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1.
Reprod Health ; 18(1): 200, 2021 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-34627302

RESUMO

PURPOSE: To explore the hope levels and influencing factors in infertile women undergoing first-time and repeated in vitro fertilization-embryo transfer (IVF-ET) cycles. METHODS: This study was a cross-sectional and convenient sampling study conducted among patients undergoing IVF-ET from January to June 2019. Patients were divided into first-time and repeated groups by the number of IVF-ET cycles, and then a questionnaire survey was administered. The questionnaire included demographic information, Herth hope index (HHI) scale, Locke-Wallace short marital-adjustment test scale and social support rating scale. Multiple linear regression was used to analyse the influencing factors associated with hope levels. RESULTS: A total of 298 IVF-ET patients were recruited for the study, including 150 (50.3%) in the first-time cycle group and 148 (49.7%) in the repeated cycle group. The HHI score of the repeated cycle group was significantly lower than that of the first-time cycle group (34.4 ± 3.5 vs. 37.5 ± 3.7, P < 0.001). Multiple linear regression analysis indicated that repeated IVF-ET and age were independently negatively correlated with HHI, with standardized coefficient ß values of - 0.895 and - 0.223, respectively (both P < 0.001). High education level (P = 0.002), high monthly income (P = 0.020), high degree of short marital-adjustment test (P < 0.001) and social support rating (P < 0.001) were independently positively correlated with HHI. CONCLUSION: Infertile women undergoing repeated IVF-ET have low hope levels. Maintaining a good marriage adjustment and establishing a good social support and relationship network could effectively improve their hope levels.


Assuntos
Infertilidade Feminina , Estudos Transversais , Transferência Embrionária , Feminino , Fertilização In Vitro , Humanos , Infertilidade Feminina/terapia , Apoio Social
2.
Reprod Health ; 18(1): 193, 2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34593017

RESUMO

BACKGROUND: With the prevalence of infertility increasing every year around the world, it has seriously impacted the individual quality of family and social life. Anxiety is one of the most prevalent anxiety disorders among infertile patients. After the two-child policy, whether it affected the prevalence of anxiety is controversial. This study aimed to determine the prevalence of anxiety and its potential risk factors among Chinese infertile women after the enforcement of 'two-child policy'. METHODS: This cross-sectional study included 693 infertile patients in a reproductive medical center in Chongqing, China, between February 2016 and December 2018. Data was collected by Self-filling questionnaires including basic demographic information and the Generalized Anxiety Disorder-7 (GAD-7). SPSS statistical software (IBM SPSS version 25) was used to analyse the obtained data. Descriptive analysis was used to describe basic information and anxiety scores, the chi-square test and binary logistic regression were used to analyse the relationship between anxiety and other variables. RESULTS: The prevalence of anxiety among total infertile patients was 21.8%, and its 23.5% among first-child infertile patients (FI), and 18.4% among second-child infertile patients (SI) respectively (P > 0.05). Binary logistic regression showed that patients with lower education levels were more likely to have anxiety (P < 0.01). Patients with middle salary incomes were more likely to have anxiety (OR = 1.860, 95% CI: 1.068-3.238). Oral contraception taking history (OR = 1.778, 95% CI: 1.186-2.667), and history of allergy (OR = 2.098, 95% CI: 1.219-3.612) were associated with anxiety. CONCLUSIONS: Under the full liberalization of the "two-child policy", the total prevalence of anxiety among Chinese infertile female is comparatively high. Low education levels, middle incomes, oral contraception taking and allergy history can be the related risk factors of anxiety. We promote that all infertile patients should be evaluated for the prevalence of anxiety, especially those with potential risks, and receive consultant or targeted treatment when needed.


Assuntos
Infertilidade Feminina , Ansiedade/epidemiologia , Transtornos de Ansiedade/epidemiologia , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Infertilidade Feminina/epidemiologia , Políticas , Prevalência
3.
Front Cell Infect Microbiol ; 11: 654202, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34631595

RESUMO

The microorganisms of the reproductive tract have been implicated to affect in vitro fertilization (IVF) outcomes. However, studies on the reproductive tract microbiota of infertile women are limited and the correlation between cervical microbiota and IVF outcome remains elusive. This study aimed to characterize the cervical microbiota of IVF patients undergoing embryo transfer (ET) and assess associations between the cervical microbiota and pregnancy outcomes while exploring the underlying contributing factors. We launched a nested case-control study of 100 patients with two fresh or frozen-thawed cleavage embryos transferred per IVF cycle. Cervical swabs were collected on the day of ET and divided into four groups according to clinical pregnancy outcomes. Variable regions 3 and 4 (V3-V4) of the 16S rRNA gene were amplified and sequenced on the Illumina MiSeq platform. In fresh IVF-ET cycles, the clinical pregnancy group (FP, n = 25) demonstrated higher α diversity (P = 0.0078) than the non-pregnancy group (FN, n = 26). Analysis of similarity (ANOSIM) revealed a significant difference in ß diversity between the two groups (R = 0.242, P = 0.001). In frozen-thawed ET cycles, though not significant, similar higher α diversity was found in the clinical pregnancy group (TP, n = 27) compared to the non-pregnancy group (TN, n = 22) and ANOSIM analysis showed a significant difference between the two groups (R = 0.062, P = 0.045). For patients in fresh IVF-ET groups, Lactobacillus, Akkermansia, Desulfovibrio, Atopobium, and Gardnerella showed differentially abundance between pregnant and non-pregnant women and they accounted for the largest share of all taxa investigated. Among them, Lactobacillus was negatively correlated with the other genera and positively correlated with serum estradiol levels. Logistic regression analysis suggested that the composition of the cervical microbiota on the day of ET was associated with the clinical pregnancy in fresh IVF-ET cycles (P = 0.030). Our results indicate that cervical microbiota composition has an impact on the outcome of assisted reproductive therapy.


Assuntos
Infertilidade Feminina , Microbiota , Estudos de Casos e Controles , Feminino , Fertilização In Vitro , Humanos , Infertilidade Feminina/terapia , Gravidez , Resultado da Gravidez , RNA Ribossômico 16S/genética , Estudos Retrospectivos
4.
Zhonghua Yi Xue Za Zhi ; 101(35): 2798-2803, 2021 Sep 21.
Artigo em Chinês | MEDLINE | ID: mdl-34551497

RESUMO

Objective: To analyze the characteristics of magnetic resonance imaging (MRI) and clinical etiology of ovarian infertility. Methods: The data of infertile women who underwent 3.0T MRI and magnetic resonance hysterosalpingography (MR-HSG) examination in the Affiliated Hospital of Nanjing University of Chinese Medicine from September 2017 to March 2020 were collected. The ovarian factors of infertility, as well as the abnormalities of bilateral fallopian tubes and uterus, were evaluated. Etiologies assessed by MRI were finally confirmed by hysteroscopy, laparoscopy, surgery, or a comprehensive clinical diagnosis. Results: Among 1 351 patients, 1 296 cases were eligible and included for further analysis. Evaluated by MRI and MR-HSG, 494(38.12%) cases had ovarian abnormalities, including 239(48.38%) cases of ovarian endometriosiss, 116(23.48%) cases of polycystic ovary syndrome (PCOS), 37(7.49%) cases of diminished ovarian reserve (DOR), 33(6.68%) cases of ovarian mass, 28(5.67%) cases of ovarian injury, and 41(8.30%) cases who had at least two kinds of ovarian diseases. Unilateral and bilateral ovarian abnormalities accounted for 52.02% (257/494) and 47.98%(237/494), respectively.In total, 453 of 494(91.7%) patients had only one kind of ovarian disease. Among the 494 patients, 103(20.85%) cases had abnormal ovary with normal uterus and fallopian tubes, and the other 391(79.15%) cases had abnormalities not only in ovary, but in fallopian tube and/or uterus. Conclusion: Infertility-related ovarian diseases have certain characteristics of MRI findings. 3.0T MRI is useful for comprehensive analysis of etiology in ovarian infertility. Combined with MR-HSG, it provides one-stop assessments of the pelvic factors in female infertility.


Assuntos
Infertilidade Feminina , Laparoscopia , Tubas Uterinas , Feminino , Humanos , Histerossalpingografia , Infertilidade Feminina/diagnóstico por imagem , Infertilidade Feminina/etiologia , Imageamento por Ressonância Magnética , Ovário/diagnóstico por imagem
5.
Eur J Obstet Gynecol Reprod Biol ; 265: 102-106, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34482233

RESUMO

OBJECTIVE: Autoantibodies are associated with worse outcomes in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI), including increasing miscarriage rate, lowering pregnancy rate, and lowering delivery rate. However, little is known about improving IVF/ICSI outcomes for autoantibody-positive women, especially in frozen-thawed embryo transfer (FET) cycles. This study aimed to investigate whether pituitary suppression before FET improves the clinical pregnancy rate (CPR) and live birth rate (LBR) for IVF/ICSI women positive for serum autoantibodies. STUDY DESIGN: A total of 181 infertile women positive for serum autoantibodies were recruited, including 65 women receiving GnRHa and hormone replacement therapy protocols (G-HRT group) and 116 women using modified natural cycles (MNC)/mild stimulated cycles (MSC) as FET protocols (MNC/MSC group). The outcomes were compared between two groups, including CPR, implantation rate (IR), miscarriage rate (MR), ongoing pregnancy rate (OPR), LBR, and gestational age (GA). The primary outcome of the study was CPR. RESULTS: CPR, OPR, and LBR per embryo transferred in the G-HRT groups were significantly higher than those in the MNC/MSC group. No statistically significant differences were observed in the IR and MR. The CPR, IR, MR, OPR, and LBR was 72.23%, 64.00%, 12.77%, 63.07%, and 63.07% in the G-HRT group, respectively, while that was 56.90%, 53.07%, 10.60%, 50.00%, and 50.00% in the MNC/MSC group, respectively. After adjusting for partial potential confounding factors using multiple logistic regression, the type of endometrial preparation is the factor independently associated with enhanced CPR (OR = 0.48, 95%CI: 0.24-0.96, P = 0.039). CONCLUSIONS: The current study showed that prior long-term GnRHa suppression could benefit patients with high serum autoantibody levels during IVF/ICSI FET cycles.


Assuntos
Infertilidade Feminina , Autoanticorpos , Regulação para Baixo , Transferência Embrionária , Feminino , Humanos , Infertilidade Feminina/terapia , Gravidez , Taxa de Gravidez
6.
BMC Infect Dis ; 21(1): 913, 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34488670

RESUMO

BACKGROUND: While miliary tuberculosis (TB) in pregnancy is rare after in vitro fertilization and embryo transfer (IVF-ET), it poses a serious threat to the health of pregnant women and their fetuses. The present study aimed to describe the clinical features of miliary TB and pregnancy outcomes of patients after IVF-ET. METHODS: Data of infertile patients who received IVF-ET at Peking University Third Hospital between January 2012 and December 2017 were retrospectively analyzed. Patients who developed miliary TB during pregnancy were identified, and clinical characteristics of miliary TB were described. RESULTS: Out of 62,755 infertile women enrolled, 7137 (11.4 %) showed signs of prior pulmonary TB on chest X-ray (CXR). Among the 15,136 women (mean age: 33.2 ± 5.0 years) who successfully achieved clinical pregnancy, seven patients aged 28-35 years had miliary TB during pregnancy, with two patients having a complication of TB meningitis. All these patients presented with fever. Notably, old TB lesions were detected on CXR in six patients before IVF-ET; nevertheless, no anti-TB therapy was administered. Furthermore, salpingography revealed oviduct obstruction in all patients (7/7). Patients received anti-TB therapy following a diagnosis of miliary TB and were clinically cured. However, pregnancy was terminated due to spontaneous (4/7) and induced (3/7) abortion. CONCLUSIONS: TB reactivation, mostly as miliary TB and TB meningitis, is severe in pregnant women after IVF-ET and deleterious to pregnancy outcomes. Signs of prior TB on CXR may be risk factors for TB reactivation during pregnancy.


Assuntos
Infertilidade Feminina , Tuberculose Miliar , Adulto , Transferência Embrionária , Feminino , Fertilização In Vitro , Humanos , Infertilidade Feminina/terapia , Gravidez , Resultado da Gravidez , Estudos Retrospectivos , Tuberculose Miliar/diagnóstico
7.
Eur J Obstet Gynecol Reprod Biol ; 265: 96-101, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34478926

RESUMO

OBJECTIVES: To compare the effects of atosiban (oxytocin antagonist) on uterine peristalsis and pregnancy outcomes in the frozen embryo transfer (FET) cycle. SETTING: Srinagarind Hospital, a university hospital, Khon Kaen, Thailand. DESIGN: A randomized, double-blinded, controlled trial. METHODS: Fifty infertile women were randomized into the atosiban (n = 25) and placebo group (n = 25). Women in the study group received intravenous atosiban 6.75 mg, 30 min before embryo transfer, and continued infusion at 18 mg/h for 1 h. The dose was reduced to 6 mg/h for another 2 h. Saline solution was applied in the placebo group. The uterine peristalsis frequency was measured by transvaginal ultrasound 30 min before and 3 h after the embryo transfer. RESULTS: The respective mean baseline uterine peristalsis frequency (time) in the atosiban and placebo group was 10.3 ± 2.4 and 9.2 ± 3.4. The respective duration of uterine peristalsis in the atosiban and placebo group after receiving the intervention was reduced to 7.9 ± 2.1 and 6.9 ± 2.7. The implantation rate and clinical pregnancy rate were not statistically significant different between atosiban group and placebo group (37.5% versus 31.0%, RR 1.21, 95%CI: 0.60-2.44 and 44% versus 36%, RR 1.22, 95%CI: 0.62-2.42, respectively). Subgroup analysis indicated that the clinical pregnancy rate in those >35 years of age was not significantly different between both groups (31.6% and 18.8 %, RR 1.68, 95%CI: 0.50-5.68). CONCLUSION: Adding atosiban in FET did not reduce uterine peristalsis but may benefit the advanced age group.


Assuntos
Infertilidade Feminina , Peristaltismo , Transferência Embrionária , Feminino , Hospitais Universitários , Humanos , Gravidez , Taxa de Gravidez , Tailândia , Vasotocina/análogos & derivados
8.
Nutrients ; 13(7)2021 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-34371958

RESUMO

Female reproductive aging is an irreversible process associated with a decrease in oocyte quality, which is a limiting factor for fertility. Previous studies have shown that dehydroepiandrosterone (DHEA) has been shown to improve in vitro fertilization (IVF) outcomes in older women. Herein, we showed that the decline in oocyte quality with age is accompanied by a significant decrease in the level of bioenergetic metabolism genes. We compared the clinical characteristics between groups of infertile women who either received DHEA or did not. Treatment with DHEA may enhance oocyte quality by improving energy production and metabolic reprogramming in cumulus cells (CCs) of aging women. Our results showed that compared with the group without DHEA, the group with DHEA produced a large number of day-three (D3) embryos, top-quality D3 embryos, and had improved ongoing pregnancy rate and clinical pregnancy rate. This may be because DHEA enhances the transport of oxidative phosphorylation and increases mitochondrial oxygen consumption in CCs, converting anaerobic to aerobic metabolism commonly used by aging cells to delay oocyte aging. In conclusion, our results suggest that the benefit of DHEA supplementation on IVF outcomes in aging cells is significant and that this effect may be mediated in part through the reprogramming of metabolic pathways and conversion of anaerobic to aerobic respiration.


Assuntos
Desidroepiandrosterona/administração & dosagem , Suplementos Nutricionais , Metabolismo Energético , Infertilidade Feminina/metabolismo , Oócitos/metabolismo , Biogênese de Organelas , Adulto , Envelhecimento , Senescência Celular , Células do Cúmulo/metabolismo , Feminino , Fertilização In Vitro , Humanos , Mitocôndrias/metabolismo , Fosforilação Oxidativa , Consumo de Oxigênio , Gravidez , Resultado da Gravidez
9.
Niger J Clin Pract ; 24(8): 1144-1149, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34397022

RESUMO

Background: Infertility is a common gynecological problem in sub-Saharan Africa, including Nigeria. It tends to affect the sexual life of couples and may affect their quality of life. Objective: The study was aimed to assess the impact of infertility on the sexual life of women with infertility seeking care in Enugu, South-East Nigeria. Methods: A questionnaire-based, multicenter cross-sectional study of women with infertility managed at the Gynecology units of the two government-owned tertiary hospitals in Enugu over a 2 months period. The relevant data were obtained and analyzed using SPSS version 20.0. Results: Three hundred and sixty female respondents participated in the study. Their mean age was 35.23 ± 5.7 years. The majority of them were married (98.3%) and attained a tertiary level of education (69%). The number of respondents that reported adequate sexual intercourse dropped from 33.9% before the diagnosis of infertility to 12.2% after the diagnosis. Almost two-thirds of the respondents (65%) reported that they no longer enjoy sex with their husband/partner, whereas 38.9% of them feel they were no longer attracted to their partners. Conclusion: Infertility seems to have a negative effect on the sexual life of women. Addressing this identified negative effect may improve the outcome of infertility management and also may improve the quality of life of women with infertility in the region.


Assuntos
Infertilidade Feminina , Adulto , Estudos Transversais , Feminino , Humanos , Infertilidade Feminina/epidemiologia , Nigéria , Qualidade de Vida , Comportamento Sexual , Inquéritos e Questionários
10.
Front Public Health ; 9: 686115, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34350151

RESUMO

Background: The COVID-19 pandemic has implied worldwide the imposition of confinement measures and mobility restrictions, to a greater or lesser extent. It has also meant the closure of some public medical services such as reproductive care. This situation may have impacted the health-related behaviour and quality of life of women with fertility problems. Objective: The objective of this study was to analyse the effects of confinement and the suspension of reproductive medical care on the lifestyle (diet, physical exercise, and smoking habits), anxiety and depression, and quality of life of infertile women by comparing their pre- and post-confinement situations. Methods: We carried out a cross-sectional, internet-based study. Information was collected on these women's adherence to the Mediterranean diet (MEDAS questionnaire), physical exercise (IPAQ-SF), anxiety and depression (HADS), and quality of life related to fertility (FertiQol) before, during, and after confinement. The survey was conducted between 1 September and 28 October 2020. Results: A total of 85 women participated. There had been a significant increase in anxiety and depression levels (P < 0.001) and an increase in tobacco consumption among female smokers during confinement vs. pre-confinement (62.5% had increased their consumption). The participants had also increased the mean number of hours they spent sitting (P < 0.001). There had also been an increase in vigorous and moderate exercise levels by 40 and 30%, respectively (P = 0.004). However, no differences were observed in these patients' eating habits as a result of confinement (P = 0.416). When the reproduction service was resumed, the participants showed higher anxiety level scores (P = 0.001) with respect to the pre-confinement situation as well as lower mean FertiQol scale score (P = 0.008). Conclusions: Confinement had increased anxiety and depression levels among these infertile women as well as tobacco use among the participants who were smokers. The prolonged closure of reproductive care units decreased the quality of life of the participants of this study. These results suggest the need to implement online programs to improve healthy habits and quality of life of this population group.


Assuntos
COVID-19 , Dieta Mediterrânea , Infertilidade Feminina , Estudos Transversais , Feminino , Fertilidade , Humanos , Infertilidade Feminina/epidemiologia , Estilo de Vida , Pandemias , Qualidade de Vida , SARS-CoV-2
11.
Ann Palliat Med ; 10(7): 7813-7822, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34353068

RESUMO

BACKGROUND: Several factors affect vitamin D levels, such as sunshine, region, diet, obesity and so on. The primary objective of this study is to determine the prevalence of vitamin D deficiency (VDD) among infertile women in China and the contribution of VDD to the risk of infertility in women. METHODS: This single-center, retrospective case-control study included 2,456 infertile women. We investigated the vitamin D levels in all patients in the different seasons and across different ages. The clinical data of 411 patients who were in the assisted fertilization programs [in vitro fertilization (IVF) and ICSI] were also analyzed, as well as the correlation between vitamin D status and IVF clinical outcome. RESULTS: There were significant differences in 25-hydroxyvitamin D (25(OH)D) concentrations in different seasons (P<0.01). The proportions of severe VDD in spring, winter, summer, and autumn were 18.5%, 18.6%, 7.8%, and 8.8%, respectively. The normal levels of 25(OH)D concentration (50-74.9 nmol/L) in summer, autumn, spring, and winter were 28.5%, 26.4%, 13.5%, and 18.3%, respectively. The 25(OH)D concentrations in 3 months (July, August, and September) had the highest levels, with levels over 40 nmol/L in these months. Compared with winter, the risk of severe VDD was lower in summer and autumn (P<0.01). Serum 25(OH)D concentration significantly correlated with female infertility. CONCLUSIONS: Inference from these results shows that vitamin D may minimize the risk of female infertility and may be related to the seasons and age.


Assuntos
Clínicas de Fertilização , Infertilidade Feminina , Estudos de Casos e Controles , Feminino , Humanos , Estudos Retrospectivos , Vitamina D
12.
FASEB J ; 35(9): e21872, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34449947

RESUMO

Repeated implantation failure (RIF) is a major problem that limits the pregnancy rate associated with assisted reproductive technology. However, the pathogenesis of RIF is still unknown. Recently, the expression levels of circular RNAs (circRNAs) were profiled in the endometrial tissues of patients with RIF. However, the exact role of circRNAs in RIF remains unclear. In our study, we found that circFAM120A levels were significantly down-regulated in the endometrium at the window of implantation in RIF patients compared with non-RIF controls. The suppression of circFAM120A expression inhibited decidualization in human endometrial stromal cells (hESCs). Furthermore, RNA-seq analysis after circFAM120A knockdown revealed ABHD5 as a potential downstream target gene of circFAM120A. As expected, down-regulating ABHD5 in hESCs also inhibited decidualization. Using the starBase and TargetScan databases, we predicted that miR-29 may interact with ABHD5, based on nucleotide sequence matching. Luciferase reporter assay showed that miR-29 bound to the 3' UTR of ABHD5 at the predicted complementary sites. Moreover, miR-29 mimics efficiently reduced ABHD5 expression levels and suppressed the decidualization process, whereas a miR-29 inhibitor partly rescued ABHD5 mRNA expression level and decidualization reduced by the knockdown of circFAM120A. Therefore, circFAM120A modulated decidualization in RIF through the miR-29/ABHD5 axis.


Assuntos
1-Acilglicerol-3-Fosfato O-Aciltransferase/genética , Implantação do Embrião/genética , MicroRNAs/genética , Proteínas de Ligação a RNA/genética , Regiões 3' não Traduzidas/genética , Adulto , Decídua/metabolismo , Regulação para Baixo/genética , Endométrio/metabolismo , Feminino , Humanos , Infertilidade Feminina/genética , Gravidez , Células Estromais/metabolismo
14.
BMC Womens Health ; 21(1): 317, 2021 08 28.
Artigo em Inglês | MEDLINE | ID: mdl-34454485

RESUMO

BACKGROUND: To analyze the characteristics of basal thyroid hormone levels in infertile women consulting for assisted reproductive technology (ART) treatment. METHODS: This was a retrospective study. Serum TSH, FT3 and FT4 levels of women seeking ART consultation were tested routinely. Analyses were performed based on age and sampling time. One-way ANOVA or Kruskal-Wallis rank sum test was used to compare the continuous data among the groups, and the chi-square test or Fisher's exact test was used to compare categorical data where appropriate. RESULTS: A total of 6426 women were initially included in the study. After exclusion criteria were applied, the remaining 4126 women were categorized into different groups. The prevalence of subclinical hypothyroidism significantly decreased with age and sampling time, from 21.09 to 11.91% and from 28.57 to 10.67%, respectively (P < 0.001, respectively). Mean serum TSH, FT3, and FT4 levels decreased significantly with age (P = 0.017, < 0.001, < 0.001, respectively). In the context of sampling time, TSH levels from early in the morning were significantly higher (P < 0.001), while FT4 and FT3 levels were similar in different groups (P = 0.258, 0.300, respectively). CONCLUSIONS: The prevalence of subclinical hypothyroidism significantly decreased with increasing age and sampling time, as did the serum TSH levels. Even though, the establishment of reference interval of TSH level based on age or sampling time was not recommended. Full consideration of age and sampling time should be carefully taken before initiation of treatment.


Assuntos
Infertilidade Feminina , Feminino , Humanos , Infertilidade Feminina/epidemiologia , Estudos Retrospectivos , Tireotropina , Tiroxina , Tri-Iodotironina
15.
BMC Womens Health ; 21(1): 318, 2021 08 28.
Artigo em Inglês | MEDLINE | ID: mdl-34454492

RESUMO

BACKGROUND: The aim of this study is to compare anxiety, depression, body image, self-esteem, sexual function, and quality of life (QoL) between infertile women and control fertile women undergoing tubal ligation (TL) and using condom. METHODS: This cross-sectional study was conducted on 600 women in three groups of infertile and control fertile women with or without TL (200 women in each group), who met the inclusion criteria. They were selected from Royan Institute and a number of health care centers in Tehran (Iran) from May 2017 to February 2019. The subjects were asked to fill out the Short Form Health Survey (SF-12), Female Sexual Function Index (FSFI), Hospital Anxiety and Depression Scale (HADS), Body Image Concern Inventory (BICI), and Rosenberg' Self-Esteem Scale (RSES). One-way ANOVA was used to identify the possible statistical differences between the three groups of participants. RESULTS: The mean scores of all FSFI domains were lower in the control TL women, and the differences between the three groups in all dimensions were statistically significant. In addition, the TL group had more female sexual dysfunction (FSD) comparing to the infertile and condom group (22.43 ± 5.30, 24.79 ± 4.74, and 28.03 ± 3.29, respectively P < 0.001). There was a significant difference between the three groups in SF-12 scores (76.59 ± 13.14, 68.49 ± 14.47, and 78.87 ± 12.62, respectively P < 0.001). Also there was a significant difference between the three groups in anxiety, depression, and total scores of HADS (P < 0.001). Furthermore, infertile women had lower body image (P < 0.05) and the TL group had lower self-esteem comparing to the two other groups (P < 0.05). CONCLUSIONS: The findings revealed the adverse effects of using TL on the anxiety, depression, sexual life, body image, and QoL of women. It is recommended that health-care professionals should increase their awareness and knowledge regarding the side-effects of using TL on women's lives and share this information with the patients.


Assuntos
Infertilidade Feminina , Esterilização Tubária , Estudos Transversais , Feminino , Humanos , Irã (Geográfico) , Qualidade de Vida , Inquéritos e Questionários
16.
Hum Reprod ; 36(9): 2421-2428, 2021 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-34333641

RESUMO

Polycystic ovary syndrome (PCOS) is the most common cause of anovulatory infertility; however, whether women with PCOS and spontaneous or drug-induced ovulatory cycles have the same reproductive potential as non-PCOS controls is a matter of debate. In the present opinion paper, the author takes the opportunity to summarize the collective evidence supporting the hypothesis of reduced fertility potential in women with PCOS, regardless of ovulatory status, and speculate that reduced reproductive potential may be caused by altered oocytes, embryo and endometrial competence, and infertility-related co-morbidities as well as an increased risk of pregnancy complications.


Assuntos
Infertilidade Feminina , Síndrome do Ovário Policístico , Endométrio , Feminino , Fertilidade , Humanos , Infertilidade Feminina/etiologia , Oócitos , Síndrome do Ovário Policístico/complicações , Gravidez
17.
BMC Womens Health ; 21(1): 302, 2021 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-34404415

RESUMO

BACKGROUND: Anovulation is one of the common causes of infertility. Polycystic ovary syndrome (PCOS) is the most common disorder with chronic Anovulation. To the best of our knowledge, insulin resistance relates significantly to PCOS. Therefore administration of insulin-sensitizing drugs such as pioglitazone can be used for ovulation stimulation in PCO patients. METHODS: After obtaining approval from the Ethics Committee of Mashhad University of Medical Sciences, 61 patients with PCOS were enrolled in the study based on inclusion/ exclusion criteria. Patients were divided into two groups. The first group received 30 mg (mg) of pioglitazone daily from the second day of the menstrual period. The second one received a placebo. 150 mg clomiphene citrate was administered from the third to the seventh day of the menstrual cycle. Vaginal sonography was performed in all women, and in cases with the mature follicle, intrauterine insemination was conducted after human chorionic gonadotropin injection. Ovary stimulation and pregnancy rate were compared between groups. RESULTS: There were no differences between groups regard to demographic characteristics and infertility type. Body mass index was higher in the pioglitazone group (28.3 ± 3.8 versus 26.2 ± 3.5, P value = 0.047). The size of the follicle was not significantly different between groups (2.2 ± 1.4 versus 1.3 ± 1.1, P value = 0.742). pregnancy rate [4 (12.9%) versus 4 (13.3%), P value = 1] had no differences between groups. CONCLUSION: Although the number of follicles was higher in the pioglitazone group, our study showed no differences in ovary stimulation and pregnancy rate.


Assuntos
Infertilidade Feminina , Síndrome do Ovário Policístico , Clomifeno/uso terapêutico , Feminino , Fármacos para a Fertilidade Feminina/uso terapêutico , Humanos , Infertilidade Feminina/tratamento farmacológico , Infertilidade Feminina/etiologia , Indução da Ovulação , Pioglitazona/uso terapêutico , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/tratamento farmacológico , Gravidez , Taxa de Gravidez
18.
Obstet Gynecol ; 138(3): 478-481, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34352856

RESUMO

BACKGROUND: Little is known about the long-term reproductive effects of pelvic infection when a levonorgestrel-releasing intrauterine device (LNG-IUD) is in situ. Society guidelines do not recommend removing an LNG-IUD during pelvic infection. CASE: A 37-year-old woman presented with primary infertility, and the only contributing factor was intrauterine adhesions in the shape of an IUD. She was known to previously have an LNG-IUD and was treated for asymptomatic chlamydia infection while the IUD was in place. After lysis of adhesions, she successfully conceived spontaneously. CONCLUSION: Data on long-term reproductive effects of pelvic infection with an LNG-IUD in situ are not available, and there may be consequences affecting the intrauterine milieu requiring further studies and potential counseling.


Assuntos
Infecções por Chlamydia/diagnóstico , Dispositivos Intrauterinos Medicados/efeitos adversos , Levanogestrel , Doenças Uterinas/diagnóstico , Adulto , Infecções por Chlamydia/complicações , Diagnóstico Diferencial , Feminino , Humanos , Infertilidade Feminina/etiologia , Aderências Teciduais/induzido quimicamente , Aderências Teciduais/complicações , Aderências Teciduais/diagnóstico , Aderências Teciduais/diagnóstico por imagem , Doenças Uterinas/induzido quimicamente , Doenças Uterinas/complicações , Doenças Uterinas/diagnóstico por imagem
19.
J Obstet Gynaecol Res ; 47(10): 3583-3589, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34355476

RESUMO

OBJECTIVE: One in seven couples is infertile and ovulatory dysfunction accounts for 25% of the cases. Polycystic ovarian syndrome (PCOS) is the most common endocrinopathy associated with ovulatory dysfunction. Traditionally, clomiphene is considered the first-line drug for infertile PCOS women. Recently, letrozole was found to be an effective alternative ovulogen. The recent Cochrane review concluded that although live birth was higher with letrozole in unselected PCOS population, evidence was insufficient regarding effect of letrozole in treatment-naïve women. MATERIALS AND METHODS: We conducted a cohort study that included treatment-naïve infertile PCOS women at a tertiary level infertility center in South India. Participants in the prospective arm were given letrozole 2.5 mg daily for 5 days and the retrospective arm included women who had undergone ovulation induction with clomiphene (100 mg) for up to five treatment cycles. The primary outcome was ovulation rate. Secondary outcomes were clinical pregnancy, live birth, multiple pregnancy, and miscarriage rate. The trial was registered under the Clinical Trials Registry, India (CTRI/2018/07/014704). RESULTS: A total of 135 women in the letrozole group and 127 women in the clomiphene group underwent treatment. The ovulation rate per woman was similar in both groups (84.4% vs. 77.2%; p = 0.13). Letrozole was associated with significantly higher clinical pregnancy (38.5% vs. 22.0%; p = 0.004) and live birth rate per woman (30.3% vs. 18.9%; p = 0.03). CONCLUSION: The current study found letrozole to be a superior ovulation induction agent as compared to clomiphene in treatment-naïve infertile women with PCOS.


Assuntos
Infertilidade Feminina , Preparações Farmacêuticas , Síndrome do Ovário Policístico , Estudos de Coortes , Feminino , Fármacos para a Fertilidade Feminina/uso terapêutico , Humanos , Infertilidade Feminina/tratamento farmacológico , Infertilidade Feminina/etiologia , Letrozol , Ovulação , Indução da Ovulação , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/tratamento farmacológico , Gravidez , Estudos Prospectivos , Estudos Retrospectivos
20.
Int J Mol Sci ; 22(16)2021 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-34445441

RESUMO

Nearly 40-50% of infertility problems are estimated to be of female origin. Previous studies dedicated to the analysis of metabolites in follicular fluid (FF) produced contrasting results, although some valuable indexes capable to discriminate control groups (CTRL) from infertile females (IF) and correlate with outcome measures of assisted reproduction techniques were in some instances found. In this study, we analyzed in blind FF of 35 control subjects (CTRL = patients in which inability to obtain pregnancy was exclusively due to a male factor) and 145 IF (affected by: endometriosis, n = 19; polycystic ovary syndrome, n = 14; age-related reduced ovarian reserve, n = 58; reduced ovarian reserve, n = 29; unexplained infertility, n = 14; genetic infertility, n = 11) to determine concentrations of 55 water- and fat-soluble low molecular weight compounds (antioxidants, oxidative/nitrosative stress-related compounds, purines, pyrimidines, energy-related metabolites, and amino acids). Results evidenced that 27/55 of them had significantly different values in IF with respect to those measured in CTRL. The metabolic pattern of these potential biomarkers of infertility was cumulated (in both CTRL and IF) into a Biomarker Score index (incorporating the metabolic anomalies of FF), that fully discriminated CTRL (mean Biomarker Score value = 4.00 ± 2.30) from IF (mean Biomarker Score value = 14.88 ± 3.09, p < 0.001). The Biomarker Score values were significantly higher than those of CTRL in each of the six subgroups of IF. Posterior probability curves and ROC curve indicated that values of the Biomarker Score clustered CTRL and IF into two distinct groups, based on the individual FF metabolic profile. Furthermore, Biomarker Score values correlated with outcome measures of ovarian stimulation, in vitro fertilization, number and quality of blastocysts, clinical pregnancy, and healthy offspring. These results strongly suggest that the biochemical quality of FF deeply influences not only the effectiveness of IVF procedures but also the following embryonic development up to healthy newborns. The targeted metabolomic analysis of FF (using empowered Redox Energy Test) and the subsequent calculation of the Biomarker Score evidenced a set of 27 low molecular weight infertility biomarkers potentially useful in the laboratory managing of female infertility and to predict the success of assisted reproduction techniques.


Assuntos
Biomarcadores/análise , Fertilização In Vitro , Líquido Folicular/metabolismo , Infertilidade Feminina/metabolismo , Metaboloma , Estresse Oxidativo , Adulto , Aminoácidos/análise , Antioxidantes/análise , Feminino , Humanos , Infertilidade Feminina/terapia , Itália , Pessoa de Meia-Idade , Estresse Nitrosativo , Indução da Ovulação , Purinas/análise , Pirimidinas/análise , Resultado do Tratamento
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