International Journal of Fertility and Sterility

70-75

Authors: Ramyar Rahimi Darehbagh, Behzad Khalafi, Azra Allahveisi, Mehrdad Habiby

Infertility is one of the major problems faced in medicine. There are numerous factors that play a role in infertility. For example, numerous studies mention the impact of the quantity and quality of mitochondria in sexual gametes. This is a narrative review of the effects of the mitochondrial genome on fertility. We searched the PubMed, Science Direct, SID, Google Scholar, and Scopus databases for articles related to “Fertility, Infertility, Miscarriage, Mitochondria, Sperm, mtDNA, Oocytes” and other synonymous keywords from 2000 to 2020. The mitochondrial genome affects infertility in both male and female gametes; in sperm, it mainly releases free radicals. In the oocyte, a mutation in this genome can affect the amount of energy required after fertilisation, leading to gestation failure. In both cases, infertile cells have substantially less mitochondrial DNA (mtDNA) copies. The effects of mtDNA on gamete fertility occur via changes in oxidative phosphorylation and cellular energy production. Also, a reduction in the number of mtDNA copies is directly associated with sex cell infertility. Therefore, evaluation of the mitochondrial genome can be an excellent diagnostic option for couples who have children with neonatal disorders, infertile couples who seek assisted reproductive treatment, and those in whom assisted reproductive techniques have failed.

85-89

Authors: Jacob Göhring, Maja Drewes, Matthias Kalder, Karel Kostev

Background: The aim of this study was to investigate whether the prevalence and the therapy patterns of endometriosis differ in 2010 and 2019. Materials and Methods: This retrospective cross-sectional study was based on the data from the IQVIA Disease Analyzer database and included women with at least one visit to one of the 136 private gynecologist practices in Germany in 2010 or 2019. The prevalence of endometriosis as well as prevalence of each endometriosis therapy such as Dienogest, other Progestins than Dienogest, and Gonadotropin-Releasing Hormones, was calculated in both years. Results: The present study included 346,249 women documented in 2010 and 343,486 women documented in 2019. The prevalence of endometriosis increased from 0.53% in 2010 to 0.66% in 2019 (P<0.001). The proportion of endometriosis patients treated with Dienogest increased significantly between 2010 and 2019 (18.1 vs. 35.0%). The proportion of women prescribed other Progestins than Dienogest has not significantly changed between 2010 and 2019 (8.4 vs. 8.3%). Gonadotropin-releasing hormones were prescribed only rarely in both 2010 and 2019, with a significant decrease in prescriptions between these two years (3.7 vs. 2.0%). Conclusion: There were significant changes in the prevalence and medical therapeutic patterns of endometriosis in 2010 versus 2019 reflecting changes in therapy guidelines and possibly in diagnostic methods.

95-101

Authors: Faezeh Nazarzadeh, Mohammad Hossein Ahmadi, Soheila Ansaripour, Mohammad Niakan, Iman Pouladi

Background: Mycoplasma hominis (M. hominis) is an important cause of bacterial infections of the genital tract. Macrolides are the first selective agents used to treat mycoplasma infections. However, widespread use of macrolides has led to a rapid and global emergence of macrolide-resistant strains. We evaluated macrolide resistance in M. hominis isolated from endocervical specimens of patients who referred to Ibn Sina Infertility Centre in Tehran, Iran. Materials and Methods: In this cross-sectional descriptive-analytical study, 160 samples of Dacron endocervix swabs (80 infertile patient samples and 80 healthy controls) were collected and transferred to the laboratory. All samples were cultured in liquid pleuropneumonia-like organisms (PPLO) broth and PPLO agar solid media. After culturing and genome extraction, polymerase chain reaction (PCR) was performed using specific primers. Then, minimum inhibitory concentration (MIC) was obtained using the broth microdilution method. The MIC was recorded and reported for all samples positive for M. hominis against erythromycin. Results: From the 160 endocervical specimens cultured in PPLO agar medium, 19 cases (23.75%) were positive. A total of 35 cases (42.5%) were positive using specific primers of M. hominis species. MIC results from all samples positive for M. hominis were measured against erythromycin. All of the M. hominis samples were resistant to erythromycin. Conclusion: The results of the present study showed that a significant percentage of infertile women were infected with M. hominis. Also, MIC results from the broth microdilution method indicated that all strains positive for M. hominis were also resistant to erythromycin.

108-114

Authors: Areepan Sophonsritsuk, Nipawan Attawattanakul, Morakot Sroyraya, Sineenart Songkoomkrong, Wanwisa Waiyaput, Kanthanadon Dittharot, Tharintorn Chansoon, Artit Jinawath, Yada Tingthanatikul

Background: Dysregulation of the immune response contribute to a significant role in endometriosis. This research examined macrophages and natural killer (NK) cells numbers in endometriotic lesions and their association with the different lesion colors: red, black, and white. To investigate the amount of the CD68 and CD56 in eutopic endometrium and different type of the endometriotic lesions. Materials and Methods: A cross-sectional analytic study was conducted. Women suspected endometriosis requiring laparoscopic surgery between July 2016 and January 2017 were recruited. Their lesions were classified as red, black, or white and these lesions were excised by standard laparoscopic surgery. Twenty-four endometriotic lesions from each color group were obtained from 45 women who met the inclusion criteria. One type of lesion was collected from 25 women. Two different lesion types and three-color lesion types were collected from the same women in 13 and 7 subjects, respectively. Immunohistochemistry staining with anti-human mouse cluster of differentiation (CD) 68 monoclonal antibody for macrophages and mouse anti-human CD56 monoclonal antibody for NK cells were performed. Results: The number of CD68 macrophages in red lesions was higher than in black and white lesions [median (25th-75th percentile); 10 (5-19.4), 0 (0-6.9), 0 (0-2.5) cells per mm2, respectively, adjusted P=0.001 for red vs. black lesions and red vs. white lesions, and adjusted P=1.000 for black and white lesions]. The number of CD56 NK cells was not significantly different among red, black, and white lesions [median (25th-75th percentile; 5 (2-16.5), 3.8 (0-14.4), 1.3 (0-6.9) respectively, adjusted P=1.000 for red vs. black lesions and black vs. white lesions, and adjusted P=0.617 for red vs. white lesions]. Conclusion: The dynamic changes in the immune cells in ectopic endometrium were specific to the macrophages but not to the NK cells, as demonstrated by the highest number of CD68 macrophages in the red lesion, the earliest established ectopic endometrium. NK cells in endometriosis may have a role in the uterus.

122-127

Authors: Alireza Panahi, Sina Mirza Ahmadi, Golnaz Asaadi Tehrani

Background: Improving sperm motility results in increasing the success of a treatment cycle. Recently, sperm RNA has been used for diagnostic purposes such as whole seminal fluid, sperm analysis, and sperm quality test in patients undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI). SPATA18-P53 pathway is considered an essential pathway related to sperm mitochondria, which controls mitochondrial quality by eliminating its oxidative proteins. Oxidative stress may decrease sperm motility and affect sperm quality negatively due to an increase in P53 expression. SPATA18 protein is found in satellite fibers related to outer dense fibers in the middle piece of sperm. The downregulation of SPATA18 in the asthenospermia group can represent this gene’s critical function in sperm motility and fertility. The present study aimed to assess the relationship between SPATA18 and P53 gene expression in sperm cells obtained from normospermia and asthenospermia. Materials and Methods: In this case-control study, the quantitative real-time polymerase chain reaction (RT-PCR) technique was used to measure the SPATA18 and P53 gene expression level in sperm samples collected from 21 patients and 63 healthy individuals. Further, the sperm DNA fragmentation assay (SDFA) kit was applied to determine the relative apoptosis level in cells and evaluate the biochemical information related to the patients’ sperm samples. Furthermore, all the participants completed the consent form, and the ethics committee confirmed the study. Results: Based on the results, the P53 and SPATA18 gene expression levels in most of the samples, in which motility was less than 40%, increased and decreased (P≤0.001), respectively. Conclusion: The SPATA18 and P53 gene expression levels increased and decreased in the asthenospermic patients, respectively, compared to the control group. Thus, the P53 and SPATA18 expression levels can be used as an appropriate marker for diagnosing sperm motility in males.