Asian Pacific Journal of Reproduction

211-219

Authors: Sahar Rostami, Farzane Fereidouni, Arezoo Maleki-Hajiagha, Mohadese Motaharinejad, Somayye Majidi,Fardin Amidi

Objective: To present an overview of the adverse effects of water pipe smoking on various aspects of reproduction and perinatal complications, covering all the most relevant studies, from descriptive findings to clinical trials. Methods: We reviewed the literature and included full publications in English provided by international biomedical databases, including PubMed, Science Direct, EBSCO, Scopus, and Google Scholar, and Cochrane Library over the last 38 years (May 1985 to June 2023). Search terms (Water pipe, Narghile, Shisha, Dokha, etc., and Reproduction, Fertility, etc.) were adopted from Medical Subheading (MeSH) and Boolean operators were utilized to improve sensitivity. Results: 133 Papers were identified in the initial search, of which 29 were excluded due to duplication. Eliminating search overlap and irrelevant records by reviewing titles and abstracts reduced 42 papers. 62 Full-publication articles met the inclusion criteria. We summarized the effects of waterpipe smoke exposure on reproductive health based on three main categories: male and female fertility, fetal and neonatal outcomes, and pregnancy complications. Conclusions: Water pipe smoking has potential adverse effects on different aspects of human reproductive health, including semen parameters, male and female fertility, and fetal and neonatal health, and contributes to many maternal complications and morbidities.

229-238

Authors: Amal M. Aboelmaaty, Mohamed S. Kotp, Aya M. Fadl, Elshymaa A. Abdelnaby, Islam E. El-Seadawy, Hossam R. El-Sherbiny

Objective: To select the appropriate concentrations of methanolic pomegranate extract supplemented in rams’ semen extender for obtaining the best-cryopreserved semen quality. Methods: Tris-based semen extender was supplemented with 0.0, 0.40, 0.48, and 0.56 mg/mL pomegranate peel methanolic extract to extend semen collected from five native rams twice weekly for two months (n=80). Pooled (n=16) post-thaw semen characteristics were determined. Thawed seminal plasma of all supplemented and control groups were used to measure malondialdehyde (MDA), nitric oxide (NO), glutathione peroxidase (GPx), superoxide dismutase (SOD), ascorbic acid, zinc, copper, total cholesterol, low-density lipoproteins (LDL), lactate dehydrogenase (LDH), and alkaline phosphatase (ALP). Results: The supplementation of Tris-based semen extender with 0.48 mg/mL semen extender resulted in the highest post-thaw sperm total motility (P<0.001), sperm progressive motility (P<0.001), live sperm (P<0.001), sperm plasma membrane integrity (P<0.001), acrosome integrity (P<0.001), SOD (P<0.05), zinc (P<0.001), total cholesterol (P<0.001), and LDL (P<0.001) with the lowest percentage of abnormal sperm morphology (P<0.001), the lowest lipid peroxidation (MDA, P<0.01), ascorbic acid (P>0.05), and LDH (P>0.05). Conclusions: Pomegranate peel methanolic extract 0.48 mg/mL supplemented to Tris-based semen extender of rams is the best enrichment in preserving the sperm post-thaw characteristics via improving biochemical profiles and antioxidant capacity.

155-161

Authors: Yahia A. Amin

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may have harmful effects on expectant moms, labor, and newborns born to infected mothers. There is a risk of the initiation of pregnancy with infection. Even if the gametes are non-infected, pregnancies could be exposed later for infection by coronavirus. Investigations of COVID-19 during pregnancy highlighted the non-transmission or surprising transmission of SARS-CoV-2 to the offspring. However, other studies have exhibited the potential mother-to-fetus transmission. In this way, unanswered concerns about SARS-CoV-2 fetal transmission and the particular interface(s) controlling its pathogenesis throughout pregnancy persist. This review focuses on the potential effects of SARS-CoV-2 on vertical transmission, as well as the influence of the virus on pregnancy and placenta.

170-181

Authors: Damilare Emmanuel Rotimi, Oluyomi Stephen Adeyemi

Objective: To assess the potential of plantain-based diet in modulating testicular toxicities in rats exposed to atrazine. Methods: The plantain-based diet at 50%, 25% and 12.5% were prepared from the basal diet by substituting the corn starch with plantain fruit pulp flour at different percentages. Wistar rats were fed plantain-based diet in varying concentrations ranging from 12.5% to 50% of the basal diet for 21 days before or after atrazine treatment in a two-phase experiment: preventive and therapeutic phases. The therapeutic model (n=35) had seven groups with 5 rats each, including the control, atrazine, atrazine recovery, atrazine plus plantain-based diet 50%, 25%, 12.5%, and atrazine plus quercetin groups. The preventive model (n=30) had six groups of 5 rats, consisting of the control, atrazine, 50%, 25%, 12.5% plantain-based diet plus atrazine, and quercetin plus atrazine groups. Gonadal hormones (testosterone, luteinizing hormone and follicle-stimulating hormone), sperm parameters (sperm motility, viability, morphology and concentration), and testicular function indices (protein, cholesterol, glycogen, acid phosphatase, alkaline phosphatase and lactate dehydrogenase) were measured. Results: The gonadal hormones, sperm characteristics, and testicular function indices of the rat testis decreased significantly in the atrazine group alongside degeneration of the histoarchitecture. However, plantain-based diet restored the gonadal hormone concentrations, semen parameters, and testicular function indices in both the preventive and therapeutic models. Conclusions: Treatment with plantain-based diet protects against rat testicular toxicity caused by atrazine via the modulation of gonadal hormones, sperm quality, testicular function index as well as histoarchitecture of rat testes.

194-200

Authors: Isam B. Sharum

Objective: To determine the ovine ovarian histomorphology and follicular staging at various age periods in Awassi breed. Methods: Ovaries were collected from prenatal fetuses [gestational age (95±5) days], neonatal (day 0), and prepubertal ewe lambs (two and four months of age); each age group included six animals. Ovaries (n=12, each group) were dissected and processed for hematoxylin and eosin staining. Stained sections (n=24, each group) were imaged and utilized for histomorphology assessment, follicle measurement, and classification. Results: Prenatal ovaries were mainly enriched with primordial follicles accompanied by a lower proportion of primary follicles. In addition to primordial and primary follicles, neonatal ovaries demonstrated a proportion of centrally located multilayered and antral follicles. In comparison with neonatal ovaries, the proportion of multilayered and antral follicles was significantly higher in the ovaries of two-month-old lambs; conversely, the proportion of peripherally situated primordial follicles dramatically declined compared to that of earlier age of lamb. Although there was no statistical variation in the sizes of primordial follicles across groups, the mean diameter of the primary follicle in the prenatal ovaries was substantially smaller than in postnatal ovaries. Compared to the neonatal ovaries, the size of the multilayered and antral follicles in the prepubertal ovaries was substantially larger. Conclusions: The earliest follicular developmental stages were established prenatally whereas the advanced growth stages started in the neonatal period and greatly increased in the prepubertal period.

109-116

Authors: Tuvshinbayar Negdel, Arigbukh Enkhbat, Badrakh Munkhbayar, Khantushig Bilegsuren, Ariunaa Ganbold, Khuderchuluun Nanjid, Carol W Readhead, Lkhagva-Ochir Erkhembaatar, Erkhembaatar Tuduvdorj, Munkhzol Malchinkhuu, Odkhuu Enkhtaivan

Objective: To investigate and analyze the prevalence and risk factors of infertility in a Mongolian population. Methods: We conducted a population-based cross-sectional study between September 2016 and November 2021. Our study population of 1 919 participants consisted of residents of Ulaanbaatar city and four regions of Mongolia. A pretested standardized and structured questionnaire was used to gather data from the participants. Our questionnaire comprised categories influencing infertility, such as socioeconomic status, lifestyle factors, health, reproductive history, present status, and sexual function. In addition, trained staff conducted face-to-face interviews with the participants. Results: Our study showed an infertility incidence of 8.2%, with primary infertility at 2.76% and secondary infertility at 5.47%. Compared with the urban area of Ulaanbaatar, the prevalence of infertility was significantly higher amongst the rural population (P<0.001). Risk factors of infertility included advanced age (35- 39 years, OR 1.8, 95% CI 1.99-6.55; >40 years, OR 2.1, 95% CI 2.62-8.55), living rural region (aOR 2.4, 95% CI 1.62-3.69), alcohol consumption (aOR 1.6, 95% CI 1.11-2.44), chronic diseases (aOR 1.6, 95% CI 1.20-2.38), reproductive disease (aOR 2.6, 95% CI 1.86-3.88), gynecological operative history (aOR 2.1, 95% CI 1.38- 3.21), ovarian cyst (aOR 4.2, 95% CI 2.70-6.40), gonorrhea (aOR 2.4, 95% CI 1.01-6.16), non-malignant uterine cancer (aOR 2.9, 95% CI 1.40-6.70), and endometriosis (aOR 4.7, 95% CI 1.41-15.62). Conclusions: In Mongolia, the average infertility rate is 8.2%, similar to the average worldwide and is significantly higher in rural communities. Our study shows the most significant risk factors for infertility are age, alcohol consumption, and rural living. In addition, an unfavorable gynecological history and some diseases also pose a risk to fertility.

124-130

Authors: Hafsat Yazeed Idris, Adewale Ayodeji Adeyeye, Emmanuel Busayo Ibitoye, Millicent Ladi Umaru

Objective: To determine the effects of a glyphosate-based herbicide on the oestrous cycle of rats. Methods: Fifteen adult Wistar rats were randomly divided into three groups. Group A served as the control group, while groups B and C received 250 and 500 mg/kg of glyphosate-based herbicide orally for five oestrous cycles, respectively. Stages of oestrous cycle, oestrous cycle index, length of cycle, oestrous cycle ratio, serum estradiol and progesterone levels were determined. Results: The proestrus and oestrus stages of the glyphosate- based herbicide groups increased significantly (P<0.05), although proestrus in group C was not significantly different from the control group. There was a significant decrease in the metestrus and diestrus of the glyphosate-based herbicide groups (P<0.05). The oestrous cycle index of the glyphosate-based herbicide treated groups was altered; this was characterized by an increase in the oestrous index and a decrease in the metestrus and diestrus indexes. The proestrus index of group B increased, while that of group C decreased. The length of the cycle of the glyphosate-based herbicide groups significantly decreased from the 1st and 3rd week till the end of the study in groups B and C, respectively (P<0.05). There was a significant increase in the oestrous cycle ratio of the glyphosate-based herbicide groups compared to the control group (P<0.05). Though the estradiol and progesterone levels of the glyphosate-based herbicide groups increased and decreased, respectively, they were not significantly different from the control group. Conclusions: Glyphosate-based herbicide at the doses of 250 and 500 mg/kg can alter the pattern of the oestrous cycle in rats.

144-146

Authors: Mete Isikoglu

We may realign our priorities by focusing on the efficient, simple, and cost-effective C-IVF technique and reconsider spending our efforts and sources for struggling with mostly unproven add-ons. In other words, instead of overusing ICSI in unnecessary indications and spending precious time and money with unproven add-on techniques, it will be more prudent to switch back to C-IVF which may contribute better to the effort of achieving higher success rates and safer long-term outcomes for ART individuals. Thus, for non-male factor infertility cases, sooner or later, IVF should be placed again in the right position it deserves.

52-57

Authors: Jyoti Sharma, Nitin Kumar Joshi, Yogesh Kumar Jain, Kuldeep Singh, Pankaj Bhardwaj

Objective: To assess the utilization of reproductive health services in urban slum of Jodhpur city, India. Methods: A community based cross-sectional study was conducted in an urban slums of Jodhpur city amongst 300 married women of reproductive age between March and June 2021. Semi-structured questionnaire was used to gather demographic data and information about utilization of antenatal care (ANC) services, delivery and post-partum services. Results: The majority of females were aged less than 25 years (n=195; 65.0%), married after 18 years (n=240; 80%), living in extended families (n=265; 88.3%) and with monthly family income less than 10 000 rupees (n=182; 60.7%). Statistically significant associations were found between ≥4 ANC visits and educational level of secondary and above (OR 2.47, 95% CI 1.03–6.28; P=0.04), older age (OR 15.70, 95% CI 14.87–16.54 for women aged 26- 35 years, OR 16.14, 95% CI 12.12–20.01 for women aged ≥36 years; P<0.01), and backward and general castes (OR 15.91, 95% CI 13.57–17.85 for backward caste and OR 8.11, 95% CI 8.07–8.26 for general category of caste; P<0.01). Seven percent of females had undergone parturition. Older age was associated with higher risks of postpartum complications (OR 1.06, 95% CI 1.01–1.57 for women aged 26-35 years, OR 3.56, 95% CI 1.29–4.69 for women aged ≥36 years; P<0.01). In addition, risks of postpartum complications were associated with backward and general castes (OR 1.69, 95% CI 1.34–2.13 for backward classes and OR 5.01, 95% CI 4.29–5.31 for general category castes; P<0.01), and more than 4 ANC visits (OR 0.20, 95% CI 0.09–0.34; P<0.01). Conclusions: More frequent ANC visits are associated with a lower risk of postpartum complications. Furthermore, a high utilization of reproductive health services represents good implementation of reproductive and child health programme at the peripheral level resulting in a stark rise in maternal health indicators in the state of Rajasthan.

64-70

Authors: Maryam Shirmohamadi, Mehri Mashayekhy, Iraj Alipourfard, Javad Fazeli, Nasrin Ghasemi

Objective: To elucidate the possible role of unfractionated heparin in patients with failed repeated in in vitro fertilization and embryo transfer (IVF-ET) and thrombophilia. Methods: This case control study evaluated the efficacy of the unfractionated heparin in increasing the pregnancy and implantation ratio in women with recurrent IVF-ET failures. Eighty-six women received in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) with a record of three or more previous IVF-ET failures. Participants were randomly distributed into two groups. Group A (n=43) received unfractionated heparin 5 000 IU twice daily, and group B (n=43) did not take any antithrombotic drugs. Coagulation abnormalities such as factor V Leiden (FVL) mutation, methylene tetra hydro folate reductase (MTHFR) mutation and prothrombin mutation (FII) were evaluated. Age, body mass index, basal follicular stimulating hormone, basal estradiol, duration of infertility, and number of IVF-ET failures were compared between two groups. Results: 45.0% and 17.4% of women were pregnant with and without MTHFR and prothrombin mutation, respectively, when they received unfractionated heparin treatment. The implantation rate was more in group A (12.5%) than group B (4.3%) and differences in the fertilization rate of the two groups were observed (27.7% vs. 35.9%). The clinical pregnancy rate per cycle was remarkably more in group A (30.2%) than group B (14.0%). Conclusions: Heparin is a safe and valuable treatment for patients with repeated IVF-ET failures. The clinical pregnancy and implantation rates are higher in the heparin-treated group in contrast with the control group.

81-89

Authors: Olugbemi T Olaniyan, Ayobami Dare, Charles O. Adetunji, Gloria E. Okotie, Joseph B. Dare, Bosun M. Adigun, Femi Adebayo

Objective: To investigate the protective effect of vitamin E in dehydroepiandrosterone (DHEA)-induced polycystic ovary in rats. Methods: Premature female Wistar rats were randomly allocated into four groups, with 7 rats in each group. Group I received corn oil (vehicle) and served as the control group; group II received 0.2 mL of 0.06 mg/g DHEA in corn oil; group III received 200 mg/kg vitamin E; group IV received DHEA plus vitamin E. All treatments lasted for 15 days, with DHEA administered subcutaneously, while vitamin E and corn oil were administered orally. After the experiment, serum samples and ovaries were harvested for biochemical, immunohistochemical, hormonal, and histological analysis. The ovarian mRNA expression of androgen receptor was analyzed by reverse transcriptase quantitative polymerase chain reaction (qPCR). Results: The antioxidant and metabolic enzyme activity significantly decreased in the DHEA-treated rats compared to the control rats (P<0.05). Administration of vitamin E to DHEA- treated rats significantly decreased cytokines and malondialdehyde compared to the DHEA-treated rats. The histological analysis showed reduced atretic and cystic ovaries, increased E-cadherin and Bcl-2 expression, and reduced expression of Bax in the DHEA- treated rats co-treated with vitamin E. The mRNA expression of androgen receptor was upregulated in the DHEA-treated rats compared to the control rats. Conclusions: Vitamin E ameliorates the hyperandrogenic effect of DHEA-induced polycystic ovaries via metabolic, antioxidant, and anti-apoptotic pathways.

10-15

Authors: Muhammed Asif, Asha S. Vijay, Maheshwari, Syed Fyzullah, Usha Rani, Swathi R, Damodara Gowda KM

Objective: To investigate the association between age and semen parameters among male partners of subfertile couples. Methods: This retrospective study analyzed the semen of 1 523 infertile men aged 26 to 50 years. Data were extracted from GarbhaGudi IVF Centre database from January 2019 to September 2020. The basic semen parameters were interpreted according to the WHO manual 2021, 6th edition. Semen parameters in different age groups were compared. Results: Total and progressive motile sperms were significantly higher in the age group of 26-30 years compared to other age groups (P<0.05). Normal sperm count was significantly higher in the age group of 26-30 years compared to the age groups of 41-45 years and >46 years (P=0.001). However, sperm head defects, neck and midpiece defects, tail defects, and cytoplasmic droplets showed statistically insignificant difference in all the age groups (P>0.05). Semen viscosity showed no statistical difference in all the age groups compared to the reference age group of 26 to 30 years. Conclusions: Higher age can lead to a significant decrease in normal sperms and motility in subfertile men. Hence, male partner age should be considered as one of the major determining factors for reproductive outcomes.

23-34

Authors: Sunita Shailajan, Sasikumar Menon, Swati Singh,Yugandhara Patil

Objective: To investigate the potential activity of novel herbal combination and novel herbal formulation (syrup) in female Sprague Dawley rats with letrozole-induced polycystic ovary syndrome (PCOS). Methods: Forty-two rats were randomly divided into seven groups with six rats in each group. Group 1 received 0.5% carboxy methylcellulose orally for 37 days and served as the normal control group. Group 2 was orally administered with letrozole of 1 mg/kg for 21 days and served as the PCOS induction group without treatment. Group 3 to 7 were administered with letrozole of 1 mg/kg for 21 days orally to induce PCOS, and then respectively received clomiphene citrate at 1 mg/kg, 100 and 200 mg/kg of novel herbal combination, 200 mg/kg of novel herbal formulation (syrup), and 400 mg/kg of marketed formulation of Pushyanuga churna, once daily for 15 days. Effects of the novel herbal combination and its syrup formulation were evaluated on the hormonal profile, the levels of antioxidants, the lipid profile and on the ovarian morphology, using letrozole-induced PCOS model in rats. Results: Letrozole caused alterations in hormonal levels and lipid levels similar to PCOS and ovarian histology showed presence of ovarian cysts confirming the induction of PCOS in rats. On treatment with the novel herbal combination and its syrup formulation in PCOS-induced rats, the altered hormonal and lipid profiles showed significant recovery to normal levels. Ovarian histology confirmed the restoration of folliculogenesis in the PCOS-induced rats. The treatment with the syrup formulation of novel herbal combination was found to be more effective than novel herbal combination and showed better recovery in various parameters evaluated. The results of the study, however, suggested that treatment with novel herbal combination and its syrup formulation provided minimal protection against oxidative stress caused due to the induction of PCOS. Conclusions: The integrated approach for management of PCOS is to counterbalance the limitations associated with modern therapy. Both the novel herbal combination and the syrup formulation of novel herbal combination show efficacy in the management of PCOS in rats and restore folliculogenesis in the ovary. The syrup formulation of novel herbal combination is most effective in the management of PCOS and shows potential to be developed as an adjuvant therapeutic agent.

42-48

Authors: Efigênia B. Cordeiro, Bianca R. Silva, Laís R. F. M. Paulino, Pedro A. A. Barroso, Laryssa G. Barrozo, Miguel F. de Lima Neto, José R. V. Silva

Objective: To investigate the effects of different concentrations of N-acetylcysteine on follicular growth and morphology, as well as on viability, levels of reactive oxygen species (ROS) and meiotic progression of oocytes from in vitro cultured bovine early antral follicles. Methods: Isolated early antral follicles (about 500 μm) were cultured in TCM-199 + alone or supplemented with 1.0, 5.0 or 25.0 mM N-acetylcysteine at 38.5℃ with 5% CO2 for 8 days. Follicle diameters were evaluated at day 0, 4 and 8 of culture. At the end of culture, the levels of ROS, chromatin configuration and viability (calcein-AM and ethidium homodimer-1 staining) were investigated in the cumulus-oocyte complexes. Comparisons of follicle diameters between treatments were performed. Data on percentages of morphologically normal follicles, growth rates and chromatin configuration in different treatments were compared. Results: An increase in follicular diameters after culture in all treatments was observed, except for follicles cultured with 25.0 mM N-acetylcysteine. Fluorescence microscopy showed that oocytes cultured in all treatments were stained positively with calcein- AM, and that 5.0 mM N-acetylcysteine reduced fluorescence for ethidium homodimer-1. Intracellular levels of ROS in oocytes from follicles cultured with 1.0 mM N-acetylcysteine showed a significant reduction compared to other treatments. The presence of N-acetylcysteine in culture medium did not influence the rates of oocyte at the germinal vesicle stage. Conclusions: N-acetylcysteine at concentrations of 1.0 and 5.0 mM reduces ROS levels and staining for ethidium homodimer-1 in in vitro cultured follicles, respectively, while 25.0 mM N-acetylcysteine decreases follicular growth and the percentages of continuously growing follicles.