Perfluoroalkyl and polyfluoroalkyl substances (PFAS) and their effects on the ovary
AbstractBACKGROUNDPerfluoroalkyl and polyfluoroalkyl substances (PFAS) are found widespread in drinking water, foods, food packaging materials and other consumer products. Several PFAS have been identified as endocrine-disrupting chemicals based on their ability to interfere with normal reproductive function and hormonal signalling. Experimental models and epidemiologic studies suggest that PFAS exposures target the ovary and represent major risks for women ’s health.OBJECTIVE AND RATIONALEThis review summarises human population and toxicological studies on the association between PFAS exposure and ovarian function.SEARC...
Source: Human Reproduction Update - May 29, 2020 Category: OBGYN Source Type: research

Studying human reproductive biology through single-cell analysis and in vitro differentiation of stem cells into germ cell-like cells
AbstractBACKGROUNDUnderstanding the molecular and cellular mechanisms of human reproductive development has been limited by the scarcity of human samples and ethical constraints. Recently,in vitro differentiation of human pluripotent stem cells into germ cells and single-cell analyses have opened new avenues to directly study human germ cells and identify unique mechanisms in human reproductive development.OBJECTIVE AND RATIONALEThe goal of this review is to collate novel findings and insightful discoveries with these new methodologies, aiming at introducing researchers and clinicians to the use of these tools to study hum...
Source: Human Reproduction Update - May 28, 2020 Category: OBGYN Source Type: research

The functions of CAP superfamily proteins in mammalian fertility and disease
AbstractBACKGROUNDMembers of the cysteine-rich secretory proteins (CRISPS), antigen 5 (Ag5) and pathogenesis-related 1 (Pr-1) (CAP) superfamily of proteins are found across the bacterial, fungal, plant and animal kingdoms. Although many CAP superfamily proteins remain poorly characterized, over the past decade evidence has accumulated, which provides insights into the functional roles of these proteins in various processes, including fertilization, immune defence and subversion, pathogen virulence, venom toxicology and cancer biology.OBJECTIVE AND RATIONALEThe aim of this article is to summarize the current state of knowle...
Source: Human Reproduction Update - May 7, 2020 Category: OBGYN Source Type: research

Advanced paternal age is associated with an increased risk of spontaneous miscarriage: a systematic review and meta-analysis
AbstractBACKGROUNDAlthough spontaneous miscarriage is the most common complication of human pregnancy, potential contributing factors are not fully understood. Advanced maternal age has long been recognised as a major risk factor for miscarriage, being strongly related with fetal chromosomal abnormalities. The relation between paternal age and the risk of miscarriage is less evident, yet it is biologically plausible that an increasing number of genetic and epigenetic sperm abnormalities in older males may contribute to miscarriage. Previous meta-analyses showed associations between advanced paternal age and a broad spectru...
Source: Human Reproduction Update - May 2, 2020 Category: OBGYN Source Type: research

Haem oxygenases play a pivotal role in placental physiology and pathology
AbstractBACKGROUNDHaem oxygenases (HO) catabolise haem, which is the prosthetic group of numerous haemoproteins. Thus, multiple primary cellular pathways and functions rely on haem availability. HO exists in two isoforms, both expressed in the placenta, namely HO-1 and HO-2, the first being inducible. Haem oxygenases, particularly HO-1, have garnered specific interest in the field of physiological and pathological placental function. These enzymes mediate haem degradation by cleaving the alpha methene bridge to produce biliverdin, which is subsequently converted to bilirubin, carbon monoxide and iron. HO-1 has anti-inflamm...
Source: Human Reproduction Update - April 29, 2020 Category: OBGYN Source Type: research

Hypothetical roadmap towards endometriosis: prenatal endocrine-disrupting chemical pollutant exposure, anogenital distance, gut-genital microbiota and subclinical infections
AbstractBACKGROUNDEndometriosis is a gynaecological hormone-dependent disorder that is defined by histological lesions generated by the growth of endometrial-like tissue out of the uterus cavity, most commonly engrafted within the peritoneal cavity, although these lesions can also be located in distant organs. Endometriosis affects ~10% of women of reproductive age, frequently producing severe and, sometimes, incapacitating symptoms, including chronic pelvic pain, dysmenorrhea and dyspareunia, among others. Furthermore, endometriosis causes infertility in ~30% of affected women. Despite intense research on the mechanisms i...
Source: Human Reproduction Update - February 28, 2020 Category: OBGYN Source Type: research

Long-acting reversible contraception immediately after medical abortion: systematic review with meta-analyses
AbstractBACKGROUNDLong-acting reversible contraceptives (LARCs) are safe, effective and convenient post-abortal methods. However, there is concern that some LARCs may reduce the effectiveness of abortifacient drugs or result in other adverse outcomes.OBJECTIVE AND RATIONALEWe undertook two systematic reviews to examine the early administration of LARCs in women undergoing medical abortion with mifepristone and misoprostol. (i) For women who are having a medical abortion and who plan to use a progestogen-only contraceptive implant or injectable, does administration of the contraception at the same time as mifepristone influ...
Source: Human Reproduction Update - February 25, 2020 Category: OBGYN Source Type: research

Identifying biomarkers for predicting successful embryo implantation: applying single to multi-OMICs to improve reproductive outcomes
AbstractBACKGROUNDSuccessful embryo implantation is a complex process that requires the coordination of a series of events, involving both the embryo and the maternal endometrium. Key to this process is the intricate cascade of molecular mechanisms regulated by endocrine, paracrine and autocrine modulators of embryonic and maternal origin. Despite significant progress in ART, implantation failure still affects numerous infertile couples worldwide and fewer than 10% of embryos successfully implant. Improved selection of both the viable embryos and the optimal endometrial phenotype for transfer remains crucial to enhancing i...
Source: Human Reproduction Update - February 25, 2020 Category: OBGYN Source Type: research

The role of microRNAs in ovarian function and the transition toward novel therapeutic strategies in fertility preservation: from bench to future clinical application
AbstractBACKGROUNDNew therapeutic approaches in oncology have converted cancer from a certain death sentence to a chronic disease. However, there are still challenges to be overcome regarding the off-target toxicity of many of these treatments. Oncological therapies can lead to future infertility in women. Given this negative impact on long-term quality of life, fertility preservation is highly recommended. While gamete and ovarian tissue cryopreservation are the usual methods offered, new pharmacological-based options aiming to reduce ovarian damage during oncological treatment are very attractive. In this vein, advances ...
Source: Human Reproduction Update - February 24, 2020 Category: OBGYN Source Type: research

Disturbed genomic imprinting and its relevance for human reproduction: causes and clinical consequences
AbstractBACKGROUNDHuman reproductive issues affecting fetal and maternal health are caused by numerous exogenous and endogenous factors, of which the latter undoubtedly include genetic changes. Pathogenic variants in either maternal or offspring DNA are associated with effects on the offspring including clinical disorders and nonviable outcomes. Conversely, both fetal and maternal factors can affect maternal health during pregnancy. Recently, it has become evident that mammalian reproduction is influenced by genomic imprinting, an epigenetic phenomenon that regulates the expression of genes according to their parent from w...
Source: Human Reproduction Update - February 18, 2020 Category: OBGYN Source Type: research

Adjuvant treatment strategies in ovarian stimulation for poor responders undergoing IVF: a systematic review and network meta-analysis
ABSTRACTBACKGROUNDDespite great advances in assisted reproductive technology, poor ovarian response (POR) is still considered as one of the most challenging tasks in reproductive medicine.OBJECTIVE AND RATIONALEThe aim of this systemic review is to evaluate the role of different adjuvant treatment strategies on the probability of pregnancy achievement in poor responders undergoing IVF. Randomized controlled trials (RCTs) comparing 10 adjuvant treatments [testosterone, dehydroepiandrosterone (DHEA), letrozole, recombinant LH, recombinant hCG, oestradiol, clomiphene citrate, progesterone, growth hormone (GH) and coenzyme Q10...
Source: Human Reproduction Update - February 11, 2020 Category: OBGYN Source Type: research

Endometrial ablation or resection versus levonorgestrel intra-uterine system for the treatment of women with heavy menstrual bleeding and a normal uterine cavity: a systematic review with meta-analysis
AbstractBACKGROUNDEndometrial ablation/resection and the levonorgestrel intra-uterine system (LNG-IUS) are well-established treatment options for heavy menstrual bleeding to avoid more invasive alternatives, such as hysterectomy.OBJECTIVEThe aim was to compare the efficacy and safety of endometrial ablation or resection with the LNG-IUS in the treatment of premenopausal women with heavy menstrual bleeding and to investigate sources of heterogeneity between studies.SEARCH METHODSWe searched the databases MEDLINE, EMBASE, CENTRAL, Web of Science, Biosis and Google Scholar as well as citations and reference lists published up...
Source: Human Reproduction Update - January 28, 2020 Category: OBGYN Source Type: research

Do cancer therapies damage the uterus and compromise fertility?
The objective of this narrative review was to critically evaluate the available literature regarding the capacity for the uterus to sustain a healthy pregnancy following exposure to radiotherapy or chemotherapy.SEARCH METHODSThe authors performed PubMed (Medline) searches using the following key words: uterus, cancer survivors, radiotherapy, chemotherapy, pregnancy outcome, fertility preservation, infertility. There were no limits placed on time of publication.OUTCOMESOverall, there were major limitations to the current available literature, meaning that interpretations should be taken with caution. Despite these drawbacks...
Source: Human Reproduction Update - December 20, 2019 Category: OBGYN Source Type: research

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