International Journal of Reproductive BioMedicine (IJRM)

Diagnostic potential of cell-free fetal nucleic acids in predicting pregnancy complications: A systematic review and meta-analysis on trisomy, pre-eclampsia, and gestational diabetes

Sat, 26 Apr 2025 00:00:00 +0000

Background: Recent studies reveal an association between increased cell-free fetal (cff) nucleic acid in maternal blood and pregnancy challenges like loss, pre-eclampsia, growth restriction, and preterm labor. Objective: This article assesses the role of cff nucleic acids as potential diagnostic markers for the prediction and monitoring progression of severe pregnancy-related complications.

Materials and Methods: In this systematic review and meta-analysis, various databases were searched. Original articles reporting on the role of cff nucleic acids in predicting the complications of pregnancy were included. I square test and funnel plot were used to analyze heterogeneity and publication bias, respectively. The quality of studies was assessed using the critical appraisal checklists for studies created by the Joanna Briggs Institute.

Results: 70 publications were selected for the final qualitative analysis. Articles were published between 2010 and 2023, and most studies were conducted in the USA and China. The majority of studies were conducted on the quantity of cff-DNA (n = 40), and the remaining on microRNA (n = 18), messenger RNA (n = 11), and cell-free RNA (n = 1). The pooled sensitivity of cff nucleic acids for detecting trisomy was found to be 90.9 (95% CI: 80.9–100%). MicroRNA levels were significantly increased in participants with gestational diabetes mellitus, with a standardized mean difference of 1.22 (95% CI: -0.90–3.34).

Conclusion: Fetal nucleic acids can serve as accurate noninvasive diagnostic tools for predicting serious complications during pregnancy.

Diabetic pregnancy: A literature review of maternal and neonatal adverse outcomes

Sat, 26 Apr 2025 00:00:00 +0000

Of all pregnant women in the United States an average of 1.5% reported to have type 1 or type 2 diabetes mellitus. Our review article will discuss and explore the relationship between pre-pregnancy diabetes and its adverse outcomes in mothers and neonates. Diabetes in pregnancy can cause a myriad of complications, many of which are related to microvascular changes, including diabetic nephropathy and retinopathy associated with preterm delivery, cesarean sections, and intrauterine growth restriction. Pregnant patients with diabetes also have an increased risk of pre-eclampsia, likely due to complications related to abnormal structure and function of the placenta. In addition, cardiovascular complications are more common and may present antepartum, intrapartum, or postpartum. Adverse neonatal outcomes that have been observed in diabetic pregnancies include fetal stillbirth and perinatal death, macrosomia, congenital malformations, respiratory distress, and neurological impairments. These complications explain the increased morbidity and mortality rate of infants of diabetic mothers, and the increased frequency of neonatal intensive care unit hospitalizations after birth. Diabetes in pregnancy causes a spectrum of changes in the maternal-fetal interface. This review addresses the placental changes during pregnancy and its adverse maternal and neonatal outcomes. We strongly believe the material discussed in this article can help in understanding the effects of diabetes during pregnancy which will ultimately aid in designing interventions to prevent these adverse outcomes.

Endometrial compaction can improve assisted reproductive technology outcomes in frozen-thawed embryo transfer cycles using hormone replacement therapy: A cross-sectional study

Shahrzad Moeinaddini, Saeideh Dashti, Zahra Amini Majomerd, Nooshin Hatamizadeh — Sat, 26 Apr 2025 00:00:00 +0000

Background: Endometrial compaction (EC) is an ultrasound evaluation method that may predict assisted reproductive technology outcomes. Objective: This study aimed to assess the impact of EC on assisted reproductive technology outcomes in frozen embryo transfer cycles with hormone replacement therapy.

Materials and Methods: In this cross-sectional study, 100 women who underwent first or second frozen embryo transfer cycle at Yazd Reproductive Sciences Institute, Yazd, Iran from June to October 2024 were included. Endometrial thickness was compared between the day of starting progesterone and embryo transfer day. Then participants were divided into 2 groups, no compaction and compaction group. Biochemical, clinical, and ongoing pregnancy rates (OPR) were assessed between the 2 groups.

Results: Statistically significant differences were observed in biochemical, clinical, and OPR between the compaction and no compaction groups. Logistic regression analysis demonstrated significantly higher pregnancy rates in EC 10–15% and > 15%. We found a significant influence of EC 10–15% (p = 0.02, p = 0.01, p = 0.01), and EC > 15% (p = 0.002, p = 0.001, and p = 0.002) on biochemical, clinical, and OPR, respectively.

Conclusion: EC after progesterone administration in hormone replacement therapy-frozen embryo transfer cycles can increase biochemical, clinical, and OPR. The percentage of EC changes also influence the outcomes of these cycles.

Assessment of addiction behavior and spermatogenesis in glial cell line-derived neurotrophic factor-treated cannabis-addicted rats: An experimental study

Rozhina Laleh, Mitra Heydari Nasrabadi, Parvin Khodarahmi, Jamshid Soltani — Sat, 26 Apr 2025 00:00:00 +0000

Background: Cannabis addiction poses risks to male fertility by lowering levels of glial cell line-derived neurotrophic factor (GDNF), which is vital for spermatogenesis. Objective: This research aimed to determine if the injection of exogenous GDNF into the brain of cannabis-addicted rats has a positive impact on their behavior and spermatogenesis.

Materials and Methods: This study involved 15 male Wistar rats divided into 3 equal groups: control, model, and experimental. Cannabis addiction was induced in the model and experimental groups using a smoking machine with a 0.25 gr dose per 5 rats, and the experimental group received a 0.5 mg GDNF treatment via stereotaxic injection. Behavioral changes were assessed through plus maze, open field, and sucrose preference tests before and after treatments. Sperm parameters were evaluated with H&E staining, sperm morphology with Diff-Quik staining, DNA damage and viability with acridine orange and trypan blue staining.

Results: Addicted rats displayed increased anxiety, which was improved by GDNF treatment (p < 0.05). Although cannabis significantly reduced germ cells and the size of the testis and epididymis compared to controls (p = 0.0006, p = 0.003), GDNF had a limited effect on these aspects. Cannabis significantly altered sperm morphology (p = 0.0016), but GDNF reversed abnormal sperms. GDNF improves sperm quality, reverses cannabis-induced sperm grading alterations (grade C, p = 0.0295), reduces DNA damage significantly (p = 0.0242), and enhances sperm viability, highlighting its potential to counteract some of cannabis’s harmful effects on male reproductive health.

Conclusion: The findings of this experiment suggest that exogenous GDNF could be a potential therapeutic agent for cannabis addiction and sperm parameters.

An investigation of the therapeutic potential of the testicular tissue encapsulated in amnion membrane in mouse model: An experimental study

Sat, 26 Apr 2025 00:00:00 +0000

Background: Restoring fertility in male cancer individuals through testicular tissue transplantation faces challenges due to hypoxia-induced loss of spermatogonial stem cells (SSCs). Hydrogel encapsulation was explored to minimize hypoxic damage in testicular tissue transplantation. For this purpose, human amnion membrane (hAM)-derived hydrogel could be an alternative.

Objective: The potential of hAM-derived hydrogel to support testis tissue grafts was evaluated. Materials and Methods: In this experimental study, testicular tissue samples (1–3 mm³) were obtained from 16 male NMRI mice (4–5 wk, 22 ± 2 gr). These tissue fragments were either encapsulated within a hydrogel derived from a hAM or left unencapsulated (control) prior to being autologously transplanted beneath the dorsal skin of mice subjected to hemilateral or bilateral orchiectomy. The grafted testicular tissues were histologically evaluated for key parameters, including the integrity of seminiferous tubules, survival of SSCs, Sertoli cell functionality, as well as hypoxia and apoptosis on day 21.

Results: No significant differences were observed between groups regarding ST integrity, number of SSCs, Sertoli cell functionality, or the rate of hypoxia-inducible factor 1-alpha and apoptosis (p ≤ 0.05).

Conclusion: In conclusion, this study demonstrated no effect of hAM hydrogel encapsulation on the outcomes of testicular tissue transplantation.

The protective effects of melatonin on testis, sperm parameters quality, and in-vitro fertilization in mice following treatment with aflatoxin B1: An experimental study

Sat, 26 Apr 2025 00:00:00 +0000

Background: Aflatoxin B1 (AFB1) contamination of foods and animal feeds is a public health issue. Exposure to AFB1 induces oxidative stress and can cause male reproductive toxicity. Melatonin (MLT) is a neuro-hormone produced by the pineal gland and the testis and is known as a potent antioxidant.

Objective: This study aims to determine the protective effect of MLT on testicular tissue alterations, sperm parameter indexes, and in vitro fertility assays in mice treated with AFB1. Materials and

Methods: In this experimental study, 28 adult male NMRI mice (8–10 wk old, 25–27 gr) were divided randomly into 4 groups: control, MLT (20 mg/kg/day, intraperitoneally), AFB1 (50 μg/kg/day, intraperitoneally) and MLT+AFB1. After 35 consecutive days, testis histological changes, sperm quality parameters, the rate of sperm with DNA damage, and in vitro fertilization outcomes up to the blastocyst stage were surveyed and compared between groups.

Results: Our results showed that AFB1 administration induced histological alterations in the testis and significantly decreased all the sperm parameters and in vitro fertility (fertilization and blastocyst formation rates) compared to control. Additionally, the percentages of immature sperms and sperms with DNA damage significantly (p < 0.001) increased in the AFB1-treated group. MLT treatment in the MLT+AFB1 group significantly increased testis quality and sperm parameters and improved in vitro fertilizaton rate and in vitro embryonic development.

Conclusion: These findings demonstrated that MLT can compensate for the adverse effects of AFB1 on the quality of testicular tissue, sperm parameters, sperm DNA, and in vitro fertilization outcomes.

Evaluation of laparoscopic surgery effects on pain severity and quality of life in different subtypes of endometriosis: A follow-up study

Sat, 26 Apr 2025 00:00:00 +0000

Background: Studies have shown that endometriosis significantly has a negative impact on women’s mental health and quality of life (QoL), resulting in these participants experiencing a diminished QoL.

Objective: This study aimed to evaluate the effect of laparoscopic surgery on the severity of pain and the QoL of women with different types of endometriosis.

Materials and Methods: In this follow-up study 50 women with endometriosis, who underwent laparoscopic surgery, who met a high visual analog score (> 6) with impaired QoL, lack of response to analgesics, infertility with pain unresponsive to assisted reproductive therapy, and involvement of other organs such as the bowel or ureter at the Amir Al Momenin hospital, Zabol, Iran, from August 2022 to January 2023 were enrolled. The participants were categorized into 2 groups: those with stage IV endometriosis and those with lower stages (I-III). Groups according to the higher occurrence of grade 4 endometriosis, as 55.1% were affected by it. The pain score was measured using the visual analog score, and the participants’ QoL score was measured using the endometriosis health profile questionnaire.

Results: The mean age of participants was 32 yr, with a standard deviation of 8.6 yr. Participants were divided into 2 groups: those with grade 4 endometriosis (55.1%) and those with a grade lower than 4, as classified by the American Society for Reproductive Medicine. Over 12 months, both groups experienced a significant decrease in pain severity and QoL scores (p < 0.0001). However, the changes in pain and QoL scores between the 2 groups were not statistically significant (p = 0.520 and p = 0.984, respectively).

Conclusion: Laparoscopic treatment can reduce pain and QoL scores (increase the QoL indices) in women with endometriosis, regardless of the disease’s severity.

Impact of ovarian hyperstimulation syndrome on intracytoplasmic sperm injection outcomes in poly-cystic ovarian syndrome women: A cross-sectional study

Mufeda Ali Jwad, Maryam Hussein Khaleefah, Ramih Abd AlFattah Naser — Sat, 26 Apr 2025 00:00:00 +0000

Background: Polycystic ovarian syndrome (PCOS) is a complex disorder that affects the endocrine, metabolic, and reproductive systems. While controlled ovarian hyperstimulation can increase the number of oocytes retrieved and improve the number of good-quality embryos, it may also negatively affect oocyte maturity, embryo quality, endometrial receptivity, and pregnancy outcomes.

Objective: This study aimed to find out if ovarian hyperstimulation syndrome (OHSS) has negative effects on intracytoplasmic sperm injection outcomes in a sample of PCOS women.

Materials and Methods: In this cross-sectional study, data of 84 PCOS women who underwent controlled ovarian stimulation using a flexible antagonist protocol-treated intracytoplasmic sperm injection cycles referred to the Infertility Department of Higher Institute for the Diagnosis of Infertility and Assisted Reproduction Techniques, Baghdad, Iraq between January 2020 and December 2023 was extracted from their medical records. Participants were categorized into 2 groups after undergoing controlled ovarian hyperstimulation protocol: PCOS with OHSS (n = 54) and PCOS without OHSS (n = 30). The dosage was tailored based on age, body mass index, and response to previous stimulation cycles, if applicable. The trigger was administered using decapeptyl 0.2 mg alone or in combination with recombinant human chorionic gonadotrophin, depending on the estradiol levels at the time of the trigger.

Results: Significant differences were observed in the duration of stimulation (p = 0.005), oocyte yield (p = 0.001), mature oocytes (p = 0.001), and fertilized oocytes (p = 0.036); however, no significant difference was observed, neither in number of good quality embryos (p = 0.52) nor in pregnancy rate (p = 0.54) after fresh and frozen embryo transfer between the 2 groups.

Conclusion: OHSS does not affect the embryo quality or pregnancy rate in PCOS women.