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Results in Journal Advances in Reproductive Sciences: 119

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Mama Sy Diallo, Oumar Faye, Yoro Diallo, Rokhaya Ndiaye Diallo, Jean Pascal Demba Diop, Abdoulaye Séga Diallo, Babacar Diao
Advances in Reproductive Sciences, Volume 05, pp 47-55; https://doi.org/10.4236/arsci.2017.53006

Abstract:
Varicocele is the first etiology of infertility in men worldwide and affects almost half of the men dealing with infertility in Senegal. Varicocele is associated with a high rate of sperm DNA fragmentation so this test is being more and more recommended especially when patients have to benefit from an ART (Assisted Reproductive Technology) procedure. The aim of our study was to assess if our patients with varicocele are concerned by higher DNA fragmentation rate in spermatozoon. Sperm samples were collected (95 cases of varicocele and 30 controls) and analyzed between January 2013 and June 2016 in a prospective study. Sperm DNA damage, characterized by the rate of DNA fragmentation was evaluated by TUNEL assay using fluorescence microscopy. There was a significant higher percentage of DNA fragmentation in patients with varicocele (p < 0.001), compared to controls. We plan to study a bigger cohort to assess this tendency and study the benefits of surgery in varicocele by evaluating DNA fragmentation after the procedure.
P. O. Ezeonu, K. C. Ekwedigwe, M. E. Isikhuemen, M. O. Eliboh, R. C. Onoh, L. O. Lawani, L. O. Ajah, E. I. Dimejesi
Advances in Reproductive Sciences, Volume 05, pp 39-46; https://doi.org/10.4236/arsci.2017.53005

Abstract:
Background: Giving birth should be a period of joy, but for more than half a million women, their pregnancy and childbirth end in death while some develop vesicovaginal fistula. Vesicovaginal fistula is an abnormal communication between the bladder and the vagina leading to continuous leakage of urine through the vagina. Little is known about the perception of pregnant women about obstetric fistula and this group of women are those who are at risk of the disease. Our aim therefore was to evaluate the level of awareness of vesicovaginal fistula among pregnant women attending antenatal clinic in a rural hospital. Methodology: This was a cross sectional study conducted at Mile 4 missionary Hospital, Abakaliki, between 1st of May and 1st of July, 2017. Data was collected with the use of questionnaire. Ethical clearance was gotten from the institutions ethical committee. Results: Their mean age was 27 ± 5 years and mean parity was 2 ± 2. Awareness of vesicovaginal fistula was 57.8%. Risk factors identified for vesicovaginal fistula were prolonged obstructed labour, instrumental vaginal delivery, caesarean section and short stature. Only 80 (39.2%) believed vesicovaginal fistula could be treated. Conclusion: Awareness of vesicovaginal fistula in the study population was 57.8%. A significant number of women were not aware that vesicovaginal fistula could be treated.
P. O. Ezeonu, K. C. Ekwedigwe, M. E. Isikhuemen, M. O. Eliboh, R. C. Onoh, L. O. Lawani, L. O. Ajah, E. I. Dimejesi
Advances in Reproductive Sciences, Volume 05, pp 33-38; https://doi.org/10.4236/arsci.2017.53004

Abstract:
Introduction: Caesarean section is the delivery of a foetus through an incision made on the uterus. It is useful in situations where vaginal delivery is not feasible. Women in our setting usually see it as a reproductive failure and a sign of weakness. Our aim was to evaluate the perception of caesarean section among pregnant women attending antenatal clinic in a rural missionary hospital. Methodology: This was a cross-sectional study conducted at Mile 4 missionary hospital, Abakaliki among women attending routine antenatal clinic. Information was obtained from respondents with the aid of a questionnaire. Ethical clearance was obtained for the study. Data was analysed using the Statistical Package for Social Sciences (SPSS) version 21. Results: A total of 209 pregnant women participated in this study. Their age ranged from 14 to 43 with a mean age of 27 ± 5 years. One hundred and seventy two women (82.3%) have heard of caesarean section in the past. Eighteen (8.6%) have had caesarean section in the past while 5 were not willing to undergo the procedure again. Sixty (28.7%) are not willing to undergo caesarean section even when it is indicated. Conclusion: Despite awareness of caesarean section, women do not appear to have a positive attitude towards the procedure.
A. Al-Rezaki, W. Aldahmash, S. Alwassel, Z. Abotalib
Advances in Reproductive Sciences, Volume 05, pp 23-32; https://doi.org/10.4236/arsci.2017.52003

Abstract:
Background and Objective: Female infertility may be attributed to several causes that are fundamentally related to the health status of women. The main objective of this project was to correlate the abundance of the microbiota in cervicovaginal fluid to infertility. Materials & Methods: A total of 36 married women who voluntarily came to the hospital in Riyadh for a routine visit participated in the study. To collect the cervicovaginal liquid, a SoftcupTM menstrual device was used by the participant; the cup was then transported in a liquid nitrogen box to the laboratory for analysis. Results: The mean vaginal pH in normal women and infertile women was 3.96 and 5.06, respectively, and the difference between the two cohorts was significant (p < 0.0001). The results showed a clear correlation between the pH value and the floral species detected in the cervicovaginal liquid. In fact, normal flora is primarily composed of a heterogeneous group of Lactobacillus species that have been detected at pH range 3.0 - 4.5, whereas a second group of bacteria mainly composed of Gard-nerella vaginalis, Peptostreptococcus anaerobius and L. iners has been detected in a pH range between 4.5 and 5.5. The third group, with a pH range >5.5, is primarily composed of G. vaginalis, P. anaerobius, Mycoplasma hominis, Mobiluncus species and Atopobium vaginae. The protein content and viscosity of the cervicovaginal liquid were significantly lower in infertile women compared to normal women (p < 0.05).
Ssimbwa Godfrey, Eze Ejike Daniel, Sheu Sulaiman Oluwadare, Begumya Yovani
Advances in Reproductive Sciences, Volume 05, pp 11-22; https://doi.org/10.4236/arsci.2017.52002

Abstract:
Chemically, soy contains a group of phytoestrogens called isoflavones, pre-dominantly genistein and daidzein. The aim of the present study was to determine the effects of post weaning consumption of dietary soy isoflavones on prepubertal and postpubertal serum levels of some reproductive hormones of male Wistar rats. The study involved investigating the effects of different doses of isoflavones in the diet. Male rats were weaned on either soy isoflavone free diet or on isoflavone containing diets, formulated by adding increasing amounts of Novasoy, a commercially available isoflavone supplement to the isoflavone free diet to give varying concentrations of isoflavones. Three isoflavone containing diets were used and these had 74.5, 235.6 and 1046.6 mg total isoflavones/kg pelleted diet. These diets represented the isoflavone concentration lower, equal to and more than that found in soy-based infant formulas respectively. The results obtained showed that; administration of low doses soy isoflavones (74.5 mg/kg) produced significant (p < 0.05) increase in serum Antimullerian Hormone levels both in prepubertal and post pubertal rats, when compared to the control groups. Administration of moderate doses of isoflavones (235.6 mg/kg) produced significant (p < 0.05) increase in serum levels of Antimullerian Hormone and Inhibin in both prepubertal and post pubertal rats when compared to the control groups. Administration of high doses of isoflavones (1046.6 mg/kg) produced significant (p < 0.05) increase in serum levels of Inhibin in both prepubertal and post pubertal rats when compared to the control groups. From this study, it was concluded that post-weaning consumption soy isoflavones produced significant changes in serum Inhibin and Antimullerian Hormone both in prepubertal and post pubertal male Wistar rats and the changes were dose dependent.
S. H. Dodampahala, S. N. Jayakody, W. C. C. Gunathilake, A. N. Rahubaddha
Advances in Reproductive Sciences, Volume 04, pp 93-99; https://doi.org/10.4236/arsci.2016.43011

Abstract:
Introduction: Transvaginal colour Doppler is a non-invasive ultrasound-based technique that allows an in-vivo assessment of tumor vascularization. Several researches done in the last decade have evaluated the role of this technique in assessing carcinoma of the cervix. However there is a significant paucity of literature linked to pre-malignant lesions of the cervix and its diagnosis based on transvaginal colour doppler and its pulstality index (PI). In this paper we present a case control study conducted to assess the validity of transvaginal colour doppler scan and PI in diagnosing malignant and pre-malignant lesions of the cervix. Methodology: A case control study with a total sample of 57 women was conducted at the Nawaloka Hospital for duration of two years. 19 cases of recently diagnosed patients with cervical carcinoma, using cytobrush and colposcopy guided biopsy, evaluated by a consultant histopathologist, were recruited. Staging was done according to FIGO classification. 40 age-matched patients with histologically confirmed normal cervix were selected as controls and 2 were excluded from the study due to the presence of cervical infection. All cases and controls were subjected to transvaginal colour doppler sonography using a 5 MHz 3D probe using GEvolusion6 US machine. The machine was also set for high pass filter at 100 Hz to eliminate low frequency signals occurring from vessel-wall motion. Cervical colour doppler ultrasonography pattern was captured in each case of malignancy, pre-malignancy and controls, and pulstality index (PI) was assessed by the lead gynecologist accredited with ISUOG standards. The highest PI was assessed and recorded in the descending branch of the uterine artery. Results: Women’s mean age was 55.5 years (range 35 - 78). According to clinical staging, there were 4 females with carcinoma in situ, 4 Females with Stage I a, 3 with Stage I b, 4 with Stage II a and 4 with Stage III a. Histologic examination revealed 13 women with squamous cell carcinoma, 2 women with adenocarcinoma and 4 with carcinoma in situ (CIN III) of the cervix. Mean PI value for the cases were 1.94 (range 1.2 - 3.1) and the mean PI value for the controls were 0.805 (range 0.3 - 1.5). Neovascularization was markedly seen in the patients with invasive cervical carcinoma with a PI ranging between 1.99 and 3.10. Chi square test results showed a very high statistically significant difference of PI values between cases and controls (p value < 0.0001). An ROC analysis revealed the optimal cut-off value of PI at 1.475 with a sensitivity of 89.5% and a specificity of 93.5%. Conclusion: Transvaginal doppler ultrasonography and PI of the descending cervical branch of the uterine artery and its branch vasculature allow a non-invasive assessment of tumor vascularization in cervical carcinoma and pre-malignancy. PI with a cut off value of 1.475, can be reliably used to detect and screen pre-malignancies and malignancies at a relatively early stage with a sensitivity of 89.5% and a specificity of 93.5% enabling further definitive evaluation, in a routine gynecology trans vaginal ultrasound assessment.
, Naser A. El Sawy
Advances in Reproductive Sciences, Volume 04, pp 101-113; https://doi.org/10.4236/arsci.2016.44012

Abstract:
Background: The aim of the study is to investigate the role of socio-demographic, life-style and clinical risk factors of low birth weight (LBW) among pregnant women in Saudi Arabia. It is a hospital-based, case-control study of mothers of 135 LBW and 65 normal birth weight neonates at the Obstetrics and Gynecology Unit of the Maternity and Children Hospital, KSA. Methods: On comparison by Duncan’s test, the gestational age of three LBW groups was found to be significantly different (P = 0.0026). The mean duration of hospital stay of the infants also increased for the LBW, very LBW and extreme LBW groups, and their difference was statistically significant (P = 0.0012). Results: A statistically significant, progressive decline was observed in the weight, length and circumference of the head of infants in the LBW to VLBW to ELBW groups. Conclusion: The present study has assessed the state of this significant public health problem of LBW in KSA, and identified several maternal modifiable risk factors. There is an urgent need for the development of reference charts using current data for the Middle Eastern population.
Adinma Joseph Ifeanyi Brian, Osita Umeononihu, Adinma Dolly Echendu, Nkemakolam Eke
Advances in Reproductive Sciences, Volume 04, pp 87-92; https://doi.org/10.4236/arsci.2016.43010

Abstract:
Background: Sexual behaviour is the manner in which humans experience and express their sexuality. When it is risky, it can lead to untoward health consequences. Objective: The study was undertaking to assess the sexuality pattern of 276 students from a tertiary educational institution in Anambra state of south eastern Nigeria to determine the pattern of risk-behavior among them. Subjects/Methods: This is a cross-sectional questionnaire based study of undergraduates in a tertiary educational institution. Results: Majority of the respondents 190/276 (68.8%) are sexually active. Most of the sexually active respondents are unmarried 156 (82.1%) while only 34 (17.9%) were married. A considerable number of the respondents 34 (17.9%) had 2 to 5 sex partners in the past one year while 26 (13.7%) had at least 6 sex partners the past year also. Interestingly, 140 (73.7%) respondents were having sex for pleasure and while only 14 (7.4%) had sex for money. Conclusion: Majority of the undergraduates in this study indulge in premarital sexual intercourse and usually often with multiple partners. This constitutes high risk sexual behavior. Recommendations: Safer-sex sexuality education is recommended for students in tertiary educational institutions to minimize this ugly trend.
Tono Djuwantono, Dian Tjahyadi, Mohammad Wahyu Ferdian
Advances in Reproductive Sciences, Volume 04, pp 74-85; https://doi.org/10.4236/arsci.2016.42009

Abstract:
The main aspect of in vitro fertilization (IVF) cycle individualization is to offer every patient the best therapy adjusted to each individual characteristic. Usually, clinicians choose the FSH starting dose based on anamnesis and clinical criteria, the most important is the results of previous IVF. If there are no previous cycles, the criteria will be based on the patient’s age, body mass index (BMI), and markers of ovarian reserve. The issue is whether an follicle stimulating hormone (FSH) starting dose nomogram based on antral follicle count (AFC) amount, third day FSH serum levels, and age are suitable to female patients who are going through IVF in Aster Clinic Hasan Sadikin Hospital Bandung. This study aims to create a nomogram based on AFC and age to calculate the correct FSH starting dose for IVF therapy in Aster Clinic Hasan Sadikin Hospital Bandung. The research type in this study is observational analytic with a retrospective cohort design, which is a type of research that study outcomes which are evaluated at certain time points. This type of research seeks to study the dynamic of relationships or correlations between risk factors with its impact or effects. Risk factors and impacts or effects are observed simultaneously, which means that the research subject is observed once and risk factors including effects are measured based on the situation or status at the time of observation. The result of this study is a nomogram designed based on AFC and age to calculate the correct FSH starting dose for IVF therapy. The nomogram will be used in Aster Clinic Hasan Sadikin Hospital Bandung.
Kulvinder Kochar Kaur, Gautam Allahbadia
Advances in Reproductive Sciences, Volume 04, pp 53-73; https://doi.org/10.4236/arsci.2016.42008

Abstract:
Endometriosis is an inflammatory oestrogen dependent disease defined by the presence of endometrial glands and stroma at extrauterine sites. The modern advance in treatment of endometriosis management is tackling the debilitating pain it causes, besides the infertility in patients desiring fertility in reproductive age group. This can be achieved by surgical or medical means, although in most cases a combination of both treatments is required. Usually, long term treatment is required in most cases. Unfortunately in most cases, pain symptoms recur between 6months and 12 months once treatment is stopped. A lot of research has gone in understanding the pathogenesis and further medical management of endometriosis besides surgery to be useful in relieving pain and use in patients desiring fertility besides hormonal treatments used earlier like hormonal contraceptives (oral, transdermal or vaginal administration), progestogens, danazol, Gonadotrophic releasing hormone agonist (GnRH), aromatase inhibitors. Newer agents like antiangiogenic drugs, phytochemical agents like resveratrol, TNF-α inhibitors, GnRH antagonists like egalogolix, statins, antiinflammatory agents like COX2 Inhibitors and PPARγ inhibitors like pioglitazone etc., with recent work of combined efficacy of telmesartan of both PPARγ partial agonism along with angiotensin 1 receptor agonism having more efficacy, role of immunomodulators like rapamycin, lipoxin 4 and pentoxyphylline, GnRH antagonists like egalogolix are still under study undergoing phase III trials although preliminary results show promising results with fewer side effects as compared to similar duration of GnRH agonist and much less BMD side effects. Increasing number of trials show the safety of SPRM’s, along with efficacy although disadvantage is suppression of fertility so cannot be used for women desiring fertility. Currently, only mifepristone and ulipristal have received FDA approval for indication in fibroid treatment, MTP and not for endometriosis as yet. The advantages and disadvantages of all the recent advances are discussed in an update in the pathophysiology as well medical treatment of endometriosis.
Shammi Karn, Hong Yu, Sourabh Karna, Liqin Chen,
Advances in Reproductive Sciences, Volume 04, pp 46-52; https://doi.org/10.4236/arsci.2016.42007

Abstract:
Childbirth experience is one of the most intense pain that majority of women will endure during their lifetime. Concerns about pain in labor remain a hot topic, and its popularity gets more common day by day as more women become aware of their rights to achieve a better quality of care during labor. There are various non-pharmacologic (transcutaneous electrical nerve stimulation, hydrotherapy, intradermal water injections and acupuncture) and pharmacologic treatments (nitrous oxide, opioids and regional analgesia techniques: spinal, epidural and combined epidural analgesia) available today. Among these, epidural analgesia offers the most effective form of pain relief and is considered to be the gold standard of labor analgesia. Despite having labor analgesic services, most women still go through painful labor due to lack of knowledge regarding it, particularly in developing countries. The main source of information regarding pain reliefs is from friends and relatives, revealing the lack of information from caregiver’s side. So this study reflects that there is a wide gap in the communication between pregnant women and obstetricians. It supports the fact that obstetricians through the practice of routinely offering labor analgesia can significantly improve the maternal and perinatal outcomes of pregnancy. Provision of standardized epidural analgesia information at an appropriate time in their pregnancy may benefit them by the practice of mutual decision-making. Thus, it may prevent women from making a difficult choice of cesarean section to avoid the fear of painful labor.
Senani Hemantha Dodampahala, Hemantha Pieris, Lal Gotabaya Chandrasena, Surangi Jayakody, Chamara Gunathilaka, Chandrika Neelakanthi Wijayaratne, Gayani Sandamali Kotuwegedara Dodampahala, Amila Ruwan Meegahawatta
Advances in Reproductive Sciences, Volume 04, pp 37-45; https://doi.org/10.4236/arsci.2016.42006

Abstract:
Obstetric cholestasis (also referred to as intrahepatic cholestasis of pregnancy—ICP) is a pruritic form of reversible cholestasis that is associated with significant fetal risks. There is a paucity of research regarding pregnancy outcomes of the mothers with obstetric cholestasis in the South Asian setting. Hence, the objective of this study was to determine the prevalence of obstetric cholestasis among mothers presenting with pruritus during pregnancy and to describe the characteristics and outcomes for those diagnosed with ICP in comparison with those with pruritus in the absence of ICP. Methods: All mothers presenting with pruritus to De Soyza Maternity hospital in Colombo Sri Lanka, between 1st January 2011 to 1st January 2014, were recruited for the study. A standard set of biochemical tests were used for diagnosis of ICP. An interviewer administered questionnaire and patient records were used for data collection. Presentation, characteristics and pregnancy outcomes were assessed and compared for mothers with ICP against those with pruritus in the absence of ICP. Results: The prevalence of ICP in the study population was found to be 27% (n = 27). Generalized pruritus with pruritus of the palms and soles was identified as the commonest pattern of pruritus for diagnosed with ICP. Delivery before 37 weeks (p = 0.001), meconium stained liquor (p = 0.004), placental abruption (p = 0.005), postpartum hemorrhage (p = 0.005), bleeding manifestation (p = 0.006), preterm labor (p = 0.031) and fetal distress (p = 0.035) were found to be significantly associated with the presence of ICP. Conclusions: Nearly 1/3 of mothers presenting with pruritus in pregnancy in Sri Lanka are affected by ICP which is associated with an increase in a wide range of adverse maternal and fetal outcomes compared to those with pruritus in the absence of ICP.
Saleh H. Alwasel
Advances in Reproductive Sciences, Volume 04, pp 23-30; https://doi.org/10.4236/arsci.2016.42004

Abstract:
Postnatal life is affected by changes in fetal development due to adverse events. The present study examined the effect of maternal food restriction on uterine structure and capacity in female rats from the first and second generations (FR1 and FR2) before and after puberty. Pregnant rats were fed ad libitum (Control, C) or maintained under food-restriction conditions (50%FR) during pregnancy. After delivery, all groups were given free access to food. Females from the first generation (FR1) were divided into two subgroups for either uterine dissection or to produce the next generation (FR2). Similar to FR1, FR2 females were exposed to maternal food restriction following the same procedure. FR2 females were also assigned into two subgroups for either uterine dissection or for mating to examine pregnancy outcomes. Uteri from the C, FR1 and FR2 groups were dissected at 4 weeks of age (before puberty) or at 8 weeks of age (after puberty) to evaluate uterine weight and uterine horn length. Tissues were stained with eosin and haematoxylin for examination vialight microscopy. The results showed that food restriction did not affect uterine weight or uterine horn length in FR1 and FR2 females before puberty. However, there were effects of maternal food restriction on uterine weight and length at 8 weeks of age. Uterine weight and uterine horn length were significantly reduced in the FR1 and FR2 groups compared with the values of the controls. This was associated with changes in pregnancy outcomes. Litter size was not affected in the FR1 group; however, litter weight was significantly reduced, leading to an 18% reduction in pup weight at birth. Unlike with FR1 litters, the size of FR2 litters was significantly reduced, leading to a lower degree of pup body weight reduction at birth (only 7%). The gestational length was normal in FR1 females but was significantly decreased in FR2 females. No histopathological changes were observed. These results showed that the uterus was affected by maternal food restriction. It seemed that FR2 females had a different reproductive strategy: they tended to reduce litter size to maintain pup weight at birth. In conclusion, maternal food restriction affects the uteri of the first and second generation. Females from the FR1 and FR2 groups followed different reproductive strategies according to their previous experience with exposure to intrauterine food restriction.
Bikash Shah, Wenhao Tang, Shammi Karn
Advances in Reproductive Sciences, Volume 04, pp 31-36; https://doi.org/10.4236/arsci.2016.42005

Abstract:
Krukenbergtumor is a metastatic ovarian tumor with its primary site being the gastrointestinal tract. The pathogenesis of Krukenberg tumor formation is still in its hypothetical stage though the current understanding suggests lymphatic, hematogenous and transcoelomic route as the 3 major route of metastasis. There is a lack of description in the literature related to the pathway of metastasis. Here, we intend to search the available literature and provide a thorough review, which may be helpful to the readers to understand the issue of mechanism of Krukenberg tumor metastasis more clearly.
Weixia Wei, Qi Lin, Qianyu Huang, Huiru Tang, Liping Wang, Guoping Wang, Junxia Zhou, , Qingwen Wang, Ruiying Diao
Advances in Reproductive Sciences, Volume 04, pp 17-22; https://doi.org/10.4236/arsci.2016.41003

Abstract:
Introduction: Anti-Müllerian hormone (AMH) is shown to be a possible indicator of ovarian function. Severe systemic lupus erythematosus (SLE) patients exposed to high-dose cyclophosphamide (CTX) have a much higher risk of developing infertility and premature ovarian failure. Therefore, we performed a prospective case-control study to evaluate the impact of SLE on women’s ovarian reserve using AMH before CTX therapy. Methods: SLE patients before receiving CTX therapy were enrolled in our hospital. Age-matched healthy women were served as controls. Serum AMH level was measured using an enzyme-linked immunosorbent assay. Basal hormone levels were measured including follicle-stimulating hormone, luteinizing hormone, and estradiol on the third day of their menstrual periods. All participants underwent transvaginal ultrasonographic examination for the determination of total antral follicle count on the third day. Results: AMH value in SLE patients was significantly lower compared to healthy control with normal ovarian reserve. No significant difference in AMH levels was found between SLE and healthy control with low ovarian reserve. Conclusions: SLE patients not receiving CTX therapy even with normal menstruation, still had an impaired ovarian reserve. Therefore, early monitoring of AMH levels could better reflect the ovarian function and reproductive outcomes of SLE patients and relative protective strategy needed to reserve fertility.
José Ernesto Hernández Pichardo, Francisco Ortiz, José Luis Rodríguez, Yvonne Ducolomb, Filiberto Fernández Reyes, Miguel Betancourt, Eduardo Casas, Yvonne Heuze, Michael E. Kjelland, Salvador Romo
Advances in Reproductive Sciences, Volume 04, pp 8-16; https://doi.org/10.4236/arsci.2016.41002

Abstract:
There is little information in the scientific literature concerning sheep pregnancy and lambing success with regard to the timeframe from when in vitro produced embryos are transported to the designated location for embryo transfer (ET). The aim of this study was to transfer in vitro produced embryos under two different conditions that could typically occur using the aforementioned assisted reproductive techniques (ARTs). Abattoir ovaries were used to procure oocytes for in vitro embryo production and subsequent transfer to synchronized ewes. The study consisted of two experiments: Experiment 1 (Exp1)—embryos taken from the laboratory to a nearby surgical room for immediate ET, and Experiment 2 (Exp2)—ET after 5 hours (h) of transport to a rural farm. Lambing in relation to detected pregnancies, births compared to pregnancies, and the proportion of twin offspring were all higher in Exp2. Notably, in both Exp1 and Exp2, there was not a significant difference (P > 0.05) between the number of embryos transferred, i.e., 3 versus 4, respectively, and the number of ewes that underwent parturition in each group. Also, in both experiments there was not a significant difference (P > 0.05) in the number of ewes that underwent parturition based on the number (i.e., ≥1) of corpora lutea present. The results of the present study demonstrate the importance of evaluating different conditions when applying ARTs, as there are many variables that can influence the outcome. Importantly, Exp2 results show that ovine ET in places located far away from the embryo production site can be useful and successful provided that embryo transport, ET, and recipient conditions are adequate.
Rick W. Rorie, Chance L. Williams, Toby D. Lester
Advances in Reproductive Sciences, Volume 04, pp 1-7; https://doi.org/10.4236/arsci.2016.41001

Abstract:
Osteopontin (OPN) is a protein found at higher concentrations in the seminal plasma of bulls with above average fertility. Polymorphisms have been reported within the OPN gene promoter that can affect production of this protein and thus, affect fertility. Therefore, Angus (n = 5) and Angus x Gelbvieh (Balancer, n = 14) and Angus x Brahman (n = 15) bulls were evaluated for presence of single nucleotide polymorphisms (SNP) in the Bos taurus OPN gene (GenBank: AY878328.1) promoter region, and their possible effects on bull semen quality as evaluated by computer-assisted semen analysis (CASA). Semen was collected by electroejaculation 6 to 9 times from each bull, and each semen collection was evaluated by CASA for motile, progressive and rapid sperm within 5 mins of ejaculation. The bulls were genotyped for reported single nucleotide polymorphisms (SNP) in the promoter region of the OPN gene through amplification of two 700 base pair (bp) DNA fragments and sequencing of the resulting PCR products. Seven SNP sites were identified, at bp 3379, 3490, 3492, 5075, 5205, 5209, and 5263 of the OPN gene. The SNP identified at bp 5205, 5209 and 5263 had not been previously reported. Individual SNP sites were evaluated as the main effect on CASA sperm motility variables in a SAS MIXED model for repeated measures. A thymine to guanine substitution at bp 3379 was associated with increased (P ≤ 0.02) percentage of motile, progressive and rapid sperm in Angus x Brahman bulls, and tended (P ≤ 0.10) to increase the same sperm motility parameters in Angus, and Angus x Gelbvieh bulls. The percentages of motile, progressive and rapid sperm were similar (P ≥ 0.05) among genotypes for the other 6 SNP identified. These results suggest that identification and genotyping of polymorphisms within the promoter region of the bovine OPN gene may be useful for selecting bulls with improved sperm motility parameters.
Mama Sy Diallo, Oumar Faye, Abdoulaye Séga Diallo, Yoro Diallo, Babacar Diao
Advances in Reproductive Sciences, Volume 03, pp 97-105; https://doi.org/10.4236/arsci.2015.34012

Abstract:
The presence of DNA fragmentation in semen is associated with poor results in ART (Assisted Re-productive Technology). This has led to the introduction of sperm DNA integrity testing in the clinical assessment of male infertility. The TUNEL assay is one of the most commonly used tests to measure DNA fragmentation in research studies, but it is now being optimized for routine clinical use. So, the objectives of our study were to install the TUNEL assay in our laboratory and to use it to assess the degree of DNA fragmentation in our patients dealing with couple infertility. Forty seven (47) and 25 samples from patients followed up for infertility and known fertile men were analyzed between August 2013 and July 2015 respectively. The sperm samples were evaluated according to the World Health Organization Guidelines. Sperm DNA damage was assessed by the TUNEL assay, with a standardized protocol that we adapted for reading using fluorescence microscopy instead of flow cytometry. The Sperm DNA Fragmentation Index was significantly higher in patients with infertility compared to the controls (22.2% ± 5.6% vs. 16.7% ± 0.7%) with a p < 0.05. This Index was also high in patients with varicocele compared to the control group (22.8% ± 9.2 vs. 16.7% ± 0.7%) (p < 0.01). After establishing the ROC curve (Receiver Operating Characteristics curve), we found a 15% threshold of DNA fragmentation, separating the patients with infertility from the control group. In our study, a 15% threshold positivity of DNA fragmentation using the TUNEL assay was highly associated with infertility. The results indicate that high level DNA fragmentation is associated with infertility.
Liuhong Cai, Junxi Liu, Shaomin Lu, Jiamin Yin
Advances in Reproductive Sciences, Volume 03, pp 92-96; https://doi.org/10.4236/arsci.2015.34011

Abstract:
Introduction: Timed intercourse (TI) based on ovulation monitoring is an effective and common choice for treatment of infertility. However, TI related female sexual dysfunction remains to be elucidated. Method and Material: This was a prospective study and 105 infertile women were included using the Female Sexual Function Index (FSFI) to assess their sexual function in general sexual life (GSL) and TI cycle. Results: The mean age of the patients was 29.4 ± 3.4 years and the duration of infertility was 1.8 ± 0.5 years. The mean score of FSFI was 25.2 in GSL cycle and 24.5 in TI cycle (p = 0.008). Scores of 5 out of 6 domains of FSFI during GSL cycle were significantly higher than the counterparts during TI cycle. Female sexual function was related to stress, which mostly came from patients themselves and parents. The stronger the stress was, the more domains of FSFI were affected. Conclusion: Infertility is an important factor affecting female sexual function, especially TI condition reduced FSFI score in several domains, and this may be related to infertile stress.
Svetlana G. Tsakhilova, Tatiana E. Sharkovskaya, Olga A. Yakimovich, Aida M. Begizova, Angelina A. Malsagova
Advances in Reproductive Sciences, Volume 03, pp 81-91; https://doi.org/10.4236/arsci.2015.34010

Abstract:
Background: ELI-P-Complex is the most advanced diagnostic test designed to assess whether the female body is ready (or unready) for the normal pregnancy course and for giving birth to a healthy child. ELI-P-Complex enables the perceived abnormalities to be individually treated even prior to the pregnancy planning, thus minimizing the risk of gestational and delivery-related complications. This prospective study shows the effectiveness of ELI-P-Complex testing during preconception care in women with a history of adverse pregnancy outcomes (APO). Methods: The data were reviewed from 4519 women with a history of APO and who planned to get pregnant. Following randomization, subjects of Group A were tested with ELI-P-Complex and treated before the pregnancy based on the results obtained. Group B subjects were not examined using the ELI- P-Complex test and were prepared for pregnancy in accordance with the standard strategy of pre- conception care [1]. Results: In Group A, gestational complications (GC) were revealed in 20% of women compared to 88.7% of Group B subjects; the relative risk (RR) of GC was 11.67 (95% CI: 9.9851 to 13.6392; P < 0.0001). APO was reported in 12% of Group A subjects vs. 38.1% of Group B ones; RR of APO was 5.8908 (95% CI: 4.9365 to 7.0296; P < 0.0001). Absolutely healthy children were born from 88.1% of Group A subjects compared to 50.3% of Group B ones; RR was 7.9601 (95% CI: 6.6110 to 9.5845; P < 0.0001). The positive predictive value, sensitivity, and specificity of the test for GC were 93.82% (95% CI: 92.72% to 94.80%), 93.17% (95% CI: 92.03% to 94.20%), and 92.62% (95% CI: 91.31% to 93.78%), respectively. Conclusions: The use of ELI-P-Complex for examination and further preconception care in women with a history of APO considerably reduces GC, improves pregnancy outcomes, and increases chances of giving birth to a healthy child.
Sonam Chaudhary, C. G. Saha, Dipali Sarkar
Advances in Reproductive Sciences, Volume 03, pp 75-80; https://doi.org/10.4236/arsci.2015.34009

Abstract:
The cardiovascular system undergoes physiological changes during pregnancy. These physiological changes in the heart can be understood by simple procedures like electrocardiography. With the objective of formulating basis of alterations in heart rate and impulse conductivity from atria to ventricles during pregnancy, the study was carried out in Manipal Teaching Hospital, Pokhara, Nepal between calendar year 2012 and 2013 by comparing electrocardiograms between pregnant and non-pregnant participants. The total number of participants in this study was 120: 50% was third trimester pregnant women as cases and the other 50% was non-pregnant women as controls. The statistically significant increase in heart rate and highly significant decrease in PR interval in electrocardiograms of cases conclude that the alterations in cardiac function do occur in pregnancies which all try to meet the growing demands of developing fetus. Thus, these changes neither should be misinterpreted as of pathological origin nor the latter one if present should be misdiagnosed by any health care providers.
Advances in Reproductive Sciences, Volume 03, pp 57-65; https://doi.org/10.4236/arsci.2015.33007

Abstract:
The main objective of this study was to determine differences in sperm recovered from the three segments of the epididymis, i.e., head, corpus and cauda, using routine measurements of sperm quality and DNA fragmentation assessment. There was a larger sperm concentration (P < 0.05) in the head (3.34 × 106 sperm/mL) compared with the corpus and cauda. The percentage of normal morphology was higher in the cauda but had lower motility (P < 0.05). The DNA fragmentation index was higher for sperm obtained from the head and body of the epididymis (P < 0.01) compared with the cauda. The DNA fragmentation index values were 12% higher (P < 0.01) using Wright stain compared with DAPI stain in sperm from the head and corpus of the epididymis, but similar in the cauda. Spermatobioscopy parameters match the maturation changes that occur in the epididymal tract with higher quality sperm being from the cauda, but with a lower concentration compared to sperm found in the head.
Jilong Liu, Meiyan Chen, Chunlian Lin, Xunjin Weng, Zhongming Meng, Weijun Tang
Advances in Reproductive Sciences, Volume 03, pp 50-56; https://doi.org/10.4236/arsci.2015.33006

Abstract:
The short-term insemination technique has been widely applied, although it is not clear whether the mechanical desorption of cumulus cells can affect normal fertilization and birth outcomes. Therefore, the present study aimed to evaluate whether early cumulus cell removal could affect in vitro fertilization outcomes. Based on a history of infertility and semen analysis, 61 patients were identified, and the cumulus cells were mechanically removed at either6 h post-insemination (Group A, 387 mature oocytes) or 18 - 20 h post-insemination as traditional in vitro fertilization (Group B, 424 mature oocytes). There were no significant differences in the rates of fertilization, available embryos, high quality embryos, birth, premature birth, pregnancy, or implantation when we compared the two groups. However, Group A exhibited a significantly higher polyspermy rate, and significantly lower rates of blastocyst formation and high-quality blastocyst formation, compared with Group B. Therefore, the results of present study indicate that early cumulus cell removal (at 6 h post-insemination) may negatively affect the rates of polyspermy, blastocyst formation, and high-quality blastocyst formation.
Patience Otoo, ,
Advances in Reproductive Sciences, Volume 03, pp 41-49; https://doi.org/10.4236/arsci.2015.33005

Abstract:
Women all over the world are confronted with many difficult choices during pregnancy and child birth. Wrong choices often result in unfavorable outcomes for expectant mothers and their babies, a situation which is common in developing countries. Cultural practices, beliefs and taboos are often implicated in determining the care received by mothers during pregnancy and child birth which is an important determinant of maternal mortality. This study explored the traditional practices associated with pregnancy and childbirth in Shama District of the Western Region, Ghana. A qualitative study consisting of six focus group discussions of between eight and ten participants per group and eight in-depth interviews were held over a period of one month. The purpose was to explore local foods that are forbidden for pregnant women and why, herbal medicine use during pregnancy and child birth and reasons for choosing home or hospital delivery. The findings show that pregnant women are forbidden from taking nutritious foods such as snails, ripe plantain, okra and many others for fear of complications during pregnancy and child birth. Herbal medicines are frequently used by pregnant women and traditional birth attendants to induce labour, augment and control bleeding during labour. Traditional beliefs and practices as well as negative attitude of health workers are found to reduce health utilization by pregnant women. Health education concerning traditional practices that are detrimental to the health of pregnant women should be emphasized during ANC visits.
, Blanka Koubková, Jitka Řezáčová, Michal Krčmář, Pavel Darebný, Lucie Melicharová, Kateřina Dohnalová, Alena Vaverková, Jaroslav Feyereisl
Advances in Reproductive Sciences, Volume 03, pp 34-40; https://doi.org/10.4236/arsci.2015.32004

Abstract:
The purpose of this retrospective study was to determine whether or not there was a significant relationship between women’s age as a cause of sterility and pregnancy after IUI. Furthermore, we evaluated the effect of stimulation of antiestrogens and time of hCG administration on the success of IUI in relation to the age of women. During the period between 2008 and 2012, we performed a total number of 793 IUI. Patients were prepared for IUI in the natural cycle and stimulation with antiestrogens (clomiphene citrate-CC). Ovulation was induced by hCG (Ovitrelle) 40 hours before IUI or immediately after the procedure. Sperm was processed through density gradients. The average success rate of IUI was 10.2% of pregnant women per cycle. Significantly the highest number of pregnant women 16.3% was women with a diagnosis of anovulation. Significantly the lowest success rate of IUI was at the immunological cause of infertility and endometriosis. There was no evidence of age dependence for women on the success of IUI. Stimulation of CC did not significantly increase the chance of becoming pregnant. There was also no statistically significant difference in hCG before and after IUI pregnancy success. The most important group of women for whom IUI is a suitable form of assisted reproduction consists of patients of 35 years old with anovulation cause of sterility. Those patients with an immunological cause of infertility and endometriosis have significantly lower chances of conceiving after IUI and it is preferable for them to choose other techniques of assisted reproduction and embryo transfer.
, Henda Ben Mustapha, Amira Sallem, Meriem Harzallah, Ines Zidi, Faten Hachani, Salma Chachia, Abdeljalil Khélifi, ,
Advances in Reproductive Sciences, Volume 03, pp 27-33; https://doi.org/10.4236/arsci.2015.32003

Abstract:
The role of oxidative stress in female reproduction is becoming increasingly important, as recent evidence suggests that it has been implicated in the pathology of infertility of both known and idiopathic origin. Although its efficacy has yet to be well established, supplementation with antioxidants is a new tool being developed in the therapeutic armamentarium for female-factor infertility. We present a case of a spontaneous viable pregnancy in a 37-year-old patient with a history of two consequent In Vitro Fertilization (IVF) failures, occurring after a 5-month antioxidant treatment. This report suggests that oral antioxidants supplementation in female patients may provide an alternative or adjunct to conventional fertility therapies and improve their chances of becoming pregnant.
Matías Nicolás Tellado, , , Pablo Daniel Cetica
Advances in Reproductive Sciences, Volume 02, pp 56-67; https://doi.org/10.4236/arsci.2014.23007

Abstract:
We studied the effect of different storage conditions of porcine ovaries (time, temperature) on the characteristics of the follicular fluid, immature oocyte quality, meiotic competence and in vitro fertilization of oocytes. Ovaries were stored for 2, 4 or 6 h at 3 different temperatures (15°C, 25°C or 35°C). As the storage time increased, pH and glucose concentration of the follicular fluid, percentage of live immature oocytes at germinal vesicle stage, oxidative activity and maturation rate decreased. At higher temperatures, pH and glucose concentration decreased, but oxidative activity and oocyte maturation rate increased. Lactate concentration and immature oocyte ROS production increased as storage time and temperature increased. The ovary storage for longer than 2 h at 25°C and 35°C resulted in low pH of the follicular fluid and high ROS level in immature oocytes. Such conditions seem to damage oocytes and impair their meiotic competence. A decrease in the oxidative activity caused by long time and/or low storage temperature may imply a decrease in oocyte vitality. In conclusion, in the porcine species, the transport of ovaries at 25°C and 35°C for 2 h are the best conditions to maintain adequate oocyte quality, meiotic competence and in vitro fertilization rates.
Advances in Reproductive Sciences, Volume 02, pp 33-45; https://doi.org/10.4236/arsci.2014.22005

Abstract:
Studies conducted in Africa have demonstrated the existence of a significant association between family environment and the sexual behaviour of adolescents. Generally, empirical studies of this topic are based on parental control, and family or conjugal instability and socialization approaches. The objective of this study is to assess the association between family environment and the sexual behaviour of adolescents aged 12 to 19 years. The 2004 National Survey of Adolescents (NSA) in Burkina Faso provides data for studying operationalization. Analyses were bivariate and multivariate. The former were conducted using cross tabulations while the latter used three logistic regression models. Results indicate a significant but low association among family environment variables. Absence of both parents, or a number of individuals under 20 years old higher than the number of adults in a household is not systematically associated with risky sexual behaviour. Parental control was shown to be more discriminating of sexual behaviour of adolescents from Burkina Faso, compared with communication with family members regarding sexuality. Despite current ongoing economic crises and sociocultural mutations in Burkinabe societies, household members and family still play major roles in adolescents’ education. Results reinforce sexual and reproductive health programs where parents and household members are central to strategies.
, Ericka Barrientos, Victorino Alatriste, Isabel Martínez, Ilhicamina D. Limón, Oscar González-Flores
Advances in Reproductive Sciences, Volume 03, pp 13-26; https://doi.org/10.4236/arsci.2015.31002

Abstract:
Introduction: The existence of ovarian intrinsic neurons is well established. However, the morphology and chemical phenotype are not completely characterized and are even unknown for some species used in medical research. The purpose of this work was to determine the morphology and chemical phenotype of intrinsic neurons of the guinea pig ovary at two ages: neonates (0 days old) and sexually mature reproductive animals (90 days old). Materials and Methods: For the morphological analysis, we employed the modified Golgi-Cox impregnation technique. For the chemical phenotype, we used immunohistochemistry and the following antibodies; tyrosine hydroxylase (TH), calcitonin gene-related peptide (CGRP), transient receptor potential type 1 (TRPV1), neuron-specific nuclear protein (NeuN) and proto-oncogene product of the cFos gene (cFos). We also used enzyme histochemistry for NADPH-diaphorase detection. Results: The number of intrinsic neurons in the neonate ovary was low in comparison to the adult guinea pig ovary. The intrinsic neurons were located in the cortex and the ovarian medulla; some were isolated or clustered, forming ganglia, and others were interconnected and formed networks. The neurons were small, medium or large. In the cortex of neonate vs adult ovaries, the small and medium neurons comprised 23% vs 36% and 5.2% vs 11.6%, respectively. In the medulla, the percent of the same neurons was 10.1% vs 10.1% and 1.1% vs 2.2% in the neonate and adult, respectively. In both cortex and medulla < 1% were large neurons at two ages. Also, the neurons were rounded, fusiform or multipolar. In the cortex, they were 12.7% vs 20.9%, 14.9% vs 24.2% and 1.1% vs 3.0%, respectively. In the medulla, the percent of small vs medium neurons was 6% vs 7.1% and 4.1% vs 4.8% in the neonate and adult ovary, respectively, and <1% were large neurons at both ages. The chemical phenotypes were in the neonate and adult: TH/NeuN-positive neurons, 16.3% vs 26.5%; CGRP/NeuN, 13.5% vs 35.8%; TRPV1/NeuN, 10.2% vs 38.6%; and cFos/NeuN, 4.6% vs 5.4%, respectively.The percent of NADPHd-positive cells in the cortex was 9.5% vs 25.1% and 3.2% vs 62.2% in the medulla in the neonate and adult, respectively. Conclusion: Altogether, these data showed that the number of ovarian intrinsic neurons was low at birth and increased in the sexually mature reproductive guinea pig. The chemical phenotype was rich and peptidergic, catecholaminergic and nitrergic in nature and positive for cFos immunoreactivity. Therefore, intrinsic neurons can be chemical sensors inside of the gonad and transmit signal to the central nervous system.
, , , Abubakari Sulemana, , , , , Abena Konadu Yawson, Gifty Fosuaa Nuamah, et al.
Advances in Reproductive Sciences, Volume 03, pp 1-12; https://doi.org/10.4236/arsci.2015.31001

Abstract:
Family planning is known to prevent maternal deaths, but some social norms, limited supplies and inconsistent use makes this difficult to achieve in most low- and middle-income countries. In spite of the high fertility levels in most sub-Saharan African countries and the potential economic benefits of family planning, its patronage remains very low in the sub-region. This study was with the objective of identifying the levels of awareness, utilization, access to and perceptions about family planning and contraception. A cross-sectional study design was used for the study, with data collected from multiple sources using both quantitative and qualitative approaches. Relevant findings included a marked disconnect between family planning/contraceptive knowledge and use. The pills and injectables were the most frequently used, but females in the study population poorly patronised emergency contraception. Supplies of most family planning methods were found to be health facility based, requiring clients to have to necessarily go there for services. Some respondents harboured perceptions that family planning was the responsibility of females alone and that it fuelled promiscuity among female users. Recommendations made include ensuring that health facilities had adequate staff and expertise to provide facility-based family planning services and also to disabuse the minds of community members of the negative perceptions towards family planning.
Liuhong Cai, Rihan Hai, Bin Zhang, Yanfei Wen, Minhui Zeng, Manbo Jiang
Advances in Reproductive Sciences, Volume 02, pp 88-92; https://doi.org/10.4236/arsci.2014.24011

Abstract:
Acupuncture is an important method of treatment in Chinese medicine. The objective of this study was to evaluate the efficacy of acupuncture as an adjuvant treatment for unexplained infertility. Here we conducted a prospective study, with data consisting of acupuncture group (38 cases) and control group (42 cases). Infertility evaluation workup consisted of semen analysis, ovulation assessment, hysterosalpingogram (HSG) and blood analysis. The patients in acupuncture group received 3 acupuncture sessions, and each at seven acupuncture points (EX-CA1, CV4, CV6, SP10, ST36, SP6, and KI3). The session started 12 days before menstruation and continued for 10 days. The patients in control group did not receive acupuncture. All patients tried 1 - 3 natural cycles 3 months after HSG test, if not pregnant, underwent 1 - 3 cycles of control ovarian hyperstimulation (COH) and timed intercourse. Pregnancy was evaluated by measurement of blood β human chorionic gonadotrophin (β-hCG) and subsequent trans-vaginal ultrasound. No significant difference of clinical pregnancy rate was found between the acupuncture group and the control group, however, numbers of COH cycles were significantly less and more pregnancies occurred in natural cycle in the acupuncture group. We concluded that acupuncture can be used as an adjuvant treatment for unexplained infertility. Although acupuncture did not increase the cumulative pregnancy rate, it decreased the number of COH cycles and more patients got pregnant in natural cycles after receiving acupuncture.
, Ryoko Saruta, Naomi Kato
Advances in Reproductive Sciences, Volume 02, pp 83-87; https://doi.org/10.4236/arsci.2014.24010

Abstract:
This study determined the sources from which Vietnamese high school students currently acquire sexual knowledge as well as the sources from which they believe they should acquire it. Participants were eleventh-grade students at three public high schools in Hanoi, Vietnam. We conducted a questionnaire-based survey from September to October 2012, with 1672 students participating. Responses were received from all 1672 students, a response rate of 100%. Complete data were received from 1653 respondents (98.9%), including 896 males (54.2%) and 757 females (45.8%). The survey was a self-administrated questionnaire. Although many participants believed that they were knowledgeable about sex, only a small number of them actually possessed accurate sexual knowledge. Few participants in this study, targeted to a specific age (eleventh grade), had used the Internet as a major source for obtaining sexual knowledge, in contrast to results from previous studies which covered a wider age demographic. Future research should include comparative studies between eleventh and twelfth graders as well as between those of the same age who are and who are not enrolled in high school. Additionally, it might be beneficial to consider the relationship between adolescent age and Internet use to study the influence of the Internet on sexual knowledge. Our results suggest that parents and schoolteachers should shoulder more responsibility in providing sexual education, particularly by improving their own knowledge and ability to provide such education, because many participants indicated that sexual knowledge should be acquired from parents and schools.
, , Libby Shopen, Blais Idit, David Ishai, Zofnat Wiener-Megnazi, Ron Auslender,
Advances in Reproductive Sciences, Volume 02, pp 76-82; https://doi.org/10.4236/arsci.2014.24009

Abstract:
Purpose: Impaired hatching is associated with implantation failure following in vitro fertilization (IVF). Thickening or hardening of the zona pellucida (ZP) has been proposed as a factor in this impairment. We examined whether selective assisted hatching (AH) is beneficial with embryos having a thick ZP. Methods: This prospective, randomized controlled study was performed in the IVF unit of an obstetrics and gynecology department in a university-affiliated hospital. Only patients undergoing IVF and having a ZP thickness of ≥17 μm measured in all their embryos were included. In the intervention group, AH was applied to all embryos, before their transfer. In the control group, embryos were transferred without AH. Implantation, clinical pregnancy and live birth rates were the study endpoints. Results: Both study arms were comparable in most baseline parameters. The two groups did not differ in implantation rates (14.1% control vs. 8.92% intervention, odds ratio (OR) = 0.5974, 95% confidence interval (CI) 0.325 - 1.1), clinical pregnancy rates (36.7% vs. 25.8%, OR = 0.6025, 95% CI 0.274 - 1.325), or live birth rates (25% vs. 18.9%, OR = 0.7021, 95% CI 0.291 - 1.691). Conclusions: Selecting embryos for AH by their ZP thickness as a sole parameter was not found to be beneficial and to improve IVF outcome.
, Pedro A. Delgado, Toby D. Lester
Advances in Reproductive Sciences, Volume 02, pp 69-75; https://doi.org/10.4236/arsci.2014.24008

Abstract:
A study was conducted to evaluate variation in the ratio of X- to Y-bearing sperm of individual ejaculates and to determine any relationship between skewed sex ratio and either routine morphological evaluation or computer assisted sperm analysis (CASA). Semen was collected from bulls weekly for 6 consecutive weeks, sperm DNA was recovered and quantitative, and real-time PCR was used to determine the ratio of X- to Y-bearing sperm in each ejaculate. The overall mean of X-bearing sperm within ejaculates was 54.7% over the 6 weeks of semen collections. The percentages of X-bearing sperm were similar (P > 0.5) across all collections. Between bulls, there were differences (P < 0.05) in the mean percentage of X-bearing sperm. No significant correlations were found between CASA parameters and percentage of X-bearing sperm across bulls, so analysis was done within each bull. Different combinations of CASA and/or morphological parameters were found to correlate with the percentage of X-bearing sperm but the prediction equations were specific for individual bulls and unlikely to be of use across bulls. These results confirm that the ratio of X- to Y-bearing sperm may be skewed in some ejaculates of bull semen. Some sperm parameters measured by CASA or routine morphological evaluation were associated with semen sex ratio.
, Monia Zaouali, , Iheb Bougmiza, Souhir Mehri, Houda Ben Frej, Faten Tabka, ,
Advances in Reproductive Sciences, Volume 02, pp 24-31; https://doi.org/10.4236/arsci.2014.21004

Abstract:
Introduction: The association of the professional exposure to the decline of the male reproductive function had been the subject of several studies but without arriving to one envisagement undeniable of its existence. The ICSI, technique of reference in severe male infertilities, is visavis unexplained failures whose environmental and professional exposure could be about its cause partly. In this work, we tried to highlight an association between certain factors of professional exposure and the deterioration of the spermatic parameters, then to evaluate the effect of such factors on the result of the ICSI. Materials and Methods: It is about a study of the exposed type—no exposed, realized through collaboration between the Unit of Medicine of the Reproduction and the Service of Medicine of Work of the CHU Farhat Hached of Sousse. This study was based on a questionnaire of which part of the items was collected medical files of the patients raising the general characteristics, the profile of exposure as well as the spermatic parameters and the biological assessment of ICSI. Results: Significant associations between the deterioration of sperm and the professional risk factors such as the exposure to the formaldehydes (p = 0.01) and heat (p = 0.001) were noted. The exposure to formaldehydes was associated at the higher risk of oli gozoospermy, of asthenozoospermy with a significant reduction in mobility (p = 0.05), whereas the talks with cement had a risk higher of teratozoospermy. In addition an exposure to heat was associated at the high risk of oligoteratozoospermy. The total rate of pregnancies after ICSI among 220 patients of our series was of 14.47%. The ICSI balance showed a reduction in total fertility rate (76.6% exposed vs 75.3% no exposed). Conclusion: In spite of the limited number of the patients, this study had shown a correlation between certain professional exposures of origin and the deterioration of sperm. They are preliminary results which encourage continuing collaboration between the specialists in the reproduction and the doctors of work in order to preserve the fertility of the workers exposed to factors gonadotoxic.
Advances in Reproductive Sciences, Volume 02, pp 16-23; https://doi.org/10.4236/arsci.2014.21003

Abstract:
Background: The aim of this study was to establish normal reference values for several growth factors in semen and provide a basis for understanding their physiological significance in fertile and infertile subjects. Methods: 110 infertile men semen was evaluated according to WHO standards and by enzyme immunoassay (ELISA kit protocol) to determine the rate of growth factors (TGFβ1, IGFI, EGF). We have also listed neutrophils by staining with peroxidase to examine the association of inflammation with the levels of these factors. The determination of the epididymal (alpha-1,4-glucosidase) marker was directed according to the technical recommended by the WHO in 2010. Each patient received a hormonal balance including the determination of plasma FSH, LH and Testosterone. Results: Concentrations of TGFβ1 were significantly higher in (severe and extreme azoospermic, oligospermic) pathological groups compared to the control group (P 0.05) between control and pathological groups. The IGFI is partly testicular and/or epididymal as it is lowered in some patients with obstructive azoospermia. Positive correlations were observed between the seminal IGFI, mobility (r = 0.487) and sperm morphology (r = +0.187). Immunological sperm abnormalities and/or idiopathic do not alter the rate of EGF seminal. There is no significant correlation between seminal EGF or with sperm parameters or with plasma levels of FSH and LH. Conclusion: The growth factors are primarily peptides, handling and identification in a complex environment as the seminal plasma, but it requires a lot of precautions if we do not want to expose to the risk of bad farms/interpretations of data obtained.
Habte Bolka,
Advances in Reproductive Sciences, Volume 02, pp 8-15; https://doi.org/10.4236/arsci.2014.21002

Abstract:
The essential nutrition actions explain nutrition through life cycle approach addressing women’s nutrition during pregnancy and lactation, optimal infant and young children feeding, nutritional care for sick children and control of anemia, iodine and vitamin A deficiencies. Essential nutrition action has been implemented and resulted in positive outcome in less developed countries. However, the status of practice and associated factors were not studied in Ethiopia. Thus, institution-based cross-sectional study was conducted to assess the practice of essential nutrition actions in healthcare deliveries of Shebedino District, South Ethiopia. Quantitative data were collected though face-to-face interview with health workers and triangulated with data obtained through in-depth interview with health managers in the district and non-participatory observation of client-provider interaction in health facilities. Data were analyzed using SPSS16.0 software. Descriptive and logistic regression analyses were undertaken. The study revealed that 61 (56.0%) health workers practiced essential nutrition actions. Seventy one (65.1%) health workers were trained on essential nutrition actions. The practice of essential nutrition actions was associated with career structure of the health workers (AOR = 6.79, 95%CI: 2.31, 19.98), essential nutrition actions knowledge of health workers (AOR = 6.87, 95%CI: 2.11, 21.51) and availability of monthly nutrition related report form (AOR = 4.95, 95%CI: 1.46, 16.81). The practice of essential nutrition actions was low. The factors affecting the practice were inadequate training and knowledge of essential nutrition actions, career structure of the health workers and availability of monthly report form. Training should be provided for health workers on essential nutrition actions; moreover, essential nutrition actions indicators should be included in monthly report forms of the health institutions.
Advances in Reproductive Sciences, Volume 02, pp 1-7; https://doi.org/10.4236/arsci.2014.21001

Abstract:
Tubulobulbar Complexes (TBCs) are actin-rich structures formed between Sertoli-cells and spermatids at the time of sperm release. The main functions of the TBCs are to remove excess spermatid cytoplasm and acrosomal contents, internalize and recycle junctional complexes by endocytosis prior to spermiation. However, in addition to recycling some of the molecules undergo lysosomal degradation. The molecular machinery involved in endocytosis at the TBCs is not well understood. To bridge this gap localization of various proteins, involved at various steps of endocytosis studied in other systems, was demonstrated in TBCs using testicular fragmented material or sections by immunoblotting and immunofluroscence. The presence of key molecules like Vamp-2, syntaxin and Lamp-2 indicates occurrence of lysosomal degradation in addition to junctional recycling at the TBCs present at the time of sperm release. TBCs are endocytic devices functioning to recycle junctional molecules or remove spermatid cytoplasm that were present between spermatids and Sertoli-cells all through the process of spermatid maturation and in turn regulate male fertility.
Ejara Tolossa, Birhan Meshesha,
Advances in Reproductive Sciences, Volume 01, pp 51-56; https://doi.org/10.4236/arsci.2013.13008

Abstract:
Introduction: Emergency contraception is used as an emergency procedure to prevent unintended pregnancy secondary to an unprotected se xual intercourse and method failure. Hence, this study assessed the level of knowledge and utilization of emergency contraception among undergraduate regular female students of Hawassa University, south Ethiopia. Methods: An institution-based cross-sectional survey was conducted among female students of Hawassa University in December 2012. Seven hundred seventy six of the students were sampled by using multistage sampling technique. Pretested structured questionnaire was used to collect the data. Results: The majority 719 (92.7%) of female university students ever had sexual intercourse and 17 (2.2%) experienced forced sex. Eight (47%) of these 17 students experienced unintended pregnancy all of which resulted in an induced abortion. Three hundred seventy nine (72.2%) of the respondents had knowledge about emergency contraceptives and only 41 (10.8%) of them had ever used emergency contraceptives; oral contraceptive pills were the most widely used form of all emergency contraceptives 41 (10.8%). Age, marital status and age at menarche were associated with knowledge of emergency contraception; moreover, residence, year of study and experience of forced sex were found to be predictors of emergency contraception utilization. Conclusion: Female university students had been experiencing high rate of unintended sexual practice and pregnancy, low knowledge level and utilization of emergency contraceptives; moreover, they had no youth-friendly access to the services. Therefore, there is a need for collaborated effort to improve service access and scale up their utilization level to prevent unwanted pregnancy.
Saeed Faramarzi, , Ozlem Kayisli, Murat Basar, John Shapiro, , Joseph Huang, Longzhu Piao, ,
Advances in Reproductive Sciences, Volume 01, pp 44-50; https://doi.org/10.4236/arsci.2013.13007

Abstract:
During human pregnancy, progesterone induced decidual cells protect against hemorrhage: 1) as endovascular trophoblast breech and remodel uterine blood vessels; and 2) in the third stage of labor following preterm and term delivery. De- cidual cells promote hemostasis through enhanced expression of tissue factor (TF), the primary initiator of hemostasis via thrombin generation, and plasminogen activator inhibitor-1, which inactivates tissue type plasminogen activator, the primary fibrinolytic agent. Abruptions (decidual hemorrhage) produce excess thrombin which acts as autocrine/paracrine inducer of decidual cell expressed matrix metalloproteinases and of neutrophil chemoattractant and activator, interleukin-8. The latter mediates aseptic abruption-related neutrophil infiltration. During abruptions, decidual cell and neutrophil-derived proteases effectively degrade the decidual and fetal membrane extracellular matrix to promote preterm premature rupture of the membranes and preterm delivery (PTD). Decidual cell-derived thrombin weakens the amniotic membrane and lowers decidual cell-expressed progesterone receptor levels by increasing phospho-ERK1/2 signaling. The resulting functional progesterone withdrawal accompanies PTD.
Cyrille D’Alex Tadondjou, Ferdinand Ngoula, Henry Fuelefack Defang, Herve Kuietche Mube, Alexis Teguia
Advances in Reproductive Sciences, Volume 01, pp 38-43; https://doi.org/10.4236/arsci.2013.13006

Abstract:
This study was designed to examine the effects of dietary energy levels on some growth and reproductive parameters of local barred chickens in Cameroon. For this purpose, One hundred and forty four day-old barred male chicks, weighing 28.33 g in average were randomly divided into 12 groups of 12 chicks each. Three feeding programs (FP) comprising each a starter diet from day old to 12 weeks (S0: 2800 Kcal/Kg; S1: 2900 Kcal/Kg; S2: 3000 Kcal/Kg) and grower diet from 13 to 20 weeks (G0: 2900 Kcal/Kg; G1: 3000 Kcal/ Kg; G2: 3100 Kcal/Kg) were used and designated FP1, FP2 and FP3 respectively. Each of the FP was randomly allotted of 4 groups of 12 birds in a completely randomized design. Throughout experiment (1 day old to 20 weeks), body weight was recovered every 2 weeks. At 20 weeks of age, roosters were sacrificed; semen characteristic was analyzed and testes were characterized. Between 2 to 10 weeks old, body weight of cocks fed with FP3 was significantly higher (P < 0.05) as compared to others FP. Inversely, from 12 to 20 weeks, body weight of cocks receiving FP1 was significantly higher (P < 0.05) than that of cocks receiving feeding programs 2 and 3. At 20 weeks, 100% of cocks fed on FP3 produced semen versus 66.66% and 16.66% respectively for those on FP1 and FP2. Semen volume and mass motility of cocks fed on FP3 or FP1 were significantly (P < 0.05) higher than FP2. It was concluded that FP1 had more suitable dietary energy levels for growth and reproduction of local barred cocks.
Victorino Alatriste, Irma Herrera-Camacho, María I. Martínez, Ilhicamina D. Limón, Oscar González-Flores,
Advances in Reproductive Sciences, Volume 01, pp 29-37; https://doi.org/10.4236/arsci.2013.13005

Abstract:
Introduction: It has been documented that mammalian ovaries receive sympathetic, parasympathetic and sensory nerve fibers. The aim of this work was to investigate the effects of sensory denervation with capsaicin at the first vaginal opening (FVO) on follicular development and the expression of TRPV1 receptors in ovary cells as well as in the dorsal root ganglia (DRGs) and lumbar dorsal spinal cord neurons of guinea pigs. The DRGs and lumbar dorsal spinal cord neurons serve as a nerve connection from the ovaries to the CNS. Materials and Methods: Female guinea pigs received a subcutaneous injection of capsaicin (30 mM) at 10 days of age (P10), while control animals were injected with vehicle. Using light microscopy, we counted healthy preantral follicles (HPF), healthy antral follicles (HAF), atretic preantral follicles (APF), and atretic antral follicles (AAF) in the ovaries at the FVO, and the numbers of TRPV1-positive cells were counted in the ovarian follicles, DRGs, and lumbar dorsal spinal cord (L2-L4) neurons by immunohistochemistry. Results: Guinea pigs treated with capsaicin showed a significant delay of FVO in comparison with the control animals (36 vs. 44 days). In the ovaries, the number of preantral and antral follicles decreased significantly. Additionally, the number of TRPV1-positive thecainterstitial cells of the antral follicles was reduced significantly, and the number of TRPV1-positive neurons in the DRGs and lumbar dorsal spinal cord (L2-L4) decreased. Thus, we showed that TRPV1 receptors throughout the sensory fibers modulate ovarian follicular development and the onset of puberty in guinea pigs. Conclusion: Sensory denervation decreases ovarian follicular development and delays the onset of puberty of guinea pigs. Our data support the idea that through TRPV1 receptors, ovarian afferent fibers sense local stimuli that are sent to the CNS.
Reham Moftah, Salah Marzouk, Dalal El-Kaffash, Raymonda Varon, Christiane Bommer, Mohsen Karbasiyan,
Advances in Reproductive Sciences, Volume 01, pp 21-28; https://doi.org/10.4236/arsci.2013.13004

Abstract:
Objectives: The currently available methods for rapid prenatal diagnosis of common chromosomal aneuploidies are either Interphase-Fluorescence in Situ Hybridisation (I-FISH) or Quanti- tative Fluorescent Polymerase Chain Reaction (QF-PCR). QF-PCR represents a rapid, high throughput, cost-effective alternative for Interphase-FISH. The objective of the study was to evaluate the performance of QF-PCR, as a molecular-based technique for the detection of chromosome 21, 18 and 13 copy numbers. Study design: A retrospective cohort of 163 samples referred for screening of common chromosomal aneuploidies was blindly tested for chromosome 21, 18 and 13 copy numbers using QF-PCR and the results were compared with those of conventional cytogenetic analysis. Results: QF-PCR demonstrated optimal sensitivity and specificity (100%) for non mosaic trisomies. QF-PCR was able to consistently detect maternal cell contamination and mosaic trisomies when the trisomic cell line was present at an adequate level (23% or more). However, QF-PCR was unable to detect chromosomal rearrangements for which the primers were not designed. Conclusion: QF- PCR proved its superior performance as a molecular-based method for autosomal aneuploidy detection concerning both sensitivity and specificity.
Advances in Reproductive Sciences, Volume 01, pp 15-20; https://doi.org/10.4236/arsci.2013.13003

Abstract:
164 previous sperm donors completed an online survey regarding health and genetic experiences and views. Results highlight that donors desire to act responsibly with recruiting facilities is not always possible. Objective: Obtaining the views and experiences of sperm donors regarding health and genetic matters. Design: Online survey. Setting: Not applicable. Participants: 164 previous sperm donors. Interventions: Not applicable. Main outcome measures: Views and experiences on health and genetic issues. Results: A variety of approaches are adopted by recruiting facilities in regard to selection and post-donation factors. The vast majority of donors said they had not been contacted by the facility they donated at to update their medical information, while almost one quarter of donors indicated that a health or genetic risk factor had occurred. A great majority of donors felt that they had not received any education or counselling on the potential curiosities of donor conceived people. Donors sought to be honest and open with staff but often found there were difficulties in doing so. Conclusions: Overall, donors indicate that they see donating as involving responsibilities to the offspring and families. The study highlights however that their ability to act responsibly is limited by some of the interactions or lack of them with the facilities where they donated. Implications for recruiting facilities need to be considered.
Ermanno Greco, , Alessandra Ruberti, Daniela Zavaglia,
Advances in Reproductive Sciences, Volume 01, pp 7-14; https://doi.org/10.4236/arsci.2013.12002

Abstract:
Preimplantation genetic diagnosis allows to test the genetic status of embryos prior to implantation. In order to obtain genetic material, on which carry out a genetic diagnosis, a procedure named embryo biopsy is required. In the last two decades, embryo biopsy at the cleavage stage has been the mostly performed procedure. However, recently, alternative methods allowing the retrieval of a larger number of cells (blastocyst stage biopsy), or representing a valid alternative to overcome ethical issues (polar body biopsy) have obtained increasing consensus. This article reviews different methods of embryo biopsy and points out their positive and negative aspects.
Bing Bing Wang$Family Planning Research Institute, , Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Advances in Reproductive Sciences, Volume 01, pp 1-5; https://doi.org/10.4236/arsci.2013.11001

Abstract:
Introduction: Non-invasive methods that can predict sperm recovery in patients with non-obstructive azoospermia (NOA) arouse interest of clinicians. The aim of this study was to evaluate the predictive value of sperm retrieval in NOA. Materials and Methods: In the retrospective study, fine needle aspiration (FNA) was performed on 306 patients with NOA at the department of andrology, Wuhan Tongji Reproductive Medical Hospital. Inhibin B, FSH and LH plasma levels were analyzed and sperms were retrieved in 67 of 306 cases (21.89%). Results: There were statistically significant differences between successful and unsuccessful sperm recoverygroups in terms of mean serum inhibin B, FSH and LH levels. The areas under the curve (AUC) of inhibin B, FSH and LH were 0.696, 0.729 and 0.747 respectively, and the AUC for the combined value of the three hormones is 0.832. The cut-off points were 27.31 pg/ml, 11.68 IU/L and 4.04 IU/L for inhibin B, FSH and LH respectively. Conclusions: This study suggests that the combined evaluation of inhibin B, FSH and LH is a more effective predictor for successful sperm retrieval in patients with NOA before decision making of an invasive procedure than any single factor.
Ehab A. M. Elagab, Majed Alshahrani, Amin A. A. Elbadawi, Abdullah I. Aedh, Ahmed M. Osman, Hanadi M. Osman
Advances in Reproductive Sciences, Volume 10, pp 73-90; https://doi.org/10.4236/arsci.2022.103008

Abstract:
Pregnancy is a complex physiological process involving several interconnected systems. Many researchers were concerned that the formation of a fetus with different genetic components may contradict the normal state of immunity, which attempts to reject and fight foreign bodies. This piqued the interest of biologists and immunologists, who set out to discover the immune system’s composition and mode of response in the uterus. According to several studies, natural killer (NK) cells are present in a significant percentage that differs from what is seen in peripheral blood. As a result, several scientific studies have been conducted on uterine NK cells, investigating their types, characteristics, receptors, secretions, and interactions with the surrounding environment. Research has also indicated the capacity of uterine NK cells to strike a balance between eradicating uterine infections and effectively contributing to different phases of pregnancy. Various studies have shown that NK cell activity is intimately related to the success or failure of pregnancy. In this review, we describe the uterine NK cell subtypes; decidual (dNK) cells and endometrial NK cells (eNK) cells and their important role during different phases of pregnancy.
Takang Ako Wiliiam, Epey Felicite Ngale, Dobgima Walter Pisoh, Halle-Ekane Gregory
Advances in Reproductive Sciences, Volume 10, pp 49-58; https://doi.org/10.4236/arsci.2022.102006

Abstract:
Background: Armed conflict increases the occurrence of adverse obstetrical outcomes especially in low and middle-income countries. However, there is paucity of data on obstetrical outcomes in the South-West and North-West Regions of Cameroon since the onset of the socio-political instability. Objectives: Our aim was to evaluate obstetrical outcomes in the Buea and Bamenda Regional Hospitals, Cameroon during the period of socio-political instability. Methods: A hospital-based retrospective cohort study was carried out at the aforementioned hospitals. Data was collected from case notes of pregnant women before the period of socio-political instability (from January 1, 2014 to December 31, 2016) and during the period of socio-political instability (from January 1, 2017 to October 31, 2019). The Chi square and Fischer’s exact test were used to compare categorical variables where appropriate and modeled into multivariate analysis. A p-value Results: The mean maternal age was 27.09 (±5.25) years, before and during the conflict. The mean weight of neonates (regardless of gestational age) during the conflict was significantly higher [3.28 (±0.65) kg] compared to that before the conflict [3.21 ± (0.52) kg] (p yrs [OR = 1.97; CI (1.16 - 3.37), p = 0.01], and delivery during the period of socio-political instability [OR = 1.97; CI (1.16 - 3.37)], p = 0.01 and [OR = 1.89; CI (1.53 - 2.33)], p Conclusion: This study identifies increased incidence of adverse maternal outcomes in mothers exposed to socio-political instability.
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