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Infertility female [keywords]
- Masturbation Frequency and Sexual Function Domains Are Associated With Serum Reproductive Hormone Levels Across the Menopausal Transition. [JOURNAL ARTICLE]
- J Clin Endocrinol Metab 2014 Nov 20.:jc20141725.
Objective: To determine whether reproductive hormones are related to sexual function during the menopausal transition. Design: The Study of Women's Health Across the Nation (SWAN) is a multiethnic cohort study of the menopausal transition located at seven US sites. At baseline, the 3302 community-based participants, aged 42-52, had an intact uterus and at least one ovary and were not using exogenous hormones. Participants self-identified as White, Black, Hispanic, Chinese, or Japanese. At baseline and at each of the 10 follow-up visits, sexual function was assessed by self-administered questionnaires, and blood was drawn to assay serum levels of T, estradiol, FSH, SHBG, and dehydroepiandrosterone sulfate. Main Outcome Measures: Self-reported frequency of masturbation, sexual desire, sexual arousal, orgasm, and pain during intercourse. Results: Masturbation, sexual desire, and arousal were positively associated with T. Masturbation, arousal, and orgasm were negatively associated with FSH. Associations were modest. Estradiol was not related to any measured sexual function domain. Pain with intercourse was not associated with any hormone. Conclusions: Reproductive hormones were associated with sexual function in midlife women. T was positively associated, supporting the role of androgens in female sexual function. FSH was negatively associated, supporting the role of menopausal status in female sexual function. The modest associations in this large study suggest that the relationships are subtle and may be of limited clinical significance.
- [Birth Rate and Fertility: Knowledge and Expectations Analysis of 3585 University Students.] [JOURNAL ARTICLE]
- Acta Med Port 2014 Sep-Oct; 27(5):601-608.
Introduction: Nowadays, Portuguese birth rate is insufficient to ensure renewal of generations. Women high education levels and labor market integration and increased economic difficulties are some of multiple factors leading to a delay in average parenting age and an increase of infertility; also subject to others such as obesity, smoking and alcohol consumption.Material and Methods: Transversal epidemiological study, analytical, uncontrolled, from self-filled online questionnaires, promoted by students' university unions. A sample of 3585 university students was considered and a global and by gender statistic analysis was done through SPSS, Excel was used to build graphics and tables and ArcMap to represent maps. Results: Mainly students from the Health Sciences (40.6%), Universidade de Lisboa (59.4%), female (76.9%), median age of 22; intention to marry/ union 71.0%, parenthood 85.7%. A total of 18.4% smoke, 22.3% consume alcohol and obesity 15.4%; employment (47.4%) and the partner's will (39.9%) were important determinants for parenthood decision as well as having financial stability to provide a good education (33.6%) and healthcare (38.6%); A total of 53.6% have considered the hypothesis of infertility and highlight above 35 year old maternal age (18.7%), obesity (18%) and female smoking (19.0) as factors. Higher and more significant values for smoking (p = 0.001) and alcohol consumption (p = 0.000) in males were found.Discussion: The sample seems representative, well distributed among different areas of study, with more female respondents than the university portuguese ratio. There are more students with parenting projects than marriage/cohabitation, in accordance with Portuguese data. Nevertheless, the same students identify the family as a priority in comparison with employment and career. Parenting decisions are tied by social-economic situation but an important factor is the low fertility due to the maternal age delay of the first pregnancy.Conclusion: University student unions are an excellent instrument to access them; a high number of respondents consider having children but delay the decision; there is a lack of information about the consequences of delaying parenting age and about infertility factors. The negative trend of fertility must be seen as a necessity to develop specific policies.
- Evaluation of embryo quality after concurrent use of ovarian stimulating hormones and gamma irradiation. [JOURNAL ARTICLE]
- Iran J Reprod Med 2014 Aug; 12(8):573-580.
Background: Radiotherapy has many side effects on fertilization in young women. Radiation can lead to ovarian failure in women who underwent abdomen or pelvic radiotherapy. Objective: This study helps us to investigate ovarian response of NMRI female mice to ovarian stimulating hormones (PMSG, HCG) after whole-body gamma irradiation. Materials and Methods: 45 pregnant mice were divided into two groups of control and experimental. The experimental group was classified into three sub-groups: Irradiation group (2 or 4Gy),Superovulation group (10 or 15IU),and superovulation and gamma-radiation group (2Gy & 10IU, 2Gy & 15IU, 4Gy & 10IU,4Gy & 15IU). Female mice were killed and embryos were removed from oviduct .The number of embryos cells counted and the quality of them was evaluated in each group. Kruskal-Wallis test and Mann-Whitney test were used to analyze the data. Results: There was a significant difference in the number of 2-4 cells grade D embryos in 2Gy & 15IU group compared with control and 2Gy groups (p=0.01), and the number of embryos in 4Gy group was more than in 10IU and 15IU (p=0.03) and 2Gy & 15IU groups (p=0.01). It was more significantly embryos in 4Gy & 15IU group compared to 2Gy & 15IU group (p=0.01).In addition There were no significant differences in the number of 2-4 cells grades A, B and C embryos and also number of 4-8 cells grades A, B and C, D embryos in groups. Conclusion: The concurrent use of ovulation stimulating hormones and gamma rays ameliorates this problem of drastic decrease in number of living embryos due to whole-body irradiation.
- A population-based study on infertility and its influencing factors in four selected provinces in Iran (2008-2010). [JOURNAL ARTICLE]
- Iran J Reprod Med 2014 Aug; 12(8):561-566.
Background: Infertility has a varied impact on multiple dimensions of health and functioning of women. Objective: We aimed to identify the burden of infertility and its influencing factors based on a population based study conducted in four provinces of Iran. Materials and Methods: A sample of 1126 women, aged 18-45 years, was selected using the multi stage, stratified probability sampling procedure; those met the eligibility criteria were invited for further comprehensive interview. This study used the definition of infertility proposed by World Health Organization "the woman has never conceived despite cohabitation and exposure to pregnancy for a period of 1 year". Results : The overall prevalence of lifetime infertility and current primary infertility were 21.1% (95% CI: 18.4- 23.8) and 6.4% (95% CI: 4.8-8) respectively. The probability of first pregnancy at the end of 2 years of marriage was 94% for all ever-married women. Infertility were observed as significantly higher among women age 31-35 (OR: 4.6; 95% CI: 1.9-11.5; p=0.001) and women with more than 9 years of education (OR: 2.8; 95% CI: 1.5-3.3; p<0.0001). Conclusion: The necessities of modern living have compelled many women to postpone childbearing to their late reproductive years; however they must be informed of being at risk of infertility with ageing.
- Comparison of two dimensional and live three dimensional ultrasounds for the diagnosis of septated uterus. [JOURNAL ARTICLE]
- Iran J Reprod Med 2014 Aug; 12(8):547-554.
Background: Traditionally, septate uterus was diagnosed with invasive method like hysterosalpingography and hysteroscopy. Nowadays transvaginal ultrasonography was reported to be a sensitive tool for detection of septate uterus too. Objective: The objective of the present study was to evaluate the application of two dimensional ultrasound (2-DUS) and real time three dimensional ultrasound (3-DUS) in differentiating various type of septated uterus. Hysteroscopy confirmation was assigned as the gold standard. Materials and Methods: This retrospective study was performed among 215 infertile women with suspected septate uterus from October 2008 to July 2012. An inclusion criterion was septated uterus based on HSG or experiencing abortion, preterm labor, or recurrent IVF failure. Fusion anomalies were excluded from the study (unicornuate, bicornuate and didelphys anomalies). The results of 3D and 2D sonographies were compared, while they were confirmed by hysteroscopy result in detection of septated uterus. Kappa index for agreement between 2DUS and hysteroscopy, as well as 3-DUS and hysteroscopy in detection of septate uterus was carried out. By receiver operating characteristic (ROC) curve, cut off points for predicting the kind of anomalies were proposed. Results: The women were evaluated by 2-DUS (n=89) and (II) 3-DUS (n=126). All women underwent hysteroscopy, following 2-DUS and 3-DUS at the same or subsequent cycle. The results of kappa (K) index were 0.575 and 0.291 for 3-DUS and hysteroscopy, as well as 2-DUS and hysteroscopy, respectively. Also, the cutoff points were 27% for arcuate and subseptate, and 35% for differentiating septate and subseptate. Conclusion: Real time 3-DUS has better ability for visualization both uterine cavity and the fundal uterine, so it has higher agreement in detection of septate uterus than 2-DUS.
- Sexual dysfunction in patients with polycystic ovary syndrome and its affected domains. [JOURNAL ARTICLE]
- Iran J Reprod Med 2014 Aug; 12(8):539-546.
Background: Polycystic Ovary Syndrome (PCOS) is presented with characteristic complications such as chronic an ovulation, obesity, and hyperandrogenism which can affect sexual function in women of reproductive age. Objective: Herein we evaluated the frequency and predisposing factors of sexual dysfunction in infertile PCOS patients. Materials and Methods: In this cross-sectional study, 130 married women with a definite diagnosis of PCOS who were referred due to infertility were recruited. They were evaluated concerning their sexual function in the domains of desire, arousal, lubrication, orgasm, satisfaction and pain with the female sexual function index (FSFI) questionnaire. Results: The frequency of sexual dysfunction was verified 57.7% in PCOS patients with the domains of desire and arousal being commonly affected in 99.2% and 98.5%of cases respectively. BMI had a significant effect on sexual desire and arousal (p=0.02) while the effect of hirsutism was significant on all domains (p<0.001 for total FSFI score) except for dyspareunia. Conclusion: PCOS patients markedly suffer from sexual dysfunction as comorbidity. It seems appropriate to screen all PCOS patients for sexual function with a simple short questionnaire such as FSFI. Targeted interventions could be considered to help improve their quality of life along with other treatments.
- Role of nuclear progesterone receptor isoforms in uterine pathophysiology. [REVIEW]
- Hum Reprod Update 2014 Nov 18.
Progesterone is a key hormonal regulator of the female reproductive system. It plays a major role to prepare the uterus for implantation and in the establishment and maintenance of pregnancy. Actions of progesterone on the uterine tissues (endometrium, myometrium and cervix) are mediated by the combined effects of two progesterone receptor (PR) isoforms, designated PR-A and PR-B. Both receptors function primarily as ligand-activated transcription factors. Progesterone action on the uterine tissues is qualitatively and quantitatively determined by the relative levels and transcriptional activities of PR-A and PR-B. The transcriptional activity of the PR isoforms is affected by specific transcriptional coregulators and by PR post-translational modifications that affect gene promoter targeting. In this context, appropriate temporal and cell-specific expression and function of PR-A and PR-B are critical for normal uterine function.Relevant studies describing the role of PRs in uterine physiology and pathology (endometriosis, uterine leiomyoma, endometrial cancer, cervical cancer and recurrent pregnancy loss) were comprehensively searched using PubMed, Cochrane Library, Web of Science, and Google Scholar and critically reviewed.Progesterone, acting through PR-A and PR-B, regulates the development and function of the endometrium and induces changes in cells essential for implantation and the establishment and maintenance of pregnancy. During pregnancy, progesterone via the PRs promotes myometrial relaxation and cervical closure. Withdrawal of PR-mediated progesterone signaling triggers menstruation and parturition. PR-mediated progesterone signaling is anti-mitogenic in endometrial epithelial cells, and as such, mitigates the tropic effects of estrogen on eutopic normal endometrium, and on ectopic implants in endometriosis. Similarly, ligand-activated PRs function as tumor suppressors in endometrial cancer cells through inhibition of key cellular signaling pathways required for growth. In contrast, progesterone via PR activation appears to increase leiomyoma growth. The exact role of PRs in cervical cancer is unclear. PRs regulate implantation and therefore aberrant PR function may be implicated in recurrent pregnancy loss (RPL). PRs likely regulate key immunogenic factors involved in RPL. However, the exact role of PRs in the pathophysiology of RPL and the use of progesterone for therapeutic benefit remains uncertain.PRs are key mediators of progesterone action in uterine tissues and are essential for normal uterine function. Aberrant PR function (due to abnormal expression and/or function) is a major cause of uterine pathophysiology. Further investigation of the underlying mechanisms of PR isoform action in the uterus is required, as this knowledge will afford the opportunity to create progestin/PR-based therapeutics to treat various uterine pathologies.
- New biomarkers to fight urogenital schistosomiasis: a major neglected tropical disease. [Journal Article]
- Biomark Med 2014 Oct; 8(9):1061-3.
- Ovarian function in female survivors after multimodal Ewing sarcoma therapy. [JOURNAL ARTICLE]
- Pediatr Blood Cancer 2014 Nov 15.
With advances in cancer care, more young women with Ewing sarcoma (ES) survive after treatment. Thus, we sought to analyze the ovarian function in prepubertal, pubertal and postpubertal females and young women receiving multimodal therapy for ES, and to identify patients at risk of infertility on whom fertility preservation would be indicated.Twenty-seven female survivors of ES were included in this retrospective multiinstitutional study. Patients were classified into four groups according to the treatment received: chemotherapy (CHT) without pelvic radiation (pRT), chemotherapy and pRT, CHT and autologous hematopoietic cell stem rescue (aHSCT) without pRT, and CHT + pRT + aHSCT. The ovarian function and fertility outcomes were analyzed.At a median follow-up of 5.7 years from diagnosis, and at median age at follow-up of 16.3 years, 67% of the survivors had premature ovarian insufficiency, including all patients receiving pelvic RT and 87.5% of patients who underwent aHSCT, independent of chemoprotection. Thirty-seven percent of patients had a clinical syndrome of premature menopause. The relative risk (RR) of premature ovarian insufficiency of a survivor was 3.9 (p 0.03) for pRT, and 2.4 (p 0.07) for aHSCT. On multivariate analysis, radiation therapy was a significant predictor of higher risk of premature ovarian insufficiency over chemotherapy alone.A large proportion of women receiving multimodal therapy for ES develop premature ovarian insufficiency. Patients and guardians should be informed about the reproductive potential and strategies for preservation of ovarian function should be considered individually. Pediatr Blood Cancer © 2014 Wiley Periodicals, Inc.
- Effect of induced peritoneal endometriosis on oocyte and embryo quality in a mouse model. [JOURNAL ARTICLE]
- J Assist Reprod Genet 2014 Nov 16.
To assess the impact of peritoneal endometriosis on oocyte and embryo quality in a mouse model.Peritoneal endometriosis was surgically induced in 33 B6CBA/F1 female mice (endometriosis group, N = 17) and sham-operated were used as control (sham group, N = 16). Mice were superovulated 4 weeks after surgery and mated or not, to collect E0.5-embryos or MII-oocytes. Evaluation of oocyte and zygote quality was done by immunofluorescence under spinning disk confocal microscopy.Endometriosis-like lesions were observed in all mice of endometriosis group. In both groups, a similar mean number of MII oocytes per mouse was observed in non-mated mice (30.2 vs 32.6), with a lower proportion of normal oocytes in the endometriosis group (61 vs 83 %, p < 0.0001). Abnormalities were incomplete extrusion or division of the first polar body and spindle abnormalities. The mean number of zygotes per mouse was lower in the endometriosis group (21 vs 35.5, p = 0.02) without difference in embryo quality.Our results support that induced peritoneal endometriosis in a mouse model is associated with a decrease in oocyte quality and embryo number. This experimental model allows further studies to understand mechanisms of endometriosis-associated infertility.