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Background: The recognized role of Anti-Müllerian hormone (AMH) as a marker for women's biological age and ovarian reserve prompts debate on its efficacy in predicting oocyte quality during IVF/ICSI. Recent findings challenging this view compelled us to conduct this study to examine the correlation between AMH levels and quantity/quality of oocytes in IVF/ICSI procedures. Methods: The data were collected retrospectively from the medical records of 320 women between 25-42 years old. The included patients were divided into two groups: the high AMH group (>1.1 ng/ml) and the low AMH (=<1.1 ng/ml) group. The high AMH group comprised 213 patients, while the low AMH group consisted of 107 patients. Spearman's correlation coefficient and Multinomial logistic regression were computed to assess the relationships between different variables. Results: Significant positive correlations were detected between AMH level and the number of aspirated follicles (rho=0.741, p<0.001), retrieved oocytes (rho=0.659, p<0.001), M2 oocytes (rho=0.624, p<0.001), grade A embryos (rho=0.419, p<0.001), and grade AB embryos (rho=0.446, p<0.001. In contrast, AMH levels had negative associations with the number and duration of cycles (p<0.05). AMH emerged as a statistically significant independent predictor of the number of M2 oocytes. Conclusions: Serum AMH level could represent the quantity and quality of oocytes following IVF/ICSI treatments. Future studies should aim to delve deeper into the correlations between AMH levels and both the quality and quantity of embryos. Additionally, it would be beneficial to consider the influence of sperm factors, as well as assess pregnancy rates.

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Background: Considering the considerable influence of the vaginal microbiome on endometrial receptivity and embryo implantation, we hypothesized that cases of recurrent implantation failure (RIF) might benefit from the intravaginal probiotic administration. Objective: Evaluation of the effects of intravaginal probiotic administration before frozen embryo transfer (FET) on the rates of pregnancy and the status of vaginal lactobacillary flora in cases of RIF. Materials and Methods: This was a randomized, parallel-group, clinical trial conducted at an infertility clinic in Tehran, Iran between January 2021 and September 2022. A total of 166 reproductive-aged women with a history of unexplained RIF were randomly assigned to either the probiotic group or the control group (n = 83/each group). The probiotic group received intravaginal probiotics (LactoVagⓇ) daily for 2 wk from the second day of the menstrual cycle along with the routine treatment of FET. The control group received only the routine treatment of FET. The primary outcome was the chemical pregnancy rate, and the secondary outcomes were the clinical pregnancy rate and the status of vaginal lactobacillary flora. Results: A total of 163 participants were included in the final analysis. The probiotic group had a slightly higher chemical pregnancy rate than the control group (39.02% vs. 33.33%), but the difference was not statistically significant (risk ratio: 1.71, 95% CI: 0.77-1.76; p = 0.449). The clinical pregnancy rate was also non-significantly higher in the probiotic group than the control group (37.80% vs. 33.33%; RR: 1.14, 95% CI: 0.76-1.74; p = 0.623). Conclusion: Intravaginal probiotic administration did not significantly improve the pregnancy rates in RIF cases undergoing FET. Further studies are needed to explore the optimal dose, duration, and timing of probiotic administration, as well as the mechanisms of action and the potential adverse effects of probiotics on the vaginal microbiome and the implantation process.

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PROBLEM: Achieving pregnancy through in vitro fertilization (IVF) remains a challenge, with less than one-third of women succeeding. There is a pressing need for reliable predictive tools to assess the likelihood of post-IVF pregnancy. While some serum inflammatory biomarkers have been investigated for their predictive potential, substantial knowledge gaps persist. This study examined the utility of different inflammatory markers in predicting IVF outcomes. METHOD OF STUDY: Inflammatory markers including the white blood cell count, neutrophil-to-lymphocyte ratio (NLR), platelet count, mean platelet volume, platelet distribution width, platelet-to-lymphocyte ratio (PLR), C-reactive protein (CRP), erythrocyte sedimentation rate, and vitamin D3 were assessed. Study outcomes were chemical pregnancy (positive serum beta-human chorionic gonadotropin 2 weeks post-embryo transfer), clinical pregnancy (detection of pregnancy sac via transvaginal ultrasonography), and viable pregnancy (detection of fetal heart rate). Univariate and multivariate logistic regression analyses were conducted, with multivariate analysis incorporating age, body mass index, infertility duration, type, and etiology, as well as all studied serum inflammatory markers, embryo count, stage, quality, and endometrial thickness. RESULTS: Lower NLR (p < 0.001, odds ratio [OR] = 0.372 [0.247-0.559]) and CRP (p = 0.035, odds ratio = 0.956 [0.916-0.997]) predicted chemical pregnancy in univariate analysis, with NLR maintaining significance in multivariate analysis (p = 0.022, OR = 0.319 [0.120-0.848]). Lower NLR (p < 0.001, OR = 0.309 [0.198-0.482]) and PLR (p = 0.013, OR = 0.994 [0.990-0.999]) predicted clinical pregnancy, with NLR surviving multivariate analysis (p = 0.005, OR = 0.217 [0.075-0.626]). Lower NLR (p < 0.001, OR = 0.320 [0.198-0.516]) also predicted viable pregnancy, maintaining statistical significance in multivariate analysis (p = 0.002, OR = 0.177 [0.058-0.541]). Other studied inflammatory markers did not predict IVF outcomes. CONCLUSIONS: NLR emerged as a robust independent predictor of pregnancy attainment after IVF.

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Biomarcadores , Fertilización In Vitro , Humanos , Femenino , Embarazo , Adulto , Estudios Retrospectivos , Biomarcadores/sangre , Resultado del Embarazo , Proteína C-Reactiva/análisis , Proteína C-Reactiva/metabolismo , Inflamación/sangre , Neutrófilos , Estudios de Cohortes , Linfocitos

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OBJECTIVES: The outbreak of the COVID-19 pandemic has had wide-ranging outcomes on adolescents' well-being. However, less attention has been paid to the adolescent's mental health during the pandemic. The pandemic may impair adolescents' mental health through stress spillover from other family members, contextual and policy changes, and the disruption of everyday life routines. Therefore, our research is motivated by a need to address the relative scarcity of research examining adolescent mental health during the pandemic. CONTENT: This systematic review was conducted through the medical database, Web of Science, Scopus, Medline, Embase, Google Scholar, and Cochrane databases for peer-reviewed, cross-sectional, cohort studies assessing the mental health status of adolescents during the Covid-19 virus pandemic from May 2020 till Dec 2022 without language restriction. Keywords were selected based on the Mesh terms and Emtree. SUMMARY: Studies on coronavirus have revealed many significant psychological effects on teens of all ages. The most commom problems were on the stress and anxiety, sleep disorders, depression, post-traumatic stress disorder. Risk factors were concidered as prior mental health problem, female sexuality, fear of covid-19, nutrition, physical activity and listening the covid 19 news. OUTLOOK: Considering the critical age of teenagers, the role of parents is vital. Health policy maker should support parents as a key factors to approprate care for adolescent. Parents should be educated on parenting methods during the covid pandemic to avoid irreparable damage of adolescent's mental health.

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COVID-19 , Adolescente , Femenino , Humanos , COVID-19/epidemiología , Salud Mental , Pandemias , Estudios Transversales , Ansiedad/epidemiología , Ansiedad/psicología , Responsabilidad Parental , Depresión/epidemiología

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The sympathetic nervous system (SNS) is hyperactive in women with polycystic ovary syndrome (PCOS). This study was designed in two sections: in vivo/in vitro with clonidine as the alpha-2 adrenoceptor (ADR-α2) agonist for modulating this hyperactivity. Eighty women with PCO participated in this randomised clinical trial (in vivo). A clonidine (0.1 mg) tablet was given twice a day for two months. Polycystic ovary morphology (PCOM) and pregnancy rate were the main outcome measurements. In the candidates for in vitro fertilisation (IVF), clonidine was added to the culture medium during IVF for two study groups (PCO-clonidine/PCO-without) and two control groups (egg donors-clonidine/egg donors-without). Our results showed that the pregnancy rate significantly was higher in the study group (p = .002). The mRNA expression of ADR-α1 and ADR-ß2 in PCO was higher than control group (p value <.001). But ADR-α1 expression in PCO-clonidine group decreased (p value = .042), the same as ADR-α2 expression. The intensity of this effect showed a pattern for ADR-α1

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Infertilidad Femenina , Síndrome del Ovario Poliquístico , Clonidina/farmacología , Clonidina/uso terapéutico , Femenino , Fertilización In Vitro/métodos , Humanos , Infertilidad Femenina/tratamiento farmacológico , Infertilidad Femenina/etiología , Síndrome del Ovario Poliquístico/complicaciones , Síndrome del Ovario Poliquístico/tratamiento farmacológico , Síndrome del Ovario Poliquístico/metabolismo , Embarazo , Receptores Adrenérgicos

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Background: Ischemia-reperfusion (I/R) induced by testicular torsion can damage the testicles. In the present study, we assessed the effects of coenzyme Q10 (CoQ10) and diamond nanoparticles on sperm parameters in I/R testes in rats. Materials and Methods: Forty-eight Wistar adult male rats were divided into eight groups: healthy control (Ch), diamond nanoparticle healthy control group (Ch+Dia), CoQ10 healthy control group (Ch+Q10), diamond nanoparticles+CoQ10 healthy control group (Ch+Q10+Dia), torsion/detorsion group (Ct), the Ct group that received diamond nanoparticles (Ct+Dia), the Ct group that received CoQ10 (Ct+Q10), and Ct group that received diamond nanoparticles and CoQ10 (Ct+Q10+Dia). The rats were euthanized, and we collected the semen from the epididymal tissues to evaluate sperm viability, motility, concentration, and morphology parameters. Results: The I/R of the testicles significantly reduced sperm concentration, motility, viability, and altered sperm morphology in the rats. However, the administration of CoQ10 significantly improved sperm parameters in the rats with testicular I/R. Diamond nanoparticles decreased the sperm parameters; however, simultaneous administration of diamond nanoparticles and CoQ10 led to improved sperm parameters. Conclusion: CoQ10 potentially appeared to have protective effects against the long-term side-effects of I/R in testes in rats. Co-administration of diamond nanoparticles with CoQ10 significantly improved sperm parameters and greatly reduced the negative effects of diamond nanoparticles alone. Therefore, green synthesis of nanoparticles with the use of antioxidants such as CoQ10 is recommended.

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BACKGROUND: Advances in recombinant DNA technology led to the development of recombinant follitropin alfa. Recombinant human follicle-stimulating hormone products are used to stimulate follicular maturation. OBJECTIVE: To compare the efficacy and safety of a biosimilar-candidate recombinant human follicle-stimulating hormone (Cinnal-fⓇ; CinnaGen, Iran) with the reference product (Gonal-fⓇ; Merck Serono, Germany) in women undergoing ovarian stimulation for intracytoplasmic sperm injection (ICSI). MATERIALS AND METHODS: In this randomized controlled trial, a total sample size of 200 women (age < 35 yr, candidate for ICSI) was calculated. Participants began a pituitary downregulation protocol with buserelin. They received 150 IU daily of either Cinnal-fⓇ or Gonal-fⓇ from the second day of their cycle. The primary outcome of the study was the percentage of metaphase II (MII) oocytes. The secondary outcomes included the number and quality of oocytes retrieved, duration of stimulation, fertilization rate, embryo quality, the number of clinical and ongoing pregnancies, and the incidence of ovarian hyperstimulation syndrome (as an important safety marker). RESULTS: A total of 208 women were enrolled, of whom, 200 completed the study period. Ovarian stimulation with Cinnal-fⓇ resulted in a comparable percentage of MII oocytes as with Gonal-fⓇ (78.64% vs 80.02%, respectively; p = 0.81). No statistically significant difference was seen in the secondary outcomes between the groups. CONCLUSION: Cinnal-fⓇ proved non-inferior to Gonal-fⓇ, based on the percentage of MII oocytes in women aged < 35 yr undergoing ICSI. Our findings confirm that the efficacy and safety profiles of Cinnal-fⓇ and Gonal-fⓇ are similar.

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BACKGROUND: Both oral contraceptive pills (OCPs) and estradiol valerate (E2) have been used to schedule a gonadotropin-releasing hormone antagonist in vitro fertilization (IVF) cycles. Since the suppression of follicle-stimulating hormone by OCPs can stay 5-7 days after stopping the pills, it seems that starting the gonadotropin-releasing hormone (GnRH) after 6 days of pre-treatment discontinuation may be important in IVF outcomes. OBJECTIVE: The aim of the present study was to determine the number of mature oocyte and pregnancy rate of three pretreatment methods for fresh embryo transfer cycles. MATERIALS AND METHODS: In this randomized controlled trial, two-hundred ten women (18-35 yr and less than 2 previous IVF attempts) undergoing IVF with the GnRH antagonist protocol were randomized to the OCP, E2, and no pretreatment arms. OCP group (n=53) received OCP (ethinyl estradiol30 µg and levonorgestrel150 µg), E2 group (n=63) received 4 mg/day oral E2 (17ß-E2) for 10 days from day 20 of the previous cycle and GnRH antagonist stimulation was started 6 days after the interruption of OCP and E2. The control group (n =70) did not receive any pretreatment. RESULTS: No significant difference was observed in the mean number of the mature oocyte, endometrial thickness, and embryo quality. The pregnancy rate in E2 group was higher than the two other groups (42.9% vs 39.6% and 34.3% in OCP and control group, respectively), but the difference was not statistically significant (p=0.59). CONCLUSION: It seems OCP or E2 pretreatment could not improve the fresh IVF-embryo transfer outcomes.

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BACKGROUND: Human and experimental studies suggest that the sympathetic regulatory drive in the ovary may be unbalanced (hyperactivity) in polycystic ovary syndrome (PCOS). Dysfunctional secretion of interleukin (IL) -1 (α & ß) or related cytokines may thus be related to abnormal ovulation and luteinization. OBJECTIVE: The aim of this study was the evaluation of cytokines' pattern in PCOS women and discussion about the explanation of cross-talk between two super systems: sympathetic and immune systems and explanation sympatho-excitation and relationship with interleukins. MATERIALS AND METHODS: In this study, 171 PCOS women aged between 20-40 years were studied the. Their body mass index was <28. The patients were divided into two groups: study group (n=85, PCOS women) and control group (n=86 normal women). The blood sample was obtained on the 3rd day of menstruation cycle. IL-17, IL-1α, IL-1ß, and TNF-α concentrations were determined in both groups. RESULTS: The median serum level of IL-1α in the PCOS group was higher than the control group (293.3 and 8.0, respectively, p<0.001). Also, the median serum level of IL-1ß was higher than the control group (5.9 and 3.1 respectively). But the median serum of level IL-17 in women with PCOS was significantly lower than the control group (p<0.001). CONCLUSION: Our results confirm that PCOS is a low-level chronic inflammation.