Objectives: Polycystic ovary syndrome (PCOS) is associated with insulin resistance and impaired oocyte competence. In vitro maturation (IVM) is a viable alternative, and supplementation with platelet-rich plasma (PRP) may improve outcomes. However, previous studies have primarily focused on autologous PRP. This study aimed to evaluate the effect of 5% allogeneic PRP supplementation in IVM medium on oocyte maturation in women with PCOS, using growth differentiation factor-9 (GDF-9) and bone morphogenetic protein-15 (BMP-15) as surrogate biomolecular markers of oocyte maturation. Materials and Methods: This quasi-experimental study was conducted between 2024 and 2025. Immature germinal vesicle (GV)stage oocytes (n=24) from patients with PCOS were allocated to either a non-PRP group (n=12 oocytes) cultured in standard G-IVF (TM) medium or a PRP group (n=12 oocytes) cultured in G-IVF (TM) supplemented with 5% allogeneic PRP. After 24 hours, GDF-9 and BMP-15 concentrations in the culture media were quantified using ELISA. Results: Post-IVM, GDF-9 and BMP-15 levels were significantly higher in the PRP group (1.036 +/- 0.004 pg/mL and 0.888 +/- 0.008 pg/ mL, respectively) than in the non-PRP group (1.032 +/- 0.003 pg/mL and 0.878 +/- 0.004 pg/mL) (P= 0.020 and P= 0.001, respectively). Multivariate analysis confirmed that PRP supplementation was the only significant variable associated with increased GDF-9 (B=0.004, P= 0.047, R-2=33.7%) and BMP-15 (B=0.012, P = 0.002, R-2=50.7%) levels. Although the absolute changes were small (Delta GDF-9 = 0.004 pg/mL; Delta BMP-15 = 0.012 pg/mL), large effect sizes were observed (Cohen's d = 1.13 and 1.58). Conclusions: Supplementing IVM medium with 5% allogeneic PRP was associated with increased GDF-9 and BMP-15 levels, which are considered surrogate biomarkers of oocyte maturation.
Introduction: Placenta increta is a major obstetric complication that can lead to life-threatening postpartum hemorrhage (PPH), particularly when it is undiagnosed during vaginal delivery. Case Report: This report presents two cases of vaginally delivered pregnancies complicated by placenta increta, both treated with uterine artery embolization (UAE) followed by placental extraction at different time intervals. In both cases, UAE proved highly effective in controlling acute and severe vaginal bleeding. In case 1, immediate placental extraction was attempted after UAE; however, uncontrolled vaginal bleeding recurred, necessitating a laparotomy for further placental extraction. This was followed by ligation of the bilateral uterine arteries and application of uterine body compression sutures. In case 2, manual placental extraction was performed 48 hours after UAE, when ultrasound Doppler indicated adequate uterine contraction and minimal placental blood flow. The placenta was successfully extracted intact with minimal bleeding. Conclusions: Delayed placental extraction following UAE may reduce the risk of recurrent massive vaginal bleeding in vaginal deliveries complicated by placenta accreta spectrum (PAS).
Objectives: Episiotomy is a surgical intervention to decrease the risk of obstetric anal sphincter injuries (OASIs) that adversely affect normal vaginal delivery (NVD). However, the intervention itself may lead to significant perineal laceration and postpartum anal incontinence. This research aimed to compare the suture angle and postpartum anal incontinence of mediolateral episiotomy aided with a 60-degree triangular set square (TRSS-60) with those of a routine mediolateral episiotomy. Materials and Methods: This prospective study was performed on primiparous pregnant women with NVD requiring episiotomy inYas hospital from April 2020 to November 2020. The subjects were assigned to control and intervention groups at a 1:1 ratio. Outcome measures included suture angle and Wexner fecal incontinence scores between the groups. Results: Forty primiparous women have enrolled in the study. The average perineal body length was 3.64 +/- 0.54 cm at the first stage of labor and 4.86 +/- 0.71 cm during crowning. The mean suture angle varied significantly (P < 0.001) between the intervention and control groups (48.5 vs. 33.7). The suture angle of all participants in TRSS-60 was higher than 40 degrees. Wexner score assessment revealed that the most frequent complaint was gas incontinence in postpartum women (four in the control group and one in the intervention group). Conclusions: This study suggests thatTRSS-60 could be used as an affordable, highly accessible, inexpensive, and effective approach to reach the safe zone angles during episiotomies, reduce OASIs, and supply an appropriate replacement for EPICSISSOR-60 in low-resource areas.
Objectives: Stem cell factor (SCF) is a crucial cytokine growth factor that significantly contributes to hematopoiesis, as well as the development of melanocytes and germ cells. This study aimed to compare the levels of SCF in serum and seminal plasma among patients with non-obstructive azoospermia (NOA), oligozoospermia, and men with normozoospermic controls, and to determine whether it could serve as a potential biomarker for the local testicular biomarker. Materials and Methods: This cross-sectional comparative study enrolled 132 patients who were divided into three equal groups: normozoospermia, NOA, and oligozoospermia (n = 44 each). A comparison was made in all groups based on age, hormones, and SCF level. SCF level in serum and seminal fluid was measured by ELISA. Results: Our research indicated the concentrations of SCF in both seminal plasma and serum across three groups. Seminal plasma SCF levels showed a significant difference between groups (P = 0.002), with higher levels observed in the oligozoospermia group compared with both NOA and normozoospermia groups; no significant difference was observed between NOA and normozoospermia. In contrast, serum ligand levels were significantly elevated in the NOA and normospermia groups compared to the oligospermia group P < 0.001). Units are expressed as ng/mL. Conclusions: Our findings identified that seminal plasma SCF, in contrast to its serum, was significantly elevated in oligozoospermia and may serve as a promising and direct biomarker of the active local testicular microenvironment in states of diminished sperm production.
Objectives: The aim of this study was to explore the constructs of the theory of planned behavior (attitude, subjective norms, perceived behavioral control) in health information seeking behavior among Iranian pregnant women. Methods: This is a qualitative study with an interpretive phenomenological approach involving 23 in-depth semi-structured interviews with pregnant women at 12-36 weeks of gestation. The data were analyzed using inductive qualitative content analysis by MAXQDA software. For validation, the coding process was performed by two independent researchers, and a Cohen's kappa agreement coefficient of 0.85 was calculated. The extracted codes were reviewed and finalized in group discussion sessions with the research team. In addition, some of the findings were confirmed by the participants, and the researchers' triangulation method was used to increase reliability. Results: A total of 115 concepts were identified across three main constructs and 10 components. Attitude toward behavior (30 concepts) included positive/negative beliefs and outcome assessments; subjective norms (32 concepts) included injunctive/descriptive norms and motivation to comply; and perceived behavioral control (53 concepts) included internal/external control, barriers and facilitators. Attitude toward behavior emerged as the most salient construct in participants' accounts of health information seeking. Conclusions: Health information seeking behavior of pregnant women is affected by complex interactions of three theoretical constructs. Cultural, social, and economic factors play moderating roles in this regard. The results provide a foundation for designing targeted interventions to improve this behavior and enhance maternal and fetal health.
Objectives: Low-dose aspirin is widely recommended for women at increased risk of intrauterine growth restriction (IUGR) or preeclampsia (PET), yet real-world adherence and outcomes remain variable. This study evaluated adherence to aspirin prophylaxis in high-risk pregnancies and examined associations with maternal and neonatal outcomes. Materials and Methods: A total of 140 women were included, comprising 75 in the IUGR surveillance cohort and 65 in the PET cohort. Adherence was assessed across three domains: initiation before 16 weeks, use of the recommended 75-150 mg dose, and continuation until at least 36 weeks or delivery. Maternal and neonatal outcomes included recurrent IUGR, development of PET, neonatal intensive care unit (NICU) admission, birthweight, and gestational age. Statistical analysis included descriptive summaries, chi-square tests, and Welch's t-tests. Results: Adherence to the recommended dose was universal (100%) across both cohorts, but initiation (77% in IUGR, 83% in PET) and duration adherence (75% in IUGR, 63% in PET) were less consistent, resulting in overall adherence rates of 59% and 52%, respectively. Recurrent IUGR occurred in 21% of the IUGR cohort, while PET developed in 19% of the PET group. NICU admission was more frequent in the PET cohort (29%) compared with the IUGR group (20%). Importantly, adherence was associated with higher birthweight in the IUGR cohort (2959 g vs 2713 g, P = 0.041), although the observed difference was modest, and no significant effect was observed on gestational age or PET outcomes. Conclusions: These findings highlight that while aspirin prophylaxis is widely adopted, persistence remains suboptimal, particularly with respect to duration adherence.
Objectives: Predicting outcomes in intracytoplasmic sperm injection (ICSI) cycles is challenging. Traditional markers provide limited insight into ovarian reserve and pregnancy potential. Recent studies suggest that combining anti-M & uuml;llerian hormone (AMH) with gonadotropin metrics may enhance prognosis. This study evaluates the diagnostic utility of LH/AMH, FSH/AMH, and AMH/AFC ratios for predicting pregnancy after day-5 embryo transfer in ICSI cycles. Materials and Methods: This multicenter prospective observational study enrolled 120 infertile women aged 20-35 years (AFC >= 5, AMH >= 0.5 ng/mL, BMI < 30 kg/m(2)) undergoing a standardized GnRH-antagonist ICSI protocol. Day-2 serum LH, FSH, and AMH levels and transvaginal ultrasound-derived AFC were measured. Ratios (LH/AMH, FSH/AMH, AMH/AFC) were calculated. Outcomes included biochemical pregnancy and clinical pregnancy. Results: Biochemical and clinical pregnancy rates were 29.2% and 18.3%, respectively. AMH and AFC exhibited positive correlations with mature follicles, oocyte yield, fertilization rate, FOI, OSI, and FORT, whereas LH, FSH, and their AMH-based ratios showed inverse correlations. The AMH/AFC ratio demonstrated a modest association with clinical pregnancy (OR 0.02; 95% CI 0.001-5.39; P = 0.17) and yielded an AUC of 0.59, specificity of 78.6%, and PPV of 85.6% at a cut-off <= 0.13, which were not significant. Conclusions: The AMH/AFC ratio can be a supplementary predictor of ovarian reserve, with potential clinical value in counseling and designing cycles for ICSI.
Objectives: This study aimed to investigate the effect of a treatment with sodium and calcium bicarbonate on the sex determination of a fetus. Materials and Methods: A total of 60 mice were obtained from Pasteur Institute, Karaj, Iran. Female mice were stimulated to ovulate with PMSG hormone, and the oocyte was released by human chorionic gonadotropin (hCG) hormone. Sperms were collected from the male mice. In vitro fertilization (IVF) was performed in the completely sterile conditions in a control culture medium with pH=7.4. Then six experimental groups, three experimental groups with sodium bicarbonate as well as three experimental groups and the embryos, were transferred from the multicellular stage (the blastocyst) to pseudopregnant mice. Results: Three groups treated with sodium bicarbonate with different pHs were significantly different from the control group regarding the percentage of the born male fetuses (P <= 0.05); however, this difference was not significant between the sodium bicarbonate groups with different pH (P >= 0.05). Among the groups receiving calcium bicarbonate treatment, only the average pH level of male infants at 7.7 demonstrated a significant distinction when compared to both the control group and the remaining treatment groups (P <= 0.05). Conclusions: Using sodium bicarbonate and calcium bicarbonate as well as adjusting the pH of the oocyte and sperm fertilization environment based on them may have been a safe and cheap method to determine the sex of a fetus.
Objectives: The reproductive rights debate in India, France and the United States points to how constitutionally protected rights, judicial reasoning, and health systems inform access to safe abortion. The Medical Termination of Pregnancy (MTP) Act, 1971 in India has come a long way, but issues persist. Whereas France has continued to broaden the right to abortions, and recently even constitutionalised it, and on the other hand, the U.S. has moved in the opposite direction after the Dobbs v. Jackson case, which reversed Roe v. Wade. Materials and Methods: Aggregate data on abortion rates and indicators of maternal health status were collected from identified sources. Secondary data were thoroughly analysed to identify trends in abortion and maternal health outcomes in all three jurisdictions. The analysis produced time-trend graphics and descriptive visual charts to illustrate the evolution of the abortion rate. Results: France exhibits a steady progress in perinatal health outcomes along with a firm, and permissive legislation on abortion with significant post-legalisation reductions in abortion-related maternal mortality. The U.S. experiences sharp oscillations associated with the prohibitive policy changes, especially after Dobbs case, including post-Dobbs case service disruptions and earlier evidence of mortality reduction under Roe v. Wade case. While India shows progressive legal reforms but the health outcomes are mixed showing long-term maternal mortality ratio (MMR) decline, slowed progress post-2015, and pandemic-related maternal care disruption. Conclusions: Firm rights-based legal environments as is the case in France are linked to better health outcomes, while more restrictive contexts have been shown to reduce access and increase risks to health. Rights-based abortion laws are associated with lower abortion-related maternal mortality, while restrictive regimes show poorer outcomes.
Objectives: This research aims to compare the insulin-like growth factor-1 (IGF-1)/follicle-stimulating hormone (FSH) ratio between infertile women with DOR and those with usual ovarian reserve. Materials and Methods: This observational longitudinal study was conducted on 80 women scheduled for in vitro fertilization (IVF) in our infertility department. Each participant underwent blood sample testing for the measurement of FSH, anti-Mullerian hormone (AMH), and IGF1 serum levels on the second day of the menstrual cycle. The infertile women were placed into two groups: Group I consisted of infertile women who were diagnosed with DOR according to the Bologna criteria, and group II included women with unexplained infertility and usual ovarian reserve. Results: The mean IGF-1 level was 113.72 +/- 45.37 ng/mL in group I, and 119.37 +/- 45.79 ng/mL in Group II, with no significant difference (P= 0.649). We found a significant positive correlation between AMH levels and IGF-1 (P = 0.005) and IGF/FSH ratio (P< 0.001) in DOR (group I) women. In contrast, this correlation was significant only for AMH levels and IGF/FSH ratio (P= 0.002) in group II. The IGF-1/FSH ratio was significantly less in group I versus group II (14.76 +/- 1.28 vs. 28.27 +/- 6.30; P= 0.001). The IGF1/E2 ratio was significantly less in group 1 versus group 2 (5.52 +/- 0.98 vs. 11.69 +/- 3.2; P= 0.029). Conclusions: Our results show that IGF1 and the IGF/FSH ratio are significantly positively correlated with ovarian reserve markers. Hence, this ratio may be used as a screening marker to predict ovarian reserve, independent of age.
Objectives: This study aimed to investigate the impact of diaphragmatic breathing (DB) exercise, when incorporated into pelvic floor muscle training (PFMT), on the incontinence severity, the life quality, and the intensity of symptoms in individuals afflicted with stress urinary incontinence (UI). Materials and Methods: The study included 66 women diagnosed with UI who met the inclusion criteria. Participants were randomly assigned to a control group (n=33) receiving PFMT alone and an intervention group (n=33) receiving PFMT plus DB exercises. The Incontinence Severity Index (ISI) was utilized to evaluate the severity of incontinence, whereas quality of life was assessed using both the Incontinence Quality of Life Questionnaire (I-QOL) and the King's Health Questionnaire (KHQ). All evaluations were performed face-to-face at the start of the study and again at the eight-week follow-up. Results: Significant improvements were obtained in both groups after treatment in the ISI, the psychological impact and total scores of the I-QOL, and the Symptom Severity Scale. In the KHQ, no significant changes were found in most sub-dimensions, except for physical limitations and personal relationships in the intervention group, and incontinence severity in the control group. Following the intervention, no statistically significant differences were observed between the groups across any of the evaluated parameters. Conclusions: This study demonstrated improvements in incontinence severity, incontinence-related life quality and symptom severity in both groups. However, the integration of DB exercises with PFMT did not produce significantly better outcomes compared to PFMT alone. This study demonstrated improvements in incontinence severity, symptom severity, and specific aspects of incontinence-related quality of life, particularly psychological impact and total scores, in both groups. However, the integration of DB exercises with PFMT did not produce significantly better outcomes compared to PFMT alone.
Objectives: Preconception health significantly influences maternal and child health outcomes. Identifying and addressing preconception health indicators can facilitate healthier pregnancies and improved maternal and fetal outcomes. This scoping review examines various preconception health indicators, including biomedical and social factors, highlighting the need for comprehensive preconception care (PCC). Methods: A comprehensive search was performed using Scopus, PubMed, Cochrane Library, and Web of Science databases. Studies on multiple preconception health indicators were included based on predefined levels of inclusion criteria. Data was extracted, charted, and synthesized to identify key indicators and their influences on reproductive health. Results: The qualitative synthesis included 31 studies. The review identified critical biomedical indicators, such as preconception folic acid (FA) supplementation, preventing 69% of neural tube defects (NTDs) worldwide. Other indicators included managing metabolic disorders, cardiovascular diseases, autoimmune conditions, and vaccination coverage. Behavioral indicators stressed reducing tobacco use, promoting physical activity, and supporting mental health. Social indicators focused on access to health care, health literacy, education, and socioeconomic stability. Additionally, paternal PCC and genetic counseling are vital for optimizing pregnancy outcomes. Women lacking social support face significant health risks during pregnancy and implementing social support systems can reduce maternal death rates and improve reproductive health. Conclusions: Improving maternal and child health measures requires addressing preconception health indicators using comprehensive care programs. Chronic condition interventions should focus on management, promoting healthy lifestyle behaviors, nutrition, and access to healthcare services. Paternal PCC and genetic counseling can be added as valuable measures.
Merve Didem Eşkin Tanrıverdi graduated from the Faculty of Medicine at Ankara University, Ankara, Turkey. She completed her residency in obstetrics and gynecology at Ankara Bilkent City Hospital, formerly known as Zekai Tahir Burak Women’s Health Education and Research Hospital, in 2023. She has worked as an obstetrician and gynecologist at Ardahan State Hospital in Ardahan, Turkey, and is currently employed at Ankara Bilkent City Hospital. She is pursuing a Ph.D. in the Department of Anatomy at the Faculty of Medicine, Ankara University. Her areas of interest include pelvic surgical anatomy, neuropelviology, minimally invasive gynecological surgery, and endometriosis.
Sperm morphology as part of a complete semen analysis becomes more and more significant from a clinical point of view for infertility and perhaps men’s health. The current manuscript reviews the effect of some environmental and lifestyle factors on sperm morphology. A new look into an old challenge is delivered based on contemporary scientific and clinical evidence. The impact of lifestyle, age of the male, heat stress, and other factors on sperm morphology, DNA fragmentation index (DFI), and, consequently, assisted reproductive techniques (ARTs) outcome is discussed. Sperm morphology is probably the most relevant parameter of the traditional semen evaluation and can be used as a valid biomarker assessment of male fertility potential in in vitro fertilization (IVF)/ intracytoplasmic sperm injection (ICSI) programs.
Objectives: Early detection of preeclampsia (PE) is crucial to prevent severe maternal and fetal complications. Ophthalmic artery Doppler (OAD) presents a viable and non-invasive placenta-independent approach, especially in low-resource settings. This study aims to evaluate the diagnostic accuracy of OAD parameters and address the lack of standardized protocols and comparative analyses with other biomarkers. Methods: This study followed PRISMA guidelines. Data on peak ratio (PR), resistance index (RI), and pulsatility index (PI) were extracted from studies comparing PE and normotensive pregnancies. Bivariate models were used for summary ROC curves to estimate pooled sensitivity, specificity, diagnostic odds ratio (DOR), and area under the curve (AUC). All analyses were performed using R Studio. Results: Seventeen studies involving 2699 pregnant women were included. The PR showed a pooled sensitivity of 0.80 (95% CI 0.66– 0.89, I² = 0.0%), specificity of 0.92 (95% CI 0.80–0.97, I² = 91.0%), DOR of 48.85 (95% CI 12.79–186.53, I² = 50.5%, P < 0.001), and AUC of 0.911. The RI showed a pooled sensitivity of 0.76 (95% CI 0.68–0.82, I² = 0%), specificity of 0.76 (95% CI 0.57–0.88, I² = 93.2%), DOR of 11.14 (95% CI 6.01–20.64, I² = 35.6%, P < 0.001), and AUC of 0.774. The PI showed a pooled sensitivity of 0.69 (95% CI 0.58–0.78, I² = 75.2%), specificity of 0.86 (95% CI 0.64–0.96, I² = 88.2%), DOR of 12.89 (95% CI 5.40–30.78, I² = 85.2%, P< 0.001), and AUC of 0.768. The pooled analysis of PR, PI, and RI showed that the PE group had MDs of -0.21 (95% CI -0.21; -0.02), -0.36 (95% CI -0.56; -0.15), and -0.06 (95% CI -0.08; -0.03), respectively. Conclusions: The OAD, particularly the PR parameter, demonstrates high diagnostic accuracy, strong sensitivity, and specificity for identifying PE.
Objectives: Abnormal uterine bleeding (AUB) is a common gynecological complaint requiring accurate endometrial assessment. This study aimed to compare the diagnostic accuracy of Pipelle aspiration biopsy and dilatation & curettage (D&C) with histological findings from hysterectomy specimens in patients with AUB. Materials and Methods: In this retrospective cross-sectional study, medical records of 124 women diagnosed with endometrial hyperplasia who underwent subsequent hysterectomy between 2018 and 2023 at Kamali hospital, Karaj, were reviewed. Preoperative endometrial sampling was performed via Pipelle (n=65) or D&C (n=59). Histopathological results from both methods were compared with the final hysterectomy findings. Diagnostic accuracy, sensitivity, specificity, and concordance rates were calculated. Results: The overall diagnostic concordance with hysterectomy findings was 72.88% for D&C and 70.76% for Pipelle. For the detection of atypia, D&C showed a sensitivity of 76% (95% CI: 52%-92%), specificity of 86% (95% CI: 72%-96%), and accuracy of 83% (95% CI: 71%-91%), while Pipelle demonstrated a sensitivity of 73% (95% CI: 54%-87%), specificity of 80% (95% CI: 63%-91%), and accuracy of 77% (95% CI: 65%-86%). The confidence intervals for these metrics overlapped substantially. No statistically significant differences were found between the two methods in direct comparisons (P>0.05). D&C was associated with a lower rate of pathological upgrading than Pipelle (13.16% vs. 22.22% for missed atypia). However, this difference was not Conclusions: Both Pipelle and D&C demonstrate comparable diagnostic performance, with high and statistically similar concordance rates with final hysterectomy pathology. D&C shows a non-significant trend towards higher accuracy and a lower rate of missed atypia. Clinicians should be aware of the potential for underdiagnosis of atypia with both methods, particularly with Pipelle, when planning management strategies for endometrial hyperplasia.
Objectives: The present study aimed to investigate the Impact of mesenchymal stem cell (MSC) therapy in women with Refractory Thin Endometrium. Materials and Methods: In this single-blind randomized clinical trial, 60 infertile women with a history of at least one in vitro fertilization (IVF) cycle cancellation due to less than 7 mm endometrial thickness (ET) after receiving standard hormonal therapy were randomly assigned into two groups (n=30/each): the intervention group recived intrauterine injection of 5 mL exosome suspension on the 8th day of IVF cycle) and the control group received Intrauterine injection of 5 mL sterile water on the 8th day of IVF cycle). Demographic characteristics, pre-and post-treatment endometrioma size, pelvic pain, dysmenorrhea, and dyspareunia were compared in both groups. Results: Baseline information has no significant differences between the two groups. Despite the significant increase in the ET following hormonal therapy in both groups, the number of women with ET less than 7 mm in the control group was about twice (13 vs. 6) that of the intervention group, resulting in cycle cancellation. Of the cases who enter the embryo transfer cycle, pregnancy was detected in 3 women (12.5%) in the intervention group and 1 case (6.6%) in the control group, with no significant difference between the groups (P= 0.612). Conclusions: Finally, the results of the present study showed that although the use of MSCs can decrease the number of IVF cycle cancellations; however, larger studies is needed to confirm our findings.
Objectives: This study aimed to evaluate the impact of hesperidin on the expression of follicle-stimulating hormone receptor (FSHR), luteinizing hormone receptor (LHCGR), and estrogen receptors (ER) during follicular development in female rats following ovarian torsion/detorsion (OTD). Methods and Materials: In this experimental study, 32 female rats were randomly divided into four groups: Group 1 (control), group 2 (OTD group, subjected to ovarian torsion/detorsion), group 3 (OTH group, torsion/detorsion + 50 mg/kg hesperidin), and group 4 (healthy group, receiving 50 mg/kg hesperidin without torsion). After 21 days of treatment, ovarian tissues were harvested for histological assessment, and mRNA levels of ER, FSHR, and LHCGR were analyzed. Serum concentrations of testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estrogen were also measured. Results: Histological analysis revealed that OTD induced structural damage, including oocyte and granulosa cell shrinkage, which was mitigated by hesperidin administration. The treated groups exhibited increased serum levels of estrogen, LH, and FSH, along with decreased testosterone levels. Additionally, hesperidin significantly upregulated the expression of ER, FSHR, and LHCGR, suggesting a positive effect on ovarian function and fertility. Conclusions: The results indicate that hesperidin exerts protective effects on ovarian tissue following torsion/detorsion. It modulates hormonal balance and enhances the expression of key reproductive receptors (ER, FSHR, LHCGR), suggesting protective effects on ovarian function; however, further clinical studies are required before definitive conclusions can be drawn regarding its impact on fertility.
