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1.
Ann Hematol ; 100(11): 2831-2841, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34536088

RESUMO

Since the survival rates of pediatric patients undergoing cancer treatment or hematopoietic stem cell transplantation (HSCT) have increased rapidly in recent decades, the late effects of treatment are now an important focus of patient care. Access to fertility preservation (FP) procedures as well as their financing differs considerably across Europe. However, some countries in Europe have recently changed the legal basis for financing FP procedures; therefore, the implementation of structures is mandatory to give patients access to FP. In this prospective cohort study, we characterized the process for establishing pediatric fertility counseling, including the development of an in-house standard procedure for recommendations regarding FP with potentially gonadotoxic treatment and valuating data from all FP counseling sessions. All data concerning patient characteristics (pubertal status, disease group) and recommendation of FP measures were prospectively collected and adoption of FP measures analyzed. Prior to the establishment of a structured process for FP in our pediatric oncology and stem cell transplantation center, there was no standardized FP counseling. We demonstrate that with the establishment of an inhouse standard procedure, it is possible to give consistent yet individualized FP counseling to approximately 90% of our patients facing gonadotoxic treatment, counseling over 200 patients between 2017 and 2019. This pilot study could potentially be adapted in other pediatric hematology, oncology, and stem cell transplantation centers to allow a more standardized handling of FP counseling for all patients facing gonadotoxic treatment.


Assuntos
Aconselhamento/métodos , Preservação da Fertilidade/métodos , Adolescente , Antineoplásicos/efeitos adversos , Criança , Pré-Escolar , Criopreservação , Feminino , Preservação da Fertilidade/economia , Preservação da Fertilidade/normas , Transplante de Células-Tronco Hematopoéticas , Humanos , Lactente , Infertilidade Feminina/induzido quimicamente , Infertilidade Feminina/etiologia , Infertilidade Feminina/prevenção & controle , Infertilidade Masculina/induzido quimicamente , Infertilidade Masculina/etiologia , Infertilidade Masculina/prevenção & controle , Masculino , Neoplasias/terapia , Recuperação de Oócitos , Ovário/transplante , Estudos Prospectivos , Puberdade , Lesões por Radiação/prevenção & controle , Radioterapia/efeitos adversos , Preservação do Sêmen , Condicionamento Pré-Transplante/efeitos adversos , Adulto Jovem
2.
Food Chem Toxicol ; 153: 112247, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33951485

RESUMO

Ochratoxin A (OTA) is a mycotoxin produced by Aspergillus and Penicillium molds. Grain-based foods account for most human dietary exposures to OTA. OTA is a teratogen, but its reproductive and developmental effects are poorly understood. A one-generation reproductive toxicity study was conducted with groups of 16 male and 16 female Fischer rats exposed to 0, 0.026, 0.064, 0.16, 0.4 or 1.0 mg OTA/kg in diet. Dams exposed to 1.0 mg OTA/kg diet had statistically significant F1 pup losses between implantation and postnatal day (PND 4). Delays in preputial separation (PPS) and vaginal opening (VO) were indicative of delayed puberty in F1 rats. Mild renal lesions in nursing pups indicated that exposure prior to weaning impacted the kidneys. The developing kidney was more susceptible to OTA than the adult kidney. Significant increases in multi-oocyte follicles (MOFs) and proportional changes in resting and growing follicles were observed in F1 female ovaries. Plasma testosterone was reduced in F0 males, and there were negative effects on sperm quality in F0 and F1 male rats. The results confirm that continuous dietary exposure to OTA causes post-implantation fetotoxicity in dams, and renal and reproductive toxicity in their male and female offspring.


Assuntos
Blastocisto/efeitos dos fármacos , Infertilidade Feminina/induzido quimicamente , Infertilidade Masculina/induzido quimicamente , Nefropatias/induzido quimicamente , Ocratoxinas/toxicidade , Motilidade Espermática/efeitos dos fármacos , Animais , Animais Lactentes , Bloqueadores dos Canais de Cálcio/toxicidade , Relação Dose-Resposta a Droga , Feminino , Masculino , Ocratoxinas/administração & dosagem , Folículo Ovariano/efeitos dos fármacos , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Ratos , Ratos Endogâmicos F344
3.
Eur J Endocrinol ; 184(5): R177-R192, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33630753

RESUMO

Fertility and ovarian protection against chemotherapy-associated ovarian damage has formed a new field called oncofertility, which is driven by the pursuit of fertility protection as well as good life quality for numerous female cancer survivors. However, the choice of fertility and ovarian protection method is a difficult problem during chemotherapy and there is no uniform guideline at present. To alleviate ovarian toxicity caused by anticancer drugs, effective methods combined with an individualized treatment plan that integrates an optimal strategy for preserving and restoring reproductive function should be offered from well-established to experimental stages before, during, and after chemotherapy. Although embryo, oocyte, and ovarian tissue cryopreservation are the major methods that have been proven effective and feasible for fertility protection, they are also subject to many limitations. Therefore, this paper mainly discusses the future potential methods and corresponding mechanisms for fertility protection in chemotherapy-associated ovarian damage.


Assuntos
Antineoplásicos/efeitos adversos , Preservação da Fertilidade/métodos , Infertilidade Feminina/induzido quimicamente , Infertilidade Feminina/prevenção & controle , Antineoplásicos/uso terapêutico , Feminino , Preservação da Fertilidade/tendências , Humanos , Neoplasias/tratamento farmacológico , Reserva Ovariana/efeitos dos fármacos , Ovário/efeitos dos fármacos , Ovário/fisiologia , Insuficiência Ovariana Primária/induzido quimicamente , Insuficiência Ovariana Primária/prevenção & controle , Insuficiência Ovariana Primária/terapia
4.
Reprod Biomed Online ; 42(3): 505-519, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33388265

RESUMO

RESEARCH QUESTION: Can melatonin provide non-invasive ovarian protection against damage caused by cis-diamminedichloroplatinum (cisplatin) and preserve fertility in female cancer patients? And if so, what is the possible mechanism? DESIGN: Athymic BALB/c nude tumour-bearing female mice were used to demonstrate whether melatonin affects the antineoplastic effect when co-administrated with cisplatin. Sexually mature and newborn C57BL/6 female mice were used to evaluate the potential effects of melatonin on the ovarian follicle pool, pregnancy rate and litter number in cisplatin-treated mice. The ovaries underwent immunohistochemical, TdT (terminal deoxynucleotidyl transferase)-mediated dUTP nick-end labelling (TUNEL) and gene array analysis to explore the underlying mechanism. In addition, granulosa cells were isolated to investigate the potential protective mechanism of melatonin. RESULTS: Melatonin not only enhanced the anti-cancer effect of cisplatin in tumour-bearing nude mice, but also reduced ovarian toxicity and preserved long-term fertility in cisplatin-treated C57BL/6 female mice. When co-administrated, melatonin was able to reduce the DNA damage and toxic effects on lipid peroxidation in the ovaries caused by cisplatin. Specifically, melatonin was able to largely restore lipid peroxidation in granulosa cells and thus prevent ovarian follicles from being depleted. CONCLUSIONS: Melatonin has the potential to be used as a chemotherapeutic adjuvant to simultaneously improve the outcome of anti-cancer treatment and preserve ovarian function during cisplatin chemotherapy. Notably, its properties of DNA protection and antioxidant effects on follicles may benefit female cancer survivors and prevent premature ovarian failure as well as fertility loss caused by chemotherapy.


Assuntos
Antineoplásicos/efeitos adversos , Antioxidantes/uso terapêutico , Cisplatino/efeitos adversos , Infertilidade Feminina/prevenção & controle , Melatonina/uso terapêutico , Ovário/efeitos dos fármacos , Animais , Animais Recém-Nascidos , Avaliação Pré-Clínica de Medicamentos , Feminino , Infertilidade Feminina/induzido quimicamente , Camundongos Nus
5.
Toxicol Appl Pharmacol ; 413: 115409, 2021 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-33476676

RESUMO

There is increasing evidence that bisphenols BPS and BPF, which are analogues of BPA, have deleterious effects on reproduction even at extremely low doses. Indirect exposure via the maternal route (i.e. across the placenta and/or by breastfeeding) is underestimated, although it can be assumed to be a cause of idiopathic female infertility. Therefore, we hypothesised the deleterious effects of exposure to BPA analogues during breastfeeding on the ovarian and oocyte quality of offspring. A 15-day exposure period of pups was designed, whilst nursing dams (N ≥ 6 per experimental group) were treated via drinking water with a low (0.2 ng/g body weight/day) or moderate (20 ng/g body weight/day) dose of bisphenol, mimicking real exposure in humans. Thereafter, female pups were bred to 60 days and oocytes were collected. Immature oocytes were used in the in-vitro maturation assay; alternatively, in-vivo-matured oocytes were isolated and used for parthenogenetic activation. Both in-vitro- and in-vivo-matured oocytes were subjected to immunostaining of spindle microtubules (α-tubulin) and demethylation of histone H3 on the lysine K27 (H3K27me2) residue. Although very low doses of both BPS and BPF did not affect the quality of ovarian histology, spindle formation and epigenetic signs were affected. Notably, in-vitro-matured oocytes were significantly sensitive to both doses of BPS and BPF. Although no significant differences in spindle-chromatin quality were identified in ovulated and in-vivo-matured oocytes, developmental competence was significantly damaged. Taken together, our mouse model provides evidence that bisphenol analogues represent a risk to human reproduction, possibly leading to idiopathic infertility in women.


Assuntos
Compostos Benzidrílicos/toxicidade , Fertilidade/efeitos dos fármacos , Infertilidade Feminina/induzido quimicamente , Lactação/metabolismo , Leite/metabolismo , Oócitos/efeitos dos fármacos , Ovário/efeitos dos fármacos , Fenóis/toxicidade , Sulfonas/toxicidade , Animais , Animais Lactentes , Compostos Benzidrílicos/metabolismo , Epigênese Genética , Feminino , Regulação da Expressão Gênica no Desenvolvimento , Técnicas de Maturação in Vitro de Oócitos , Infertilidade Feminina/metabolismo , Infertilidade Feminina/patologia , Infertilidade Feminina/fisiopatologia , Exposição Materna , Camundongos Endogâmicos ICR , Oócitos/metabolismo , Oócitos/patologia , Reserva Ovariana/efeitos dos fármacos , Ovário/metabolismo , Ovário/fisiopatologia , Fenóis/metabolismo , Gravidez , Medição de Risco , Fuso Acromático/efeitos dos fármacos , Fuso Acromático/metabolismo , Fuso Acromático/patologia , Sulfonas/metabolismo
6.
Rheumatology (Oxford) ; 60(6): 2706-2713, 2021 06 18.
Artigo em Inglês | MEDLINE | ID: mdl-33241288

RESUMO

OBJECTIVES: Pre-pregnancy counselling in women with systemic lupus erythematosus (SLE) is important in order to improve knowledge on the risks of pregnancy and to optimize pregnancy outcomes. Knowledge on the preferences of women with SLE regarding pre-pregnancy counselling have not yet been studied. In a closely monitored cohort of women with SLE we enquired about the present status of their wish to have children, and wish for and experiences with pre-pregnancy counselling. METHODS: A questionnaire developed by physicians in collaboration with two women with SLE was sent to all (n = 177) women participating in the Amsterdam SLE cohort. The questionnaire comprised 32 items, of which 15 focused on the above-mentioned three themes. RESULTS: A total of 124 women (70%) returned the questionnaire. The median disease duration was 13 years (interquartile range 9-19). Childlessness occurred in 51 women and 31% declared this was due to SLE [conscious decision (21%), stringent medical advice (6%), infertility due to medication (4%)]. Half of the women preferred the first pre-pregnancy counselling immediately after the SLE diagnosis (53%), together with their partner (69%). Information given by healthcare providers (81%) was preferred over information provided via brochures (35%) or the internet (26%). Pre-pregnancy face-to-face counselling from a rheumatologist and/or gynaecologist separately was preferred in 54%. CONCLUSION: One-third of women attributed their childlessness to SLE-related reasons. Pre-pregnancy counselling was preferred shortly after the onset of the disease in a non-multidisciplinary setting. The results of this study underline the importance of timely pre-conceptional counselling by healthcare providers on fertility, risks and pregnancy outcomes in women with SLE.


Assuntos
Aconselhamento/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Lúpus Eritematoso Sistêmico/psicologia , Cuidado Pré-Concepcional/métodos , Complicações na Gravidez , Feminino , Humanos , Infertilidade Feminina/induzido quimicamente , Pessoa de Meia-Idade , Países Baixos , Educação de Pacientes como Assunto/métodos , Preferência do Paciente , Cuidado Pré-Concepcional/estatística & dados numéricos , Gravidez , Resultado da Gravidez , Comportamento Reprodutivo/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos
7.
Esc. Anna Nery Rev. Enferm ; 25(1): e20190374, 2021. tab
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1124784

RESUMO

RESUMO Objetivo identificar em mulheres em idade reprodutiva, com câncer e durante o tratamento quimioterápico, as orientações sobre preservação de fertilidade e planejamento reprodutivo e conhecer as informações fornecidas pela equipe de saúde. Métodos estudo descritivo, realizado com mulheres na pré-menopausa, com diagnóstico de câncer e em tratamento quimioterápico. A coleta de dados foi realizada com apoio de um instrumento com informações sociodemográficas, sobre o câncer e seus tratamentos, informações referentes a preservação de fertilidade e uso de métodos contraceptivos antes e após o diagnóstico do câncer. A análise dos dados foi feita por meio de estatística descritiva. Resultados a média de idade das 49 participantes foi de 38,2 anos (DP=6,1) e 79,6% estavam em tratamento devido ao câncer de mama. Quanto as informações recebidas sobre a importância do planejamento reprodutivo, 77,6% das participantes referiram que foram orientadas e 59,2% receberam tais orientações da equipe médica. Entretanto, em relação ao aconselhamento sobre métodos para manter a fertilidade, apenas, 6,1% das participantes foram orientadas. Conclusão e Implicações para a prática Deve-se considerar a relevância do aconselhamento especializado e a da manutenção de tomada de decisões ativas da mulher sobre a preservação de sua fertilidade.


RESUMEN Objetivo identificar en mujeres en edad reproductiva, con cáncer y durante el tratamiento de quimioterapia, las orientaciones sobre preservación de la fertilidad y planificación reproductiva y conocer las informaciones proporcionadas por el equipo de salud. Métodos estudio descriptivo, realizado con mujeres premenopáusicas diagnosticadas con cáncer y sometidas a quimioterapia. La recolección de datos se realizó con apoyo de un instrumento con información sociodemográfica sobre el cáncer y sus tratamientos, información sobre la preservación de la fertilidad y uso de métodos anticonceptivos antes y después del diagnóstico del cáncer. El análisis de los datos se realizó mediante estadística descriptiva. Resultados la media de edad fue de 38,2 años (DE= 6,1), y 79,6% estaban en tratamiento para el cáncer de mama. Cuanto a la información recibida sobre la importancia de la planificación reproductiva, 77,6% de los participantes informaron que estaban orientados y 59,2% recibió orientación del equipo médico. Sin embargo, con respecto al asesoramiento sobre métodos para mantener la fertilidad, solo 6,1% de las participantes recibieron asesoramiento. Conclusión e Implicaciones para la práctica Debe tenerse en cuenta la importancia de la asesoría experta y el mantenimiento de una toma de decisiones activa por parte de las mujeres para preservar su fertilidad.


ABSTRACT Objective to identify in women of reproductive age, with cancer and during chemotherapy treatment, the guidelines on fertility preservation and reproductive planning and to know the information provided by the health team. Methods descriptive study, conducted with premenopausal women diagnosed with cancer and undergoing chemotherapy. Data collection was performed with the support of an instrument with sociodemographic information about cancer and its treatments, information regarding the preservation of fertility and the use of contraceptive methods before and after cancer diagnosis. Data analysis was performed using descriptive statistics. Results the average age of the 49 participants was 38.2 years (SD=6.1) and 79.6% were being treated for breast cancer. Regarding the information received about the importance of reproductive planning, 77.6% of participants reported that they were oriented and 59.2% received such guidance from the medical team. However, regarding counseling on methods to maintain fertility, only 6.1% of participants were counseled. Conclusion and Implications for practice consideration should be given to the importance of expert counseling and the maintenance of active decision making by women about preserving their fertility.


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Planejamento Familiar , Fertilidade/efeitos dos fármacos , Neoplasias/tratamento farmacológico , Anticoncepção/estatística & dados numéricos , Aconselhamento , Gravidez não Planejada , Infertilidade Feminina/induzido quimicamente , Neoplasias/diagnóstico
8.
Artigo em Inglês | MEDLINE | ID: mdl-33256215

RESUMO

A realistic picture of our world shows that it is heavily polluted everywhere. Coastal regions and oceans are polluted by farm fertilizer, manure runoff, sewage and industrial discharges, and large isles of waste plastic are floating around, impacting sea life. Terrestrial ecosystems are contaminated by heavy metals and organic chemicals that can be taken up by and accumulate in crop plants, and water tables are heavily contaminated by untreated industrial discharges. As deadly particulates can drift far, poor air quality has become a significant global problem and one that is not exclusive to major industrialized cities. The consequences are a dramatic impairment of our ecosystem and biodiversity and increases in degenerative or man-made diseases. In this respect, it has been demonstrated that environmental pollution impairs fertility in all mammalian species. The worst consequences are observed for females since the number of germ cells present in the ovary is fixed during fetal life, and the cells are not renewable. This means that any pollutant affecting hormonal homeostasis and/or the reproductive apparatus inevitably harms reproductive performance. This decline will have important social and economic consequences that can no longer be overlooked.


Assuntos
Ecossistema , Poluentes Ambientais , Poluição Ambiental , Infertilidade Feminina , Metais Pesados , Animais , Monitoramento Ambiental , Poluentes Ambientais/toxicidade , Feminino , Fertilidade , Humanos , Infertilidade Feminina/induzido quimicamente , Mamíferos , Esgotos
9.
Epilepsy Behav ; 113: 107563, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33242778

RESUMO

The aim of the present study was to review existing knowledge on the impact of epilepsy in reproductive health of both sexes. Extensive searches of relevant documentation published until February 2020 were retrieved from PubMed and Google Scholar literature in English or in other languages with an English abstract. In females, epilepsy may lead to estrogen and androgen level abnormalities. Women with epilepsy may develop Polycystic Ovaries Syndrome (PCOS), anovulatory cycles, and menstrual disorders. In men, epilepsy may cause sex hormone dysregulation and influence spermatogenesis. Males with epilepsy may also suffer from sexual dysfunction. Antiepileptic drugs (AEDs) have adverse effects on peripheral endocrine glands, influence hormones' biosynthesis and protein binding, diminish the bioactivity of serum sex hormones, and lead to secondary endocrine disorders related to changes concerning body weight and insulin sensitivity. Valproic acid (VPA) was the first recognized AED to cause disturbances potentially due to metabolic changes and increasing weight. Women taking VPA may develop PCOS, while men may have sperm abnormalities and/or sexual dysfunction. Liver enzyme inducing AEDs may also cause menstrual and sexual disorders in women and sexual dysfunction in men. Newer AEDs are much safer but studies still suggest reduced sexuality and erectile dysfunction.


Assuntos
Epilepsia/complicações , Infertilidade Feminina/etiologia , Infertilidade Masculina/etiologia , Disfunções Sexuais Fisiológicas/etiologia , Anticonvulsivantes/efeitos adversos , Anticonvulsivantes/uso terapêutico , Epilepsia/tratamento farmacológico , Feminino , Hormônios Esteroides Gonadais/sangue , Humanos , Infertilidade Feminina/induzido quimicamente , Infertilidade Masculina/induzido quimicamente , Masculino , Síndrome do Ovário Policístico/induzido quimicamente , Síndrome do Ovário Policístico/etiologia , Saúde Reprodutiva , Comportamento Sexual , Disfunções Sexuais Fisiológicas/induzido quimicamente , Ácido Valproico/efeitos adversos , Ácido Valproico/uso terapêutico
10.
Obstet Gynecol Surv ; 75(11): 683-691, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33252698

RESUMO

Importance: Many adolescents and young adults diagnosed with Hodgkin lymphoma (HL) experience disease progression requiring high-dose alkylating salvage therapy, which often results in permanent infertility. Objective: The aim of this report is to discuss fertility preservation options in female patients with consideration of chemotherapeutic agents in HL. Evidence Acquisition: An electronic literature review was performed utilizing a combination of the terms "Hodgkin lymphoma," "fertility preservation," "ovarian tissue cryopreservation," "oocyte cryopreservation," "embryo cryopreservation," and "gonadotropin-releasing hormone agonist." References and data from identified sources were searched and compiled to complete this review. Results: Initial treatment of HL is often nonsterilizing; however, salvage therapy and conditioning for stem cell transplantation confer significant gonadotoxicity. Established fertility preservation options for pubertal females include embryo cryopreservation and oocyte cryopreservation. These options are contraindicated within 6 months of receipt of chemotherapy. Ovarian tissue cryopreservation is an option for patients who require salvage therapy within 6 months of first-line therapy. Conclusions: Timing and choice of fertility preservation techniques depends on planned first-line chemotherapy and response to treatment. In patients initially treated with low-risk chemotherapy, it is reasonable to defer invasive fertility techniques until treatment failure; however, upfront fertility preservation should be considered in patients planning to undergo primary treatment with high-risk therapy.


Assuntos
Antineoplásicos Alquilantes , Preservação da Fertilidade , Doença de Hodgkin , Infertilidade Feminina , Antineoplásicos Alquilantes/administração & dosagem , Antineoplásicos Alquilantes/efeitos adversos , Feminino , Preservação da Fertilidade/métodos , Preservação da Fertilidade/normas , Doença de Hodgkin/patologia , Doença de Hodgkin/terapia , Humanos , Infertilidade Feminina/induzido quimicamente , Infertilidade Feminina/prevenção & controle , Tempo para o Tratamento
11.
Sci Rep ; 10(1): 17058, 2020 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-33051529

RESUMO

The use of poly (ADP-ribose) polymerase (PARP) inhibitors is expected to increase, but their effect on fertility is still unclear. The aim of this study was to investigate the effect of PARP inhibitors on ovarian function. In an in vitro study, cultures of ovaries and granulosa cells (GCs) exposed to the PARP inhibitor olaparib were evaluated by real-time RT-PCR, histological study, and hormone assays. In an in vivo study, mice were administered olaparib orally and evaluated via in vitro fertilization (IVF), follicle count, immunohistochemical staining, and real-time RT-PCR. In vitro, the gene expression of GC markers decreased in the olaparib-treated group. Olaparib also negatively affected estradiol production and the expression of GC markers in cultured GCs, with abnormal morphology of GCs observed in the treated group. The follicle number indicated depletion of follicles due to atretic changes in the treatment group, both in vitro and in vivo. Also, olaparib reduced the number of retrieved oocytes and the fertilization rate of IVF, but they recovered after 3 weeks of cessation. Our results indicate that olaparib is toxic to ovaries.


Assuntos
Células da Granulosa/efeitos dos fármacos , Ovário/efeitos dos fármacos , Ftalazinas/farmacologia , Piperazinas/farmacologia , Animais , Apoptose/efeitos dos fármacos , Feminino , Infertilidade Feminina/induzido quimicamente , Camundongos , Camundongos Endogâmicos ICR , Folículo Ovariano/metabolismo , Reserva Ovariana/efeitos dos fármacos , Ovário/metabolismo , Ftalazinas/metabolismo , Piperazinas/metabolismo , Inibidores de Poli(ADP-Ribose) Polimerases/metabolismo , Inibidores de Poli(ADP-Ribose) Polimerases/farmacologia , Poli(ADP-Ribose) Polimerases/metabolismo , Ribose/metabolismo
13.
Mol Cell Endocrinol ; 518: 110934, 2020 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-32659439

RESUMO

Numerous evidences have alerted on the toxic effects of the exposure to glyphosate on living organisms. Glyphosate is the herbicide most used in crops such as maize and soybean worldwide, which implies that several non-target species are at a high risk of exposure. Although the Environmental Protection Agency (EPA-USA) has reaffirmed that glyphosate is safe for users, there are controversial studies that question this statement. Some of the reported effects are due to exposure to high doses; however, recent evidences have shown that exposure to low doses could also alter the development of the female reproductive tract, with consequences on fertility. Different animal models of exposure to glyphosate or glyphosate-based herbicides (GBHs) have shown that the effects on the female reproductive tract may be related to the potential and/or mechanisms of actions of an endocrine-disrupting compound. Studies have also demonstrated that the exposure to GBHs alters the development and differentiation of ovarian follicles and uterus, affecting fertility when animals are exposed before puberty. In addition, exposure to GBHs during gestation could alter the development of the offspring (F1 and F2). The main mechanism described associated with the endocrine-disrupting effect of GBHs is the modulation of estrogen receptors and molecules involved in the estrogenic pathways. This review summarizes the endocrine-disrupting effects of exposure to glyphosate and GBHs at low or "environmentally relevant" doses in the female reproductive tissues. Data suggesting that, at low doses, GBHs may have adverse effects on the female reproductive tract fertility are discussed.


Assuntos
Disruptores Endócrinos/toxicidade , Fertilidade/efeitos dos fármacos , Glicina/análogos & derivados , Herbicidas/toxicidade , Animais , Sistema Endócrino/efeitos dos fármacos , Sistema Endócrino/fisiologia , Feminino , Genitália Feminina/efeitos dos fármacos , Genitália Feminina/embriologia , Genitália Feminina/crescimento & desenvolvimento , Glicina/química , Glicina/toxicidade , Herbicidas/química , Humanos , Infertilidade Feminina/induzido quimicamente , Infertilidade Feminina/epidemiologia , Reprodução/efeitos dos fármacos , Maturidade Sexual/efeitos dos fármacos
14.
BMC Womens Health ; 20(1): 125, 2020 06 16.
Artigo em Inglês | MEDLINE | ID: mdl-32546170

RESUMO

BACKGROUND: For a long time, the relationship between caffeine consumption and infertility in the general population is unclear, this study is aimed to systematically review the evidence from any type of controlled clinical studies to explore whether caffeine intake is a risk factor for human infertility. METHODS: Seven databases were searched from inception to May 2019. We included women/men without a history of infertility but were willing to have children in prospective studies and women/men who were diagnosed with infertility in retrospective studies. The observed exposure factor should be caffeine or caffeine containing beverage. Diagnosis of infertility or not for participants was the key outcome. The Newcastle-Ottawa scale (NOS) or Cochrane risk of bias tool were used to assess the methodological quality of included studies. Meta-analysis was conducted if there were acceptable clinical and statistical heterogeneity among studies. The GRADE method was used to assess the certainty of the evidence. RESULTS: Four studies (one cohort study and three case-control studies) involving 12,912 participants were included. According NOS, the average score of case-control studies was 6, and the cohort study achieved 9. Meta-analysis and subgroup analysis were conducted. The results showed that low (OR 0.95, 95%CI 0.78-1.16), medium (OR 1.14, 95%CI 0.69-1.86) and high doses (OR 1.86, 95%CI 0.28-12.22) of caffeine intake may not increase the risk of infertility. The quality of the current evidence bodies were all low. CONCLUSION: Our study provides low quality evidence that regardless of low, medium and high doses of caffeine intake do not appear increase the risk of infertility. But the conclusion should be treated with caution.


Assuntos
Cafeína/efeitos adversos , Fertilidade/efeitos dos fármacos , Infertilidade Feminina/induzido quimicamente , Cafeína/administração & dosagem , Criança , Ensaios Clínicos Controlados como Assunto , Feminino , Humanos , Masculino , Gravidez
15.
Taiwan J Obstet Gynecol ; 59(3): 415-419, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32416890

RESUMO

OBJECTIVE: The purpose of this study was to define the pregnancy and oncologic outcomes after fertility-sparing treatment of atypical hyperplasia (AH)/endometrial intraepithelial neoplasia (EIN) and early-stage endometrioid endometrial cancer (EEC). MATERIALS AND METHODS: The retrospective cohort study included patients who had applied to Baskent University's Ankara Hospital between January 2007 and October 2018 with either AH/EIN (n: 27; Group A) or EEC (n: 30; Group B), and who had the desire to preserve their fertility. The medical records of all patients included in the study were reviewed retrospectively from the hospital records. RESULTS: There were 2 (7.4%) and 5 (16.7%) recurrences, whereby one patient from Group A and two patients from Group B underwent staging surgery. In Group A, 8 patients attempted pregnancy after their treatment and 4 of them (50%) became pregnant, while 3 of them (37.5%) had a live birth. In Group B, there were 17 patients who wanted to become pregnant following treatment of the disease; 8 of them (47%) became pregnant after treatment, 5 of them (16.6%) had a live birth, 1 experienced intrauterine exitus (at 21st gestational week, 350 g), and 2 currently have ongoing pregnancies. CONCLUSION: Hysteroscopic resection of visible lesions and full endometrial curettage prior to hormonal therapy as a fertility-preserving approach for women of reproductive age with endometrial malignancies can achieve promising oncologic and obstetric responses.


Assuntos
Carcinoma in Situ/terapia , Hiperplasia Endometrial/terapia , Neoplasias do Endométrio/terapia , Preservação da Fertilidade/métodos , Histeroscopia/métodos , Adulto , Antineoplásicos Hormonais/efeitos adversos , Carcinoma in Situ/patologia , Hiperplasia Endometrial/patologia , Neoplasias do Endométrio/patologia , Feminino , Humanos , Infertilidade Feminina/induzido quimicamente , Infertilidade Feminina/prevenção & controle , Estadiamento de Neoplasias , Lesões Pré-Cancerosas , Gravidez , Estudos Retrospectivos , Resultado do Tratamento
16.
Arch Iran Med ; 23(4Suppl1): S16-S22, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-32349503

RESUMO

BACKGROUND: War causes more death and disability than many major diseases. There are few studies in the context of the deleterious impact of war on fertility potential; therefore, in this study, we tried to review articles about the adverse effects of war on male/ female fertility potential. METHODS: In this study, a total of 183 articles related to the effects of war on fertility potential were examined by a systematic search using known international medical databases. RESULTS: Among these studies, there were limited studies on the effects of war on female infertility and most studies examined the effects of war on sperm parameters and male infertility. The physical and psychological trauma of war can increase the risk of infertility in men and women. Presence of reproductive system toxins in weapons, stressful periods of war and direct damage to the reproductive system can impair the fertility of men and women. The way war affects male fertility is not clear, but the higher degree of stress during wartime seems to play an important role. Using reproductive toxicants during the war also increases the risk of impairment in reproductive function in men. Some studies have shown the harmful effects of Sulfur mustard as a war chemical toxin especially on sperm quality and male infertility. Oxidative stress induced by free radicals is a major mechanism for the direct effects of Sulfur mustard on male infertility. CONCLUSION: The study of past research suggests that exposure to war may be an independent risk factor for reproductive disorders and infertility in men. For female infertility, war leads to menstrual dysfunction.


Assuntos
Substâncias para a Guerra Química/toxicidade , Infertilidade Feminina/induzido quimicamente , Infertilidade Masculina/induzido quimicamente , Gás de Mostarda/toxicidade , Feminino , Fertilidade , Radicais Livres , Humanos , Infertilidade Feminina/epidemiologia , Infertilidade Masculina/epidemiologia , Masculino , Estresse Oxidativo , Medição de Risco , Lesões Relacionadas à Guerra/epidemiologia
17.
Eur J Cancer ; 133: 56-65, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32442924

RESUMO

BACKGROUND: This study assessed the effects of gonadotropin-releasing hormone agonists (GnRHa) on the prevention of chemotherapy-induced ovarian insufficiency among young patients with malignant ovarian germ cell tumour (MOGCT) receiving chemotherapy. METHODS: This multicentre, retrospective study was conducted at 15 sites affiliated with the Korean Gynecologic Oncology Group and enrolled 354 patients between January 1995 and September 2018. Among them, 227 patients were included in this study and divided into two groups according to the use of GnRHa during chemotherapy (GnRHa versus no GnRHa groups). The primary objective was to compare the rates of menstrual resumption between the two groups. We also assessed the clinical determinants affecting menstrual resumption among the study groups. RESULTS: There were no significant differences between the GnRHa (n = 63) and no GnRHa (n = 164) groups regarding age at diagnosis, parity, ethnicity, age at menarche, body mass index, International Federation of Gynecology and Obstetrics stage, mode of surgery and surgery type. The rate of menstrual resumption after chemotherapy was 100% (63 of 63) in the GnRHa group and 90.9% (149 of 164) in the no GnRHa group (p = 0.013). The mean periods from last chemotherapy to menstrual resumption were 7.4 and 7.3 months in the GnRHa and no GnRHa groups, respectively. GnRHa co-administration during chemotherapy reduced the likelihood of amenorrhoea after chemotherapy, although statistical significance was not confirmed in the univariate analysis (odds ratio: 0.276; 95% confidence interval, 0.004-1.317; p = 0.077). CONCLUSION: Temporary ovarian suppression with GnRHa during chemotherapy does not significantly increase the chances of menstrual resumption in young patients with MOGCT.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Fármacos para a Fertilidade Feminina/uso terapêutico , Hormônio Liberador de Gonadotropina/agonistas , Neoplasias Embrionárias de Células Germinativas/tratamento farmacológico , Neoplasias Ovarianas/tratamento farmacológico , Insuficiência Ovariana Primária/induzido quimicamente , Insuficiência Ovariana Primária/prevenção & controle , Adolescente , Adulto , Amenorreia/induzido quimicamente , Amenorreia/epidemiologia , Amenorreia/prevenção & controle , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Bleomicina/administração & dosagem , Bleomicina/efeitos adversos , Cisplatino/administração & dosagem , Cisplatino/efeitos adversos , Etoposídeo/administração & dosagem , Etoposídeo/efeitos adversos , Estudos de Viabilidade , Feminino , Preservação da Fertilidade/métodos , Humanos , Infertilidade Feminina/induzido quimicamente , Infertilidade Feminina/epidemiologia , Infertilidade Feminina/prevenção & controle , Menopausa Precoce/efeitos dos fármacos , Menstruação/efeitos dos fármacos , Neoplasias Embrionárias de Células Germinativas/epidemiologia , Neoplasias Ovarianas/epidemiologia , Ovário/efeitos dos fármacos , Gravidez , Insuficiência Ovariana Primária/epidemiologia , República da Coreia/epidemiologia , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
18.
BMC Womens Health ; 20(1): 103, 2020 05 13.
Artigo em Inglês | MEDLINE | ID: mdl-32404142

RESUMO

BACKGROUND: Agricultural activities as well as exposure to pesticides could have many adverse effects on health status and reproductive outcomes especially in reproductive aged greenhouse workers. The present study aimed to compare the general and reproductive health outcomes between female greenhouse workers and housewives. METHODS: This cross-sectional study was conducted on 645 females of reproductive age. They were categorized into two groups according to occupation in greenhouse (308 female greenhouse workers as exposed group and 337 housewives as control group). Participants were interviewed using a questionnaire about reproductive outcomes and occupational status. Clinical measures include blood pressure (BP), pulse and respiratory rate (PR and RR), body mass index (BMI) and hematological parameters. Mann-Whitney U test was used to assess differences between two groups in quantitative variables. Chi-square or Fisher's exact tests was used to determine the differences in the distribution of categorical variables. Data was analyzed using SPSS software version 16. RESULTS: The average daily working hours of the greenhouse workers were 6.94 ± 1.99 h. Only 44.3% of them used personal protective equipment. Data revealed that the rate of spontaneous abortion, infertility, low birth weight (LBW), abnormal births and preterm birth were significantly higher among the greenhouse workers compared to the control group (p ≤ 0.05). The average number of female infants in greenhouse workers was significantly higher than the control group (p ≤ 0.05). Clinical measurements indicated an increase in RR of greenhouse workers and mean of BMI was decreased in them. Hematological parameters demonstrated that there was a significant increase in white blood cells (WBC) and significant decrease in hemoglobin (Hb), hematocrit (HCT), mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC) among the female greenhouse workers compared to the control (p ≤ 0.05). CONCLUSION: Local government efforts is needed to address associated issues including acute effects on health and long-term health risks, resulting from pesticide exposure to greenhouse workers, and gender differences should be considered. Also, occupational health and safety training is necessary and can be helpful in reducing adverse reproductive outcomes.


Assuntos
Aborto Espontâneo/induzido quimicamente , Infertilidade Feminina/induzido quimicamente , Doenças Profissionais/induzido quimicamente , Exposição Ocupacional/efeitos adversos , Praguicidas/efeitos adversos , Nascimento Prematuro/etiologia , Reprodução/efeitos dos fármacos , Saúde Reprodutiva , Aborto Espontâneo/epidemiologia , Adulto , Criança , Estudos Transversais , Feminino , Jardinagem , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Infertilidade Feminina/epidemiologia , Exposição Ocupacional/análise , Gravidez , Nascimento Prematuro/induzido quimicamente , Nascimento Prematuro/epidemiologia
20.
Toxicology ; 439: 152466, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32315717

RESUMO

Glyphosate is the most popular herbicide used in modern agriculture, and its use has been increasing substantially since its introduction. Accordingly, glyphosate exposure from food and water, the environment, and accidental and occupational venues has also increased. Recent studies have demonstrated a relationship between glyphosate exposure and a number of disorders such as cancer, immune and metabolic disorders, endocrine disruption, imbalance of intestinal flora, cardiovascular disease, and infertility; these results have given glyphosate a considerable amount of media and scientific attention. Notably, glyphosate is a powerful metal chelator, which could help explain some of its effects. Recently, our findings on 2,3-dimercapto-1-propanesulfonic acid, another metal chelator, showed deterioration of oocyte quality. Here, to generalize, we investigated the effects of glyphosate (0 - 300 µM) on metaphase II mouse oocyte quality and embryo damage to obtain insight on its mechanisms of cellular action and the tolerance of oocytes and embryos towards this chemical. Our work shows for the first time that glyphosate exposure impairs metaphase II mouse oocyte quality via two mechanisms: 1) disruption of the microtubule organizing center and chromosomes such as anomalous pericentrin formation, spindle fiber destruction and disappearance, and defective chromosomal alignment and 2) substantial depletion of intracellular zinc bioavailability and enhancement of reactive oxygen species accumulation. Similar effects were found in embryos. These results may help clarify the effects of glyphosate exposure on female fertility and provide counseling and preventative steps for excessive glyphosate intake and resulting oxidative stress and reduced zinc bioavailability.


Assuntos
Embrião de Mamíferos/efeitos dos fármacos , Embrião de Mamíferos/metabolismo , Glicina/análogos & derivados , Herbicidas/toxicidade , Metáfase/efeitos dos fármacos , Oócitos/efeitos dos fármacos , Oócitos/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Zinco/metabolismo , Animais , Cromossomos/efeitos dos fármacos , Feminino , Glicina/toxicidade , Infertilidade Feminina/induzido quimicamente , Infertilidade Feminina/patologia , Camundongos , Microtúbulos/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Gravidez , Fuso Acromático/efeitos dos fármacos
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