International Journal of Reproductive BioMedicine (IJRM)

Comparison of pregnancy outcome after adding oral or intramuscular progesterone to vaginal progesterone in frozen embryo transfer: A cross-sectional study

Fri, 06 Dec 2024 00:00:00 +0000

Background: Currently, frozen embryo transfers (FET) account for 41% of all embryo transfer cycles. Vaginal progesterone preparations have become the leading choice for luteal phase support due to their convenient application; however, using only vaginal progesterone during FET cycles results in a lower ongoing pregnancy rate.

Objective: This study aimed to investigate whether replacing intramuscular (IM) progesterone with oral dydrogesterone in FET cycles affects pregnancy outcomes or not.

Materials and Methods: In this cross-sectional study, pregnancy outcomes were analyzed in women who underwent cleavage stage FET during an endometrial preparation cycle using hormone replacement therapy at Yazd Reproductive Sciences Institute, Yazd, Iran, between April 2023 and November 2023. The study examined 2 groups based on a luteal phase support regimen: the dydrogesterone group, which received vaginal progesterone and oral dydrogesterone, and the IM progesterone group, which received vaginal progesterone and IM progesterone. Data were extracted from patient files to compare outcomes between the 2 groups.

Results: A total of 960 cycles meeting the inclusion criteria were analyzed, with 292 women in the dydrogesterone group and 668 women in the IM progesterone group, and pregnancy outcomes were compared between the 2 groups. The chemical pregnancy rates (28.4% vs. 29.9%, p = 0.636), clinical pregnancy rates (25.3% vs. 26.9%, p = 0.604), and ongoing pregnancy rates (21.9% vs. 23.8%, p = 0.525) were lower and miscarriage rates (14.7% vs. 11.7%, p = 0.210) were higher in dydrogesterone group compared to IM progesterone group, although this difference was not statistically significant.

Conclusion: Based on the ease of use and similar pregnancy outcomes of oral dydrogesterone, it can potentially replace the daily injections of IM progesterone.

Placental pathological findings and their association with maternal and fetal clinical outcomes: A cross-sectional study

Soheila Sarmadi, Elham Mirzaian, Fatemeh Nili, Fatemeh Khalafrezaei — Fri, 06 Dec 2024 00:00:00 +0000

Background: Placental pathological changes can occur in both normal and high-risk pregnancies, leading to adverse maternal and neonatal outcomes.

Objective: This study aimed to investigate the relationship between placental histopathological findings and maternal and fetal clinical outcomes, as well as to determine if there is an association between maternal comorbidities and placental pathologies. Materials and Methods: In this study, 250 placenta samples were evaluated. The slides and paraffin blocks were retrieved from the archive of the pathology department of Shariati and Yas hospitals, Tehran, Iran. The placental histopathological findings were analyzed in relation to maternal and fetal clinical data.

Results: The average age of pregnant women was 31.84 yr. The average gestational age at birth was 28 wk. The most prevalent pathological finding was maternal vascular malperfusion, observed in 59.6% of cases. The presence of nucleated red blood cells (NRBC) in umbilical cord blood vessels was observed in 16.4% of cases. Fetal vascular malperfusion was significantly associated with intrauterine fetal demise. Maternal inflammatory response was associated with premature rupture of membranes. Maternal vascular malperfusion and the presence of NRBC in umbilical cord blood vessels was significantly associated with pre-eclampsia and preterm labor. Furthermore, a history of maternal malignancy was associated with placental infarction and the presence of NRBC in umbilical cord blood vessels.

Conclusion: The findings of this study underscore the importance of evaluating placental histopathological findings in relation to maternal and fetal clinical outcomes. Therefore, understanding these placental pathological changes will be crucial in predicting and preventing complications in subsequent pregnancies.

Follicular fluid meiosis activating sterol supplementation enhances oocyte maturation and fertilization in a microfluidic system: A lab trial study

Fri, 06 Dec 2024 00:00:00 +0000

Background: In vitro maturation (IVM) is a promising technique in assisted reproductive technologies, offering benefits such as reducing the risk of ovarian hyperstimulation syndrome.

Objective: This study aimed to evaluate the effects of timed follicular fluid meiosis-activating sterol (FF-MAS) supplementation on the IVM of germinal vesicle oocytes using a dynamic microfluidic system.

Materials and Methods: In this lab trial study, 266 germinal vesicle oocytes were collected from the Infertility Center of Fatemieh hospital, Hamedan, Iran between June 2023 and January 2024. The oocytes were allocated into 3 groups for dynamic microfluidic culture. Each group received culture medium at a flow rate of 0.36 μL/min for 24 hr through inlet A and FF-MAS supplementation through inlet B for 1, 2, and 6 hr. The study evaluated maturation and fertilization rates, embryo development, and mitochondrial status, which was assessed using the JC-1 mitochondrial membrane potential assay.

Results: Maturation rates were significantly higher in the medium-term FF-MAS exposure (MTG) and long-term FF-MAS exposure groups compared to the short-term FF-MAS group (STG) (p < 0.05). Fertilization rates were also higher in the MTG and long-term FF-MAS group compared to the STG (p < 0.05). Embryo formation rates and the proportion of good-quality embryos were higher in the MTG compared to the STG (100% vs. 75%; p = 0.03) and (83.3% vs. 33.3%; p = 0.01), respectively. Mitochondrial peripheral distribution was significantly higher in the MTG than in the STG (p = 0.04).

Conclusion: Optimizing FF-MAS exposure duration enhances IVM efficiency, offering a promising strategy to increase oocyte utilization in in-vitro fertilization programs.

Maternal and neonatal outcomes in women with COVID-19: A retrospective cohort study

Fri, 06 Dec 2024 00:00:00 +0000

Background: Considering the conflicting evidence that exists regarding the effect of the coronavirus disease 2019 (COVID-19) on pregnancy and newborn outcomes, it is necessary to conduct this research during the first year in the north of Iran, a highly visited and trafficked place, which increases the possibility of contracting the virus and severity of the infection.

Objective: This study aimed to compare maternal and neonatal outcomes in pregnant women with and without COVID-19.

Materials and Methods: In this retrospective cohort study, data from 160 pregnant women referred to 3 hospitals in Mazandaran, Iran from April 2020 to March 2021 were extracted from their medical records using checklists. Participants were divided into 2 groups: group A) 80 pregnant women with COVID-19 and group B) 80 noninfected pregnant women. All information related to maternal and neonatal outcomes were extracted and compared from the files of the 2 groups. The results obtained from comparing 2 groups of pregnant women from the result of the reverse-transcription polymerase chain reaction test were analyzed.

Results: The most common symptoms in the COVID-19 group were fever and cough. Pregnancy complications such as abortion, pre-eclampsia, and premature birth were not significant between groups (p = 0.4, 0.45, 0.45, respectively). No statistically significant difference was observed between groups regarding maternal and neonatal outcomes.

Conclusion: Despite the peak and severity of the COVID-19 disease in the first year of the pandemic, it seems that it had no effect on maternal and neonatal outcomes in each trimester of pregnancy in affected women.

Comparing intra-uterine injection of mononuclear cells and platelet-rich plasma on the pregnancy rate of women with recurrent implantation failure: An RCT

Fri, 06 Dec 2024 00:00:00 +0000

Background: Recurrent implantation failure (RIF) can be explained mainly by improper crosstalk between the embryo and endometrium. The T-helper1/T-helper2 profile balance influences effective embryo implantation. Endometrial immunomodulation via intrauterine injection of activated peripheral blood mononuclear cells (PBMCs) or autologous platelet-rich plasma (PRP) is a potentially efficient treatment option.

Objective: This study aims to examine the biochemical and clinical pregnancies resulting from the intrauterine administering of activated PBMCs and PRP in RIF women.

Materials and Methods: This randomized clinical trial study was done in the Rooya Infertility Treatment Center, Qom, Iran from November 2022 to April 2024. 96 women with at least 2 RIFs were randomized into control, PBMC, and PRP groups. Briefly, 3 ml of blood sample was collected and PBMCs were isolated using Ficoll separation solution, and cultured for 72 hr. PRP was separated from 10 ml of peripheral blood through centrifugation. 2 days before embryo transfer PBMCs or PRP were transferred into the endometrial cavity.

Results: Except for the duration of infertility, which was higher in the PBMC group, all other baseline characteristics were not statistically different. Moreover, a significantly higher rate of biochemical pregnancy was observed in the PRP (10/32) and PBMC (12/32) groups compared to the control (3/32) (p = 0.027), while the rate of clinical pregnancy was only significantly higher in the PBMC group (10/32) than in the control group (2/32) (p = 0.038).

Conclusion: Neither PBMC nor PRP interventions exhibited a substantial advantage over one another regarding biochemical and clinical pregnancy rates.

Association between menstrual disorders and anti-Müllerian hormone with COVID-19: A prospective cohort study

Fri, 06 Dec 2024 00:00:00 +0000

Background: Coronavirus 2019 (COVID-19) has affected almost all communities throughout the world. It affects different systems in the body, which causes irreparable consequences.

Objective: This study aimed to investigate the effect of the COVID-19 virus on menstrual disorders, anti-Mullerian hormone (AMH), thyroid peroxidase (TPO), thyroid stimulating hormone (TSH), and prolactin levels in women with COVID-19 disease.

Materials and Methods: This prospective cohort study was conducted on 201 women (101 healthy, and 100 women with COVID-19) in Nomadic hospital, Khorramabad, Iran from February-October 2021. After recovery from COVID-19, participants were interviewed about their menstrual cycle in their 1st and 4th months. Blood samples were collected during 1st and 4th months, and AMH, TSH, TPO, and prolactin levels were assessed.

Results: No significant differences were observed in the 1st and 4th months regarding menstrual disorders, TPO, and prolactin levels in the patient group (p > 0.05). The mean level of AMH in the healthy group was higher than the patient group in both times (p < 0.001). A relationship between TSH and COVID-19 was observed in the 1st month (p < 0.001); however, no significant relationship was observed in the 4th month, in this regard.

Conclusion: Endocrine dysfunction in the form of low AMH and high TSH were common among COVID-19 patients. Due to the importance of menstrual and hormonal disorders, especially AMH and TSH, and their association with COVID-19, health policymakers should find appropriate solutions to reduce complications.

Secretome of human amniotic membrane stem cells promote recovery and testicular functions through modulating SIRT1/NRF2/TNF-α pathway in mice testicular torsion: An experimental study

Fri, 06 Dec 2024 00:00:00 +0000

Background: Testicular ischemia/reperfusion injury, a significant result of testicular torsion, can lead to the risk of male infertility.

Objective: The current study aimed to evaluate the effect of human amniotic membrane-derived mesenchymal stem cells (hAMSCs) secretome on testicular torsion/detorsion (T/D) in mice.

Materials and Methods: All the experiments were performed in the Anatomy Department of Tehran University of Medical Sciences, Tehran, Iran, during the period of March 2023 to December 2023. 40 male NMRI mice (5–7 wk, 25–30 gr) were randomized into: 1) the sham group: mice received sham operations with no other interventions, 2) T/D group, 3) negative control group; torsion detorsion + intratesticular injection of Dulbecco’s Modified Eagle Medium/Nutrient Mixture F-12, and 4) the T/D group + hAMSCs secreted factors. Serum testosterone levels, hematoxylin and eosin staining, and sperm quality parameters were used to evaluate the therapeutic effects of hAMSCs secreted factors on the testicular structure and function. Tissue oxidative stress was measured by determining malondialdehyde, superoxide dismutase, catalase, and glutathione peroxidase-1. Nuclear factor erythroid 2-related factor 2, Kelch-like ECH-associated protein 1, NAD-dependent deacetylase sirtuin-1, tumor necrosis factor-alpha and tumor protein P53 mRNA expressions were assessed in testis via real-time polymerase chain reaction.

Results: The results showed that hAMSCs secreted factors alleviated testicular T/D injury by attenuating oxidative stress, inflammatory response, and apoptosis via modulating the sirtuin-1/ nuclear factor erythroid 2-related factor 2 / tumor necrosis factor-alpha signaling pathway.

Conclusion: hAMSCs secreted factors increased antioxidative, anti-inflammatory, and antiapoptotic properties which consequently increased testosterone levels, spermatogenesis, and sperm quality parameters.

Corrigendum to “Impact of chronic opioid on cognitive function and spermatogenesis in rat: An experimental study” [Int J Reprod BioMed 2024; 22: 579-592]

Fri, 06 Dec 2024 00:00:00 +0000

The publisher has been informed of an error that occurred on page 579 in which the last authors affiliation must be changed to Department of Biology, Faculty of Sciences, Malayer University, Malayer, Iran. On behalf of the author, the publisher wishes to apologize for this error. The online version of the article has been updated on October 31, 2024 and can be found at https://doi.org/10.18502/ijrm.v22i7.16971.