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1.
Andrology ; 2025 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-39901824

RESUMO

Spermatogenesis is primarily controlled by follicle-stimulating hormone and luteinizing hormone-driven testosterone. Luteinizing hormone acts on the Leydig cells, stimulating steroid production, predominantly testosterone, and activating critical inter-related spermatogenesis regulatory pathways. Despite evidence that exogenous gonadotropins containing luteinizing hormone activity, particularly human chorionic gonadotropin, can effectively restore spermatogenesis in azoospermic males with hypogonadotropic hypogonadism, the use of these drugs to treat other forms of non-obstructive azoospermia is the subject of an ongoing debate. In this review, we delve into the molecular properties and functions of human chorionic gonadotropin in spermatogenesis regulation and explore available preparations for therapeutic use. We examine the evidence regarding the effectiveness of human chorionic gonadotropin in treating infertility in men with pre-testicular or testicular non-obstructive azoospermia and, additionally, identify the main areas for future research. Our review highlights the critical role of luteinizing hormone activity in spermatogenesis and emphasizes the potential of human chorionic gonadotropin in treating male infertility. The variation in the characteristics of patients with non-obstructive azoospermia underscores the importance of assessing hormonal profiles when contemplating hormonal treatment for these patients. A novel stratification of male infertility patients, the APHRODITE criteria, which considers clinical and laboratory indicators, may assist in identifying individuals who could benefit from human chorionic gonadotropin therapy. While accumulating evidence suggests promising venues for pharmacological treatment in male infertility, including non-obstructive azoospermia, further research is required to completely elucidate the mechanisms underlying the effects of exogenous gonadotropins with luteinizing hormone activity on sperm production and to establish the most effective dosages and treatment durations.

2.
Biol Trace Elem Res ; 2025 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-39786535

RESUMO

Arsenic in drinking water has been associated with an increased risk of health concerns. This metalloid is ingested and distributed throughout the body, accumulating in several organs, including the testis. In this organ, arsenic disturbs steroidogenesis and spermatogenesis and affects male fertility. Although testicular impairment induced by arsenic is well documented, it is still controversial whether such disturbance remains days after the removal of arsenic insult. Therefore, we used a meta-analytical approach to evaluate the magnitude of arsenic effects on testicular parameters and verify whether a withdrawal period can mitigate these alterations. The search terms 'testis" and 'arsenic' were used in PubMed/Medline, Scopus, and Web of Science databases. A total of 1,217 articles were obtained from the literature search, and 73 articles were included in this meta-analysis. Our results showed that arsenic negatively affected hormone synthesis and secretion, testicular weight, tubular and intertubular morphometry, and daily sperm production 24 h after ending exposure. Arsenic inhibited antioxidant enzyme activity, culminating in high oxidative metabolite production and apoptosis occurrence. Most of these effects were not observed in the testis between eight and fifty days after arsenic withdrawal, remaining endocrine dysregulation and oxidative metabolite production. Sodium arsenite was the most toxic compound to the testis at subchronic exposure. These findings shed light on the plasticity and regenerative capacity of testicular interstitium and spermatogonial stem cell niche. However, sexual hormone imbalance remained after arsenic removal. This review evidenced the importance of understanding its toxicity's short- and long-term effects on male reproductive competence.

3.
JBRA Assist Reprod ; 2025 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-39835798

RESUMO

OBJECTIVE: To evaluate the impact of infertility and Medically Assisted Procreation (MAP) on female sexuality. Human sexuality presents a multifaceted complexity, shaped by diverse factors and individual intricacies. Infertility and assisted reproductive treatments entail a prolonged and arduous journey, amplifying pre-existing sexual dysfunctions and serving as a rigorous trial of the affected women's sexuality and the resilience of couples. METHODS: This is a prospective descriptive comparative study with an analytical section, involving 140 female participants: 70 with infertility undergoing assisted reproductive technology (ART) treatment, and 70 who are fertile and had no prior history of conceiving problems. The evaluation of the sexual function of the two groups was conducted using the Female Sexual Function Index (FSFI) score. RESULTS: The infertile group exhibited a higher level of marital adjustment compared to the fertile cohort. A majority of participants within the infertile cohort (51.4%) presented with primary infertility and (48.6%) experiencing secondary infertility. A marginal elevation in the frequency of sexual intercourse among infertile participants was observed. The mean global score of female sexual function was (21.57±3.36) in the infertile group, which was significantly lower compared to (24.46±1.97) in the fertile group. Notably, both scores fell within the criteria for high risk of sexual dysfunction. The difference between the two groups was significant for all dimensions of FSFI. CONCLUSIONS: Infertility and its treatments pose challenges to female sexuality, often leading to sexual dysfunction. Thus, counseling and sexological support are crucial during treatment.

4.
Reprod Biol Endocrinol ; 23(Suppl 1): 6, 2025 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-39800700

RESUMO

The production of spermatozoa, a process known as spermatogenesis, is primarily controlled by follicle-stimulating hormone (FSH) and luteinizing hormone (LH)-driven testosterone. LH acts on the Leydig cells, stimulating steroid production, predominantly testosterone, and activating critical inter-related spermatogenesis regulatory pathways. Despite evidence that exogenous gonadotropins containing LH activity can effectively restore spermatogenesis in males with hypogonadotropic hypogonadism, the use of these drugs to treat other forms of male infertility is the subject of an ongoing debate. In this review, we delve into the molecular properties and functions of LH activity in spermatogenesis regulation and explore available preparations for therapeutic use. We also examine the evidence regarding the effectiveness of LH-containing drugs in treating specific male infertility conditions and identify the main areas for future research. Our review highlights the critical role of LH in spermatogenesis and emphasizes the potential of LH-containing drugs in treating male infertility. However, further research is required to completely elucidate the mechanisms underlying the effects of LH activity on sperm production and to establish the most effective dosages and treatment durations.


Assuntos
Infertilidade Masculina , Hormônio Luteinizante , Espermatogênese , Espermatogênese/efeitos dos fármacos , Espermatogênese/fisiologia , Masculino , Hormônio Luteinizante/metabolismo , Humanos , Infertilidade Masculina/metabolismo , Infertilidade Masculina/tratamento farmacológico , Animais , Testosterona/metabolismo , Hipogonadismo/tratamento farmacológico , Hipogonadismo/metabolismo , Células Intersticiais do Testículo/metabolismo , Células Intersticiais do Testículo/efeitos dos fármacos
5.
JBRA Assist Reprod ; 2025 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-39873421

RESUMO

Endometriosis is a chronic disease that affects around 10% of reproductive age women worldwide and a common cause of infertility. One of its manifestations is ovarian endometriomas, which are present in 17-44% of endometriosis patients. Endometriomas can impair fertility by mechanical stretching and local inflammation, promoting oxidative stress in the surrounding ovarian cortex that could lead to apoptosis and necrosis of early follicles. The removal of endometriomas may improve spontaneous pregnancy rates, as already demonstrated by some studies. To reduce endometriomas recurrence, it is advised to perform cystectomy followed by hormonal suppression. However, this approach is unfeasible in patients desiring pregnancy. At the same time, cystectomy poses a threat to ovarian reserve and, therefore, to controlled ovarian stimulation. Women who have endometriomas surgically removed are at risk to have diminished response to ovarian stimulation if in vitro fertilization is needed in the future.

6.
Reprod Toxicol ; 132: 108844, 2025 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-39875005

RESUMO

This study aimed to investigate, in vitro, the toxicity of WTA on ovarian follicles. Initially, a cytotoxicity assay was conducted using tumor and non-tumor cell lines to determine the IC. Initially, a cytotoxicity assay was conducted using tumor and non-tumor cell lines to determine the IC50 of the WTA and validate its antitumor activity. Mouse ovaries were cultured in vitro (IVC) for 6 days in the presence of 1 % dimethyl sulfoxide (DMSO), doxorubicin at 0.3 µg/mL (DXR), or WTA at 0.6 µM or 6.0 µM. DXR or WTA were added to the IVC medium once (1DXR, 1WTA0.6, 1WTA6.0) or three times (3DXR, 3WTA0.6, 3WTA6.0). After the IVC, the ovarian stroma, follicular morphology and development, cell proliferation, senescence, DNA damage, and apoptosis were assessed. The degeneration rate in 3DXR and WTA6.0 (1x and 3x) was higher (p < 0.05) compared to the DMSO group. 1DXR and 3WTA0.6 reduced (p < 0.05) the percentage of primordial follicles and increased (p < 0.05) the number of developing follicles compared to the control (CTR) and DMSO groups. An increase (p < 0.05) in lipofuscin granules was observed with DXR and WTA at both concentrations and exposure frequencies compared to the CTR. In the presence of 3WTA0.6, staining for cleaved caspase-3 was more pronounced (p < 0.05). Additionally, 3WTA0.6, 1WTA6.0, and 3DXR increased (p < 0.05) DNA fragmentation in the stroma compared to the CTR and DMSO groups. We conclude that, like chemotherapy agents used for cancer treatment, WTA induces severe cytotoxic effects on ovarian follicles and stroma, especially at high concentrations and exposure frequencies.

7.
Gynecol Endocrinol ; 41(1): 2456578, 2025 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-39862138

RESUMO

OBJECTIVES: Polycystic Ovary Syndrome (PCOS) is a complex condition affecting approximately 1 in 10 women of reproductive age. However, limited data are available regarding the specific characteristics and needs of women with PCOS in Latin America. This consensus sought to evaluate the evidence-based practices for the management of PCOS for Latin American populations, consolidate regional insights, identify eventual gaps in implementation and identify key research opportunities. METHODS: Using the Delphi strategy, experts from various Latin American countries selected and reviewed a subset of recommendations from the 2023 International Evidence-Based Guideline (EBG) for the Assessment and Management of PCOS. Virtual and in-person meetings facilitated discussions on the selected recommendations, followed by voting rounds to achieve consensus. RESULTS: A total of 33 recommendations for PCOS diagnosis and treatment were evaluated. In the initial voting round, 25 recommendations achieved strong agreement (80%-100% support), while eight received less than 80% agreement. After further discussions on their relevance and potential to influence behavior change among health professionals and public health policies, the remaining recommendations achieved near-unanimous support in the second round. CONCLUSIONS: This consensus underscored evidence-based practices for PCOS diagnosis and treatment deemed appropriate for the Latin American context. It also highlighted implementation barriers such as cost and accessibility, while identifying opportunities for research to improve PCOS management and address regional challenges. These findings aim to enhance clinical care and inform public health strategies tailored to the needs of Latin American women living with PCOS.


Assuntos
Consenso , Síndrome do Ovário Policístico , Síndrome do Ovário Policístico/terapia , Síndrome do Ovário Policístico/diagnóstico , Humanos , Feminino , América Latina/epidemiologia , Prática Clínica Baseada em Evidências , Técnica Delphi , Endocrinologia/normas , Endocrinologia/organização & administração , Guias de Prática Clínica como Assunto , Ginecologia , Sociedades Médicas , Medicina Baseada em Evidências
8.
Expert Opin Pharmacother ; : 1-11, 2025 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-39862122

RESUMO

INTRODUCTION: Endometriosis is a chronic inflammatory estrogen-dependent disease affecting 10% of women worldwide leading to chronic pelvic pain and infertility which may be treated clinically or surgically. AREAS COVERED: Current literature was reviewed using the keywords 'gonadotropin releasing hormone agonists (GnRHa),' 'endometriosis,' 'infertility' and 'chronic pelvic pain.' Relevant papers prioritizing randomized controlled clinical trials (RCT), systematic reviews, meta-analyses, as well as international guidelines were evaluated. EXPERT OPINION: Available options for relieving endometriosis-associated pain include GnRHa, progestagens, and combined oral contraceptives, all of which block menstruation to control symptoms without curing the disease. GnRHa administration decreases pain and symptom recurrence after surgical treatment, but side effects and costs limit its use. Published studies to test its effectiveness in easing endometriosis-associated pain are heterogeneous, consider different outcomes with no long-term results. Drug choice should be individualized considering the side-effect profile, tolerability, costs, risks, and benefits as one size does not fit all. As we wait for the development of an ideal pharmacological agents, GnRHa with an add-back regimen remains a second-line option to alleviate the painful symptoms in women with endometriosis. Endometriosis management should consider the systemic nature of the disease and the complexity involved in the pathogenesis of symptoms.

9.
Microorganisms ; 13(1)2025 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-39858956

RESUMO

Infertility, both primary and secondary, is strongly influenced by microbiological factors, with the vaginal microbiota playing a key role in reproductive health. OBJECTIVE: The aim of this study was to characterize the vaginal microbiota of 136 Mexican women diagnosed with infertility-primary (n = 58) and secondary (n = 78)-by evaluating the presence of pathogenic bacterial species and their associations with infertility conditions. METHODS: Samples were obtained through cervical swabs, and microorganism identification was performed using qPCR techniques. RESULTS: Analysis revealed a positive correlation between increased age and the likelihood of primary infertility, as well as a negative correlation with secondary infertility. Significant differences in microbial composition were also observed between the two infertility groups. Lactobacillus crispatus and Lactobacillus gasseri were dominant in women with primary infertility, in addition to a high prevalence of Gardnerella vaginalis and Fannyhessea vaginae. Additionally, correlations were found between the presence of human papillomavirus (HPV) and sexually transmitted bacteria, as well as Gardnerella vaginalis. CONCLUSION: Our findings suggest that the composition of the vaginal microbiota may play a decisive role in infertility, highlighting the need for personalized therapeutic strategies based on microbial profiles.

10.
Heliyon ; 10(23): e40685, 2024 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-39660199

RESUMO

Background and aims: Celiac disease (CeD) affects 1-2% of the world's population. The aim of this study was to relate the incidence of CeD-related serological markers to symptoms, pathologies, and environmental exposure to wheat flour, given the number of flour mills present in the region. Materials & methods: Serum samples were collected from 537 inhabitants from a rural city. Levels of anti-transglutaminase (a-tTg), anti-gliadin, anti-DGP antibodies and total IgA levels were measured. Volunteers completed a questionnaire covering environmental factors, demographics, pregnancies, other diseases, symptoms, and CeD diagnosis. Geo-referencing of volunteers' homes and mills in the city was performed, and correlations between the different parameters assessed were analysed. Results: A CeD incidence of 1.76 % was found. However, a-tTg and a-gliadin levels were elevated in the population without CeD diagnosis (9.6 % and 30.1 %). Subjects with CD diagnosis showed diarrhoea and colic pain. Women with CeD had fewer pregnancies. Positive a-tTg and number of CeD-associated symptoms appear to correlate with proximity to flour mills. Conclusion: A high prevalence of CeD-related specific antibody positivity in a rural population was found, possibly due to environmental factors related to flour mills. Further research is needed to better understand CeD's pathogenesis and its health implications.

11.
Arch Med Res ; 55(8): 103139, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-39642787

RESUMO

Infertility, defined as the inability to achieve pregnancy after one year of unprotected, frequent sexual intercourse, is a global burden that affects approximately 15% of couples, or 190-230 million people worldwide, who are trying to start a family. The male contributes significantly, directly accounting for 30-35% and up to 52% of total couple infertility, affecting approximately 7-8% of all men. This work aims to present, in a didactic and objective way, a standardization of the initial steps toward a thorough evaluation of subfertile and infertile men. We have focused on the evaluation of initial management, emphasizing the need for a comprehensive evaluation that includes a detailed history, physical examination, and semen analysis as the golden triple helix of basic evaluation of the infertile male. General and genital physical examinations are highly valuable due to the wealth of information they provide, from potential diagnoses to pregnancy prognoses. Comprehensive and quality-controlled semen analysis provides reliable information as a baseline test to evaluate the patency of the reproductive tract and to evaluate basic sperm parameters and fertility potential. However, it is not a fertility determinant and should preferentially be complemented with sperm functional tests. like biomarkers of oxidative stress, sperm immaturity and DNA fragmentation. Most cases of infertility require evaluation by a specialist in andrology, nonetheless the understanding and rationale of the initial assessment of the infertile male can be undertaken by non-specialists, thus improving the care and counseling of couples facing this troubling issue and avoiding unnecessary use of assisted reproductive technologies (ART) since most cases of male infertility can be treated and reversed by medical or surgical interventions, and the fertility status can be restored. The ultimate goal is to achieve natural pregnancy, the use of ART should not be the initial offered resource.


Assuntos
Infertilidade Masculina , Análise do Sêmen , Humanos , Masculino , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/terapia , Infertilidade Masculina/fisiopatologia , Análise do Sêmen/métodos , Feminino , Gravidez , Exame Físico/métodos
12.
Artigo em Inglês | MEDLINE | ID: mdl-39669302

RESUMO

Assisted reproductive technology (ART) has been evolving since 1978, with the number of techniques performed increasing over the years. Despite continued advances, some couples continue to have difficulties getting pregnant, and it has recently been considered that the microbiome of the female genital tract (FGT) may influence embryo implantation and the establishment of pregnancy. This review aims to evaluate the role of probiotics on reproductive outcomes in infertile women on ART. A search throughout medical databases was performed, and six articles met the criteria. Five studies showed improvements in pregnancy rates, with only one demonstrating statistical significance. One article showed no improvement but reported a statistically significant reduction in the miscarriage rate in the probiotic group. Further research is needed to evaluate the true potential of probiotics, namely to assess whether they effectively modulate the FGT microbiome and if these changes are maintained over time.


Assuntos
Genitália Feminina , Microbiota , Probióticos , Técnicas de Reprodução Assistida , Humanos , Probióticos/uso terapêutico , Feminino , Gravidez , Genitália Feminina/microbiologia , Infertilidade Feminina/terapia , Infertilidade Feminina/microbiologia
13.
Camb Q Healthc Ethics ; : 1-8, 2024 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-39627931

RESUMO

Uterus transplants (UTx) provide women without a uterus the possibility of experiencing gestational motherhood. This paper delineates the complex bioethical landscape surrounding UTx, focusing on the critical aspects of informed consent, risk-benefit analysis, justice considerations, and the distinct challenges encountered by both donors and recipients. While not discussing UTx directly, John Harris' seminal work, The Value of Life: An Introduction to Medical Ethics (1985) in its advocacy for reproductive freedom and informed consent provides an informative starting point for the discussion.As an example, UTx is analyzed within the socio-political context of Mexico. The impact of the Mexican healthcare and legal systems on UTx procedures is discussed and the regulatory measures necessary to ensure that UTx is conducted ethically and equitably are outlined.

14.
J Law Biosci ; 11(2): lsae027, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39691105

RESUMO

Uterus transplantation is a new fertility treatment for some women who lack a functioning uterus. The number of countries where these transplants are performed has steadily increased, and in Mexico, there is a growing interest in this procedure among patients, researchers, and clinicians. In this paper we look at Mexico and its legal system in order to determine what is the legal status of uterus transplants, and whether there is a right to them according to Mexican legislation. To achieve this objective, we have organized this paper into four sections. First, we present a brief synopsis of what uterus transplants entail. Second, we carry out a historical overview of uterus transplants in Mexico. Third, we present the federal laws and regulations that apply to uterus transplants in Mexico. Finally, we defend that under Mexican legislation there is a positive right to uterus transplants. We substantiate the former by focusing on the right to the protection of health and the right to family making.

15.
JBRA Assist Reprod ; 28(4): 618-623, 2024 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-39626003

RESUMO

OBJECTIVE: This study aims to investigate whether alterations in sperm DNA fragmentation rates are more frequent when Krüger strict morphology is ≥4% (normal). METHODS: The retrospective study included 132 participants from March 2020 to November 2021. Participants were divided into two groups based on the inclusion criteria: normal and abnormal Krüger strict morphology, with a mean age of 40 years. Seminal analyses were conducted following the guidelines outlined in the 6th edition of the Manual for Examination and Processing of Human Semen (2021). The sperm chromatin dispersion test was used. RESULTS: The results did not reveal a statistically significant difference between Krüger strict morphology and Sperm DNA Fragmentation Index correlation (p<0.05) between the normal and abnormal morphology groups (p<0.05) and in Seminal Parameters. Sperm concentration is lower when Krüger strict morphology is < 4% (abnormal) (p=0.007). CONCLUSIONS: In conclusion, abnormal Krüger strict morphology does not have a higher predisposition to increased sperm DNA fragmentation.


Assuntos
Fragmentação do DNA , Análise do Sêmen , Espermatozoides , Humanos , Masculino , Adulto , Estudos Retrospectivos , Análise do Sêmen/métodos , Pessoa de Meia-Idade , Infertilidade Masculina/genética , Motilidade dos Espermatozoides , Contagem de Espermatozoides
16.
JBRA Assist Reprod ; 28(4): 624-628, 2024 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-39626004

RESUMO

OBJECTIVE: The primary goal of this article is to analyze whether there is still room for ovarian stimulation in poor responders prescribed the long protocol. METHODS: This retrospective cohort study analyzed the medical charts of patients seen at the Vida Centro de Fertilidade, a private fertility clinic in Rio de Janeiro, Brazil, from January 2018 to June 2023. It included poor responders described based on the Bologna criteria who were first prescribed conventional treatment with an antagonist protocol, without success, and then the long agonist protocol. Statistical analysis was performed on the Statistical Package for the Social Sciences (version 20). Comparisons of continuous variables between groups were performed with the Mann-Whitney U test or Student's t-test, as appropriate. The chi-square test was used to compare categorical variables. Statistical significance was achieved when p<0.05. RESULTS: We found a better response among patients on the agonist than on the antagonist protocol in terms of number of follicles larger than 14 mm on the day of trigger (3.17 versus 2.1; p<0.05), number of eggs on the day of retrieval (3.5 versus 1.37; p<0.05), number of mature eggs (2.67 versus 1.37; p<0.05), and number of embryos after fertilization on the first day of development (1.87 versus 0.8; p<0.05). This protocol's cancellation rate was slightly lower (0.03 versus 0.43; p<0.05). CONCLUSIONS: The long protocol still yields positive results in poor responders who were previously prescribed the antagonist protocol.


Assuntos
Indução da Ovulação , Humanos , Feminino , Estudos Retrospectivos , Indução da Ovulação/métodos , Adulto , Gravidez , Fertilização in vitro/métodos , Brasil , Taxa de Gravidez
17.
JBRA Assist Reprod ; 28(4): 678-682, 2024 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-39626005

RESUMO

OBJECTIVE: To use hashtag and content analysis to determine the prevalence, authorship, and types of fertility-related and oncofertility information shared on Instagram in Brazil. METHODS: Eleven fertility-related hashtags were chosen according to https://www.tagsfinder.com/: #infertility, #ivf, #endometriosis, #tryingotconceive, #maternity, #humanreproduction, #pregnancy, #invitrofertilization, #assistedreproduction, #pregnant, #difficulttogetpregnant. For oncofertility, the hashtags were #cancerandpregnancy, #oocytecryopreservation), #oncofertility, and #fertilitypreservation. Posts receiving over 20 comments in March 2021 were analyzed for topic and content. They were divided into six categories (educational, patient experience, outreach, emotional, social support, and coping mechanisms) before being analyzed by three authors. Authorship was divided into healthcare professionals (HCP) and lay people (LP). Posts not written in Brazilian Portuguese, videos, reposts of another account, and commercial posts were excluded. RESULTS: A total of 220 posts with fertility-related terms were analyzed. HCP accounted for 52% (n=114) and LP for 48% (n=106). Most HCP posts were made by medical doctors (n=78; 68.4%) and fertility clinics (n=27; 23.6%). Authorship analysis (HCP vs. LP) for each hashtag was as follows: #infertility (35% vs. 65%), #ivf (35% vs. 65%), #endometriosis (45% vs. 55%), #tryingtoconceive (65% vs. 35%), #maternity (LP 100%), #humanreproduction (20% vs. 80%), #pregnancy (95% vs. 5%), #invitrofertilization (50% vs. 50%), #assistedreproduction (5% vs. 95%), #pregnant (85% vs. 15%), #difficulttogetpregnant (5% vs. 95%). The category breakdown was as follows: 39% educational, 19% emotional, 16% social support, 13% patient experience, 9% coping, and 4% outreach. A total of 98 posts with #oncofertility were retrieved. Most (77.5%; n=62) were written by HCP. They fell into the following categories: 55% educational, 15% patient experience, 12.5% emotional, 11.2% support, and 3.2% coping. CONCLUSIONS: Both HCP and LP write about major fertility topics on Instagram. Oncofertility appears to gain less attention. In Brazil, educational content, followed by emotional content, prevails on Instagram.


Assuntos
Autoria , Infertilidade , Brasil , Humanos , Infertilidade/terapia , Mídias Sociais/estatística & dados numéricos , Feminino
18.
JBRA Assist Reprod ; 28(4): 805-807, 2024 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-39626007

RESUMO

This article reports a case of Massilia timonae, an understudied Gram-negative rod, in the culture media of an embryo produced by intracytoplasmic sperm injection into the oocyte cytoplasm. Cultivation was monitored with a time-lapse technology. Microbial contamination can cause embryo developmental arrest.


Assuntos
Técnicas de Cultura Embrionária , Oxalobacteraceae , Injeções de Esperma Intracitoplásmicas , Adulto , Feminino , Humanos , Gravidez , Blastocisto , Imagem com Lapso de Tempo , Oxalobacteraceae/crescimento & desenvolvimento
19.
JBRA Assist Reprod ; 2024 Dec 26.
Artigo em Inglês | MEDLINE | ID: mdl-39723884

RESUMO

OBJECTIVE: To study the reliability and effectiveness of the percutaneous sperm retrieval technique. METHODS: We retrospectively analyzed the records of 123 consecutive patients with obstructive azoospermia who underwent percutaneous sperm retrieval and intracytoplasmic sperm injection (ICSI) using Percutaneous Epididymal Sperm Aspiration (PESA) with or without a rescue Testicular Sperm Aspiration (TESA). We compared patients who had the first sperm retrieval ever and patients who had more than one sperm retrieval performed. In addition, the rate of adequate sperm retrieved for ICSI and reproductive outcomes between the groups and literature were compared. The primary outcome was the rate of adequate sperm retrieved for ICSI; the secondary outcomes were reproductive. RESULTS: The successful sperm retrieval was 157 in 157 attempts, with a cumulative sperm retrieval rate of 100%, whether the first or repeated retrieval attempt. The clinical pregnancy rate in patients who had the first sperm retrieval ever and patients who had more than one sperm retrieval performed was 36/108 (33.3%) vs. 15/29 (51.7%) (Pearson chi2(1) = 3.3088; p = 0.085), respectively. Other reproductive outcomes (fertilization rate, cleavage rate, and biochemical pregnancy) were also similar in both groups. CONCLUSIONS: PESA associated with or without rescue TESA is a reliable and effective strategy either for retrieving sperm for ICSI, demystifying the concerns about the reliability of repeated PESA, or for reproductive results. This information is reassuring, especially but not exclusively to places with limited resources.

20.
Anim Reprod ; 21(4): e20240027, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39494127

RESUMO

Anticancer therapy often leads to premature ovarian insufficiency (POI) and infertility due to the extreme sensitivity of the ovarian follicle reserve to the effects of chemotherapy. Withanolides are known for their cytotoxic effect on cancer cells and low cytotoxicity on non-malignant or healthy cells. Therefore, this study aimed to investigate the in vivo effects of three withanolides derivatives: 27-dehydroxy-24,25-epoxywithaferin A (WT1), 27-dehydroxywithaferin A (WT2), and withaferin A (WTA) on fertility, and the ovarian preantral follicles of young female mice. To achieve this, mice received 7 intraperitoneal doses of WT1, WT2, or WTA at a concentration of 2 mg/kg (Experiment I) and 5 or 10 mg/kg (Experiment II) over 15 alternate days. In experiment I, two days after administration of the last dose, half of the mice were mated to evaluate the effects of withanolides on fertility. The other half of the mice, as well as all mice from experiment II, were sacrificed for histological, inflammation, senescence, and immunohistochemical analyses of the follicles present in the ovary. Regardless of the administered withanolide, the concentration of 2 mg/kg did not show toxicity on the follicular morphology, ovarian function, or fertility of the mice. However, at concentrations of 5 and 10 mg/kg, the three derivatives (WT1, WT2, and WTA) increased follicular activation, cell proliferation, and ovarian senescence without affecting inflammatory cells. Furthermore, at a concentration of 10 mg/kg, the three withanolides showed intensified toxic effects, leading to DNA damage as evidenced by the labeling of γH2AX, activated Caspase 3, and TUNEL. We conclude that the cytotoxic effect of the tested withanolide derivatives (WT1, WT2, and WTA) in the concentration of 2 mg/kg did not show toxicity on the ovary. However, in higher concentrations, such as 10 mg/kg, toxic effects are potentiated, causing DNA damage.

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