Obesity and assisted reproduction.

The World Health Organization defines obesity as an abnormal or excessive accumulation of fat that is harmful to health. Obesity and overweight have a negative effect not only on general health, but also on reproductive health. Obesity is associated with reduced fertility, more frequent pregnancy losses and other pregnancy complications. Due to an obesity pandemic, an increasing proportion of women seeking medical help for infertility will be overweight or obese. Obesity is involved in the pathogenesis of polycystic ovary syndrome (PCOS), approximately 40-70% of PCOS patients are overweight or obese. The risk of miscarriage is increased in obese women who become pregnant after in vitro fertilisation, regardless of whether their own oocytes or donated oocytes are used. In men, the link between obesity and reduced fertility is less well-studied than in women. Mechanisms by which obesity may affect spermatogenesis include thermal effects, hyperestrogenism, hypogonadotropic hypogonadism, diabetes mellitus, sexual dysfunction, and sperm epigenetic disorders. Obesity in both women and men negatively affects the results of assisted reproduction. Overweight or obese women should be informed about the overall health and obstetric risks and about the lower success rate of infertility treatment with assisted reproduction methods.

Elevated serum concentrations of S100-A11 and AIF-1 in cervical dysplasia patients.

OBJECTIVE: The aim of this study was to compare TFF3, AIF-1, S100-A11 and DKK1 serum levels in patients with cervical dysplasia, and in healthy female controls. METHODS: The first group included 59 patients with a histological dia-gnosis of precancerous disease CIN 1. The second group included 198 patients with a histological dia-gnosis of precancerous disease CIN 2 or CIN 3. The control group was comprised of 90 patients who underwent elective total hysterectomy for nonmalignant disorders. In all patients, preoperative serum samples were taken and separated; the sera were all stored at -80°C until the analysis for TFF3, AIF-1, S100-A11 and DKK1. RESULTS: The serum levels of S100­A11 (P < 0.0001) and AIF-1 (P < 0.0001) were statistically significantly higher in patients with mild precancerous lesions (CIN 1) than in controls. The levels of TFF3 and DKK1 were not statistically significantly different in patients with CIN 1 and in the control group. The serum levels of S100­A11 (P < 0.0001) and AIF-1 (P < 0.0001) were statistically significantly higher in patients with severe precancerous lesions (CIN 2/3) than in controls. TFF3 and DKK1 levels were not statistically significantly different in patients with CIN 2/3 compared to controls. CONCLUSION: S100-A11 and AIF-1 represent potential bio-markers in patients with cervical dysplasia.

Serum concentrations of S100-A11 and AIF-1 are elevated in cervical cancer patients with lymph node involvement.

OBJECTIVE: The aim of this study was to compare the serum levels of TFF3, AIF-1, S100-A11 and DKK1 in surgically staged patients with cervical cancer, and in healthy female controls. METHODS: In total 85 consecutive patients dia-gnosed at the Department of Obstetrics and Gynecology, University Hospital in Olomouc with cervical cancer undergoing radical hysterectomy or fertility sparing surgery with pelvic lymphadenectomy were included. Ninety patients who underwent elective total hysterectomy for nonmalignant disorder represented a control group. In all patients, preoperative serum samples were taken and separated; the sera were all stored at -80 °C until analysis for TFF3, AIF-1, S100-A11 and DKK1. RESULTS: According to the final histopathological examination, 32 (40.5%) out of 79 cervical cancer patients with microscopically examined lymph nodes were lymph node-positive. S100­A11 (P < 0.0001) and AIF-1 levels (P < 0.0001) were higher in cervical cancer patients than in controls. Furthermore, the serum levels of S100­A11 (P > 0.04) and AIF-1 (P > 0.01) were significantly higher in lymph node-positive patients as compared to lymph node-negative patients. The levels of TFF3 and DKK1 were higher (P < 0.0001) in controls than in cervical cancer patients and were not different in groups with or without nodal involvement.. CONCLUSION: S100-A11 and AIF-1 represent potential bio-markers in patients with cervical cancer. Moreover, the levels of S100-A11 and AIF-1 increase in patients with lymph node  involvement.

Systemic Inflammatory Response After Open, Laparoscopic and Robotic Surgery in Endometrial Cancer Patients.

AIM: To study inflammatory response and nutritional biomarkers in operated endometrial cancer (EC) patients. MATERIALS AND METHODS: A total 109 consecutive EC patients undergoing open laparotomy (LT), laparoscopic (LS) or robot-assisted surgery (RS) were studied. Twenty four patients served as controls. Pre- and postoperative levels of inflammatory and nutritional biomarkers were analyzed prospectively. RESULTS: The estimated blood loss was significantly lower in RS compared to all other groups. C-reactive protein (CRP) and interleukin-6 (IL-6) correlated with each other and exhibited positive correlation with age, body-mass index (BMI), leukocyte count, platelet count, kynurenine, kynurenine/tryptophan ratio and urinary neopterin and a negative correlation with vitamin D and retinol. Hemoglobin, retinol, alpha-tocopherol, vitamin D and citrulline concentrations decreased and inflammatory biomarkers increased after surgery to a different extent in LT, LS, RS and control groups. CONCLUSION: The present data demonstrate a differential response to surgical trauma in patients with endometrial carcinoma.