Acupuncture and in vitro fertilisation research: Current and future directions

2018 ◽  
Vol 36 (2) ◽  
pp. 117-122 ◽  
Author(s):  
Lee E Hullender Rubin ◽  
Belinda J Anderson ◽  
LaTasha B Craig
Keyword(s):  
Stress Reduction ◽  
Endometrial Thickness ◽  
Current Evidence ◽  
In Vitro Fertilisation ◽  
Future Directions ◽  
Acupuncture Intervention ◽  
Related Stress ◽  
The Impact ◽  
Improve Patient

Background Acupuncture is a common adjuvant treatment to support patients undergoing in vitro fertilisation (IVF). However, the impact of acupuncture and the different roles it can play in IVF remain unclear. Objective In this paper, we present an overview and critique of the current evidence on acupuncture's impact on IVF-related stress, describe harms, and propose future directions for investigation. Conclusion Two to three acupuncture sessions performed on or around the day of embryo transfer are insufficient interventions to improve IVF birth outcomes but provide significant IVF-related stress reduction. Research investigating acupuncture to support IVF is heterogeneous and confounded by the lack of an appropriate comparator. However, evidence suggests several acupuncture sessions improve endometrial thickness, reduce stress, and improve patient satisfaction. Observational studies suggest more sessions are associated with increases in clinical pregnancy and live birth rates. An optimised acupuncture intervention with a reasonable comparator is necessary for future studies, with evidence-based guidance on technique and number of sessions. Acupuncture should not be rejected as an adjuvant therapy for IVF, but more studies are needed to clarify acupuncture's role in supporting IVF cycles.

scholarly journals Individualized embryo selection strategy developed by stacking machine learning model for better in vitro fertilization outcomes: an application study

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Qingsong Xi ◽  
Qiyu Yang ◽  
Meng Wang ◽  
Bo Huang ◽  
Bo Zhang ◽  
...  
Keyword(s):  
Machine Learning ◽  
In Vitro Fertilization ◽  
Endometrial Thickness ◽  
Learning System ◽  
Embryo Selection ◽  
Selection Strategy ◽  
Application Study ◽  
Vitro Fertilization ◽  
The Impact

Abstract Background To minimize the rate of in vitro fertilization (IVF)- associated multiple-embryo gestation, significant efforts have been made. Previous studies related to machine learning in IVF mainly focused on selecting the top-quality embryos to improve outcomes, however, in patients with sub-optimal prognosis or with medium- or inferior-quality embryos, the selection between SET and DET could be perplexing. Methods This was an application study including 9211 patients with 10,076 embryos treated during 2016 to 2018, in Tongji Hospital, Wuhan, China. A hierarchical model was established using the machine learning system XGBoost, to learn embryo implantation potential and the impact of double embryos transfer (DET) simultaneously. The performance of the model was evaluated with the AUC of the ROC curve. Multiple regression analyses were also conducted on the 19 selected features to demonstrate the differences between feature importance for prediction and statistical relationship with outcomes. Results For a single embryo transfer (SET) pregnancy, the following variables remained significant: age, attempts at IVF, estradiol level on hCG day, and endometrial thickness. For DET pregnancy, age, attempts at IVF, endometrial thickness, and the newly added P1 + P2 remained significant. For DET twin risk, age, attempts at IVF, 2PN/ MII, and P1 × P2 remained significant. The algorithm was repeated 30 times, and averaged AUC of 0.7945, 0.8385, and 0.7229 were achieved for SET pregnancy, DET pregnancy, and DET twin risk, respectively. The trend of predictive and observed rates both in pregnancy and twin risk was basically identical. XGBoost outperformed the other two algorithms: logistic regression and classification and regression tree. Conclusion Artificial intelligence based on determinant-weighting analysis could offer an individualized embryo selection strategy for any given patient, and predict clinical pregnancy rate and twin risk, therefore optimizing clinical outcomes.

scholarly journals Current Evidence of Natural Agents in Oral and Periodontal Health

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 585 ◽  
Author(s):  
Gaetano Isola
Keyword(s):  
Stress Reduction ◽  
Inflammatory Diseases ◽  
Periodontal Diseases ◽  
Current Evidence ◽  
Clinical Approach ◽  
Natural Agents ◽  
Periodontopathogenic Bacteria ◽  
Oral Conditions ◽  
Relationship Of ◽  
The Impact

Oral and periodontal diseases, chewing disorders, and many destructive inflammatory diseases of the supporting tissues of the teeth are usually caused by an imbalance between host defense and environmental factors like smoking, poor nutrition, and a high percentage of periodontopathogenic bacteria. For these reasons, it is important also to focus attention on plaque control and also on improving host resistance through smoking and stress reduction, and a healthy diet. During the last decades, the importance of micronutrients has been extensively reviewed, and it was concluded that the prevention and treatment of periodontitis should include correct daily nutrition and a correct balance between antioxidants, probiotics, natural agents, vitamin D, and calcium. Recently, there has been growing interest in the literature on the impact of nutraceutical dietary aliments on oral and general health. This Special Issue provides a current and thoughtful perspective on the relationship of diet and natural agents on oral and periodontal diseases through a correct clinical approach with the last and most important evidence that may determine good oral conditions and high quality of life.

scholarly journals The Impact of Uremic Toxins on Cerebrovascular and Cognitive Disorders

Toxins ◽  
2018 ◽  
Vol 10 (7) ◽  
pp. 303 ◽  
Author(s):  
Maryam Assem ◽  
Mathilde Lando ◽  
Maria Grissi ◽  
Saïd Kamel ◽  
Ziad Massy ◽  
...  
Keyword(s):  
Animal Experiments ◽  
Cognitive Disorders ◽  
Neurological Complications ◽  
Cerebrovascular Diseases ◽  
Uremic Toxins ◽  
Current Evidence ◽  
Cognitive Disorders And Dementia ◽  
The Impact

Individuals at all stages of chronic kidney disease (CKD) have a higher risk of developing cognitive disorders and dementia. Stroke is also highly prevalent in this population and is associated with a higher risk of neurological deterioration, in-hospital mortality, and poor functional outcomes. Evidence from in vitro studies and in vivo animal experiments suggests that accumulation of uremic toxins may contribute to the pathogenesis of stroke and amplify vascular damage, leading to cognitive disorders and dementia. This review summarizes current evidence on the mechanisms by which uremic toxins may favour the occurrence of cerebrovascular diseases and neurological complications in CKD.

Putrescine supplementation during in vitro maturation of aged mouse oocytes improves the quality of blastocysts

2017 ◽  
Vol 29 (7) ◽  
pp. 1392 ◽  
Author(s):  
Dandan Liu ◽  
Guolong Mo ◽  
Yong Tao ◽  
Hongmei Wang ◽  
X. Johné Liu
Keyword(s):  
Oocyte Maturation ◽  
In Vitro Maturation ◽  
Inner Cell Mass ◽  
Cell Mass ◽  
In Vitro Fertilisation ◽  
Aged Mouse ◽  
Developmental Potential ◽  
The Impact

Mouse ovaries exhibit a peri-ovulatory rise of ornithine decarboxylase and its product putrescine concurrent with oocyte maturation. Older mice exhibit a deficiency of both the enzyme and putrescine. Peri-ovulatory putrescine supplementation in drinking water increases ovarian putrescine levels, reduces embryo resorption and increases live pups in older mice. However, it is unknown if putrescine acts in the ovaries to improve oocyte maturation. This study examined the impact of putrescine supplementation during oocyte in vitro maturation (IVM) on the developmental potential of aged oocytes. Cumulus–oocyte complexes from 9–12-month-old C57BL/6 mice were subjected to IVM with or without 0.5 mM putrescine, followed by in vitro fertilisation and culture to the blastocyst stage. Putrescine supplementation during IVM did not influence the proportion of oocyte maturation, fertilisation or blastocyst formation, but significantly increased blastocyst cell numbers (44.5 ± 1.9, compared with 36.5 ± 1.9 for control; P = 0.003). The putrescine group also had a significantly higher proportion of blastocysts with top-grade morphology (42.9%, compared with 26.1% for control; P = 0.041) and a greater proportion with octamer-binding transcription factor 4 (OCT4)-positive inner cell mass (38.3%, compared with 19.8% for control; P = 0.005). Therefore, putrescine supplementation during IVM improves egg quality of aged mice, providing proof of principle for possible application in human IVM procedures for older infertile women.

scholarly journals Individualized Embryo Selection Strategy Developed by Stacking Machine Learning Model for Better In Vitro Fertilization Outcomes: An Application Study.

2021 ◽  
Author(s):  
Qingsong XI ◽  
Qiyu YANG ◽  
Meng WANG ◽  
Bo HUANG ◽  
Bo ZHANG ◽  
...  
Keyword(s):  
Machine Learning ◽  
In Vitro Fertilization ◽  
Endometrial Thickness ◽  
Learning System ◽  
Embryo Selection ◽  
Selection Strategy ◽  
Application Study ◽  
Vitro Fertilization ◽  
The Impact

Abstract Background: To minimize the rate of in vitro fertilization (IVF)- associated multiple-embryo gestation, significant efforts have been made. Previous studies related to machine learning in IVF mainly focused on selecting the top-quality embryos to improve outcomes, however, in patients with sub-optimal prognosis or with medium- or inferior-quality embryos, the selection between SET and DET could be perplexing. Methods: This was an application study including 7887 patients with 8585 embryos treated during 2016 to 2018, in Tongji Hospital, Wuhan, China. A hierarchical model was established using the machine learning system XGBoost, to learn embryo implantation potential and the impact of double embryos transfer (DET) simultaneously. The performance of the model was evaluated with the AUC of the ROC curve. Multiple regression analyses were also conducted on the 19 selected features to demonstrate the differences between feature importance for prediction and statistical relationship with outcomes.Results: For a single embryo transfer (SET) pregnancy, the following variables remained significant: age, attempts at IVF, estradiol level on hCG day, and endometrial thickness. For DET pregnancy, age, attempts at IVF, endometrial thickness, and the newly added P1+P2 remained significant. For DET twin risk, age, attempts at IVF, 2PN/ MII, and P1×P2 remained significant. The algorithm was repeated 30 times, and averaged AUC of 0.7945, 0.8385, and 0.7229 were achieved for SET pregnancy, DET pregnancy, and DET twin risk, respectively. The trend of predictive and observed rates both in pregnancy and twin risk was basically identical. XGBoost outperformed the other two algorithms: logistic regression and classification and regression tree. Conclusion: Artificial intelligence based on determinant-weighting analysis could offer an individualized embryo selection strategy for any given patient, and predict clinical pregnancy rate and twin risk, therefore optimizing clinical outcomes.

scholarly journals Investigating the importance of individual mitochondrial genotype in susceptibility to drug-induced toxicity

2020 ◽  
Vol 48 (3) ◽  
pp. 787-797
Author(s):  
Sophie L. Penman ◽  
Alice S. Carter ◽  
Amy E. Chadwick
Keyword(s):  
Clinical Data ◽  
Research Effort ◽  
Personalised Medicine ◽  
Current Evidence ◽  
Mitochondrial Genetics ◽  
Drug Induced ◽  
Mitochondrial Haplogroup ◽  
Mtdna Variation ◽  
The Impact

The mitochondrion is an essential organelle responsible for generating cellular energy. Additionally, mitochondria are a source of inter-individual variation as they contain their own genome. Evidence has revealed that mitochondrial DNA (mtDNA) variation can confer differences in mitochondrial function and importantly, these differences may be a factor underlying the idiosyncrasies associated with unpredictable drug-induced toxicities. Thus far, preclinical and clinical data are limited but have revealed evidence in support of an association between mitochondrial haplogroup and susceptibility to specific adverse drug reactions. In particular, clinical studies have reported associations between mitochondrial haplogroup and antiretroviral therapy, chemotherapy and antibiotic-induced toxicity, although study limitations and conflicting findings mean that the importance of mtDNA variation to toxicity remains unclear. Several studies have used transmitochondrial cybrid cells as personalised models with which to study the impact of mitochondrial genetic variation. Cybrids allow the effects of mtDNA to be assessed against a stable nuclear background and thus the in vitro elucidation of the fundamental mechanistic basis of such differences. Overall, the current evidence supports the tenet that mitochondrial genetics represent an exciting area within the field of personalised medicine and drug toxicity. However, further research effort is required to confirm its importance. In particular, efforts should focus upon translational research to connect preclinical and clinical data that can inform whether mitochondrial genetics can be useful to identify at risk individuals or inform risk assessment during drug development.

scholarly journals Nutrition Related Stress Factors Reduce the Transfer of Extended-Spectrum Beta-Lactamase Resistance Genes between an Escherichia coli Donor and a Salmonella Typhimurium Recipient In Vitro

Biomolecules ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. 324 ◽  
Author(s):  
Eva-Maria Saliu ◽  
Marita Eitinger ◽  
Jürgen Zentek ◽  
Wilfried Vahjen
Keyword(s):  
Escherichia Coli ◽  
Salmonella Typhimurium ◽  
Butyric Acid ◽  
Bacterial Growth ◽  
Physiological Stress ◽  
Stress Factors ◽  
Extended Spectrum ◽  
Related Stress ◽  
The Impact

The transfer of extended spectrum β-lactamase (ESBL)-genes occurs frequently between different bacteria species. The aim of this study was to investigate the impact of nutrition related stress factors on this transfer. Thus, an Escherichia coli donor and a Salmonella Typhimurium recipient were co-incubated for 4 h in media containing different levels of the stress factors’ pH, osmolality, copper, zinc and acetic, propionic, lactic, and n-butyric acid, as well as subtherapeutic levels of cefotaxime, sulfamethoxazole/trimethoprim, and nitrofurantoin. Conjugation frequencies were calculated as transconjugants per donor, recipient, and total bacterial count. A correction factor for the stress impact on bacterial growth was used. Acetic, lactic, and n-butyric, acid, as well as pH, showed no significant impact. In contrast, increasing concentrations of propionate, zinc, copper, and nitrofurantoin, as well as increased osmolality reduced conjugation frequencies. Sulfamethoxazole/trimethoprim and cefotaxime showed increased transconjugants per donor, which decreased after correction for stress. This study showed, for the model mating pair, that conjugation frequencies decreased under different physiological stress conditions, and, thus, the hypothesis that stress factors may enhance conjugation should be viewed with caution. Furthermore, for studies on in vitro gene transfer, it is vital to consider the impact of studied stressors on bacterial growth.

Sex of co-twin affects the in vitro developmental competence of oocytes derived from 6- to 8-week-old lambs

2017 ◽  
Vol 29 (7) ◽  
pp. 1379 ◽  
Author(s):  
Jennifer M. Kelly ◽  
David O. Kleemann ◽  
Hayley McGrice ◽  
Jose A. Len ◽  
Karen L. Kind ◽  
...  
Keyword(s):  
Embryo Transfer ◽  
Least Square ◽  
Developmental Competence ◽  
In Vitro Fertilisation ◽  
Enhancement Effect ◽  
Limited Evidence ◽  
Intrinsic Factors ◽  
The Impact ◽  
Birth Type

Several intrinsic factors (age, genotype, liveweight) influence the reliability of juvenile in vitro fertilisation embryo transfer (JIVET) programs. Limited evidence indicates that variability between lambs is reduced in twin-born lambs. We examined the impact of birth type (single, twin, triplet) and sex of the co-twin (with age, birthweight and liveweight as covariates) on JIVET outcomes. Birth type did not influence any parameter studied. However, blastocysts produced, as a percentage of embryos cleaved or total cumulus–oocyte complexes collected, was higher (P < 0.05) for females born with a female co-twin (67.0 ± 6.1, 57.5 ± 6.0 respectively) compared with those born with a male co-twin (26.9 ± 6.5, 22.3 ± 6.2 respectively; least-square mean ± s.e.m.). Blastocyst rates for lambs born with a male co-twin did not differ significantly from lambs born either as singles (39.5 ± 6.7%, 34.6 ± 6.5% respectively) or triplets (43.1 ± 10.6%, 36.5 ± 10.3% respectively). Other parameters were not influenced by sex of the co-twin. These results are indicative of an enhancement effect of the female co-twin on oocyte development. From a practical perspective, selecting lambs for a JIVET program based on litter size and sex of the co-twin is warranted.

scholarly journals Metabolic Aspects of Anthracycline Cardiotoxicity

2021 ◽  
Vol 22 (2) ◽  
Author(s):  
Michele Russo ◽  
Angela Della Sala ◽  
Carlo Gabriele Tocchetti ◽  
Paolo Ettore Porporato ◽  
Alessandra Ghigo
Keyword(s):  
Heart Failure ◽  
Anticancer Agents ◽  
Energy Demand ◽  
Cardiac Metabolism ◽  
Current Evidence ◽  
Anthracycline Cardiotoxicity ◽  
Cardiac Side Effects ◽  
The Impact

Opinion statementHeart failure (HF) is increasingly recognized as the major complication of chemotherapy regimens. Despite the development of modern targeted therapies such as monoclonal antibodies, doxorubicin (DOXO), one of the most cardiotoxic anticancer agents, still remains the treatment of choice for several solid and hematological tumors. The insurgence of cardiotoxicity represents the major limitation to the clinical use of this potent anticancer drug. At the molecular level, cardiac side effects of DOXO have been associated to mitochondrial dysfunction, DNA damage, impairment of iron metabolism, apoptosis, and autophagy dysregulation. On these bases, the antioxidant and iron chelator molecule, dexrazoxane, currently represents the unique FDA-approved cardioprotectant for patients treated with anthracyclines.A less explored area of research concerns the impact of DOXO on cardiac metabolism. Recent metabolomic studies highlight the possibility that cardiac metabolic alterations may critically contribute to the development of DOXO cardiotoxicity. Among these, the impairment of oxidative phosphorylation and the persistent activation of glycolysis, which are commonly observed in response to DOXO treatment, may undermine the ability of cardiomyocytes to meet the energy demand, eventually leading to energetic failure. Moreover, increasing evidence links DOXO cardiotoxicity to imbalanced insulin signaling and to cardiac insulin resistance. Although anti-diabetic drugs, such as empagliflozin and metformin, have shown interesting cardioprotective effects in vitro and in vivo in different models of heart failure, their mechanism of action is unclear, and their use for the treatment of DOXO cardiotoxicity is still unexplored.This review article aims at summarizing current evidence of the metabolic derangements induced by DOXO and at providing speculations on how key players of cardiac metabolism could be pharmacologically targeted to prevent or cure DOXO cardiomyopathy.

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