The effect of surgical sterilization on ovarian function: a rat model

Objective: To evaluate the effects of various methods of sterilization on ovarian function, in a rat model. Study Design: Forty-eight female Whistar albino rats weighing 200–250 g are divided equally into four groups. All rats underwent laparotomy, while no specific intervention was made to the first group. Bilateral tubal ligation by Pomeroy’s technique, unipolar and bipolar cautery was done to the second, third and fourth groups, respectively. All rats were then individually caged and fed on demand for 6 months. Afterwards, the rats were sacrificed and underwent bilateral oophorectomy. A pathologist blinded to the groups made histological examination by counting number of healthy tertiary follicles and corpora lutea in each ovary. The results of the groups were statistically compared by one-way ANOVA using post-hoc Bonferroni correction. Results: Rats in group 1 had significantly higher number of healthy tertiary follicles than every other group. Rats in group 1 also had significantly more corpora lutea than those in group 3. Conclusion: Tubal ligation may affect ovarian function, which in turn may reflect to ovarian histology in rats.     

The effects of resveratrol on ovarian hyperstimulation syndrome in a rat model

Objective

The aim of the present study was to investigate effects of resveratrol (RSV) over ovarian hyperstimulation syndrome (OHSS) in rat model.

Diagnosis and management of tubal pregnancy: effect on fertility outcome

We analysed 188 ectopic pregnancies seen during a 2-year period. They represented 2.2% of the live births that occurred during the same time interval. Overall, 53% of the tubal pregnancies had ruptured at the time of examination. Location was ampullary in 51% of the cases, isthmic in 28%, and 10% had aborted. Sixty-nine (38%) patients had an IUD. Diagnostic sensitivity was 58%-93% for pregnancy tests, 79% for culdocentesis, 41% for ultrasound examination, 43% for dilatation and curettage, and 100% for laparoscopy. Salpingectomy was performed in 47% of the cases, salpingotomy in 27%, and tubal resection in 19%. During a follow-up of 116 women (mean 1.5 years, range 0.5-3 years) 49% delivered, 10% had repeat ectopic pregnancy, 10% had abortion, 17% were infertile and 15% practised birth control. Among those who delivered no difference was found between those who underwent salpingectomy and those who underwent conservative surgery.     

The effect of rutin on ovarian ischemia-reperfusion injury in a rat model

The effect of rutin on ovarian ischemia-reperfusion (I/R) injury was investigated in this experimental study. Eighteen Wistar albino female rats were divided into three groups as follows: I/R group (IRG; n?=?6), 50?mg/kg rutin?+?I/R group (RG; n?=?6), and a healthy control group scheduled for a sham operation (SG; n?=?6). 2?h of ischemia and following 2?h of reperfusion were created in the IRG and RG by using a torsion model involving atraumatic vascular clips. Rutin, a flavonoid glycoside, was injected intraperitoneally at the dose of 50?mg/kg to RG group 1?h before reperfusion. Then, rats were euthanized and their ovaries were removed for biochemical and histopathological examination and also assessment of the gene expressions. IRG group had a significant increase in malondialdehyde (MDA) levels, in the expressions of tumor necrosis factor alpha (TNF-α) and interleukin 1 beta (IL-1β), and also in the activity of cyclooxygenase 2 (COX-2) unlike the significant decrease in total glutathione (tGSH) levels and the activity of COX-1 when compared to the SG group. However, rutin significantly decreased MDA levels, the expressions of TNF-α and IL-1β, and also the activity of COX-2 while it increased significantly tGSH levels and the activity of COX-1 in the RG group in comparison with the IRG group. Rutin ameliorated the I/R-induced ovarian injury in rats via its possible antioxidative and anti-inflammatory effects.     

The position of the fertility counsellor in a fertility team: A critical appraisal

The ongoing evolution of reproductive medicine has revealed the complexity of emotional reactions of couples seeking to fulfil their desire for a child. The position of counselling is evaluated from three perspectives: the couple, medical staff and the individual counsellor. This leads to three proposed levels of counselling, as an integrated component of Assisted Reproductive Technology (ART).     

The effect of obesity on the outcome of infertility management in women with polycystic ovary syndrome

Introduction Obesity has become a worldwide epidemic with ever increasing incidence and public health problems in both developing and developed countries.Objective The objective of the study is to investigate the incidence of obesity among patients with polycystic ovarian syndrome attending infertility clinic and the effect on treatment outcome.Methodology Two hundred and seventy women with polycystic ovarian syndrome attending the infertility clinic were evaluated clinically, biochemically, and laparoscopically. They were stratified according to their body mass index (BMI) as follows: normal weight: 18–24; overweight: 25–29, obese:30–34, and grossly obese: 35. Therapy included induction of ovulation with clomiphene citrate and gonadotrophins. The patients were followed up through during induction of ovulation and pregnancy.Results There were ethnic differences in mean BMI. Significantly more obese women had oligomenorrhoea (p<0.01) and anovulation (p<0.01) than women with normal weight. Obesity adversely affected the outcome of ovulation induction with clomiphene citrate and gonadotrophins; 79% of women with BMI 18–24 ovulated at 6 months compared to 15.3% in those with BMI 30–34 (p<0.001) and 11.8% in women with BMI 35 (p<0.001). The pregnancy rate and outcome were also adversely affected by obesity.Conclusion Obesity has a negative impact on the outcome of treatment of infertility. Weight reduction programme should be an essential component of infertility management.     

The effect of adenomyosis on in vitro fertilisation and intra-cytoplasmic sperm injection treatment outcome

Objective

To investigate the effect of uterine adenomyosis diagnosed by transvaginal ultrasound on IVF/ICSI treatment outcome.

Study design

A retrospective cohort study of all women aged ≤ 42 years with infertility who underwent IVF/ICSI treatment at IVFAustralia-East between January 2000 and June 2006. Patients were divided into two groups according to findings on a baseline pre-treatment transvaginal pelvic ultrasound: group A consisted of women with adenomyosis and group NA consisted of women without adenomyosis. The primary outcome measure was live birth rate per patient (cycle).

Results

A total of 201 patients (37 patients in Group A, 164 patients in group NA) undergoing a single stimulated cycle of IVF/ICSI were included in the data analysis. There was no difference in live birth rate per patient (cycle) between the two groups with both raw and logistic regression adjusted data (29.7% V 26.1%; p = 0.395; OR 1.45 with 95% CI 0.61–3.43). There were no other differences in ovarian response, embryological parameters or clinical outcomes between the two groups.

Conclusions

The presence of transvaginal ultrasound diagnosed adenomyosis did not adversely affect outcome in women undergoing IVF/ICSI treatment at our unit. However, the results are not conclusive and further large, well-designed prospective cohort studies are required in order to confirm our findings.     

替勃龙对卵巢切除大鼠膀胱功能及结构的影响

目的:通过比较正常、卵巢切除及卵巢切除后补充替勃龙大鼠的膀胱功能和组织形态,探讨替勃龙对膀胱的影响及其作用机制。方法:30只雌性成年SD大鼠分为3组:正常对照组、切除双侧卵巢组(OVX组)、切除双侧卵巢后补充替勃龙组(OVX+Tib组)。用药12周后测定膀胱压力容积,Masson染色膀胱石蜡切片分析胶原纤维(CF)和平滑肌(SM)的面密度及二者比值。结果:(1)OVX组膀胱最大容量(0.32±0.20m l)、顺应性(0.012±0.006m l/cmH2O)和最大收缩力(1.4±0.4cmH2O)相对于正常对照组(分别为1.11±0.09m l、0.026±0.003m l/cmH2O和4.4±0.3cmH2O)明显减少,有统计学差异(P<0.01)。OVX+Tib组膀胱顺应性(0.022±0.003m l/cmH2O)与正常对照组比较无统计学差异(P>0.05),膀胱最大容量(0.87±0.26m l)及最大收缩力(3.3±1.0cmH2O)比正常对照组减少(P<0.05),但比OVX组增加(P<0.01);(2)CF面密度、CF面密度与SM面密度比值:OVX组(0.2180±0.0407和0.5396±0.0837)比正常对照组(0.1598±0.0387、0.3199±0.0860)增加,有统计学差异(P<0.01)。OVX+Tib组此两值(0.1893±0.0251、0.4249±0.0646)介于OVX组与正常对照组之间。结论:大鼠切除双侧卵巢后膀胱功能降低,补充替勃龙在一定程度上改善了膀胱功能,这可能是与它对胶原的抑制有关。     

Scaffold-based delivery of adipose tissue-derived stem cells in rat frozen-thawed ovarian autografts: preliminary studies in a rat model

Purpose

This study aimed to evaluate whether a gelatin-based Gelfoam sponge is feasible as a scaffold for adipose tissue-derived stem cell (ASC) therapy in rat frozen-thawed ovarian autografts.

Methods

Two sets of studies were performed. The in vitro set evaluated ASCs’ viability in the Gelfoam scaffold at different times of co-culturing (after 24, 48, 72, 96, and 120 h). The in vivo set used 20 12-week-old adult female Wistar rats. Frozen-thawed ovarian grafts were treated with ASCs delivered in Gelfoam scaffolds immediately after an autologous retroperitoneal transplant (ASCs-GS, n = 10). The controls received Gelfoam with a culture medium (GS, n = 10). Assessment of graft quality was conducted by vaginal smears (until euthanasia on the 30th postoperative day), histological analyses, follicular density, and viability and fibrosis. Immunohistochemical staining for VEGF-A expression, vascular network (vWF), apoptosis (caspase-3 and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL)), cell proliferation (Ki-67), and hormone receptors (estrogen and progesterone) were performed.

Results

The cells remained viable in Gelfoam for up to 120 h of co-culturing. The graft morphology was similar among the groups. ASC therapy promoted the earlier resumption of the estrous phase (GS 16.6 ± 3 vs. ASCs-GS 12.8 ± 1.3 days) and enhanced estrogen receptors compared with the controls (p < 0.05) without interfering with the quantity and viability of the ovarian follicles, fibrosis, endothelial cells, VEGF immunoexpression, apoptosis, or cell proliferation (p > 0.05).

Conclusion

The Gelfoam scaffold could be a feasible and safe non-invasive technique for ASC delivery in the treatment of frozen-thawed ovarian autografts. Future studies should evaluate the real benefit of this treatment on the survival and endocrine activity of the graft.     

The effect of ovarian stimulation on the outcome of intrauterine insemination

Purpose

Although intrauterine insemination is one of the oldest techniques in reproductive medicine, its significance is still controversially discussed. Many factors have been reported as influencing pregnancy rates after IUI. The aim of this retrospective analysis is to evaluate the success rate of repeated inseminations depending on the type of ovarian stimulation.

Methods

Patients who underwent intrauterine insemination in Wiesbaden Kinderwunschzentrum between 1998 and 2010, not older than 45 years of age, with male subfertility were included in this study. On the whole, 5,346 inseminations on 2,180 patients were analyzed retrospectively.

Results

Females’ mean age was 34.1, ranging from 19–45 years. In 433 cycles an insemination was performed during a natural cycle. 4,020 cycles were stimulated with recombinant FSH, 596 cycles with clomiphene, 194 with urinary FSH, 103 with HMG. The pregnancy rates range from 7.4 % in the clomiphene group to 14.4 % in the urinary FSH group. Clomiphene stimulation seems to offer the significantly lowest pregnancy rate (p = 0.03). The other types of stimulation do not differ significantly from each other concerning the pregnancy rate. Patients under 39 years of age do not profit from any ovarian stimulation. In 40 and more years of old patients, pregnancy rates are higher, if any stimulation was performed.

Conclusion

To sum up, clomiphene stimulation showed to offer significantly lower pregnancy rates in comparison to the natural cycle, FSH stimulation and HMG stimulation in IUI treatment. While women younger than 40 seem not to profit from any ovarian stimulation, women over 40 do profit.     

Dexamethasone attenuates the embryotoxic effect of endometriotic peritoneal fluid in a murine model

Purpose

The in vitro fertilization (IVF) pregnancy rate of women with advanced stage endometriosis is nearly half that of the general population, suggesting incomplete targeting of the pathophysiology underlying endometriosis-associated infertility. Compelling evidence highlights inflammation as the etiologic link between endometriosis and infertility and a potential target for adjunctive treatment. The objective of this study was to examine the effect of dexamethasone on murine embryos exposed to human endometriotic peritoneal fluid (PF) using the established murine embryo assay model.

Methods

PF was obtained from women with and without severe endometriosis. Murine embryos were harvested and randomly allocated to five groups of culture media conditions: (1) human tubal fluid (HTF), (2) HTF and 10 % PF from women without endometriosis, (3) HTF and 10 % PF from women with endometriosis (PF-E), (4) HTF with PF-E and 0.01 mcg/mL dexamethasone, and (5) HTF with PF-E and 0.1 mcg/mL dexamethasone. Embryos were cultured in standard conditions and evaluated for blastocyst development.

Results

A total of 266 mouse embryos were cultured. Baseline blastulation rates were 63.6 %. The addition of peritoneal fluid from women with endometriosis decreased the blastocyst development rate to 38.9 % (P = 0.008). The addition of 0.1 mcg/mL of dexamethasone to the culture media restored the blastulation rate to near baseline levels (61.2 %; P = 0.019).

Conclusions

The results of our in vitro study demonstrate the capacity of dexamethasone to mitigate the deleterious impact of endometriotic PF on embryo development. If confirmed in vivo, dexamethasone may prove a useful adjunct for the treatment of endometriosis-associated infertility.     

Smac基因转染对卵巢癌SKOV3/DDP裸鼠移植瘤顺铂敏感性及微血管生成的影响

目的:探讨转染Smac基因对卵巢癌SKOV3/DDP裸鼠移植瘤顺铂敏感性及微血管生成的影响。方法:建立卵巢癌SKOV3/DDP裸鼠移植瘤模型,随机分为5组,分别给予不同药物干预:(1)对照组:移植瘤内注射生理盐水;(2)DDP组:腹腔内注射顺铂;(3)空质粒+DDP组:移植瘤内注射空质粒,24h后腹腔内注射顺铂;(4)Smac组:移植瘤内注射Smac重组质粒;(5)Smac+DDP组:移植瘤内注射Smac重组质粒,24h后腹腔内注射顺铂。顺铂浓度为0.5mg/m1,给药剂量按3mg/kg计算。观察各组裸鼠移植瘤体积变化,计算抑瘤率。TUNEL法检测移植瘤组织标本的凋亡指数,免疫组化法检测CD34并计算微血管密度(MVD)。结果:Smac+DDP组的移植瘤体积最小,平均抑瘤率72.94%,与其他组比较差异有统计学意义(P0.05)。对照组、DDP组、空质粒+DDP组、Smac组、Smac+DDP组的凋亡指数分别为(19.90±3.18)%,(21.82±4.40)%,(22.64±3.81)%,(30.23±4.06)%,(48.59±4.47)%,MVD计数分别为(24.8±5.36),(21.2±3.11),(19.8±3.70),(14.4±3.85),(11.6±2.70)。其中,Smac+DDP组的凋亡指数最高,MVD最低,与其他组比较差异有统计学意义(P0.05)。结论:Smac基因转染可增强卵巢癌耐药移植瘤对顺铂的敏感性,同时减少微血管生成。     

三氧化二砷对卵巢癌细胞的生长及化疗敏感性的影响

目的:研究三氧化二砷(As2O3)对人卵巢癌COC1细胞顺铂(cDDP)化疗敏感性的影响,As2O3与cDDP联合作用的效应以及As2O3对COC1细胞的生长抑制效应及机制。方法:四甲基偶氮唑蓝(MTT)比色法检测不同浓度As2O3、cDDP作用72h对卵巢癌细胞生长的抑制作用,As2O3对顺铂化疗敏感性的影响及两药联合作用的效应。逆转录聚合酶链反应(RT-PCR)和免疫印迹技术(Western blot)分别检测PIK3CA mRNA和AKT、ERK、MMP-2蛋白表达的变化。结果:单独应用As2O3或cDDP和联合用药时卵巢癌COC1细胞生长均受到抑制,并呈浓度依赖关系,联合用药组抑制率明显高于单独用药组(P<0.05);0.08~0.15μmol/L As2O3无明显细胞毒性,不能提高COC1细胞对顺铂的敏感性。各浓度(1、3、8、16μmol/L)As2O3作用24h可以下调AKT、MMP-2蛋白水平(P<0.05),并呈浓度依赖效应,但对ERK蛋白的表达无显著影响。0.5、1、2、4μmol/L As2O3作用4h,PIK3CA mRNA表达分别降低45.03%、53.05%、61.67%和72.91%(P<0.05)。结论:As2O3抑制COC1细胞增殖具有浓度依赖性,与顺铂联用有相加效应,可能与As2O3下调PIK3CA mRNA、AKT、MMP-2蛋白水平等有关。     

The effects of ovarian hormone deficiency on wound contraction in a rat model

Objective to demonstrate the effect of a deficiency of ovarian hormones on the process of wound contraction, using the oophorectomised rat model of the human menopause.
Design A randomised controlled trial.
Population Ninety-six adult Wistar rats were randomly allocated into either an oophorectomised groupor a sham-oophorectomised control group.
Methods Having confirmed a significant reduction in plasma oestradiol levels in the oophorectomisedrats, full-thickness excised lesions were made in the flank skin of the adult rats at either two weeks orfour months after oophorectomy, so that the effects of two different durations of hormone deficiencycould be assessed and compared with the sham-oophorectomised controls. Following wounding, therats were left for 3, 5, 10 or 22 days; wound contraction was assessed from photographs of thewounds taken at these intervals after injury.
Results In the rats wounded four months after oophorectomy there was a slower rate of woundcontraction, resulting in larger wounds at days 3, 5, 10 and 22, compared with control rats. No significant difference was observed in rats wounded two weeks after oophorectomy, indicating that the effects of ovarian hormone deficiency on this process are delayed.
Conclusion Due to the pivotal role of wound contraction in the process of wound healing these findingsmay be of clinical relevance and could have an important impact on the administration of hormonereplacement therapy.     

不育症睾丸生精障碍与生殖激素、免疫反应关系的研究

本文对６４例不育症睾丸活检标本进行生精障碍分级,用放免法测定血清ＦＳＨ、ＬＨ、Ｔ、ＰＲＬ的水平,用ＡＢＣ法检测睾丸ＩｇＧ 和ＩｇＡ免疫复合物。结果显示重度、不可逆性生精障碍组与对照组比较,血清ＦＳＨ、ＬＨ、Ｔ、ＰＲＬ水平存在显著差异。ＦＳＨ水平分别升高至对照组的３．０１、３．５０倍,ＬＨ水平分别升高至对照组的２．５９、２．８７倍,Ｔ水平明显下降,分别为１６．２５ ｎｍｏｌ／Ｌ、１４．８８ ｎｍｏｌ／Ｌ（Ｐ＜０．０１）,Ｔ／ＬＨ水平明显下降,分别降至１．０６和 ０．８７。高 ＰＲＬ血症１０例,增高幅度为 ０．２１～１．４７ ｎｍｏｌ／Ｌ。提示不育症血清生殖激素水平能反映睾丸生精障碍程度,可作为确定是否进行睾丸活检的一项重要指标。重度、不可逆性生精障碍组ＩｇＧ＋分别为７１％、８２％。ＩｇＮ＋分别为６５％、７５％。表明ＩｇＧ、ＩｇＡ免疫复合物在睾丸中的沉积可能与睾丸生精障碍有关,其阳性率与生精障碍程度密切相关。     

Effect of clomiphene citrate on ovarian, endometrial, and cervical histologies in a rat model

OBJECTIVE: To examine the effect of clomiphene citrate (CC) on the ovarian, endometrial, and cervical histologies in a rat model. METHODS: The rats (n = 40) were randomly assigned to 4 treatment groups: CC 50 (repetitive doses of 0.2 mg CC); CC 100 (repetitive doses of 0.4 mg CC); CC 200 (repetitive doses of 0.8 mg CC), and control (repetitive doses of normal saline). Each study group received its CC dose intraperitoneally in 2 ml saline for 5 days and the controls received 2 ml saline only. Each treatment cycle was repeated six times. Six months later the rats were euthanized. Their ovaries, uterine horns, and cervices were removed and examined for histologic changes. RESULTS: We found no significant difference in the number of follicles and corpora lutea of the study groups (p > 0.05). The numbers of granulosa, theca, and luteal cells of the CC 100 and CC 200 groups were significantly higher than those of the CC 50 group and controls (p < 0.05). There was no important finding related to pre-malign and malign changes in ovarian, endometrial and cervical samples of the control and CC 50 groups. Focal atypia and atypical mitoses were noted in 2 cases of granulosa cells in the CC 100 and CC 200 groups. CONCLUSION: We did not find an association between the use of CC and ovarian, endometrial, and cervical neoplasms; nevertheless, we noticed an increase in granulosa, theca and luteal cells with high doses of CC, which may be a risk factor for granulosa, theca, and luteal cell tumors.     

Effects of pinealectomy and melatonin supplementation on endometrial explants in a rat model

Objective

To determine the effects of pinealectomy on endometrial explants in rats and evaluate the activity of superoxide dismutase (SOD) and catalase (CAT) and the levels of malondialdehyde (MDA) in the rat endometriosis model.

Study design

Rats with experimentally induced endometriosis were randomly divided into three groups after second-look laparotomies. Group 1 (pinealectomy, n = 8) and Group 2 (pinealectomy + melatonin, n = 8) underwent pinealectomies after the second-look laparotomies. Group 3 was presented as control group (vehicle solution + without pinealectomy (n = 6)). Melatonin was administered intraperitoneally for 4 weeks in Group 2, whereas an equal volume of vehicle solution was given to Groups 1 and 3. Evaluation of the volume of the endometrial explants, histopathological examination and preservation of explant epitheliums according to the scoring system were undertaken.

Results

There was a statistically significant increase in spherical explant volumes of Group 1 compared to Groups 2 and 3. In Group 1, the level of MDA was significantly higher and SOD and CAT activity was significantly lower compared to Groups 2 and 3. A statistically significant increase in the epithelial lining scores of explants was noted in Group 1 compared to Groups 2 and 3.

Conclusion

The effects of pinealectomy on the progression of endometriosis explants were reversed by melatonin.     

Effects of silymarin,cabergoline and letrozole on rat model of endometriosis

Objective

Silymarin as an herbal drug has potent antioxidant effects that could make it a good choice for endometriosis therapy. The aim of the current study was to determine the effects of silymarin as an herbal drug on induced endometrial lesion in rat model of endometriosis.

宫颈锥切术对宫颈上皮内瘤变患者妊娠及其结局的影响

目的探讨宫颈锥切术对宫颈上皮内瘤变（CIN）患者妊娠及其结局的影响。方法对北京协和医院妇产科1999年至2005年间收治的111例因CIN实施宫颈锥切术的患者进行电话随访,术前无原发不孕、年龄≤40岁、未生育过、有生育要求的35例患者纳入本研究。对35例患者的妊娠时间、妊娠周数、妊娠结局和终止妊娠方式进行回顾性分析。结果（1）35例患者,年龄23～40岁,平均31岁。35例患者中有25例获得26次妊娠,妊娠率为74％（26／35）,与该25例患者宫颈锥切术前的妊娠率（69％）比较,差异无统计学意义（P〉0．05）。（2）25例妊娠患者中,1例异位妊娠,4例自然流产。其中已分娩的13例患者中,1例早产行剖宫产术,早产率为8％（1／13）;胎膜早破2例,胎膜早破发生率为15％（2／13）;无低出生体重儿发生;10例行剖宫产术,剖宫产率为77％（10／13）。（3）已分娩的13例患者中,宫颈锥切高度平均为2．0cm（1．0～3．0cm）,锥切宽度平均为2．5cm（1．5～3．0cm）。结论宫颈锥切术对CIN患者的妊娠及其结局无明显影响,也不增加早产和低出生体重儿发生率。