Patients with severe β-thalassemia face not only lifelong dependence on blood transfusions but also the management of serious and potentially life-threatening complications. The pathophysiology of this disorder is largely attributed to a defective transition from γ- globin to β- globin gene expression, a process essential for normal hemoglobin production after birth. This developmental transition involves the silencing of fetal γ- globin and coordinated activation of adult β- globin gene transcription. Central to this regulation are transcription factors that directly bind to the γ- globin promoter. This review synthesized recent advances in understanding the γ-to-β-globin switch, focusing on four principal transcription factors - GATA1, BCL11A, ZBTB7A, and NFY - and partner proteins including GATA2 and KLF1. In addition, we proposed a competitive binding model in which the GATA1/NFY and ZBTB7A/BCL11A protein complexes compete for promoter occupancy. This model provides a useful framework that may inform future strategies for the prevention, diagnosis, and treatment of β-thalassemia.
A systematic review was conducted to evaluate the impact of bladder neck preservation on retrograde ejaculation, bladder neck contracture, and incontinence following standard transurethral resection of the prostate (TURP). A comprehensive literature search was conducted in PubMed, Scopus, Google Scholar, and the World Health Organization International Clinical Trials Registry Platform databases up to September 22, 2024. Original research articles meeting the inclusion criteria were selected to assess the preventive effect of bladder neck preservation on retrograde ejaculation compared with standard TURP. Two studies specifically assessing the efficacy of bladder neck preservation in preventing retrograde ejaculation during TURP were included in the analysis. The findings indicate that bladder neck preservation significantly reduces the incidence of retrograde ejaculation, with an odds ratio (OR) of 0.08 (95% confidence interval [CI]: 0.02-0.30). Bladder neck preservation appears to provide substantial benefits in reducing retrograde ejaculation while showing no notable differences in bladder neck contracture and incontinence rates compared with standard TURP.
Objective::Although farnesoid X receptor (FXR) signaling has been implicated in obesity and inflammatory disorders, its mechanistic role in polycystic ovary syndrome (PCOS) remains unclear. Here, we investigated whether the gut-restricted FXR agonist fexaramine (Fex) could ameliorate metabolic and reproductive abnormalities in a mouse model of PCOS.Methods::Female C57BL/6J mice were randomly assigned to four groups: control, Fex, PCOS, and PCOS + Fex. In parallel experiments, the PCOS phenotype was induced using either dehydroepiandrosterone combined with a high-fat diet (discovery model) or letrozole (validation model). Fex was administered via oral gavage to achieve gut-restricted FXR activation. During the intervention period, body weight, glucose metabolism, insulin sensitivity, and estrous cyclicity were monitored. At the end of the intervention, adipocyte size, reproductive hormone levels, follicular development, and ovarian transcriptomic changes were assessed. Results::Fex intervention significantly improved multiple metabolic parameters in PCOS mice, including attenuated body weight gain (5.08 ± 0.32 g vs 7.72 ± 0.43 g, P < 0.0001), enhanced glucose tolerance (oral glucose tolerance test [OGTT]- area under the curve [AUC]: 749.4 ± 131.9 vs 972.4 ± 49.88, P = 0.022), increased insulin sensitivity (insulin tolerance test [ITT]-AUC: 530.60 ± 59.11 vs 950.30 ± 148.30, P < 0.001), and reduced mean adipocyte size (3720 ± 676.3 vs 11,863 ± 845.3 pixels, P < 0.0001). Fex also ameliorated reproductive abnormalities, as evidenced by restoration of estrous cyclicity (3.0 ± 0.8 vs 0 cycles, P <0.001), reduced relative ovarian weight (0.13 ± 0.04 vs 0.19 ± 0.02 mg/g, P = 0.004), fewer antral follicles (8.5 ± 1.7 vs 18.0 ± 2.1, P < 0.001), and increased corpus luteum counts (13.2 ± 2.6 vs 7.0 ± 0.8, P = 0.029). In addition, Fex alleviated hyperandrogenemia, reflected by lower testosterone (37.39 ± 8.52 vs 52.54 ± 7.97 ng/mL, P = 0.002) and androstenedione levels (7.94 ± 2.6 vs 12.27 ± 0.99 ng/mL, P < 0.001), as well as reduced luteinizing hormone (37.22 ± 5.91 vs 52.67 ± 3.37 mIU/mL, P < 0.001) and anti-Müllerian hormone levels (1.23 ± 0.24 vs 2.05 ± 0.17 ng/mL, P < 0.001). Ovarian transcriptomic analysis further supported these findings, revealing that Fex modulated pathways associated with follicular development, steroidogenesis, and glycolipid metabolism. Conclusion::Fex ameliorated both metabolic and reproductive abnormalities in PCOS-model mice. These findings highlight gut-restricted FXR activation as a potential therapeutic strategy for PCOS, although further mechanistic studies are needed to establish causality.
Objective::To explore the origin of the translocation in the offspring of a male carrier of Robertsonian translocation der(13;14) (q10;q10) using preimplantation genetic testing for structural rearrangements (PGT-SR) combined with multiple techniques. The study also examines the associated risks and insights derived from PGT-SR.Methods::A male carrier of Robertsonian translocation der(13;14)(q10;q10) underwent assisted conception using PGT-SR. During the screening process, normal embryos were selected for transfer, resulting in a successful pregnancy. Prenatal diagnosis and postnatal peripheral blood karyotype analysis confirmed that the offspring carried the same Robertsonian translocation. The origin of the mutation was further verified using multiple techniques, including chromosomal microdissection and chromosome conformation-based karyotyping (C-MoKa).Results::Review of the PGT-SR process and kinship numerical affinity analysis confirmed that the embryo biopsy sample and the offspring were genetically identical, thereby excluding the possibility of sample misidentification during the procedures. Chromosomal microdissection revealed that the Robertsonian translocation in the offspring did not correspond to the male carrier’s translocated chromatid, suggesting the presence of a novel translocation. Using the innovative C-MoKa approach, the origin of the translocation was traced to the non-translocated chromosomes of both parents, conclusively confirming a de novo mutation. Conclusion::This study integrated quantitative kinship analysis, chromosomal microdissection, and C-MoKa technology. For the first time, the occurrence of de novo isovariant events within Robertsonian translocations was successfully validated, providing valuable reference evidence for genetic counseling before PGT-SR.
The process of embryo implantation is complex yet highly coordinated, involving differentiation of multiple cell types and dynamic mechanistic or compensatory shifts in metabolic patterns. Metabolic regulation plays a critical role in embryo implantation by modulating embryo competence and endometrial receptivity. Accordingly, metabolites function not only as sources of energy but also as signaling molecules that orchestrate communication between the endometrium and blastocyst. Here, we review the regulatory roles of key metabolites, including carbohydrates, lipids, amino acids, and their derivatives in various reproductive processes, such as blastocyst formation and activation, establishment of uterine receptivity, and embryo implantation. Interpretation of metabolic signaling may help to elucidate the intricate process of embryo implantation and provide new insights into potential clinical interventions and improvements in assisted reproductive technology.
Objective:To investigate the correlation between cuproptosis and unexplained infertility (UI).Methods:Using the GSE165004 dataset, we analyzed the expression profiles and immunological characteristics of cuproptosis regulators in UI. Using 27 cuproptosis-related genes and 24 endometrial samples from patients with UI, we explored molecular clusters based on cuproptosis-related genes and associated immune cell infiltration. Cluster-specific differentially expressed genes were identified using the weighted gene co-expression network analysis algorithm, and differences in pathway and functional enrichment of cuproptosis-related molecular clusters were explored using gene set variation analysis. Subsequently, the performances of seven machine learning models were compared to select the optimal machine model. Nomogram, calibration curve, and decision curve analysis models were used to validate the predictions.Results:Dysregulated and activated immune responses to cuproptosis-related genes were determined between UI patients and healthy female controls of childbearing age. Two cuproptosis-related molecular clusters were defined in UI. Among the machine learning models, the support vector machine (SVM) algorithm had the best discriminative performance, with relatively small residual and root mean square errors and a large area under the curve (0.918). To further evaluate the predictive efficiency of the SVM model, we constructed a nomogram to estimate the risk of aggregation of five cuproptosis-related genes. Calibration curve and decision curve analyses also demonstrated the accuracy of predicting subtypes of UI. These analyses revealed that five cuproptosis-related genes were significantly associated with UI.Conclusion:Our study systematically reveals a complex relationship between cuproptosis and UI, and these cuproptosis-related genes may serve as new candidate prognostic biomarkers for UI.
Objective: This study aimed to evaluate the efficacy of letrozole combined with the antagonist protocol in in vitro fertilization-embryo transfer (IVF-ET) for patients with poor ovarian response (POR). Methods: A total of 176 patients with anticipated POR who underwent IVF at Dongguan Maternal and Child Healthcare Hospital between 2020 and 2024 were enrolled. Based on their preferred stimulation protocol, the patients were divided into two groups: group A (n = 100), which received the GnRH antagonist protocol alone, and group B (n = 76), which received letrozole in combination with the antagonist protocol. Baseline characteristics and clinical outcomes were compared between the two groups. Results: The mean total dose of gonadotropins (Gn) required per cycle was significantly lower, and the duration of ovarian stimulation was shorter in group B compared with group A (P <0.05). Group B also showed significantly higher rates of MII oocytes, available embryos, and high-quality embryos (P <0.05). There were no significant differences in fertilization rates between the two groups (P >0.05). Clinical pregnancy and live birth rates were significantly higher in group B (P <0.05). These findings were further supported by multivariate regression analysis. When group B was sub-divided by age, both pregnancy and live birth rates were significantly lower in the older age group (39-42 years) compared to the younger age group (35-38 years). Conclusion: The combination of letrozole with a GnRH antagonist protocol in patients with expected POR (Patient-Oriented Strategies Encompassing Individualized Oocyte Number groups 3 and 4) reduced the mean total Gn dosage and shortened the stimulation duration. It also increased the number of oocytes retrieved and available embryos, and improved oocyte and embryo quality, thereby enhancing pregnancy outcomes. This effect was more pronounced in younger patients with POR.
Objective::Estrogen receptor α (ERα/ Esr1) is essential for uterine function during early pregnancy. The uterus has a dynamic immune environment, including transient endometrial inflammation in response to post-coital semen. The uterine epithelium is the first contact for uterine lumen contents (e.g., semen). We aimed to determine the function and mechanism of uterine epithelial ERα in regulating the uterine immune response to semen. Methods::Uterine tissues and uterine flushes were collected from naturally mated uterine epithelial ERα-deficient epiERα -/- ( Esr1 f/-Wnt7a Cre/+) mice and Esr1 f/- control mice on day 0.5 post-coitus (D0.5) and D3.5. Histology, immunohistochemistry, mRNA-seq, real-time polymerase chain reaction (PCR), flow cytometry, and cytokine assays were employed to determine the spatiotemporal distribution of immune cells and assess their functional states. Results::There was a sharp decline in neutrophils from D0.5 to D3.5 in both Esr1 f/- and epiERα -/- uteri. Immunohistochemistry detected ~7-fold ELANE+ neutrophils in the uterine luminal epithelium (LE) layer and ~1.5-fold in the stromal layer of D0.5 epiERα -/- uterus compared to D0.5 Esr1 f/- counterparts. Gelled uterine lumen contents with varied densities of neutrophils and sperm were detected in both D0.5 Esr1 f/- and epiERα -/- mice. Flow cytometry revealed significantly increased percentages of neutrophils among CD45 + leukocytes in uterine digests with a trend of increased neutrophil cell number and proportions in uterine flushes from D0.5 epiERα -/- mice. Dysregulation of immune genes at both mRNA and protein levels was noted in D0.5 epiERα -/- LE/uterus, especially an upregulation of inflammatory cytokines. In particular, upregulation of genes involved in signaling by interleukin (IL)-1β, a potent pro-inflammatory cytokine involved in mating-induced uterine inflammation, was observed in both the uterine tissue and uterine flush. Conclusion::These findings demonstrate an essential function of uterine epithelial ERα in controlling mating-induced inflammation in the LE layer, stromal layer, and uterine lumen, and highlight the IL-1β signaling pathway among the molecular mechanisms involved in regulation of uterine inflammation by uterine epithelial ERα.
Objective: This study aimed to determine the association of excessive gestational weight gain (GWG) and the glycated hemoglobin (HbA1c) level with adverse pregnancy outcomes in patients with gestational diabetes mellitus (GDM). Methods: The mode of delivery, Apgar score, gestational age at delivery, and birth weight were measured immediately after delivery. Neonates were categorized as small-for-gestational age, appropriate-for-gestational age, or large-for-gestational age (LGA). The rates of cesarean section, instrumental delivery, perineal tear, and postpartum hemorrhage were noted. Neonatal complications were observed. The association of excessive GWG and the HbA1c level with adverse pregnancy outcomes was determined, and receiver operating characteristic (ROC) curve analysis was performed to determine the cutoff value of the HbA1c level for predicting LGA Results: An HbA1c value of 25.7% was associated with adverse outcomes, such as lower segment cesarean section/instrumental delivery and LGA. The HbA1c cutoff value of 25.7% demonstrated a maximum sensitivity and specificity for predicting LGA and had an area under the ROC curve of 0.722. Excessive GWG was associated with adverse outcomes, such as LGA, neonatal intensive care unit admission, jaundice, hypoglycemia, respiratory distress, and perineal tear. Conclusions: Excessive GWG is associated with adverse neonatal outcomes. The cutoff value of HbA1c for predicting LGA was >= 5.7%. An elevated HbA1c level (25.7%) was associated with a higher rate of cesarean section/instrumental delivery.
Objective::Assisted reproductive technology (ART) has transformed infertility treatment but is associated with a 2-5-fold increased risk of ectopic pregnancy (EP) compared with natural conception. Despite accumulating evidence, a comprehensive bibliometric evaluation of ART-related EP (ART-EP) research—encompassing its evolution, knowledge gaps, and collaboration patterns—remains lacking. This study aimed to systematically map the ART-EP research landscape, identify critical gaps, and characterize global collaborative networks in alignment with the evidence-based optimization goals of the European Society of Human Reproduction and Embryology.Methods::Publications were retrieved from the Web of Science Core Collection (1982-2024), yielding 1,304 eligible articles. Bibliometric analyses were conducted using CiteSpace, VOSviewer, and the R package bibliometrix to assess temporal trends, geographic distribution, authorship and institutional networks, journal impact, and keyword co-occurrence, thereby identifying research hotspots and knowledge diffusion pathways.Results::ART-EP publications increased markedly after 2011, peaking between 2019 and 2022. China ( n = 335, 25.7%) and the United States (U.S., n = 187, 14.3%) were the leading contributors, forming four principal collaboration clusters: U.S.-centered, China-centered, Central European-Nordic, and transatlantic Indo-European networks. Shanghai Jiao Tong University ( n = 31) and Shandong University ( n = 26) were the most productive institutions. Core journals, including Fertility and Sterility and Human Reproduction, dominated the field, while imaging and clinical journals facilitated multidisciplinary advances in diagnosis. Citation burst analysis underscored the reduced EP risk associated with frozen-thawed embryo transfer (burst strength 10.08, since 2014) and the predictive role of endometrial thickness (burst strength 5.05, since 2020). Two major keyword clusters emerged: therapeutic strategies (e.g., methotrexate) and reproductive outcomes (e.g., live birth). Recent research trends have focused on recurrent implantation failure (burst strength 3.09, since 2022) and fresh embryo transfer (burst strength 5.53, since 2021). Conclusions::ART-EP research primarily focuses on embryo migration, donor gametes, and transfer techniques, with key risk factors including tubal pathology and procedural variables. Emerging priorities include protocol optimization and deeper mechanistic insights into EP pathogenesis. These findings provide a comprehensive evidence base to inform clinical decision-making, optimize resource allocation, and strengthen international collaboration, ultimately improving the safety, effectiveness, and cost-efficiency of ART.
Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder, accounting for approximately 80%–95% of anovulatory infertility cases. Patients with PCOS face various challenges during in vitro fertilization and embryo transfer (IVF-ET), including ovarian hyperstimulation, low fertilization rates, and an increased risk of miscarriage. The clinical manifestations of PCOS are diverse, with common symptoms including menstrual irregularities, hyperandrogenism, and polycystic ovarian morphology. Notably, approximately 50%–75% of patients with PCOS are affected by obesity, which not only exacerbates the clinical manifestations of the disease but also potentially affects reproductive outcomes. Body mass index (BMI) significantly influences IVF-ET outcomes in patients with PCOS by affecting ovarian function, oocyte quality, and endometrial receptivity. This review aims to explore the impact and underlying mechanisms of BMI on IVF treatment outcomes in patients with PCOS and emphasize the importance of weight management, with the goal of providing evidence-based support for optimizing assisted reproductive strategies, thereby improving pregnancy rates and reducing the risk of complications.
Endometriosis is a chronic gynecological disorder in which endometrial tissue grows outside the uterus. It involves angiogenesis and is influenced significantly by Vascular endothelial growth factor (VEGF), which regulates blood vessel growth and permeability.Weconducteda comprehensive meta-analysis to better understand the influence of the VEGF +405G/C polymorphism on the vulnerability to endometriosis. After applying the inclusion criteria, 14 case-control studies,from 2005 to 2024, were analyzed,with a combined sample size of 3,417 endometriosis cases and 3,531 controls without endometriosis. Statistical analysis was performed using SPSS software, and P -values <0.05 were considered statistically significant. The results showed a significant correlation between the VEGF +405 G/C polymorphism and an increased incidence of endometriosis inthe recessive [odds ratio(OR): 0.803,Confidence Interval(CI):0.70–0.92; P=0.0015] and homozygous(OR: 0.7859, CI:0.68–0.90; P =0.00114) models. However, no significant association was found in the dominant (OR:1.094, CI:0.99–1.20; P =0.064), heterozygous(OR: 0.9946, CI: 0.8979–1.1017; P =0.412), orallelic (OR:1.0552, CI:0.98–1.13; P =0.124) models.The meta-analysis findings suggested an association between endometriosis risk and the VEGF +405 G/C polymorphism, which was particularly evident in therecessive and homozygousmodels.
Objective: Cisplatin (Cis) is an anticancer agent used to treat several types of cancers, including testicular cancer. However, despite its therapeutic efficacy, it increases the levels of reactive oxygen species (ROS), which damage healthy tissues and cells, resulting in tissue toxicity. This study aimed to examine the healing effect of selenium (Se) on Cis-induced testicular injury in male rats by evaluating testicular weight and monitoring the levels of oxidative stress and reproductive function markers in testicular homogenates. Methods: A total of 38 male rats were divided into four distinct groups. The control group was administered an isotonic solution as the solvent for the active ingredients, while the Se group was administered 1 mg/kg Se dissolved in an isotonic solution via gastric gavage. The Cis group was administered 7.5 mg/kg Cis dissolved in an isotonic solution. The Cis + Se group received both the treatments. Reproductive function and oxidative stress markers in testicular homogenates were analyzed using enzyme-linked immunosorbent assay (ELISA). Results: Compared to the control group, the Cis group exhibited significantly lower testicular weight, antioxidant activity (superoxide dismutase [SOD]; total antioxidant status [TAS], P <0.001), and reproductive function activity (follicle-stimulating hormone [FSH]; inhibin B, P <0.001; luteinizing hormone [LH], P <0.01), and significantly higher oxidant levels (malondialdehyde [MDA], P <0.01; total oxidant status [TOS], P <0.01). The Cis + Se group exhibited significantly higher TAS (P <0.04) and testosterone (P <0.01) levels than the control group. Conclusion: Administration of Se ameliorated the toxic effects of Cis. Owing to its antioxidant effects, Se may be useful in preventing Cis-induced toxicity in the testicles by alleviating oxidative stress.
Objective: Persistent high-risk human papillomavirus (HPV) infection causes precancerous cervical lesions with subsequent progression to cervical cancer. HPV infection is very common in women of childbearing age, particularly with early onset of sexual activity. Treatments such as cold knife conization are usually used for women of childbearing age with cervical intraepithelial neoplasia 2+, which may cause delayed fertility, cervical insufficiency, and other adverse pregnancy outcomes during subsequent pregnancies. Methods: Focused ultrasound (FUS) is a non-ionizing, non-invasive treatment method used to treat gynecological conditions such as cervicitis and vulvovaginal disease. Results: A protocol has been developed to evaluate the value of FUS in the treatment of women of childbearing age with cervical lesions with fertility preservation. Conclusion: This study aimed to evaluate the therapeutic effect of FUS treatment and fertility protection in women of childbearing age with cervical lesions who require family planning. Trial registration number Chinese Clinical Trial Registry (ChiCTR2300076739).
Objectives: African giant rats (AGRs) exhibit low reproductive performance in captivity due to infertile copulation or lack of mating. In this study, we investigated the effects of Zingiber officinale aqueous extract (ZOAE) on libido, sperm cell kinetics, and reproductive organ development in AGRs. Methods: Twenty-four animals weighing 861.20 +/- 65.44 g were individually housed in concrete cages with ad libitum access to water and food. The animals were randomly assigned to four treatment groups. G(0) was the control group, whereas G(250), G(500), and G(1000), which received 250, 500, and 1000 mg/kg of ZOAE daily, respectively, mixed with 10 g of avocado paste. After 49 days of treatment, the animals were sacrificed for data collection. Results: The results showed that ZOAE supplementation significantly (P <0.05) enhanced libido, as indicated by a reduced reaction time. Additionally, testosterone levels increased with higher ZOAE concentrations. Sperm cell count was nearly twice as high (P <0.05) in the treated groups compared with the control. Sperm kinetic parameters (overall mobility, progressive motility, path velocity, and linear motility) were significantly greater in the ZOAE-treated groups than in the control (P <0.05). However, the weights of the reproductive organs (testes, vas deferens, and accessory glands) were not significantly affected (P >0.05). Conclusion: In conclusion, ZOAE effectively enhances libido, sperm count, and sperm kinetics in AGRs.
Objective: This study aimed to investigate the correlation between transfer time (the duration from loading embryos into catheters to expulsion into the uterine cavity) during embryo transfer and the clinical pregnancy rate (CPR). Methods: Data were collected from 486 women who underwent 486 vitrified-warmed cycles, transferring two cleavage embryos cryopreserved with good morphological quality at a single center. The cohort was stratified into tertiles based on transfer time in seconds: T1 (15-27 seconds), T2 (28-33 seconds), and T3 (34-81 seconds). Associations between transfer time and pregnancy outcomes were evaluated using multivariable linear regression analysis. Results: Our findings revealed CPRs of 55.6%, 51.2%, and 41.1% across the tertiles, while implantation rates were 35.8%, 36.3%, and 25.5%, respectively. Transfer time was not independently associated with clinical pregnancy (odds ratio [OR] = 0.98, 95% confidence interval [CI] = 0.96-1.01). Following adjustment for potential confounders, the effect size (OR) remained 0.99 (95% CI = 0.97-1.01). Compared to the T1 (reference) group, the CPR in the T3 group was significantly lower (P <0.05). Conclusions: Our study provides evidence on the impact of transfer time on pregnancy outcomes, with prolonged transfer times adversely affecting CPRs.
Objective:To evaluate the clinical efficacy of vaginal repair as a salvage treatment for cesarean scar defects in patients with previously failed repair surgery.Methods:This retrospective cohort study included 16 patients with cesarean scar defects who underwent vaginal repair as salvage therapy after prior repair surgery failure between March 2019 and September 2022 at the Department of Obstetrics and Gynecology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine. The previous failed procedures included vaginal repair, hysteroscopic repair, and laparoscopic repair. A control group of 108 patients who underwent primary vaginal repair during the same period was also analyzed. Perioperative outcomes and post-operative repair efficacy were compared. The length, width, and depth of the cesarean scar defect, as well as the thickness of the residual myometrium, were measured by transvaginal ultrasonography.Results:No significant differences were observed between the two groups in demographic characteristics. In both groups, the duration of menstruation significantly decreased after vaginal repair (from 12.8 +/- 5.3 to 6.75 +/- 1.8 days in the salvage therapy group, and from 13.5 +/- 3.8 to 7.1 +/- 1.7 days in the primary surgery group), while the thickness of the residual myometrium significantly increased (from 3.0 +/- 2.0 to 7.7 +/- 2.6 mm in the salvage therapy group, and from 2.6 +/- 1.2 to 7.7 +/- 2.5 mm in the primary surgery group). Post-operatively, there were no significant differences between the two groups in either menstrual duration (6.8 +/- 1.8 vs. 7.1 +/- 1.7 days) or residual myometrial thickness (7.7 +/- 2.6 vs. 7.7 +/- 2.5 mm). The data also indicated that performing salvage therapy within <= 21 months of the initial surgery was associated with a better prognosis.Conclusions:Vaginal repair as salvage therapy is a feasible and effective option for patients with cesarean scar defects after failed repair surgery.
Objective: Cyclophosphamide (CP) is an anticancer drug that induces oxidative stress, leading to gonadal toxicity. This study aimed to evaluate the effectiveness of co-treatment with zinc oxide nanoparticles (nZno) and melatonin (Mel) on lipid peroxidation and antioxidant enzyme levels against CP-induced testicular damage. Methods: In this study, 42 adult male rats were divided into six groups. The control group received intraperitoneal (i.p.) saline solution. The CP group was administered CP at 60 mg/kg/week. The Mel + CP and nZno + CP groups received CP along with 10 mg/kg Mel and 5 mg/kg nZno, respectively. The Mel + nZno + CP group received CP plus 10 mg/kg Mel and 5 mg/kg nZno, simultaneously. The Mel + nZno group received 10 mg/kg Mel and 5 mg/kg nZno simultaneously. Eight weeks after the treatment, hormonal assays, total antioxidant capacity (TAC), histological studies, lipid peroxidation levels, and antioxidant enzyme status were assessed. Results: Biochemical results showed that CP decreased spermatogenic lineage cells, TAC, levels of antioxidant enzymes catalase (CAT), glutathione (GSH), and glutathione peroxidase (GSH-Px), and reproductive hormone levels luteinizing hormone (LH), follicle-stimulating hormone (FSH) and testosterone, and increased malondialdehyde (MDA) content. In contrast, co-treatment with Mel and nZno in the Mel + nZno + CP group resulted in a significant improvement in all examined parameters (P <0.05). Conclusion: The results indicate that the simultaneous administration of Mel and nZno could be used as a potential protective agent against CP-induced reproductive toxicity.
Polycystic ovary syndrome (PCOS), a prevalent endocrine and metabolic disorder in women of reproductive age, necessitates standardized quality control criteria for diagnosis and treatment to minimize underdiagnosis, misdiagnosis, and enhance long-term outcomes. This article outlines key quality control strategies for PCOS based on the latest domestic and international guidelines, integrating clinical experience. Diagnostic standardization requires structured protocols for medical history collection, evaluation of clinical manifestations (eg, menstrual irregularities, hyperandrogenism), and auxiliary examinations (hormonal profiling, ultrasound) to prevent overdiagnosis or oversight. Unified quality control standards can improve the consistency of PCOS management, optimize reproductive and metabolic outcomes, and reduce future disease burden. By implementing these measures, healthcare systems can achieve higher diagnostic accuracy, promote evidence-based therapeutic interventions, and mitigate long-term health risks associated with PCOS.
Recent progress in in vitro maturation (IVM) technology using human immature oocytes for clinical applications has been reported. The success rate of IVM technology depends on the source of immature oocytes, and to date, no single protocol has demonstrated superior results over others. Attempts to adapt IVM protocols developed in animal models have not let to significant breakthroughs in culture conditions and systems. Cumulus cells are known to play an important role in oocyte maturation; however, the results of co-culture with different types of cells for IVM of human immature oocytes remain controversial. As one of the assisted reproductive technologies (ART), IVM is only involved in a specific procedure for infertility treatment and fertility preservation. With the development of IVM technology, it has been proposed that the combination of mild-stimulation cycle with retrieval of both mature and immature oocytes, followed by IVM, may offer a viable alternative to the conventional stimulation cycle treatment.
