bone-morphogenetic protein 15 (BMP15), follistatin (FST) and cathepsins (CTSs). Moreover, the quality of the oocytes and follicles may be related to both the lipid composition of the follicle cells and follicular fluid. One of the lipids, locally regulating the reproductive functions in ovaries of cattle, is lysophosphatidic acid (LPA). In this study, the expression was investigated of the genes for LPA and other factors in COCs of follicles at different stages of development and regression. The relative abundances of mRNA were determined by real-time PCR for receptors for LPA (LPARs), enzymes synthesizing LPA (autotaxin (AX) and phospholipase A2 (PLA2)), BMP15, GDF9, CTSZ, CTSB and FST in COCs isolated from healthy, transitional and atretic follicles. The expression of genes for the LPARs, AX, PLA2 and the factors involved in follicular development in cattle COCs is follicle-type dependent. Greater expression of LPAR1-3 and AX genes were detected in the healthy follicles compared to the atretic and transitional follicles (P < 0.05). The relative abundance of GDF9, BMP15, CTSZ and CTSB was also greater in COCs from healthy follicles than from transitional and atretic follicles (P < 0.05). It is postulated that the greater expression of LPARs and AX genes in healthy follicles compared with atretic follicles indicates an enhanced role of LPA in follicular development. Results of the present study also suggest the regulatory role of factors derived from the COCs in the growth and development of follicles.


Assuntos
Bovinos , Células do Cúmulo/metabolismo , Regulação da Expressão Gênica/fisiologia , Lisofosfolipídeos/biossíntese , Oócitos/metabolismo , Folículo Ovariano/fisiologia , Animais , Feminino , Fosfolipases A2/genética , Fosfolipases A2/metabolismo , Diester Fosfórico Hidrolases/genética , Diester Fosfórico Hidrolases/metabolismo , RNA Mensageiro/genética , RNA Mensageiro/metabolismo
15.
Ann Agric Environ Med ; 25(1): 120-123, 2018 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-29575864

RESUMO

OBJECTIVE: The primary aim of this preliminary study was to compare the IVF results of couples living in rural and urban areas. Additionally, the ovarian reserve parameters, such as AMH concentrations, were compared for the same groups. MATERIAL AND METHODS: The database of 1,265 women undergoing in vitro fertilization at the Invicta Fertility Center between May 2011-July 2012 were retrospectively analyzed. Women undergoing their first assisted reproductive technology cycle with ICSI, stimulated according to the long protocol, and whose AMH levels were measured using the same DSL kit, were selected. Ultimately, 651 women were included in the study. All participants were categorized based on the area where they live: rural areas, small towns (<100,000 inhabitants) and large cities (>100,000). RESULTS: The mean age of the patients living in large cities was significantly higher in comparison to those from rural areas and small towns. A significantly higher pregnancy body mass index (BMI) was found in women from rural areas in comparison to the women living in small and large towns. Serum AMH and inhibin B concentrations, number of ampules of gonadotropins, and antral follicle count (AFC), did not differ significantly among the groups. The study showed no significant differences among the groups in terms of clinical pregnancy rate, both per started cycle and per embryo transfer. CONCLUSIONS: No significant differences were found in IVF outcomes among the groups inhabiting rural areas, small and large cities.


Assuntos
Hormônio Antimülleriano/sangue , Infertilidade Feminina/sangue , Infertilidade Feminina/terapia , Adulto , Demografia , Feminino , Fertilização In Vitro , Humanos , Infertilidade Feminina/fisiopatologia , Masculino , Gravidez , Resultado da Gravidez , Taxa de Gravidez , Estudos Retrospectivos , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos
16.
Maturitas ; 109: 112-117, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29292013

RESUMO

Numerous social and environmental factors (environmental hazards, social factors such as education and career, higher economic status desired before the decision is made to have children) influence a women's decision to postpone pregnancy until late reproductive age. In turn, age is related to a fall in ovarian reserve. The main goal of testing ovarian reserve is the identification of women with so-called diminished ovarian reserve (DOR). Additionally, it provides assistance in the counselling of women who are planning to use assisted reproductive techniques (ART). This review examines current methods of testing ovarian reserve and their application. The most useful methods of assessing ovarian reserve are ultrasonographic count of ovarian antral follicles (AFC) and serum tests of both the anti-Müllerian hormone (AMH) level and the third-day level of follicle stimulating hormone (FSH). However, there are limitations to the currently used methods of testing ovarian reserve, especially in relation to their specificity and sensitivity. It is also difficult to predict egg quality based on these tests. The value of screening programmes of ovarian reserve is yet to be determined.


Assuntos
Reserva Ovariana , Pré-Menopausa/fisiologia , Hormônio Antimülleriano/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Folículo Ovariano/diagnóstico por imagem , Pré-Menopausa/sangue , Ultrassonografia
17.
Gynecol Endocrinol ; 34(2): 115-119, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28792788

RESUMO

PURPOSE: The aim of the study was to determine whether the assays exhibit an interaction with age and exhibit heterogeneous age related declines in AMH. Apart of chronological age, AMH variation was investigated with relation to menstrual cycle day (MCD). The goal implicates two questions: Are distributions of AMH concentrations homogenous after adjustment for the specific AMH assay? Does age-assay product has an effect on AMH depletion? METHODS: The study was conducted by examining results of AMH tests performed for 12,917 women with four types of AMH assays: Immunotech I generation kit (IMI, 4016 samples), Beckman Coulter II generation kit RUO (BCII RUO, 3430 samples), Beckman Coulter II generation kit with IVD certificate (BCII IVD, 830 samples), and Ansh Labs I generation kit (AnshLabs, 4641 samples). Statistical analysis included ACNOVA and least square regression technique. RESULTS: Menstrual cycle day has no effect on AMH measurements. On the other hand, AMH values differed substantially between the four assays, with a marked discordance in the rate of age-related AMH decline for the four assays (ranging from -8.16% (95% CI: -8.79, -7.54) to -11.53% (95% CI -12.20, -10.87), with a significant interaction between age and assay. CONCLUSIONS: (1) The distribution of AMH concentration is heterogeneous after controlling the age across assays; (2) the rate of AMH decline as a function of age is different for the four manual AMH ELISA assays.


Assuntos
Envelhecimento , Hormônio Antimülleriano/sangue , Regulação para Baixo , Ensaio de Imunoadsorção Enzimática , Ciclo Menstrual/sangue , Reserva Ovariana , Kit de Reagentes para Diagnóstico , Adulto , Instituições de Assistência Ambulatorial , Análise de Variância , Biomarcadores/sangue , Estudos de Coortes , Feminino , Humanos , Infertilidade Feminina/sangue , Infertilidade Feminina/fisiopatologia , Análise dos Mínimos Quadrados , Pessoa de Meia-Idade , Polônia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Índice de Gravidade de Doença , Adulto Jovem
18.
Int J Mol Sci ; 18(12)2017 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-29194370

RESUMO

Uterine fibroids (UFs) are the most common tumors of the female genital tract. The effect of UFs on the quality of life and the overall cost of treatment are significant issues worldwide. Tumor size and location are the two specific factors which influence the occurrence of symptoms, the need for, and method of, treatment (some tumors require surgery while some can be treated with selected drugs). Primary prevention and treatment of early UF disease are worthy goals that might have a great impact on health care systems. Several treatments and prophylactic methods can be used in this endeavor. This publication presents current data about lesser-known substances which may have a beneficial effect on the treatment or prophylaxis of UFs and can be administered orally, serving as an alternative to (or complement of) surgery or selective progesterone receptor modulators (SPRMs). Early prevention and treatment of UFs in women from high-risk groups should be our priority. Innovative forms of UF management are under intensive investigation and may be promising options in the near future. Many of them evaluated vitamin D, paricalcitol, epigallocatechin gallate (EGCG), elagolix, aromatase inhibitors (AIs), and cabergoline and deemed them to be safe and effective. The next step in such projects should be properly constructed randomized control trials (RCTs), carried out by successive phases.


Assuntos
Antineoplásicos/administração & dosagem , Leiomioma/tratamento farmacológico , Neoplasias Uterinas/tratamento farmacológico , Administração Oral , Antineoplásicos/uso terapêutico , Inibidores da Aromatase/administração & dosagem , Inibidores da Aromatase/uso terapêutico , Cabergolina , Catequina/administração & dosagem , Catequina/análogos & derivados , Catequina/uso terapêutico , Ergocalciferóis/administração & dosagem , Ergocalciferóis/uso terapêutico , Ergolinas/administração & dosagem , Ergolinas/uso terapêutico , Feminino , Humanos , Hidrocarbonetos Fluorados/administração & dosagem , Hidrocarbonetos Fluorados/uso terapêutico , Pirimidinas/administração & dosagem , Pirimidinas/uso terapêutico , Qualidade de Vida , Vitamina D/administração & dosagem , Vitamina D/uso terapêutico
19.
Int J Mol Sci ; 18(11)2017 Nov 17.
Artigo em Inglês | MEDLINE | ID: mdl-29149020

RESUMO

Uterine fibroids (UFs) are benign tumors of the female genital tract made of the smooth muscle of the uterus. UF growth depends mostly on the influence of the steroid hormones and selected growth factors. Transforming growth factor ß (TGF-ßs) is a polypeptide that consists of three isoforms: TGF-ß1, TGF-ß2, and TGF-ß3. At present, TGF-ß is considered to be one of the key factors in the pathophysiology of UFs. It plays a major role in cellular migration within the tumor, stimulates tumor growth, and enhances tumor metabolism. As a consequence of various dependencies, the synthesis and release of TGF-ß in a UF tumor is increased, which results in excessive extracellular matrix production and storage. High concentrations or overexpression of TGF-ß mediators may be responsible for clinically symptomatic UFs. The aim of this review was to check the available evidence for the influence of the TGF-ß family on UF biology. We conducted their search in PubMed of the National Library of Medicine with the use of the following selected keywords: "uterine fibroid", "leiomyoma", and "transforming growth factor ß". After reviewing the titles and abstracts, more than 115 full articles were evaluated. We focused on the TGF-ß-related molecular aspects and their influence on the most common symptoms that are associated with UFs. Also, we described how the available data might implicate the current medical management of UFs.


Assuntos
Leiomioma/metabolismo , Fator de Crescimento Transformador beta/metabolismo , Neoplasias Uterinas/metabolismo , Inibidores da Aromatase/uso terapêutico , Estrogênios/metabolismo , Feminino , Hormônio Liberador de Gonadotropina/análogos & derivados , Hormônio Liberador de Gonadotropina/uso terapêutico , Humanos , Leiomioma/terapia , Progesterona/metabolismo , Isoformas de Proteínas/metabolismo , Neoplasias Uterinas/terapia
20.
Hum Reprod ; 32(8): 1710-1715, 2017 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-28854583

RESUMO

STUDY QUESTION: Can anti-Müllerian hormone (AMH) automated immunoassays (Elecsys® and Access) be used interchangeably as a companion diagnostic for individualisation of follitropin delta dosing? SUMMARY ANSWER: The Access assay gives systematically higher AMH values than the Elecsys® assay which results in over 29% of women being misclassified to a different follitropin delta dose. WHAT IS KNOWN ALREADY: Follitropin delta is the first gonadotrophin to be licenced with a companion diagnostic, the Roche Elecsys® AMH Plus assay. Alternative automated AMH assays including the Beckman Coulter Access immunoassay are considered to provide similar results, but clarification of their suitability as an off-licence companion diagnostic for follitropin delta is required. STUDY DESIGN, SIZE, DURATION: We systematically searched the existing literature for studies that had measured AMH using both automated assays in the same cohort of women. Individual paired patient data were acquired from each author and combined with unpublished data. PARTICIPANTS/MATERIALS, SETTING, METHODS: We identified five eligible prospective published studies and one additional unpublished study. A 100% response from the authors was achieved. We collected paired AMH data on samples from 848 women. Passing-Bablok regression and Bland-Altman plots were used to compare the analytical performance of the two assays. The degree of misclassification to different treatment categories was estimated should the Access AMH be used as a companion diagnostic instead of the Elecsys AMH in determining the dosing of follitropin delta. MAIN RESULTS AND THE ROLE OF CHANCE: The Passing-Bablok regression shows a linear relationship (Access = -0.05 + 1.10 × Elecsys). The Access assay systematically gave higher values by an average of 10% compared with the Elecsys assay (slope = 1.10, 95% CI: 1.09 to 1.12). The average of the difference between the two assays was 2.7 pmol/l. The 95% limits of agreement were -11.7 to 6.3. Overall 253 (29.3%) women would have received an inappropriate follitropin delta dose if the Beckman Coulter Access assay was used. Specifically, a substantial proportion of women (ranging from 49% to 90% depending on the AMH category) would receive a lower dose of follitropin delta based on the Access AMH assay. Up to 10% (ranging from 2.5% to 10%) of women with high ovarian reserve would have been misclassified to a greater dose of follitropin delta based on the Access AMH assay. LIMITATIONS REASONS FOR CAUTION: We compared the values of the two principal automated assays, extrapolation of our findings to other automated AMH assays would require similar comprehensive examination. WIDER IMPLICATIONS OF THE FINDINGS: An international standard for the calibration of the automated AMH assays is warranted to facilitate efficient use of AMH as a companion diagnostic. The variable calibration of alternative automated AMH assays may adversely impact on the performance of the follitropin delta dosing algorithm. STUDY FUNDING/COMPETING INTEREST(S): No formal funding has been received for this study. SI is funded by a UK Medical Research Council skills development fellowship (MR/N015177/1). SMN has received speakers fees, travel to meetings and participated in advisory Boards for Beckman Coulter, IBSA, Ferring Pharmaecuticals, Finox, Merck Serono, Merck and Roche Diagnostics. SMN has received research support from Ansh laboratories, Beckman Coulter, Ferring Pharmaceuticals and Roche Diagnostics. TRIAL REGISTRATION NUMBER: N/A.


Assuntos
Hormônio Antimülleriano/sangue , Hormônio Foliculoestimulante Humano/administração & dosagem , Imunoensaio/métodos , Infertilidade Feminina/terapia , Adulto , Relação Dose-Resposta a Droga , Feminino , Hormônio Foliculoestimulante Humano/uso terapêutico , Humanos , Infertilidade Feminina/sangue , Estudos Prospectivos , Proteínas Recombinantes/administração & dosagem , Proteínas Recombinantes/uso terapêutico
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA