Pronounced Trace Element Variation in Follicular Fluids of Subfertile Women Undergoing Assisted Reproduction

Female subfertility is a growing concern, especially in view of an increasing prevalence of polycystic ovary syndrome (PCOS). Assisted reproductive technologies (ART) offer a perspective for pregnancy, but the outcome rate is still suboptimal. The trace elements (TE), copper (Cu), selenium (Se), and zinc (Zn) are essential for fertility and development. We hypothesized that TE concentrations are related to oocyte quality and growth and affect pregnancy outcomes in women undergoing ART. Concentrations of TE were measured by total reflection X-ray fluorescence. Extracellular glutathione peroxidase 3 (GPX3) and selenoprotein P (SELENOP) were determined as additional Se biomarkers. Corresponding serum and follicular fluid (FF) samples were available from women with (n = 20) and without (n = 20) PCOS diagnosis undergoing hormone treatment within the ART procedure, respectively, and FF samples were classified into five groups based on morphological assessment. Serum showed higher TE concentrations than FF, and TE levels correlated positively between both matrices. Individual FF from the same women showed surprisingly high variability in TE concentration, and follicles without oocytes displayed the lowest TE concentrations. Both Se biomarkers GPX3 and SELENOP were present in FF and correlated positively to Se concentrations. Some notable relationships were observed between morphokinetic parameters, TE concentrations, and GPX3 activity. A slightly depressed serum Zn concentration was observed in PCOS. Our results indicate a direct relationship between TE in serum and FF, positive correlations between the three Se biomarkers in FF, and high variability between the FF from the same woman with the lowest TE concentrations in the follicles with the poorest quality. The differences observed in relation to PCOS diagnoses appear relatively minor. Collectively, the data support the notion that TE assessment of follicles may contribute to optimal oocyte selection and subsequently influence ART success.

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The role of the growth hormone in assisted reproductive technologies cycles

GYNECOLOGY ◽

10.26442/20795696.2019.4.190526 ◽

2019 ◽

Vol 21 (4) ◽

pp. 6-8

Author(s):

Andrey Y Romanov ◽

Anastasiya G Syrkasheva ◽

Nataliya V Dolgushina ◽

Elena A Kalinina

Keyword(s):

Growth Hormone ◽

Live Birth ◽

Ovarian Stimulation ◽

Assisted Reproductive Technologies ◽

Polycystic Ovary ◽

Live Birth Rate ◽

Reproductive Technologies ◽

Blood Levels ◽

Main Research ◽

Poor Ovarian Responders

The paper analyzes the literature data on the use of the growth hormone (GH) in ovarian stimulation in assisted reproductive technologies (ART). Routine use of GH in ovarian stimulation in patients with a normal GH level does not increase pregnancy and childbirth rates in ART. Also, no benefits of using GH have been identified for patients with polycystic ovary syndrome, despite the increase in insulin and IGF-1 blood levels. The main research focus is to study the use of GH in patients with poor ovarian response. According to the meta-analysis conducted by X.-L. Li et al. (2017), GH in ovarian stimulation of poor ovarian responders increases the number of received oocytes, mature oocytes number, reduces the embryo transfer cancellation rate and does not affect the fertilization rate. The pregnancy and live birth rates are significantly higher in the group of GH use - by 1.65 (95% CI 1.23-2.22) and 1.73 (95% CI 1.25-2.40) times, respectively. Thus, it is advisable to use GH in ovarian stimulation in poor ovarian responders, since it allows to increases live birth rate in ART. However, further studies should determine the optimal GH dose and assesse it`s safety in ART programs.

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Molecular Mechanisms Responsible for Increased Vulnerability of the Ageing Oocyte to Oxidative Damage

Oxidative Medicine and Cellular Longevity ◽

10.1155/2017/4015874 ◽

2017 ◽

Vol 2017 ◽

pp. 1-22 ◽

Cited By ~ 25

Author(s):

Bettina P. Mihalas ◽

Kate A. Redgrove ◽

Eileen A. McLaughlin ◽

Brett Nixon

Keyword(s):

Oxidative Damage ◽

Molecular Mechanisms ◽

Spindle Assembly Checkpoint ◽

Assisted Reproductive Technologies ◽

Reproductive Technologies ◽

Oocyte Quality ◽

Protein Repair ◽

Protective Mechanisms ◽

Pronounced Increase ◽

Age Related

In their midthirties, women experience a decline in fertility, coupled to a pronounced increase in the risk of aneuploidy, miscarriage, and birth defects. Although the aetiology of such pathologies are complex, a causative relationship between the age-related decline in oocyte quality and oxidative stress (OS) is now well established. What remains less certain are the molecular mechanisms governing the increased vulnerability of the aged oocyte to oxidative damage. In this review, we explore the reduced capacity of the ageing oocyte to mitigate macromolecular damage arising from oxidative insults and highlight the dramatic consequences for oocyte quality and female fertility. Indeed, while oocytes are typically endowed with a comprehensive suite of molecular mechanisms to moderate oxidative damage and thus ensure the fidelity of the germline, there is increasing recognition that the efficacy of such protective mechanisms undergoes an age-related decline. For instance, impaired reactive oxygen species metabolism, decreased DNA repair, reduced sensitivity of the spindle assembly checkpoint, and decreased capacity for protein repair and degradation collectively render the aged oocyte acutely vulnerable to OS and limits their capacity to recover from exposure to such insults. We also highlight the inadequacies of our current armoury of assisted reproductive technologies to combat age-related female infertility, emphasising the need for further research into mechanisms underpinning the functional deterioration of the ageing oocyte.

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Genetic polymorphisms of reproductive hormones and their receptors in assisted reproduction technology for patients with polycystic ovary syndrome

Drug Metabolism and Personalized Therapy ◽

10.1515/dmpt-2021-0123 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Yulia A. Koloda ◽

Yulia V. Denisova ◽

Natalia M. Podzolkova

Keyword(s):

Polycystic Ovary Syndrome ◽

Assisted Reproductive Technologies ◽

Polycystic Ovary ◽

Ovarian Response ◽

Reproductive Technologies ◽

Reproductive Hormones ◽

Current Data ◽

Nucleotide Polymorphisms ◽

Ovary Syndrome ◽

Art Programs

Abstract Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in women of childbearing, which is defined by the accumulation of multiple, small fluid-filled ovarian cysts without the selection of a single dominant follicle. Most PCOS phenotypes are characterized by the absence of spontaneous ovulation, resistance toward ovulation inductors, the production of a large immature oocytes number, and the high prevalence of ovarian hyperstimulation syndrome, resulting in reduced assisted reproductive technologies (ART) programs effectiveness. The review analyses current data about the relationship between polymorphism genotypes of KISS genes, follicle stimulating hormone (FSH), luteinizing hormone (LH), anti-Müllerian hormone (AMH) and their receptors genes, gonadotropin-releasing hormone (GnRH), estrogen, and progesterone receptors genes, the PCOS risk and the features of ovarian response to stimulation during ART cycles. The use of single nucleotide polymorphisms (SNPs) as prognostic markers of ART programs outcomes would provide a personalized approach to the drugs and doses choice for ovarian stimulation and significantly increase the chance of pregnancy.

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How to Achieve High-Quality Oocytes? The Key Role of Myo-Inositol and Melatonin

International Journal of Endocrinology ◽

10.1155/2016/4987436 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 36

Author(s):

Salvatore Giovanni Vitale ◽

Paola Rossetti ◽

Francesco Corrado ◽

Agnese Maria Chiara Rapisarda ◽

Sandro La Vignera ◽

...

Keyword(s):

Assisted Reproductive Technologies ◽

Reproductive Technologies ◽

Oocyte Quality ◽

Fertilization Rate ◽

In Vitro Models ◽

The One ◽

High Level

Assisted reproductive technologies (ART) have experienced growing interest from infertile patients seeking to become pregnant. The quality of oocytes plays a pivotal role in determining ART outcomes. Although many authors have studied how supplementation therapy may affect this important parameter for both in vivo and in vitro models, data are not yet robust enough to support firm conclusions. Regarding this last point, in this review our objective has been to evaluate the state of the art regarding supplementation with melatonin and myo-inositol in order to improve oocyte quality during ART. On the one hand, the antioxidant effect of melatonin is well known as being useful during ovulation and oocyte incubation, two occasions with a high level of oxidative stress. On the other hand, myo-inositol is important in cellular structure and in cellular signaling pathways. Our analysis suggests that the use of these two molecules may significantly improve the quality of oocytes and the quality of embryos: melatonin seems to raise the fertilization rate, and myo-inositol improves the pregnancy rate, although all published studies do not fully agree with these conclusions. However, previous studies have demonstrated that cotreatment improves these results compared with melatonin alone or myo-inositol alone. We recommend that further studies be performed in order to confirm these positive outcomes in routine ART treatment.

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Effects of Inositol(s) in Women with PCOS: A Systematic Review of Randomized Controlled Trials

International Journal of Endocrinology ◽

10.1155/2016/1849162 ◽

2016 ◽

Vol 2016 ◽

pp. 1-12 ◽

Cited By ~ 33

Author(s):

Vittorio Unfer ◽

John E. Nestler ◽

Zdravko A. Kamenov ◽

Nikos Prapas ◽

Fabio Facchinetti

Keyword(s):

Systematic Review ◽

Insulin Resistance ◽

Randomized Clinical Trials ◽

Assisted Reproductive Technologies ◽

Polycystic Ovary ◽

Pathological Condition ◽

Reproductive Technologies ◽

Reproductive Age ◽

Industrialized Nations

Polycystic ovary syndrome (PCOS) is a common endocrine disorder, with complex etiology and pathophysiology, which remains poorly understood. It affects about 5–10% of women of reproductive age who typically suffer from obesity, hyperandrogenism, ovarian dysfunction, and menstrual irregularity. Indeed, PCOS is the most common cause of anovulatory infertility in industrialized nations, and it is associated with insulin resistance, type 2 diabetes mellitus, and increased cardiovascular risk. Although insulin resistance is not included as a criterion for diagnosis, it is a critical pathological condition of PCOS. The purpose of this systematic review is the analysis of recent randomized clinical trials of inositol(s) in PCOS, in particular myo- and D-chiro-inositol, in order to better elucidate their physiological involvement in PCOS and potential therapeutic use, alone and in conjunction with assisted reproductive technologies, in the clinical treatment of women with PCOS.

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Polycystic ovary syndrome, body mass index and outcomes of assisted reproductive technologies

Reproductive BioMedicine Online ◽

10.1016/s1472-6483(10)60037-5 ◽

2009 ◽

Vol 18 (6) ◽

pp. 856-863 ◽

Cited By ~ 22

Author(s):

Hind A Beydoun ◽

Laurel Stadtmauer ◽

May A Beydoun ◽

Helena Russell ◽

Yueqin Zhao ◽

...

Keyword(s):

Body Mass Index ◽

Polycystic Ovary Syndrome ◽

Body Mass ◽

Assisted Reproductive Technologies ◽

Polycystic Ovary ◽

Reproductive Technologies ◽

Ovary Syndrome

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Inositol and folates in the restoration of reproductive function in women and prevention of congenital malformations

Reproductive Endocrinology ◽

10.18370/2309-4117.2021.61.95-100 ◽

2021 ◽

pp. 95-100

Author(s):

H.I. Reznichenko ◽

Y.H. Reznichenko

Keyword(s):

Folic Acid ◽

Reproductive Health ◽

Congenital Malformations ◽

Ovarian Function ◽

Assisted Reproductive Technologies ◽

Polycystic Ovary ◽

Reproductive Technologies ◽

Late Gestation ◽

Trophoblast Invasion ◽

Pregnancy And Childbirth

In recent years, Ukraine has seen a significant deterioration in the reproductive health of women in the face of declining birth rates. One of the main causes of comorbidity of infertility and background pathologies is the insufficient supply of a woman's body in the pre-pregnancy period with micronutrients – folate, vitamins, myo-inositol and others. This increases the risk of complications during pregnancy and childbirth and congenital malformations.Literature analysis showed that myo-inositol in combination with folate are an extremely important way to prevent fertility disorders, complications of pregnancy and childbirth, congenital malformations and support the reproductive health of the next generation. Myo-inositol in combination with folic acid promotes the effects of luteinizing and follicle-stimulating hormones, normalization of ovarian function, oocyte quality, trophoblast invasion during blastocyst attachment, prevention of congenital malformations by neutralizing the action of homocysteine with metafolin in the pregravid period and during pregnancy and assisted reproductive technologies, reducing the incidence of miscarriage, preeclampsia and other complications. The neuroprotective effect of myo-inositol indicates the importance of its use for fetal neuroprotection in late gestation, especially in hypoxia.Fertifolin, which contains an improved combination of natural nutrients as myo-inositol 1000 mg and folic acid 100 µg in the form of metafolin (calcium L-methylfolate), successfully copes with this goal. Metafolin has greater bioavailability and more actively helps to increase the level of folate in blood plasma, in contrast to folic acid. Metafolin is characterized by fewer drug interactions and less often masks the symptoms of B12-deficient anemia, reduces the risk of anemia, placental dysfunction, malformations of the neural tube. Fertifolin is also effectively used as an adjunct in polycystic ovary syndrome and in assisted reproductive technology protocols.

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Assisted Reproductive Technologies for Women with Polycystic Ovarian Syndrome

Biomedical & Pharmacology Journal ◽

10.13005/bpj/2231 ◽

2021 ◽

Vol 14 (3) ◽

pp. 1305-1308

Author(s):

Muhjah Falah Hassan ◽

Pallav Sengupta ◽

Sulagna Dutta

Keyword(s):

Polycystic Ovarian Syndrome ◽

Assisted Reproductive Technologies ◽

Polycystic Ovary ◽

Fetal Loss ◽

Reproductive Technologies ◽

Fertilization Rate ◽

Reproductive Age ◽

Treatment Modalities ◽

Reproductive Techniques ◽

Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) is the most common cause of anovulatory fertility problems in women of reproductive age, with a prevalence as high as 40% to 75%. There are different treatment modalities for increasing the chance of pregnancy in PCOS patients. Since most of the PCOS patients suffer from ovulatory problems, therapeutic efforts are focused mainly towards restoring normal ovulation. However, even after pharmacological interventions to ameliorate ovulatory irregularities, women with polycystic ovary are still at high risk of fetal loss. Thus, assisted reproductive techniques (ARTs) have become popular approaches which significantly increase the chances of successful pregnancy in these women, bypassing the conditions of PCOS. The present mini-review ‘pinpoints’ on the suitability of ARTs for PCOS patients who fail to ovulate following the conventional infertility treatment. The article also briefly explains how intracytoplasmic sperm injection (ICSI), the most effectiveART, correlates with better biological parameters, fertilization rate and better quality of embryos in PCOS women.

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Anti-Mullerian hormone and its predictive value for assessing oocyte quality

GYNECOLOGY ◽

10.26442/20795696.2020.6.200473 ◽

2020 ◽

Vol 22 (6) ◽

pp. 21-26

Author(s):

Natalia V. Aleksandrova

Keyword(s):

Ovarian Reserve ◽

Predictive Value ◽

Assisted Reproductive Technologies ◽

Reproductive Technologies ◽

Oocyte Quality ◽

Laboratory Markers ◽

Diagnostic Capabilities ◽

First Time

The article systematizes information on the diagnostic capabilities of modern clinical and laboratory markers of ovarian reserve. The diagnostic capabilities of anti-Mllerian hormone (AMH) as a marker of ovarian reserve are discussed, which make it possible to adjust the dose of hormonal drugs and predict the response of the ovary to stimulation in programs of assisted reproductive technologies. This paper discusses for the first time the role of AMH in assessing the quality of oocytes and subsequent embryos. Despite insufficient literature data, further study of AMH, as well as full-scale research in this direction, seems to be extremely promising.

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Advances in Treatment Options for Polycystic Ovary Syndrome

US Endocrinology ◽

10.17925/use.2012.08.01.57 ◽

2012 ◽

Vol 08 (01) ◽

pp. 57 ◽

Cited By ~ 1

Author(s):

Sanam Lathief ◽

Lubna Pal ◽

◽

Keyword(s):

Polycystic Ovary Syndrome ◽

Ovulation Induction ◽

Assisted Reproductive Technologies ◽

Polycystic Ovary ◽

Clomiphene Citrate ◽

Reproductive Technologies ◽

Reproductive Age ◽

Comparable Efficacy ◽

Hormonal Contraceptives ◽

Ovary Syndrome

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy seen in women of reproductive age. Clinical concerns relating to PCOS range from ovulatory infertility and menstrual disorders to risk of diabetes and cardiovascular disease. Hormonal contraceptives have been the mainstay of the management of common PCOS symptoms, such as menstrual irregularity and clinical stigmata of androgen excess (i.e., hirsutism and acne). An appreciation of the relevance of metabolic pathways in the pathophysiology of PCOS is relatively recent, and has translated into an expansion of the therapeutic strategies available for the management of PCOS. Insulin sensitizers were one of the first metabolic modulators to be incorporated in the clinical management paradigm, albeit with mixed results. Recognizing that insulin resistance is central to the pathophysiology of PCOS, newer agents—e.g., thiazolidinediones— followed, with almost comparable efficacy to metformin. Statins and most recently incretins constitute novel therapies with distinct metabolic targets that seem to hold promise in the management of PCOS. In tandem with the expansion in pharmaceuticals, a host of complementary and alternative medical therapies have generated interest for purported promise in the management of PCOS, including vitamin D, acarbose, and myo-inositol. The therapeutic options for managing PCOS-related infertility have also expanded. Clomiphene citrate (CC) has long been the first-line strategy for ovulation induction in the setting of anovulatory infertility; however, aromatase inhibitors are fast gaining acceptance as an ovulation induction strategy, with results comparable or even better than those seen with CC. An increasing level of therapeutic sophistication is reflected in ovarian stimulation protocols judiciously using gonadotropins, gonadotropin-releasing hormone antagonists, the procedure of ovarian drilling, and assisted reproductive technologies within vitrooocyte maturation.

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