Novel reproductive technologies to prevent mitochondrial disease
AbstractBACKGROUNDThe use of nuclear transfer (NT) has been proposed as a novel reproductive treatment to overcome the transmission of maternally-inherited mitochondrial DNA (mtDNA) mutations. Pathogenic mutations in mtDNA can cause a wide-spectrum of life-limiting disorders, collectively known as mtDNA disease, for which there are currently few effective treatments and no known cures. The many unique features of mtDNA make genetic counselling challenging for women harbouring pathogenic mtDNA mutations but reproductive options that involve medical intervention are available that will minimize the risk of mtDNA disease in t...
Source: Human Reproduction Update - June 23, 2017 Category: OBGYN Source Type: research
Non-classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency revisited: an update with a special focus on adolescent and adult women
AbstractBACKGROUNDNon-classic congenital hyperplasia (NCAH) due to 21-hydroxylase deficiency is a common autosomal recessive disorder characterized by androgen excess.OBJECTIVE AND RATIONALEWe conducted a systematic review and critical assessment of the available evidence pertaining to the epidemiology, pathophysiology, diagnosis and management of NCAH. A meta-analysis of epidemiological data was also performed.SEARCH METHODSPeer-reviewed studies evaluating NCAH published up to October 2016 were reviewed. Multiple databases were searched including MEDLINE, EMBASE, Cochrane, ERIC, EBSCO, dissertation abstracts, and current ...
Source: Human Reproduction Update - June 5, 2017 Category: OBGYN Source Type: research
X chromosome inactivation in human pluripotent stem cells as a model for human development: back to the drawing board?
AbstractBACKGROUNDHuman pluripotent stem cells (hPSC), both embryonic and induced (hESC and hiPSC), are regarded as a valuablein vitro model for early human development. In order to fulfil this promise, it is important that these cells mimic as closely as possible thein vivo molecular events, both at the genetic and epigenetic level. One of the most important epigenetic events during early human development is X chromosome inactivation (XCI), the transcriptional silencing of one of the two X chromosomes in female cells. XCI is important for proper development and aberrant XCI has been linked to several pathologies. Recentl...
Source: Human Reproduction Update - June 5, 2017 Category: OBGYN Source Type: research
Is foetal hyperexposure to androgens a cause of PCOS?
AbstractBACKGROUNDPolycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting reproductive-aged women. The pathophysiology of this syndrome is still not completely understood but recent evidence suggests that the intra-uterine environment may be a key factor in the pathogenesis of PCOS, in particular, hyperexposure of the foetus to androgens. High concentrations of maternal serum testosterone during pregnancy have been shown to influence behaviour during childhood, the prevalence of autism disorders and anti-Mullerian hormone (AMH) concentrations in adolescence. They are also thought to re-programme the fe...
Source: Human Reproduction Update - May 20, 2017 Category: OBGYN Source Type: research
What factors hinder the decision-making process for women with cancer and contemplating fertility preservation treatment?
AbstractBACKGROUNDAlthough fertility preservation (FP) treatment options have increased, the existing evidence suggests that many women with cancer do not feel well supported in making these decisions, but find them stressful and complex and fail to take up fertility care at this crucial time. Whilst existing reviews have all made important contributions to our understanding of the FP decision-making process, none of them examine solely and specifically these processes for women of reproductive age with a diagnosis of any cancer, leaving a gap in the knowledge base. Given the expectation that care is patient-centred, our r...
Source: Human Reproduction Update - May 16, 2017 Category: OBGYN Source Type: research
The management of menopause in women with a history of endometriosis: a systematic review
We present a synthesis of the existing case reports of endometriosis recurrence or malignant transformation in women undergoing treatment for menopausal symptoms. We highlight common presenting symptoms, potential risk factors and outcomes amongst the studies. Sparse high-quality evidence was identified, with few observational studies and only two randomized controlled trials. Given this paucity of data, no definitive conclusions can be drawn concerning risk.WIDER IMPLICATIONSDue to the lack of high-quality studies, it remains unclear how to advise women with a history of endometriosis regarding the management of menopausa...
Source: Human Reproduction Update - May 11, 2017 Category: OBGYN Source Type: research
Prevalence of ‘obesity-associated gonadal dysfunction’ in severely obese men and women and its resolution after bariatric surgery: a systematic review and meta-analysis
AbstractBACKGROUNDSexual dimorphism manifests noticeably in obesity-associated gonadal dysfunction. In women, obesity is associated with androgen excess disorders, mostly the polycystic ovary syndrome (PCOS), whereas androgen deficiency is frequently present in obese men in what has been termed as male obesity-associated secondary hypogonadism (MOSH). Obesity-associated gonadal dysfunction, consisting of PCOS in women and MOSH in men, is a frequent finding in patients with severe obesity and it may be ameliorated or even resolve with marked weight loss, especially after bariatric surgery.OBJECTIVE AND RATIONALEWe aimed to ...
Source: Human Reproduction Update - May 9, 2017 Category: OBGYN Source Type: research
Motoring through: the role of kinesin superfamily proteins in female meiosis
This article contains a review of the literature with respect to the role of kinesin motor proteins in female meiosis in model species. Throughout, we discuss the function of each class of kinesin proteins during oocyte meiosis, and where such data are not available their role in mitosis is considered. Finally, the review highlights the potential clinical importance of this family of proteins for human oocyte quality.OBJECTIVE AND RATIONALETo examine the role of kinesin motor proteins in oocyte meiosis.SEARCH METHODSA search was performed on the Pubmed database for journal articles published between January 1970 and Februa...
Source: Human Reproduction Update - April 18, 2017 Category: OBGYN Source Type: research
Sperm recovery and ICSI outcomes in Klinefelter syndrome: a systematic review and meta-analysis
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">BACKGROUND</div>Specific factors underlying successful surgical sperm retrieval rates (SRR) or pregnancy rates (PR) after testicular sperm extraction (TESE) in adult patients with Klinefelter syndrome (KS) have not been completely clarified.<div class="boxTitle">OBJECTIVE AND RATIONALE</div>The aim of this review was to meta-analyse the currently available data from subjects with KS regarding SRRs as the primary outcome. In addition, when available, PRs and live birth rates (LBRs) after the ICS...
Source: Human Reproduction Update - April 4, 2017 Category: OBGYN Source Type: research
Thank you to our reviewers of 2016
(Source: Human Reproduction Update)
Source: Human Reproduction Update - March 24, 2017 Category: OBGYN Source Type: research
Men's knowledge, attitudes and behaviours relating to fertility
AbstractBACKGROUNDThe increasingly common practice in high-income countries to delay childbearing to the fourth and fifth decades of life increases the risk of involuntary childlessness or having fewer children than desired. Older age also increases the risk of age-related infertility, the need for ART to conceive, and obstetric and neonatal complications. Existing research relating to childbearing focusses almost exclusively on women, and in public discourse declining fertility rates are often assumed to be the result of women delaying childbearing to pursue other life goals such as a career and travel. However, evidence ...
Source: Human Reproduction Update - March 10, 2017 Category: OBGYN Source Type: research
Dietary patterns, foods and nutrients in male fertility parameters and fecundability: a systematic review of observational studies
AbstractBACKGROUNDInfertility is a global public health issue, affecting 15% of all couples of reproductive age. Male factors, including decreased semen quality, are responsible for ~25% of these cases. The dietary pattern, the components of the diet and nutrients have been studied as possible determinants of sperm function and/or fertility.OBJECTIVE AND RATIONALEPrevious systematic reviews have been made of the few heterogeneous low-quality randomized clinical trials (RCTs) conducted in small samples of participants and investigating the effect of specific nutrients and nutritional supplements on male infertility. However...
Source: Human Reproduction Update - March 10, 2017 Category: OBGYN Source Type: research
Ovarian hormones and obesity
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">BACKGROUND</div>Obesity is caused by an imbalance between energy intake, i.e. eating and energy expenditure (EE). Severe obesity is more prevalent in women than men worldwide, and obesity pathophysiology and the resultant obesity-related disease risks differ in women and men. The underlying mechanisms are largely unknown. Pre-clinical and clinical research indicate that ovarian hormones may play a major role.<div class="boxTitle">OBJECTIVE AND RATIONALE</div>We systematically reviewed the clini...
Source: Human Reproduction Update - March 2, 2017 Category: OBGYN Source Type: research
Surgical treatment of adhesion-related chronic abdominal and pelvic pain after gynaecological and general surgery: a systematic review and meta-analysis
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">BACKGROUND</div>Chronic pain is a frequent post-operative complication, affecting ~20 –40% of patients who have undergone surgery of the female genital or alimentary tract. Chronic pain is an important risk factor for diminished quality of life after surgery. Adhesions are frequently associated with chronic post-operative pain; however, surgical treatment of adhesion-related pain i s controversial.<div class="boxTitle">OBJECTIVE AND RATIONALE</div>The aim of this study was to investigate the ...
Source: Human Reproduction Update - March 2, 2017 Category: OBGYN Source Type: research
Tubal anastomosis after previous sterilization: a systematic review
<span class="paragraphSection"><div class="boxTitle">Abstract</div><div class="boxTitle">BACKGROUND</div>Female sterilization is one of the most common contraceptive methods. A small number of women, however, opt for reversal of sterilization procedures after they experience regret. Procedures can be performed by laparotomy or laparoscopy, with or without robotic assistance. Another commonly utilized alternative is IVF. The choice between surgery and IVF is often influenced by reimbursement politics for that particular geographic location.<div class="boxTitle">OBJECTIVE AND RATIONALE<...
Source: Human Reproduction Update - February 22, 2017 Category: OBGYN Source Type: research
