Role of angiogenesis in adenomyosis-associated abnormal uterine bleeding and subfertility: a systematic review
AbstractBackgroundAdenomyosis commonly occurs with abnormal uterine bleeding (AUB) and is associated with subfertility and a higher miscarriage rate. Recent evidence showed abnormal vascularization in the endometrium in patients with adenomyosis, suggesting a role of angiogenesis in the pathophysiology of AUB and subfertility in adenomyosis and providing a possible treatment target.Objective and rationaleWe hypothesized that the level of abnormal vascularization and expression of angiogenic markers is increased in the ectopic and eutopic endometrium of adenomyosis patients in comparison with the endometrium of control pati...
Source: Human Reproduction Update - September 2, 2019 Category: OBGYN Source Type: research

Transgenerational inheritance: how impacts to the epigenetic and genetic information of parents affect offspring health
AbstractBACKGROUNDA defining feature of sexual reproduction is the transmission of genomic information from both parents to the offspring. There is now compelling evidence that the inheritance of such genetic information is accompanied by additional epigenetic marks, or stable heritable information that is not accounted for by variations in DNA sequence. The reversible nature of epigenetic marks coupled with multiple rounds of epigenetic reprogramming that erase the majority of existing patterns have made the investigation of this phenomenon challenging. However, continual advances in molecular methods are allowing closer ...
Source: Human Reproduction Update - August 2, 2019 Category: OBGYN Source Type: research

Negative impact of polycystic ovary syndrome on bone health: a systematic review and meta-analysis
This study aimed to investigate the impact of PCOS on bone markers, BMD and fracture risk.SEARCH METHODSA systematic review and a meta-analysis were carried out. PubMed, EMBASE and Cochrane databases were searched for eligible studies from 1st of January of 1990 to 9th of October of 2018. Eligible studies enrolled women older than 18  years with PCOS, which should be diagnosed according to the Rotterdam Consensus, the Androgen Excess Society, the National Institutes of Health Consensus or the International Classification of Diseases. The studies were grouped according to patient mean BMI:
Source: Human Reproduction Update - August 2, 2019 Category: OBGYN Source Type: research

Reproductive, obstetric, and perinatal outcomes of women with adenomyosis and endometriosis: a systematic review and meta-analysis
AbstractBACKGROUNDThe reproductive impact of adenomyosis and endometriosis is widely researched but the extent of these impacts remains elusive. It has been demonstrated that endometriosis, in particular, is known to result in subfertility but endometriosis and adenomyosis are increasingly linked to late pregnancy complications such as those caused by placental insufficiency. At the molecular level, the presence of ectopic endometrium perturbs the endometrial hormonal, cellular, and immunological milieu, negatively influencing decidualization, placentation, and developmental programming of the embryo. It is unclear if and ...
Source: Human Reproduction Update - July 18, 2019 Category: OBGYN Source Type: research

The endometrial immune environment of women with endometriosis
The objective herein was to determine reproducible and consistent findings regarding specific immune cell populations and their abundance, steroid hormone responsiveness, functionality, activation states, and markers, locally and systemically in women with and without endometriosis.SEARCH METHODSA comprehensive English language PubMed, Medline and Google Scholar search was conducted with key search terms that included endometriosis, inflammation, human eutopic/ectopic endometrium, immune cells, immune population, immune system, macrophages, dendritic cells (DC), natural killer cells, mast cells, eosinophils, neutrophils, B...
Source: Human Reproduction Update - July 8, 2019 Category: OBGYN Source Type: research

The effect of physical activity on reproductive health outcomes in young women: a systematic review and meta-analysis
AbstractBACKGROUNDIn the context of increasing rates of overweight and obesity in young adult women, and the increasing numbers of women seeking help for fertility problems, it is important to understand whether physical activity (PA) could help with management of reproductive health problems, with or without weight loss.OBJECTIVE AND RATIONALEThe primary aim of this systematic review and meta-analysis was to assess the effects of PA on selected reproductive health outcomes in young adult women, in order to inform best practice advice for women in terms of promoting fertility and reproductive health in young adulthood.SEAR...
Source: Human Reproduction Update - June 22, 2019 Category: OBGYN Source Type: research

The role of glucagon-like peptide-1 in reproduction: from physiology to therapeutic perspective
AbstractBACKGROUNDGlucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1 RAs) have become firmly established in the treatment of type 2 diabetes and obesity, disorders frequently associated with diminished reproductive health. Understanding of the role of GLP-1 and GLP-1 RAs in reproduction is currently limited and largely unaddressed in clinical studies.OBJECTIVE AND RATIONALEThe purpose of this narrative review is to provide a comprehensive overview of the role of GLP-1 in reproduction and to address a therapeutic perspective that can be derived from these findings.SEARCH METHODSWe performed a series of PubMed database...
Source: Human Reproduction Update - June 13, 2019 Category: OBGYN Source Type: research

The association between endometriosis and autoimmune diseases: a systematic review and meta-analysis
AbstractBACKGROUNDEndometriosis is a chronic gynaecological disorder that affects 2 –10% of women of reproductive age. The aetiology of endometriosis is largely under-explored, yet abnormalities in the immune system have been suggested to explain the origin of ectopic endometrial tissues, and an association between endometriosis and autoimmune diseases has been proposed. Evaluati on of current evidence investigating the association between endometriosis and autoimmune diseases from population-based studies will facilitate our understanding of the causes and consequences of endometriosis and provide a reference for be...
Source: Human Reproduction Update - June 13, 2019 Category: OBGYN Source Type: research

Thank you to our reviewers of 2018
(Source: Human Reproduction Update)
Source: Human Reproduction Update - May 31, 2019 Category: OBGYN Source Type: research

Potential genetic causes of miscarriage in euploid pregnancies: a systematic review
The objective was to identify studies that have recorded monogenic genetic contributions to pregnancy loss in euploid pregnancies, establish evidence for genetic causes of pregnancy loss, identify the limitations of current evidence, and make recommendations for future studies. This evidence is important in considering additional research into Mendelian causes of pregnancy loss and appropriate genetic investigations for couples experiencing recurrent pregnancy loss.SEARCH METHODSA systematic review was conducted in MEDLINE (1946 to May 2018) and Embase (1974 to May 2018). The search terms ‘spontaneous abortion’...
Source: Human Reproduction Update - May 31, 2019 Category: OBGYN Source Type: research

Effect of environmental and pharmaceutical exposures on fetal testis development and function: a systematic review of human experimental data
We present the effects of environmental, pharmaceutical and lifestyle factors in experimental systems involving exposure of human fetal testis tissues and cells. Comparison is made with existing epidemiological data primarily derived from a recent meta-analysis.SEARCH METHODSFor identification of experimental studies, PubMed and EMBASE were searched for articles published in English between 01/01/1966 and 13/07/2018 using search terms including ‘endocrine disruptor’, ‘human’, ‘fetal’, ‘testis’, ‘germ cells’, ‘testosterone’ and related search terms. Abs...
Source: Human Reproduction Update - March 14, 2019 Category: OBGYN Source Type: research

The enigmatic morula: mechanisms of development, cell fate determination, self-correction and implications for ART
The objective of this review is to collate novel and unsuspected insights into developmental processes occurring during formation of the morula, highlighting the key importance of this stage for a better understanding of preimplantation development and an improvement of ART.SEARCH METHODSPubMed was used to search the MEDLINE database for peer-reviewed English-language original articles and reviews concerning the morula stage in mammals. Searches were performed by adopting ‘embryo’, ‘morula’, ‘compaction’, ‘cell fate’ and ‘IVF/assisted reproduction’ as main terms, ...
Source: Human Reproduction Update - March 11, 2019 Category: OBGYN Source Type: research

Female obesity is negatively associated with live birth rate following IVF: a systematic review and meta-analysis
AbstractBACKGROUNDA worldwide increase in the prevalence of obesity has been observed in the past three decades, particularly in women of reproductive age. Female obesity has been clearly associated with impaired spontaneous fertility, as well as adverse pregnancy outcomes. Increasing evidence in the literature shows that obesity also contributes to adverse clinical outcomes followingin vitro fertilization (IVF) procedures. However, the heterogeneity of the available studies in terms of populations, group definition and outcomes prevents drawing firm conclusions. A previous meta-analysis published in 2011 identified a marg...
Source: Human Reproduction Update - March 4, 2019 Category: OBGYN Source Type: research

Endometriosis and nuclear receptors
AbstractBACKGROUNDEndometriosis is recognized as a steroid-dependent disorder; however, the precise roles of nuclear receptors (NRs) in steroid responsiveness and other signaling pathways are not well understood.OBJECTIVE AND RATIONALEOver the past several years, a number of paradigm-shifting breakthroughs have occurred in the area of NRs in endometriosis. We review and clarify new information regarding the mechanisms responsible for: (i) excessive estrogen biosynthesis, (ii) estrogen-dependent inflammation, (iii) defective differentiation due to progesterone resistance and (iv) enhanced survival due to deficient retinoid ...
Source: Human Reproduction Update - February 27, 2019 Category: OBGYN Source Type: research

The risk of TESE-induced hypogonadism: a systematic review and meta-analysis
AbstractBACKGROUNDTesticular sperm extraction (TESE) is a surgical procedure to retrieve spermatozoa from the testes of men with azoospermia to help them achieve biological parenthood. Although effective, the surgical procedure is not without complications and haematoma, devascularization, inflammation and a decrease in testosterone levels have been described as such. The prevalence and duration of hypogonadism and associated symptoms after TESE have not been studied systematically.OBJECTIVE AND RATIONALEIn this systematic review we addressed the following research questions: Are serum testosterone levels decreased after T...
Source: Human Reproduction Update - May 3, 2018 Category: OBGYN Source Type: research

Non-coding RNAs in endometriosis: a narrative review
AbstractBACKGROUNDEndometriosis is a benign gynaecological disorder, which affects 10% of reproductive-aged women and is characterized by endometrial cells from the lining of the uterus being found outside the uterine cavity. However, the pathophysiological mechanisms causing the development of this heterogeneous disease remain enigmatic, and a lack of effective biomarkers necessitates surgical intervention for diagnosis. There is international recognition that accurate non-invasive diagnostic tests and more effective therapies are urgently needed. Non-coding RNA (ncRNA) molecules, which are important regulators of cellula...
Source: Human Reproduction Update - April 25, 2018 Category: OBGYN Source Type: research

Reply: Excessive fetal growth in frozen embryo transfer: false alarm or clinical concern?
(Source: Human Reproduction Update)
Source: Human Reproduction Update - April 18, 2018 Category: OBGYN Source Type: research

Excessive fetal growth in frozen embryo transfer: false alarm or clinical concern?
(Source: Human Reproduction Update)
Source: Human Reproduction Update - April 18, 2018 Category: OBGYN Source Type: research

How uterine microbiota might be responsible for a receptive, fertile endometrium
We present the available evidence regarding uterine microbiota, focusing on recent findings based on 16S rRNA, and depict the possible importance of uterine colonization for a receptive endometrium. We highlight a possible role of uterine microbiota for host immunity and tissue adaptation, as well as conferring protection against pathogens. Based on knowledge of the interaction of the mucosal immune cells of the gut with the local microbiome, we want to investigate the potential implications of commensal colonization for uterine health.SEARCH METHODSPubMed and Google Scholar were searched for articles in English indexed fr...
Source: Human Reproduction Update - April 16, 2018 Category: OBGYN Source Type: research

Infectious, inflammatory and ‘autoimmune’ male factor infertility: how do rodent models inform clinical practice?
AbstractBACKGROUNDInfection and inflammation of the reproductive tract are significant causes of male factor infertility. Ascending infections caused by sexually transmitted bacteria or urinary tract pathogens represent the most frequent aetiology of epididymo-orchitis, but viral, haematogenous dissemination is also a contributory factor. Limitations in adequate diagnosis and therapy reflect an obvious need for further understanding of human epididymal and testicular immunopathologies and their contribution to infertility. A major obstacle for advancing our knowledge is the limited access to suitable tissue samples. Simila...
Source: Human Reproduction Update - April 10, 2018 Category: OBGYN Source Type: research

Thank you to our reviewers of 2017
(Source: Human Reproduction Update)
Source: Human Reproduction Update - April 10, 2018 Category: OBGYN Source Type: research

Trophoblast retrieval and isolation from the cervix: origins of cervical trophoblasts and their potential value for risk assessment of ongoing pregnancies
AbstractBACKGROUNDEarly during human development, the trophoblast lineage differentiates to commence placentation. Where the placenta contacts the uterine decidua, extravillous trophoblast (EVT) cells differentiate and invade maternal tissues. EVT cells, identified by expression of HLA-G, invade into uterine blood vessels (endovascular EVT), as well as glands (endoglandular EVT), and open such luminal structures towards the intervillous space of the placenta. Endoglandular invasion diverts the contents of uterine glands to the intervillous space, while glands near the margin of the placenta that also contain endoglandular ...
Source: Human Reproduction Update - March 28, 2018 Category: OBGYN Source Type: research

Ethnicity, obesity and the prevalence of impaired glucose tolerance and type 2 diabetes in PCOS: a systematic review and meta-regression
AbstractBACKGROUNDOur prior meta-analyses demonstrated an increased prevalence of impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM) with polycystic ovary syndrome (PCOS), but with substantial clinical heterogeneity.OBJECTIVE AND RATIONALEWe aimed to update our previous review to quantify the prevalence of IGT and T2DM in PCOS with only quality studies (good and fair quality). We also aimed to examine the contribution of parameters including ethnicity, obesity and method of diagnosing T2DM in explaining the observed heterogeneity in IGT and T2DM prevalence in PCOS.SEARCH METHODSWe conducted a literature s...
Source: Human Reproduction Update - March 26, 2018 Category: OBGYN Source Type: research

Determinants of monozygotic twinning in ART: a systematic review and a meta-analysis
AbstractBACKGROUNDThe incidence of monozygotic twins (MZT) after ART appears to be higher than the incidence after spontaneous conceptions contradicting the aim of ART to avoid multiple pregnancies because of the associated risks.OBJECTIVE AND RATIONALEThe aim was to study the frequency of MZT after IVF and ICSI and how it is influenced by the day of embryo transfer, maternal age, zona pellucida manipulation, controlled ovarian stimulation, stimulation protocol, culture media and embryo quality.SEARCH METHODSOriginal studies and reviews were identified by searching the PubMed, Embase and Cochrane databases up to March 2017...
Source: Human Reproduction Update - March 12, 2018 Category: OBGYN Source Type: research

The effect of paternal factors on perinatal and paediatric outcomes: a systematic review and meta-analysis
AbstractBACKGROUNDMaternal factors, including increasing childbearing age and various life-style factors, are associated with poorer short- and long-term outcomes for children, whereas knowledge of paternal parameters is limited. Recently, increasing paternal age has been associated with adverse obstetric outcomes, birth defects, autism spectrum disorders and schizophrenia in children.OBJECTIVE AND RATIONALEThe aim of this systematic review is to describe the influence of paternal factors on adverse short- and long-term child outcomes.SEARCH METHODSPubMed, Embase and Cochrane databases up to January 2017 were searched. Pat...
Source: Human Reproduction Update - February 15, 2018 Category: OBGYN Source Type: research

The effect of pregnancy on endometriosis —facts or fiction?
The objective was to evaluate the evidence on whether pregnancy and lactation has a beneficiary effect on growth characteristics and symptoms of endometriosis diagnosed prior to pregnancy.SEARCH METHODSA search for articles containing keywords related to pregnancy and endometriosis was performed via PubMed. Manuscripts dealing with a potential effect of pregnancy on endometriosis were systematically reviewed. We included English, French and German language publications on human studies from 1966 to May 2017. Bibliographies of these manuscripts were searched for further relevant literature.OUTCOMESFive small observational s...
Source: Human Reproduction Update - February 15, 2018 Category: OBGYN Source Type: research

IUI: review and systematic assessment of the evidence that supports global recommendations
The objective of this review is to provide a review of the evidence of 13 prioritized questions that cover IUI with and without OS. We provide summary recommendations for the development of global, evidence-based guidelines based upon methodology established by the WHO.SEARCH METHODSWe performed a comprehensive search using question-specific relevant search terms in May 2015. For each PICO (Population, Intervention, Comparison and Outcomes) drafted by WHO, specific search terms were used to find the available evidence in MEDLINE (1950 to May 2015) and The Cochrane Library (until May 2015). After presentation to an expert p...
Source: Human Reproduction Update - February 14, 2018 Category: OBGYN Source Type: research

Sirtuins in gamete biology and reproductive physiology: emerging roles and therapeutic potential in female and male infertility
AbstractBACKGROUNDSirtuins (SIRT1-7) are a family of NAD+-dependent deacetylases that catalyze post-translational modifications of proteins. Together, they respond to metabolic challenges, inflammatory signals or hypoxic/oxidative stress, and are associated with aging and longevity. The role of Sirtuins in the regulation of fertility emerged in 2003 when a defective reproductive phenotype was observed inSIRT1-null mice. Although studies on Sirtuins in reproductive biology have been increasing in the last years, a recent comprehensive update on this issue is still lacking.OBJECTIVE AND RATIONALEThis review is aimed to provi...
Source: Human Reproduction Update - February 13, 2018 Category: OBGYN Source Type: research

Acquisition of oocyte competence to develop as an embryo: integrated nuclear and cytoplasmic events
AbstractInfertility affects ~7% of couples of reproductive age with little change in incidence in the last two decades. ART, as well as other interventions, have made major strides in correcting this condition. However, and in spite of advancements in the field, the age of the female partner remains a main factor for a successful outcome. A better understanding of the final stages of gamete maturation yielding an egg that can sustain embryo development and a pregnancy to term remains a major area for improvement in the field. This review will summarize the major cellular and molecular events unfolding at the oocyte-to-embr...
Source: Human Reproduction Update - February 8, 2018 Category: OBGYN Source Type: research

Basic mechanisms of vascularization in endometriosis and their clinical implications
AbstractBACKGROUNDVascularization is a major hallmark in the pathogenesis of endometriosis. An increasing number of studies suggests that multiple mechanisms contribute to the vascularization of endometriotic lesions, including angiogenesis, vasculogenesis and inosculation.OBJECTIVE AND RATIONALEIn this review, we provide an overview of the basic mechanisms of vascularization in endometriosis and give special emphasis on their future clinical implications in the diagnosis and therapy of the disease.SEARCH METHODSLiterature searches were performed in PubMed for English articles with the key words ‘endometriosis’...
Source: Human Reproduction Update - January 25, 2018 Category: OBGYN Source Type: research

Genetic and epigenetic factors which modulate differentiation propensity in human pluripotent stem cells
AbstractBACKGROUNDHuman pluripotent stem cell (hPSC) lines are known to have a bias in their differentiation. This gives individual cell lines a propensity to preferentially differentiate towards one germ layer or cell type over others. Chromosomal aberrations, mitochondrial mutations, genetic diversity and epigenetic variance are the main drivers of this phenomenon, and can lead to a wide range of phenotypes.OBJECTIVE AND RATIONALEOur aim is to provide a comprehensive overview of the different factors which influence differentiation propensity. Specifically, we sought to highlight known genetic variances and their mechani...
Source: Human Reproduction Update - January 25, 2018 Category: OBGYN Source Type: research

The importance of DNA repair for maintaining oocyte quality in response to anti-cancer treatments, environmental toxins and maternal ageing
AbstractBACKGROUNDWithin the ovary, oocytes are stored in long-lived structures called primordial follicles, each comprising a meiotically arrested oocyte, surrounded by somatic granulosa cells. It is essential that their genetic integrity is maintained throughout life to ensure that high quality oocytes are available for ovulation. Of all the possible types of DNA damage, DNA double-strand breaks (DSBs) are considered to be the most severe. Recent studies have shown that DNA DSBs can accumulate in oocytes in primordial follicles during reproductive ageing, and are readily induced by exogenous factors such as γ-irrad...
Source: Human Reproduction Update - January 25, 2018 Category: OBGYN Source Type: research

Reply: GnRH antagonists vs. long GnRH agonists in IVF: significant flaws in a meta-analysis lead to invalid conclusions
(Source: Human Reproduction Update)
Source: Human Reproduction Update - December 29, 2017 Category: OBGYN Source Type: research

GnRH antagonists vs. long GnRH agonists in IVF: significant flaws in a meta-analysis lead to invalid conclusions
(Source: Human Reproduction Update)
Source: Human Reproduction Update - December 29, 2017 Category: OBGYN Source Type: research

Combined oral contraceptives and/or antiandrogens versus insulin sensitizers for polycystic ovary syndrome: a systematic review and meta-analysis
AbstractBACKGROUNDAndrogen excess is a key pathogenetic mechanism in polycystic ovary syndrome (PCOS), although hyperinsulinism also contributes to androgen secretion. Therapeutic approaches for adult patients not seeking fertility include combined oral contraceptives (COC), antiandrogens (AA) and/or insulin sensitizers, although these practices are supported by limited high-quality evidence.OBJECTIVE AND RATIONALEWe aimed to assess the efficacy and safety of these common treatments for PCOS by conducting a meta-analysis of RCTs with the following review questions: Which is the more appropriate therapeutic approach for hyp...
Source: Human Reproduction Update - December 27, 2017 Category: OBGYN Source Type: research

Testicular organoids: a new model to study the testicular microenvironment in vitro?
AbstractBACKGROUNDIn recent decades, a broad range of strategies have been applied to model the testicular microenvironmentin vitro. These models have been utilized to study testicular physiology and development. However, a system that allows investigations into testicular organogenesis and its impact in the spermatogonial stem-cell (SSC) nichein vitro has not been developed yet. Recently, the creation of tissue-specific organ-like structures called organoids has resurged, helping researchers to answer scientific questions that previousin vitro models could not help to elucidate. So far, a small number of publications have...
Source: Human Reproduction Update - December 21, 2017 Category: OBGYN Source Type: research

Regulation of chromosome segregation in oocytes and the cellular basis for female meiotic errors
AbstractBACKGROUNDMeiotic chromosome segregation in human oocytes is notoriously error-prone, especially with ageing. Such errors markedly reduce the reproductive chances of increasing numbers of women embarking on pregnancy later in life. However, understanding the basis for these errors is hampered by limited access to human oocytes.OBJECTIVE AND RATIONALEImportant new discoveries have arisen from molecular analyses of human female recombination and aneuploidy along with high-resolution analyses of human oocyte maturation and mouse models. Here, we review these findings to provide a contemporary picture of the key player...
Source: Human Reproduction Update - December 13, 2017 Category: OBGYN Source Type: research

The associations of thiopurines with male fertility and paternally exposed offspring: a systematic review and meta-analysis
AbstractBACKGROUNDThiopurines are widely used immunosuppressive agents. In high dosages, they inhibit the purine synthesis and are considered to be possibly harmful to spermatogenesis, and subsequently to men ’s fertility and their offspring. However, the clear association between thiopurine exposure and male fertility and reproduction safety, if any, is still poorly understood.OBJECTIVE AND RATIONALEThe aim of this review was to systematically summarize and meta-analyse the available data, derived from animal and human studies, regarding the influence of thiopurine exposure on fertility and conception safety in men ...
Source: Human Reproduction Update - November 28, 2017 Category: OBGYN Source Type: research

Extracellular matrix in uterine leiomyoma pathogenesis: a potential target for future therapeutics
AbstractBACKGROUNDUterine leiomyoma (also known as fibroid or myoma) is the most common benign tumor of the uterus found in women of reproductive age. It is not usually fatal but can produce serious clinical symptoms, including excessive uterine bleeding, pelvic pain or pressure, infertility and pregnancy complications. Due to lack of effective medical treatments surgery has been a definitive choice for the management of this tumor.OBJECTIVE AND RATIONALEExtracellular matrix (ECM) accumulation and remodeling are thought to be crucial for fibrotic diseases such as uterine leiomyoma. Indeed, ECM plays important role in formi...
Source: Human Reproduction Update - November 23, 2017 Category: OBGYN Source Type: research

Is frozen embryo transfer better for mothers and babies? Can cumulative meta-analysis provide a definitive answer?
AbstractBACKGROUNDInitial observational studies and a systematic review published 5 years ago have suggested that obstetric and perinatal outcomes are better in offspring conceived following frozen rather than fresh embryo transfers, with reduced risks of preterm birth, small for gestational age, low birth weight and pre-eclampsia. More recent primary studies are beginning to challenge some of these findings. We therefore conducted an updated systematic review and cumulative meta-analysis to examine if these results have remained consistent over time.OBJECTIVE AND RATIONALEThe aim of this study was to perform a systematic ...
Source: Human Reproduction Update - November 13, 2017 Category: OBGYN Source Type: research

Diabetes-induced hyperglycemia impairs male reproductive function: a systematic review
AbstractBACKGROUNDHyperglycemia can result from a loss of pancreatic beta-cells or a decline in their function leading to decreased insulin secretion or may arise from insulin resistance and variable degrees of inadequate insulin secretion resulting in diabetes and related comorbidities. To date several reviews have addressed the issue of diabetes-related male infertility but most have focused on how metabolic syndrome causes the decline in male fertility. However, a comprehensive overview as to how diabetes-induced hyperglycemia impairs male fertility is missing. Impaired regulation of glucose and the resultant hyperglyce...
Source: Human Reproduction Update - November 10, 2017 Category: OBGYN Source Type: research

In vivo oxygen, temperature and pH dynamics in the female reproductive tract and their importance in human conception: a systematic review
AbstractBACKGROUNDDespite advances in ART, implantation and pregnancy rates per embryo transfer still remain low. IVF laboratories strive to ensure that the process of handling gametesin vitro closely mimics thein vivo environment. However, there remains a lack of knowledge regarding thein vivo regulation and dynamic variation in biophysical parameters such as oxygen concentration, pH and temperature within the reproductive tract.OBJECTIVE AND RATIONALETo undertake a systematic review of the current understanding of the physico-chemical parameters of oxygen tension (pO2), pH and temperature within the female reproductive t...
Source: Human Reproduction Update - October 25, 2017 Category: OBGYN Source Type: research

Patient-centered early pregnancy care: a systematic review of quantitative and qualitative studies on the perspectives of women and their partners
AbstractBACKGROUNDEarly pregnancy complications, defined as miscarriage, recurrent miscarriage or ectopic pregnancy, affect the physical and psychological well-being of intended parents. Research in this field so far has focused mainly on improving accuracy of diagnostic tests and safety and effectiveness of therapeutic management. An overview of aspects of care valued by women and/or their partners is missing.OBJECTIVE AND RATIONALEThis systematic review aims to provide an overview of aspects of care valued by women and/or their partners faced with early pregnancy complications and to identify potential targets for improv...
Source: Human Reproduction Update - October 11, 2017 Category: OBGYN Source Type: research

The epidermal growth factor network: role in oocyte growth, maturation and developmental competence
AbstractBACKGROUNDThe LH surge induces great physiological changes within the preovulatory follicle, which culminate in the ovulation of a mature oocyte that is capable of supporting embryo and foetal development. However, unlike mural granulosa cells, the oocyte and its surrounding cumulus cells are not directly responsive to LH, indicating that the LH signal is mediated by secondary factors produced by the granulosa cells. The mechanisms by which the oocyte senses the ovulatory LH signal and hence prepares for ovulation has been a subject of considerable controversy for the past four decades. Within the last 15 years sev...
Source: Human Reproduction Update - September 20, 2017 Category: OBGYN Source Type: research

How effective are weight-loss interventions for improving fertility in women and men who are overweight or obese? A systematic review and meta-analysis of the evidence
AbstractBACKGROUNDThe prevalence of obesity is increasing worldwide, with a corresponding increase in overweight and obese patients referred with infertility. This systematic review aimed to determine whether non-surgical weight reduction strategies result in an improvement in reproductive parameters affected by obesity, e.g. delayed time to pregnancy, oligozoospermia and azoospermia. No prior reviews have examined this within the general fertility population, or in both sexes.OBJECTIVE AND RATIONALEOur objective was to answer the question: ‘In overweight and obese women, men and couples seeking fertility treatment, ...
Source: Human Reproduction Update - September 13, 2017 Category: OBGYN Source Type: research

Disentangling puberty: novel neuroendocrine pathways and mechanisms for the control of mammalian puberty
AbstractBACKGROUNDPuberty is a complex developmental event, controlled by sophisticated regulatory networks that integrate peripheral and internal cues and impinge at the brain centers driving the reproductive axis. The tempo of puberty is genetically determined but is also sensitive to numerous modifiers, from metabolic and sex steroid signals to environmental factors. Recent epidemiological evidence suggests that the onset of puberty is advancing in humans, through as yet unknown mechanisms. In fact, while much knowledge has been gleaned recently on the mechanisms responsible for the control of mammalian puberty, fundame...
Source: Human Reproduction Update - August 30, 2017 Category: OBGYN Source Type: research

Human female meiosis revised: new insights into the mechanisms of chromosome segregation and aneuploidies from advanced genomics and time-lapse imaging
ABSTRACTBACKGROUNDThe unbalanced transmission of chromosomes in human gametes and early preimplantation embryos causes aneuploidy, which is a major cause of infertility and pregnancy failure. A baseline of 20% of human oocytes are estimated to be aneuploid and this increases exponentially from 30 to 35 years, reaching on average 80% by 42 years. As a result, reproductive senescence in human females is predominantly determined by the accelerated decline in genetic quality of oocytes from 30 years of age.OBJECTIVE AND RATIONALEUnderstanding mechanisms of chromosome segregation and aneuploidies in the female germline is a cru...
Source: Human Reproduction Update - August 30, 2017 Category: OBGYN Source Type: research

Disentangling puberty: novel neuroendocrine pathways and mechanisms for the control of mammalian puberty
AbstractBACKGROUNDPuberty is a complex developmental event, controlled by sophisticated regulatory networks that integrate peripheral and internal cues and impinge at the brain centers driving the reproductive axis. The tempo of puberty is genetically determined but is also sensitive to numerous modifiers, from metabolic and sex steroid signals to environmental factors. Recent epidemiological evidence suggests that the onset of puberty is advancing in humans, through as yet unknown mechanisms. In fact, while much knowledge has been gleaned recently on the mechanisms responsible for the control of mammalian puberty, fundame...
Source: Human Reproduction Update - August 30, 2017 Category: OBGYN Source Type: research

Human female meiosis revised: new insights into the mechanisms of chromosome segregation and aneuploidies from advanced genomics and time-lapse imaging
ABSTRACTBACKGROUNDThe unbalanced transmission of chromosomes in human gametes and early preimplantation embryos causes aneuploidy, which is a major cause of infertility and pregnancy failure. A baseline of 20% of human oocytes are estimated to be aneuploid and this increases exponentially from 30 to 35 years, reaching on average 80% by 42 years. As a result, reproductive senescence in human females is predominantly determined by the accelerated decline in genetic quality of oocytes from 30 years of age.OBJECTIVE AND RATIONALEUnderstanding mechanisms of chromosome segregation and aneuploidies in the female germline is a cru...
Source: Human Reproduction Update - August 30, 2017 Category: OBGYN Source Type: research