Infertility is the disability of a couple to obtain pregnancy after one year of sexual intercourse that is unprotected and regular. Bisphenol A is an industrial chemical spread worldwide, that is a raw material utilized in multiple industries. Bisphenol A is assorted as an endocrine-disrupting chemical, which can interfere with hormone activity. This study aimed to assess the effect of BPA levels in serum on ICSI outcomes. The study was conducted at the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies / Al-Nahrain University during the period from October 2021 to April 2022. sixty infertile women enrolled in this study. BPA levels were analyzed through an enzyme-linked immunosorbent assay (ELISA) technique. Mean serum BPA was not significantly higher in non-pregnant women in comparison with that of pregnant women. Serum BPA was positively correlated to immature oocytes (MI) and abnormal oocytes. Also, BPA inversely correlated to Grade1 embryos and positively correlated to Grade 3 embryos. Bisphenol A can be detected in sera of infertile female undergoing ICSI. High BPA level in serum may impact oocyte quality and embryo grading
Due to malfunction of the hypothalamus-pituitary-ovary axis and probable dysregulation of ovarian activities, ovary has a large number of small follicles but no developed follicles. L-Carnitine is a tiny, water-soluble chemical that plays a critical role in fat metabolism. It is required for appropriate mitochondrial fatty acid oxidation and acyl-CoA ester excretion, as well as affecting ATP levels. The current study was aiming at evaluating the protective effect of L-Carnitine (LC) against deleterious substances present in serum of patients with PCOS, which may affect the oocyte maturation. 60 infertile women diagnosed with polycystic ovarian syndrome have been enrolled in this study and enter their Intracytoplasmic Sperm Injection (ICSI) cycle; they were informed about the study and signed a written informed consent. They were grouped into treatment group (n=30) who were treated with L-Carnitine® tablet for two months and placebo group (n=30). All enrolled women underwent flexible antagonist protocol for ICSI. Significant increase in mean mature metaphase II (MII) oocyte count in study group than placebo group, oocyte maturity rate was significantly higher in study group in comparison with placebo group. In addition, mean fertilized (2PN) oocyte count was increased significantly in study group in comparison with placebo group. Mean fertilization rate was significantly higher in study group in comparison with placebo group. Treatment with of patients with polycystic ovary syndrome of L-Carnitine resulted better oocyte quality and the improvement in oocyte quality is reflected by mature MII oocytes, maturity rate and fertilized rate with eventual improvement in embryo quality.
Successful implantation needs a receptive endometrium, a functional and normal embryo at the stage of blastocyst developmental and a synchronized dialogue between embryonic tissues and maternal tissues. The current study was planned and conducted to investigate the potential role of vaginal pessary of hyaluronic acid on intracytoplasmic sperm injection (ICSI) outcome. This study included 63 infertile women (32 women as study group receiving hyaluronic acid and 31 control group) who were subjected to ovulation induction programs with gonadotropin releasing hormone (GnRH) antagonist protocols for in vitro fertilization (IVF)/ intracytoplasmic sperm injection (ICSI) procedures. Blood samples were taken by Vacutainer tubes and centrifuged according to the manufacturer’s instructions for the preparation of serum samples. Serum samples for Lymphatic vessel endothelial hyaluronan receptor 1 (LYVE1) were obtained from each patient when the basal hormonal status was determined. The second time point is when the samples were obtained on the day of ova pickup, after that the G1 embryos will be transferred inside the uterine cavity. Then performance of endometrial receptivity parameters or patterns evaluation and patients were followed up to do pregnancy test after14 days after embryo transfer. On the day of human chorionic gonadotropin (hCG), there was no significant difference in mean serum Lymphatic vessel endothelial hyaluronan receptor 1 (LYVE1) between hyaluronic acid group and reference group, respectively (p = 0.824). There was no significant difference in mean follicular fluid Lymphatic vessel endothelial hyaluronan receptor 1 (LYVE1) between the hyaluronic acid group and reference group, 0.92 ±0.36 pg/ml versus 0.82 ±0.22 pg/ml, respectively (p = 0.223). Treatment with the hyaluronic acid resulted in non-significant increase in serum and follicular fluid Lymphatic vessel endothelial hyaluronan receptor 1 (LYVE1), and this increment is not related to Lymphatic vessel endothelial hyaluronan receptor 1 (LYVE1) improvement in local blood endometrial blood flow as reflected by reduction in resistive index and pulsatility index with eventual improvement in pregnancy outcome.
Serum chemerin levels are associated with body fat percentage and BMI, and elevated chemerin levels are associated with metabolic problems and inflammatory shifts. This study aimed to evaluate the effect of BMI in serum and follicular fluid chemerin and Leptin levels on patients undergoing ICSI . This study was performed by 44 women who underwent ICSI procedures and divided into two groups based on BMI: the non-obese group, with a BMI<30 and the obese group, with a BMI>30. The result in the non-obese group showed a significant positive correlation was found between Serum chemerin levels, indicating a strong effect size (p< .001). This suggests that as Serum chemerin levels rise, so will FF chemerin. A significant positive correlation of r =0.92 was found between the oocytes retrieved and the Number of metaphases II, indicating a strong effect size (p<.001, This shows that the number of metaphase II oocytes increases as the number of retrieved oocytes increases. A significant positive correlation of 0.66 was found between the number of embryos and the G1 embryo, indicating a large effect size. Conclusion: Serum chemerin had a significant correlation with oocyte maturity and embryo grading, and there was no significant difference between obese and non-obese patients regarding serum chemerin pregnancy.
In a perfect world, the peak of receptivity of the endometrial lining would occur simultaneously with the entry into the uterine cavity of a healthy blastocyst, which would then be able to adhere, attach, invade, and develop protected until the time of delivery. This would be the ideal scenario. The study was carried out on 200 infertile women who have thin , poorly vascularized endometrium, those patients were divided into five groups ; 40 patients in each group, group A received esterofem oral, group B received vagifem vaginal tablets, group C received sildenafil citrate gel, group D received pentoxifylline oral and group E received 4 grams of pentoxifylline vaginal gel. The endometrial thickness, vascularity zones, sub endometrial flow, and both uterine arteries resistance and pulsatility indices were assessed at the middle of the menstrual cycle (day 11–14) on a monthly basis for six cycles or until a positive pregnancy test was obtained. Pentoxifylline vaginal gel, pentoxifylline+ vitamin E capsule, and sildenafil vaginal gel have improved the vascularity indeces of endometrium and uterine arteries, while the vagifem and esterofem were less effective in terms of improving the vascularity indeces of endometrium and uterine arteries. The study also showed that 57.5% of women succeed to get pregnant after six months of receiving pentoxifylline vaginal gel, 35% of women succeed to get pregnant after six months of Pentoxifylline+vit E, while 22.5% of women succeed to get pregnant after six months of sildenafil, about 10% of women got pregnant after six months of vagifem, and finally 2.5% of women got pregnant after six months of receiving estrofem tablets. It was discovered that pentoxifylline vaginal gel, pentoxifylline tablet plus vitamin E capsule, and sildenafil vaginal gel were able to improve the vascularity index of the endometrium, the uterine arteries and endometrial thickness, and enhance the pregnancy rates in patients with thin poorly vascularized endometrium.
The 5,10-methylenetetrahydrofolate reductase (MTHFR) enzyme is a key methionine and folate metabolism enzyme that is found in oocytes and embryos in preimplantation stages and plays a vital role in female reproduction.To assess the impact of MTHFR genetic polymorphisms (C677T and A1298C) on follicular stimulating hormone (FSH), luteinizing hormone(LH), Estradiol (E2), progesterone and antimullerian hormone (AMH) in female receiving intracytoplasmic sperm injection (ICSI), 85 infertile women undergoing ICSI treatment at the High Institute of Infertility Diagnosis and Assisted Reproductive Technologies in Baghdad, Iraq, were recruited. These patients had their MTHFR polymorphism genotypes examined, FSH, LH, E2, progesterone, and AMH levels were compared between groups. Furthermore, all demographic characteristics as well as ICSI outcomes were compared between pregnant and non-pregnant women. The research revealed no discernible variation between the means of FSH, LH, E2 and AMH with respect to the 219A>C(rs1801131) (A1298C) genotypes (p > 0.05). Progesterone level was significantly differed with high level found in CC followed by AA and AC. There was no statistically significant variation in hormonal features between CC, CT, and TT for A1298C, 219A>C(rs1801133). The demographic features (age, duration, type of infertility, cause of infertility and previous trial) were not notably different between women who were pregnant and those who were not. In women undergoing ICSI, the maternal MTHFR polymorphisms is not related to FSH, LH, E2 and AMH. MTHFR polymorphisms therefore don't offer useful information regarding the hormonal levels in our groups.