International Journal of Reproductive BioMedicine (IJRM)

Endometrial scratching in unexplained repeated implantation failure causes two competing forces, angiogenesis and anti-angiogenesis: An RCT study

2024-06-15T11:11:28+00:00

Background: A significant association between endometrial vascularity and pregnancy has been shown in previous research, while poor vascularization was attributed to repeated implantation failure (RIF). One possible approach to enhance angiogenesis for successful implantation is endometrial scratching (ES).

Objective: The purpose was to investigate endometrial responses to scratching by profiling angiogenesis-related gene expression in unexplained RIF participants.

Materials and Methods: In this randomized controlled trial study, 20 infertile women with unexplained RIF were assigned to 2 groups by the balanced block randomization method (n = 10/each group): the intervention group (group A) (who received ES in the follicular phase) and the control group (group B). Endometrial biopsy was performed in the secretory phase. Gene expression profiling was performed using a polymerase chain reaction-array kit for humanangiogenic growth factors. The implantation and clinical pregnancy rates were also assessed.

Results: Among the angiogenesis-promoting genes, FGF1, FGF13, FGF2, TGFA, ANG, ANGPT1, and VEGFA were significantly upregulated (p < 0.05). IL12A (an angiogenesis-inhibiting cytokine) was significantly upregulated (p < 0.01). In contrast, 15 genes with angiogenesisrelated functions, including CXCL11, CXCL13, CXCL3, CXCL5, CXCL6, EREG, FIGF, FST, IL10, LEP, PPBP, PROK1, RHOB, TNF, and TYMP, were downregulated after ES. No significant differences were observed between the intervention (group A) and control (group B) groups in terms of implantation (43.75% vs. 28.57%) or clinical pregnancy rates (75% vs. 57.1%).

Conclusion: ES induced significant alterations in the expression of angiogenesis-related genes, with notable up/downregulation of key angiogenic/antiangiogenic factors. These findings enhance our understanding of the molecular responses triggered by ES, underscoring the potential influence of ES on the complex processes of angiogenesis crucial for implantation.

Key words: Endometrium, Angiogenesis, Embryo implantation, Polymerase chain reaction.

The effect of Henna (Lawsonia inermis) vaginal suppository combined with antibiotic therapy in the treatment of cervicitis: An RCT

2024-06-15T11:12:57+00:00

Background: Cervicitis is a prevalent gynecologic disease, which does not usually respond to conventional treatments. Long-term cervicitis can cause serious health problems such as inflammation, infertility, and cancer. Henna oil, an herbal product in Persian medicine, is recommended for uterine diseases like cervicitis.

Objective: This study aims to evaluate the efficacy of Henna oil as a vaginal suppository in combination with an antibiotic regimen in the treatment of cervicitis.

Materials and Methods: This randomized placebo-controlled trial, included 92 nonmenopausal women with cervicitis at the Baqaipur Clinic of Shahid Sadoughi hospital in Yazd and the Persian Medicine Health Center in Ardakan, Yazd, Iran. Participants were further divided into either the Henna oil vaginal suppository group or the placebo group (n = 46/each group). During the study, the antibiotic treatment was administered to both groups. Cervicitis symptoms were compared between the groups and within each group. Results: Of 92 included individuals, 41 in each group completed the study.

Results: revealed that significant differences were observed in some outcomes, including vaginal discharge (p < 0.001), cervical ulcer size (p < 0.001), dyspareunia (p = 0.046), and postcoital bleeding (p < 0.001), indicating that the treatment was more effective in the henna group compared to the placebo group.

Conclusion: Findings supported that the vaginal suppository of Henna oil in combination with antibiotic therapy could be effective in the improvement of clinical symptoms of cervicitis regardless of its pathology.

Key words: Lawsonia inermis, Persian+traditional medicine, Uterine cervicitis, Infertility, Vaginal suppository, Clinical trial.

Changes in menstrual cycles among Iranian women during the COVID-19 pandemic: A cross-sectional study

2024-06-15T11:13:28+00:00

Background: Some women experienced alterations in their menstrual cycles during the Coronavirus disease 2019 (COVID-19) pandemic.

Objective: This study aimed to evaluate the changes in menstrual cycles among Iranian women during the COVID-19 pandemic.

Materials and Methods: This cross-sectional study included 1500 women of childbearing age referred to healthcare centers in Tehran, Iran from April-November 2022. Participants were selected using the stratified sampling method. Data were collected via a questionnaire covering information on menstrual cycle, COVID- 19 infection, and COVID-19 vaccination status. The study’s outcomes focused on menstrual changes by evaluating cycle regularity, duration, and symptoms based on participant-reported observations.

Results: The findings revealed that the pattern of menstrual change during the pandemic occurred in the form of a shorter interval in 8.6%, and longer interval in 8.9%, shorter duration in 10.4%, longer duration in 9.4%, heavier bleeding in 12.3%, lighter bleeding in 14.7%. The chance of menstrual changes in women who were infected with COVID-19 was 54% higher than that of women who were not infected, and the chance of menstrual changes in women who received 3 doses of COVID-19 vaccine was 1.5 times higher than women who had not been vaccinated.

Conclusion: Our research revealed a high incidence of menstrual changes among Iranian women of childbearing age during the COVID-19 pandemic. Healthcare providers should be knowledgeable about the menstrual changes associated with COVID-19 infection and vaccination to provide information and support to affected women.

Key words: Menstrual cycle, Menstrual irregularities, COVID-19, Vaccine.

Experimental accelerating testicular tissue recovery post-methotrexate treatment in rats: A promising role of Sertoli cell-conditioned medium: An experimental study

2024-06-15T11:15:45+00:00

Background: Methotrexate (MET) is one of the most important chemotherapy agents used against various tumors and cancer diseases. One of the critical side effects of MET is inducing male infertility.

Objective: The current study aimed to investigate Sertoli cell culture-conditioned medium (SCM) recovery effects on MET-induced conditions in rats.

Materials and Methods: 30 mature male Wistar rats were randomly divided into 3 groups (n = 10). In the first group, rats received normal saline intraperitoneally. In the second group, animals received MET (10 mg/kg; intraperitoneally) once a week for 2 wk. The rats in the third group (MET+SCM) received MET and a single injection of SCM for 56 days post-MET administration. 56 days later, serum, epididymis, and testicular tissue samples were collected, and the animals were euthanized. Sperm parameters, serum levels of luteinizing hormone, follicle-stimulating hormone, and testosterone were examined. The testicular tissues were stained using hematoxylin and eosin solution, and histopathological changes were analyzed.

Results: The MET-induced condition resulted in significant pathological changes in the testis, decreased hormone levels, and downregulated sperm parameters. However, SCM injection improved hormonal levels, testicular changes, and sperm parameters.

Conclusion: It can be concluded that a single intra-testicular SCM injection accelerates male reproductive system recovery post-MET treatment.

Key words: Sertoli cell, Conditioned culture media, Methotrexate, Testis, Histopathology, Rats.

Center for Reproductive Endocrinology and Infertility, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam.

2024-06-15T11:22:55+00:00

Background: Vitrification is a recently introduced yet widely applied assisted reproduction technique. So far, the effects of the chemicals and devices in vitrification on sperm motility and DNA integrity are still unclear.

Objective: This study aimed to examine sperm quality, as determined by semen analysis and sperm DNA integrity when vitrified with or without cryoprotectant agents (CPAs) using pulled-glass capillaries.

Materials and Methods: Between February and June 2020, 50 infertile men from the Hue Center for Reproductive Endocrinology and Infertility, Hue University of Medicine and Pharmacy, Vietnam, were enrolled. Sperm samples, prepared using the swim-up technique, were divided into 2 groups: vitrification with CPAs (group 1) and without CPAs (group 2). Vitrified sperm samples were preserved in 10 μL pulled-glass capillaries. Motility, sperm membrane integrity, and the DNA fragmentation index were tested.

Results: Sperm motility in vitrified media with CPAs (54.4 ± 11%) was statistically higher than in media without CPAs (51.14 ± 10.6%, p < 0.05). CPAs did not affect sperm membrane integrity or large halo ratio (71.34 ± 8.47 vs. 70.38 ± 8.11 and 50.84 ± 18.92 vs. 51.98 ± 19.44, respectively). Group 2 exhibited a lower DNA fragmentation index than group 1 after vitrification (14.2 ± 8.47 vs. 12.60 ± 9.03, p = 0.021).

Conclusion: Using a pulled-glass capillary for sperm vitrification, the presence of CPAs in the vitrification medium resulted in higher progressive motility and lower DNA fragmentation index than the medium without CPAs.

Key words: Vitrification, Sperm, DNA fragmentation, Cryoprotectant agents, Small volume.

Comparison of serum levels of interleukin 33 in combination with serum levels of C-reactive protein, Immunoglobulin G, Immunoglobulin A, and Immunoglobulin M in recurrent pregnancy loss: A case-control study

2024-06-15T11:18:30+00:00

Background: One of the critical cases of recurrent pregnancy loss is immunological factors, whereas obtaining effective prevention or treatment is necessary for cognition of reasons. Objective: In this study, we tried to evaluate some immunological factors related to recurrent pregnancy loss.

Materials and Methods: This case-control study was conducted on 66 women at the age of 18–35 yr who were referred to the Clinic of Gynecology and Obstetrics, Ali Ibn Abi Taleb hospital, Zahedan, Iran, from August-December 2019. Interleukin 33 (IL-33) serum levels were measured using enzyme-linked immunosorbent assay. Immunoglobulin G, Immunoglobulin A, Immunoglobulin M (IgM), and C-reactive protein levels were measured by serology and hematology methods.

Results: The mean age of total participants was 30.8 ± 3.80 yr. The mean serum IL-33 in the case group was 318.5± 254.1 pg/ml and was lower than the control group (354.2± 259.9 pg/ml), which was not statistically significant (p = 0.52). The level of C-reactive protein in the case and control was not significantly different (p = 0.27), and Immunoglobulin A and Immunoglobulin G in the case and control were also not significantly different) p = 0.46, and p = 0.16, respectively), but there were significant differences (p= 0.003) between the level of the IgM in the case and control groups.

Conclusion: No statistically significant difference was observed in the IL-33 serum level, for at least 4–6 months after the last abortion in the case group and the final live birth in the control group. In contrast, serum levels of IgM were statistically significant. Finally, the need for more studies is felt according to the different results of the previous studies in this field.

Key words: Interleukin-33, Abortion, IgG, IgA, IgM.

The report of ovarian tissue transplant in Iran: A case report

2024-06-15T11:19:45+00:00

Background: Cancer treatments such as chemotherapy and radiotherapy increase the chance of ovarian failure. Ovarian tissue transplantation (OTT) is a viable option for fertility preservation in these cases. We aim to report ovarian transplantation in a leukemia case undergoing the vitrification method.

Case Presentation: The case was a 28-yr-old female in Research and Clinical Center for Infertility, Yazd, Iran who was suffering from leukemia. Ovarian biopsy was performed by laparoscopy surgery and transported to cryopreservation lab at 4°C for 1–2 hr. The ovarian cortex was removed from the medulla, and ovarian strips were cryopreserved by vitrification. This procedure used the equilibration and vitrification solutions including medium 199 supplemented with 20% serum, and ethylene glycol and dimethyl sulfoxide with concentrations of 7.5% and 20%, respectively. Before doing OTT, we assessed the tissue viability and follicular count by chick embryo chorioallantoic membranes and histologic survey, respectively. OTT was done after complete remission, following warmed tissue sutured together and transplanted on the residual medulla on the right side. On the left side, the ovary was removed completely; however, 2 strips were put on the peritoneal pocket. Anti-Müllerian hormone, follicle-stimulating hormone, and luteinizing hormone levels were 0.1 ng/mL, 36.5 mIU/mL, and 19.8 mIU/mL before OTT. During a 6-month follow-up, the anti-Müllerian hormone increased to 0.9, and then follicle-stimulating hormone and luteinizing hormone levels decreased dramatically until 17.47 mIU/mL and 6.71 mIU/mL, respectively. Also, the patient had 3 cycles of menstrual periods.

Conclusion: We demonstrated an appropriate hormonal profile, and the restoration of the menstrual cycle might indicate a successful transplant. Further investigations are needed to achieve successful clinical outcomes.

Key words: Cryopreservation, Tissue transplantation, Leukemia, Vitrification, Ovarian follicle.

Massive aggressive angiomyxoma of ischioanal region with relapse: A case report

2024-06-15T11:21:20+00:00

Background: Aggressive angiomyxoma (AA) is a rare and slow-growing tumor in the pelvic and perineal regions that might develop into other perineal structures. It can present variably, ranging from a painless mass to non-specific symptoms such as dyspareunia. Due to the high relapse rate, extensive tumoral resection is reasonably required to prevent recurrences. It is also commonly confused with other conditions such as lipomas, Bartholin’s gland cysts, and hernias.

Case Presentation: A 43-yr-old female diagnosed with AA 10 yr ago was evaluated as a consequence of the tumor recurrence. She presented rare manifestations of a giant and cystic pelvic mass involving pararectal and paravaginal tissue in front of the sacrum.

Conclusion: Although AA is a rare and slow-growing tumor, close observation is recommended due to the high relapse rate. Furthermore, extensive tumoral resection and regular follow-up can reduce morbidity in these patients.

Key words: Vulvar neoplasm, Perineum, Pelvic neoplasms, Recurrence.