Relationship between oxidative stress and clinical pregnancy in assisted reproductive technology treatment cycles

PurposeTo examine the relationship between serum total oxidant (TOS) and antioxidant (TAS) levels and clinical pregnancy in assisted reproductive technology (ART) cycles.MethodsPrior to and after oocyte pick-up (OPU) and embryo transfer (ET), blood samples were collected from gynecologically normal females (n = 70) who were enrolled for ART solely due to male factor infertility. TAS, TOS levels and oxidative stress indexes (OSI: TOS/TAS) in four phases of treatment cycle (pre and post OPU and ET) between clinically pregnant and non-pregnant patients were compared. Critical cut-off values of significantly different TAS, TOS levels and OSIes for clinical pregnancy were established.ResultsThe TAS levels in patients with clinical pregnancy were significantly higher in all of the four phases of the cycle. Post-OPU and pre-ET TOS levels were significantly higher in clinically pregnant patients. According to OSIes; only the pre-OPU OSI was significantly lower in clinically pregnant patients compared with non-pregnant ones. Moreover, the highest area under the ROC curve (AUC) from the seven different significant measurements [1) pre-OPU OSI, 2) pre-OPU TAS, 3) post-OPU TAS, 4) pre-ET TAS, 5) post-ET TAS, 6) post-OPU TOS, 7) pre-ET TOS] was related to pre-OPU OSI.ConclusionsIn ART cycles, women with a higher total antioxidant status prior to and after OPU and prior to and after ET have an increased probability of clinical pregnancy. Additionally; OSI before OPU was one of the most important determinants for clinical pregnancy, so the oxidant and antioxidant balance is as important as the antioxidant concentration alone.     

The effect of the modes of delivery on the maternal and neonatal dynamic thiol–disulfide homeostasis

Abstract

Background: Thiols are organic compounds containing sulfhydryl groups which exert antioxidant effects via dynamic thiol–disulfide homeostasis. The shift towards disulfide indicates the presence of oxidative environment. The thiol–disulfide homeostasis has not been studied in different mode of delivery before.

Aims: To investigate the effects of mode of parturition on the thiol–disulfide homeostasis in mothers and term infants.

Study design: The participants were grouped according to the mode of their delivery: group vaginal delivery (VD, n?=?40) and group cesarean section (C/S, n?=?40). Three serum samples were collected: from mothers at the beginning of labor, from the cord blood (CB), and from the infants at the 24th hour after birth. The dynamic thiol–disulfide homeostasis in both groups were compared.

Results: The levels of native-thiol and total-thiol in CB were significantly higher in VD group than those with C/S group. The levels of disulfide were higher in infants born by C/S compared with those born by VD. The disulfide-to-native thiol ratio, disulfide-to-total thiol ratio, and native thiol-to-total thiol ratio were similar between two groups.

Conclusion: Our results showed that the dynamic thiol–disulfide homeostasis of the neonate was greatly influenced by the way of delivery and supported that vaginally delivered infants have less oxidative stress.     

Peritoneal fluid concentrations of β-chemokines in endometriosis

Objective

To examine whether the levels of MCP-1, RANTES and MCP-3 in the peritoneal fluid correlate with endometriosis.

Study design

Patients with endometriosis were compared with controls. Setting: Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA. Subjects: This study involved 95 women of reproductive age who were undergoing laparoscopy for evaluation of infertility or for pelvic pain. They were divided into an endometriosis group (n = 54) and a control group (n = 41). Interventions: Peritoneal fluid samples were obtained and β-chemokines (MCP-1, RANTES and MCP-3) were measured using ELISA. Statistical analysis: Mean and median values were used to present values. Due to the non-normality of chemokines, a log transformation was applied. Differences were examined using independent samples t-test. One-way ANOVA and Tukey HSD multiple comparison post hoc tests were applied. A significance level at 0.05 was set.

Results

The levels of MCP-1 are higher (p for log values = 0.024) in the control group (mean = 687.6, SD = 467.7 pg/ml) than those of the endometriosis group (mean = 570.4, SD = 633.1 pg/ml). The same is true for the median values of MCP-1 (control median = 568.5, endometriosis median = 384.7 pg/ml). MCP-3 and RANTES do not differ significantly (MCP-3 p = 0.787, RANTES p = 0.153). The levels of MCP-1 in patients with stage II endometriosis are significantly lower in comparison with stage III (p = 0.048) and stage IV (p = 0.033) endometriosis.

Conclusions

A decrease in the concentrations of MCP-1 in stage I endometriosis has been observed, which is even larger in stage II, in contrast to stage III and stage IV endometriosis, which exhibit concentrations similar to the controls.     

A randomized study of simultaneous hCG administration with intrauterine insemination in stimulated cycles

Objective(s)

To compare the clinical pregnancy rates between intrauterine insemination (IUI) simultaneously or 34–36 h following hCG injection in gonadotropin-stimulated IUI cycles.

Study design

Randomized, prospective, controlled, study conducted in a university infertility clinic. Of 923 infertile couples, 220 couples with unexplained infertility or mild male factor infertility were included to the study. Before ovarian stimulation patients were randomized into two groups: IUI at 34–36 h after hCG injection (group I) (n = 106) and IUI simultaneously with hCG administration (group II) (n = 98). The primary outcome was clinical pregnancy rates.

Results

There was no significant difference between the groups according to baseline patient and cycle characteristics. Clinical pregnancy rates were 9.4% and 12.2% in group I and group II, respectively (p = 0.523). Although group II had better outcomes there was no statistically significant difference in clinical pregnancy rates between the different timing methods: IUI simultaneously with hCG versus IUI at 34–36 h after hCG (odds ratio (OR) = 1.35, 95% CI 0.53–3.42).

Conclusion(s)

There is no difference in simultaneous use of hCG injection compared to cycles in which IUI is performed after 34–36 h following hCG injection. Prospective randomized trials with larger sample sizes or meta-analyses are required.     

Evaluation of the psychological problems in children with sickle cell anemia and their families

Sickle cell anemia (SCA) is a chronic disease and it would be expected that the children with SCA are at high risk of developing psychosocial problems. In this study the authors intended to evaluate both the psychiatric problems among SCA patients and their families and put forward the relation between the clinical findings and psychiatric problems. Forty children were included in the study. The patients were classified according to their histories of painful crises in the past 1 year. The children who have had a history of painful crisis 1-4, 5-10, and over 10 times were classified as group 1, group 2, and group 3, respectively. The depression levels of the children in group 3 were higher than group 1 (P = .018). The state of the anxiety level of the children and Beck Anxiety Inventory of the mothers were higher in group 3 than in group 1 (P = .004). In addition, anxiety levels of the mothers who had children with social limitations and painful episodes were higher than the anxiety levels of the mothers who had children without social limitations and painful episodes (P = .006 and P = .004, respectively). We found a relationship between the anxiety and depression levels in children and the anxiety, depression, and marital adjustment levels in mothers. In conclusion, the frequency of psychological disorders appears to increase in patients with SCA, as with many chronic diseases. Especially, the patients who had higher frequencies of painful crises and their mothers had increased depression and state anxiety levels. Thus, the patients with SCA and their families should be evaluated regularly in terms of psychological disorders.