Intratesticular testosterone plays a crucial role in male reproductive function and overall health. Body Mass Index (BMI) and smoking are known lifestyle factors that can influence hormonal balances. Elevated BMI has been associated with alterations in testosterone levels, impacting male fertility and endocrine function. The aim was to examine the concurrent relationships between intratesticular testosterone, BMI, and smoking habits. Biopsies of the testicles were taken from 32 patients with non-obstructive azoospermia. Testicular sperm extraction (TESE) under spinal or general anesthesia was performed after a comprehensive history, physical examination, and investigations. After performing a minced biopsy and centrifuging the fluid, testicular fluid was extracted. The highest intratesticular testosterone levels were in normal patients and lowest levels in over weight patient; on the contrary the highest serum 17-hydroxyprogesterone levels were found in over weight patient and lowest levels in normal weight patients; There were insignificantly higher both intratesticular testosterone and 17-hydroxyprogesterone levels in non-smokers. In conclusion, the statistical analysis revealed that there is an insignificantly low correlation between intratesticular testosterone levels, BMI, and smoking.
Background: Immunological infertility is expected to be the reason of infer-tility in 9-36% of the concerned twosomes. The major cause of immunological infertility is the creation of anti-sperm antibodies (ASA), which influence the capability of insemination of spermatozoa. It has been detected that anti-sperm antibodies (ASA) are present either systemically in blood or locally in seminal plasma of approximately 10% of infertile male patients. Immunity to sperm can cause infertility; humoral antibodies directed against sperm did not necessarily impair fertility unless the circulating antibodies are also present within the re-productive tract and on the living sperm surface. Hormonal imbalance and sperm autoimmunity have been considered as two systems that play in near association and affect each other. Testosterone is the Steroid hormone necessary for the de-velopment and maintenance of secondary sexual characteristics as well as initi-ation and maintenance of Spermatogenesis .It was known that males with abnor-mal seminal fluids have lower concentrations of the testosterone hormone. Objectives: To study the serum & seminal plasma antisperm antibodies levels in relevance to levels of testosterone in serum and seminal plasma accordingly to sperm function parameters in different groups of infertile patients. Subjects,Materials and Methods: Blood and semen samples were collected from (80) subjects (60) infertile patients (20Asthenozoospermic, 20 Oligozoospermic,20Azoospermic) and 20 Normozoospermic subjects .The anti-sperm antibody and testosterone levels were measured by using Enzyme Linked Immunosorbent Assay (ELISA). Results: The Antisperm antibodies were positive in serum of normozoospermic, asthenozo-ospermic, oligozoospermic and azoospermic men respectively are about 10%, 5%, 20%,5% and in the total group was 10% positive. The ASA in seminal plasma of normozoospermic men, asthenozoospermic men, oligozoospermic men and azoospermic men respectively are 0%, 0%, 5%, 5% and in the total groups 2.5%.These findings lead to no possibility to make clear correlations with the studied hormones. There was significant increase (P<0.05) in the levels of testosterone in serum and seminal plasma in comparison between normozoospermic and infertile men subgroups. There was significant decrease (P<0.05) in the levels of pro-gesterone in serum and seminal plasma in comparison between normozoospermic men and infertile men subgroups, the highest levels were observed in asthenozoospermic subgroup. The study showed that 10 patients (12.5%) out of 80 patients showed a positive ASA positive in serum or seminal plasma of all groups. The result was considered positive if the value was ≥60 RU / ml .On these basis and regarding that screening criteria the positive ASA group showed the association with the low levels of testosterone in both types of the samples(serum and seminal plasma), these results was exhibited a high significant difference when compared with negative ASA group. Conclusion: Determination of the relevance of the levels of testosterone and anti-sperm anti-bodies in the serum and seminal plasma, which in turn is important to determine the type of infertility especially the immunological type.
Background: Elevated serum concentrations of testosterone is common in women with polycystic ovary syndrome (PCOS)but it'srelationto body mass in dex(BMI), isstillunknown. Objective: The present study was conducted to investigate the relationship between testosterone level and body massindexin womenwith polycysticovary syndrome. Methods: A total of eighty PCOS women with average age 27.6±0.7 and BMI 31.9±0.5 were compared with twenty-two healthy women considered as a control group (age 28.2±1.1, BMI 28.8±1.0). Patients and controls were grouped according to (BMI: Lean, overweight and obese. Allwomen in both groups were subjected to the following investigations: evaluation of luteinizing hormone (LH), follicle stimulating hormone (FSH.), prolactin (PRL), testosterone levels and ultrasonography. Results: The serum levels of LH, LH/FSH and testosterone were significantly higher (P< 0.05) in PCOS compared to control women,while in FSH and PRL the difference was non significant. Obese women with PCOS also had a significantly higher (P<0.05) mean level of testosterone (1.33±0.28ng/ml) compared to lean and overweight patients (0.53±0.17, 0.61±0.08 ng/ml respectively). Uitrasound examination was performed in the ovulatory phase during (12-14) days of the cycle in both PCOS patients and controls, and all women with PCOS with evidence of polycystic ovaries on ultrasonography. Conclusion: Testosterone levelwas significantly elevated in obesecompared to overweightand lean women with PCOS.The role of weight reduction is more beneficial in the management of PCOS and improvementoftestosteronelevel.
Background: The brain seems to be inherently feminine. Masculine characteristics of the structure and functions are imposed on developing CNS by the action of testicular hormones during a critical embryonic period. Testosterone is a prohoromone responsible for sexually dimorphic characteristics of the brain. A number of structural sex differences in the human brain have been reported, but their functional significance are less well established. Brain function in men appears to be more lateralized than women and this may be the reason that women are more likely than men to recover speech, after a stroke that damages cortical speech areas. Objective: this study examines the effects of testosterone on sexually dimorphic nucleus of the rat spinal cord i.e. the spinal nucleus of the bulbocavernosus muscle, which innervates two sexually dimorphic, androgen-sensitive perineal muscles that are active during copulation, the bulbocavernosus and levator ani. Methods: the study was performed on litters of albino rats. Their pregnant mothers received on embryonic days (E16-E20) subcutaneous injection of 2mg of testosterone propionate. The spinal nucleus of bulbocavernosus was examined in control group, female litters with and without prenatal testosterone injection. Results: It was demonstrated that perinatal injection of testosterone prevented the involution of spinal nucleus of bulbocavernosus in the female rats. Conclusions: It is concluded that androgens have a sparing effect on the motor neurons of this nucleus that prevent the developmental cell death of neuronal cells. The mechanism of the effects of androgen are discussed, whether it is through direct effect of androgen on motor neurons themselves, or indirect effect as a result of the androgen action on the target androgen-sensitive perineal muscles.
Background: Polycystic ovary syndrome (PCOS) is the most common cause of hyperandrogenism anovulatory infertility; it affects 510-% of females in the reproductive age. PCOS is a risk disease; it has an association with gynecological malignancy. Objectives: To determine whether Cancer Antigen 125 (CA125) and Cancer Antigen 153-(CA153-) levels are increased in PCOS and possibility of CA125 and CA153- to be used as a diagnostic marker of PCOS. Methods: Seventyfemales with PCOS diagnosed depending on threecriteria: Menstrualhistoryofoligomenorrhea ultrasound examinations revealed polycystic ovaries and biochemical hyperandrogenism. Twenty normal fertile females serve as control group. Blood samples were obtained from all individuals from 2nd-4th day of menstrual cycle to measure levels of FSH, LH and testosterone.Second blood samples were collected from the same patients during late follicular phase to measure CA153- and CA125( by ELISA). Results: Females with PCOS and controls differed significantly(p< 0.05) in total serum testosterone (p). Females with PCOS and controls have highly significant difference (p < 0.001) in LH mean level (7.881.83+ vs 3.900.73+) respectivelyand, highly significant difference (p < 0.001) in LH/FSH ratio and BMI parameters. No significant differences (p > 0.05) were found in FSH, CA125 and CA153- between PCOS patients and the controls.There were positive correlation between testosterone and CA125.Negative correlation between testosterone and CA153- serum values. Conclusion: There were no changes in the serum levels of CA125andCA153- in PCOS patient at the age of reproduction and those cancer antigens could not be used as diagnostic markers for polycystic ovarian syndrome.
Oligoasthenoteratozoospermia is a prevalent cause of male infertility. (iOAT). It is generally acknowledged that, due to the fact that spermatogenesis is a sex-hormone-dependent process, specific endocrine treatments might enhance or recover male fertility. The typical negative feedback of sex steroids is disrupted by anti-estrogen medication, leading to a rise in endogenous gonadotropin-releasing hormone secretion (FSH and LH) straight from the pituitary. The stimulation of Leydig cells in the testes by FSH and LH is thought to promote local testosterone synthesis, which in turn may improve spermatogenesis. The study sample consisted of 42 iOAT patients. Baseline seminal fluid analysis (SFA) and hormonal assessment (FSH, LH, prolactin, and testosterone) were taken. Each patient was given medical treatment with tamoxifen (20 mg/day) for three months. SFA, FSH, and testosterone were taken after three months. There was a significant increase in FSH, testosterone, sperm concentration, and progressive motility after treatment (p value <0.001), furthermore, there was no significant correlation between hormonal changes and changes in SFA study markers (p value > 0,05). Improvements in hormone levels following tamoxifen treatment for patients with idiopathic oligoasthenoteratospermia do not correlate with alterations in SFA markers.
Background: Polycystic ovarian syndrome (PCOS) is the most common cause of hyperandrogenism anovulatory infertility; it affects 5-10% female reproductive age. The present study aims to investigate the total prostate specific antigen levels, total serum testosterone, FSH and LH in women with PCOS and compare the results with control group of normal fertile females of corresponding age group on Iraqis PCOS patients. Materials and Methods: Seventy patients with PCOS diagnosed depending on three criteria: Menstrual history: Oligomenorrhea, Ultrasound reveals polycystic ovaries and Biomedical and/ or clinical hyperandrogenism. Twenty normal fertile females who serve as control group in this study. Blood samples were aspirated from all individuals from 2-4 day of menstrual cycle to measure total prostate specific antigen(PSA), total testosterone and FSH, LH. Results: Patients with PCOS and controls differed significantly in PSA, Total serum testosterone (p<0.05). Patients with PCOS and controls have highly significant difference in LH level, the mean was (7.88±1.83 vs 3.90±0.73) respectively highly significant difference in LH/FSH ratio and BMI parameters (p<0.001). No significant differences were found in FSH (p>0.05). Positive correlation between PSA and testosterone, PSA and BMI. Conclusion: Total serum prostate specific antigen levels are higher in patient with PCOS. Total testosterone levels are higher in patient with PCOS. Serum PSA measurement might be marker of hyperandrogenism in females suffering from PCOS.
Background: Over 70 million couples suffer from infertility worldwide and the majority of those couples can be found in developing countries. Aims of study: This study aims to determine if there is any significant difference in levels of inhibin B and gonadal hormones in fertile and infertile men. Subjects, Materials & Methods: Clinical and hormonal characteristics related to male infertility factor of the infertile patients(n=75)and representative proven fathers as a control(normozoospermic ones)(n=25)were studied. All males attending infertility clinic at Baquba General Hospital, Diyala in Iraq. The study included the measurement of gonadal hormones levels by using (ELISA)method and it was also used in analyzing the inhibin B hormone. The VIDAS instruments were used for enzyme immunoassay measurements Luteininzing Hormone(LH),Testosterone(T) ;and Follicle Stimulating Hormone(FSH). The samples were analyzed and classified according to WHO criteria. Results: The results of this study showed that inhibin B hormone and other gonadal hormones in control (representative proven fathers-normozoospermic ones)as inhibin B (240.2±17.4)Pg/ml, LH (1.639±0.103)mIU/ml, Testosterone (0.6253±0.035)ng/ml and FSH (0.469±0.0103)mIU/ml. In asthenozoospermic ones as an example of infertile patients the results showed that inhibin B (76.9±8.99)Pg/ml, LH(1.4311±0.033)mIU/ml, T (0.5483±0.030)ng/ml and FSH (0.495±0.0124)mIU/ml. Except the inhibin B comparisons all of other non significant evaluated parameters & correlations within this study could be ascribed to the role of cascaded role of inhibin B with the gonadal hormones in spermatogenesis. Conclusions: It concluded from this study that decreased levels of inhibin B, LH,Testosterone, but increased levels of FSH hormones were shown in asthenozoospermia group as an example of infertile patients,and increased levels of inhibin B,LH and Testosterone but decreased levels of FSH were shown in normozoospermia as control.
Background: Leptin is an adipocyte —secreted protein that participates in the regulation of energy homeostasis. It prevents the body from storing fat, controls hunger and cravings, regulates food intake and energy expenditure, provides the body with an index of nutritional status and controls the whole body fat metabolism. Leptin is a product of ob gene created by adipocytes. It seems to signal metabolic information to the reproductive system. Objective: The aim of this study to evaluate the relationship between serum leptin and infertility in oligozoospermic men. Materials and Methods: Seventy men were investigated; fertile normozoospermic as a control (n=35) and infertile oligozoospermic (n=35). The patients underwent estimation of body weight (kg), height body mass index (BMI), semen analysis, serum FSH, LH, testosterone and leptin, lipid profile and serum malondialdehyde (MDA). The infertile group was given a treatment course of clomiphene citrate (50 mg) and vitamin E (400mg) and then all the previous parameters were reevaluated after 3 months. Results: Mean body weight was significantly higher in infertile oligozoospermia compared to controls. The height showed no significant difference between the groups. Hormonal profile revealed significant (P=0.0001) difference in FSH between control group and oligozoospermic group (7.04±4.20 versus 3.35±1.47 mIU/ml), but after treatment with clomiphene citrate and vitamin E there is a slight non-significant (P=0.231) decrease in the level of FSH in oligozoospermic group. The level of testosterone showed a statistically significant (P=0.0001) difference between fertile normozoospermic (5.52 ±1.29 ng/ml) and infertile oligozoospermic. This hormone showed a significant (P<0.0001) increase in its level after treatment with clomiphene citrate and vitamin E (3.48±1.56 ng/ml). Other hormone showed non significant difference between the two groups pre and post treatment. Lipid profile showed no significant difference between the two groups. There was no significant (P=0.477) difference in serum MDA between the control and the infertile groups (4.69±1.32 vs. 5.18±1.19 µmol/L) respectively, but after treatment the results showed a mild significant (P=0.026) decrease in comparison to the level in the control group and also a significant (P=0.0001) decrease in comparison to the level before treatment. Infertile oligozoospermic had significantly higher serum leptin level (8.03±1.22 ng/ml) than control (3.62 ± 1.00 ng/ml). Conclusion: Serum leptin demonstrated a significant positive correlation with age, body weight, BMI and a significant inverse correlation with serum testosterone. It had nonsignificant correlation with the height and sperm concentration. These results are suggestive of a link between the adipocyte derived hormone leptin and male reproduction.
The study aim is to evaluate the predictive rate of positive sperm retrieval of serum concentration of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone (TT) in azoospermic patients presenting to High Institute of infertility diagnosis and assisted reproductive technologies. The study records of 65 azoospermic men with who underwent open testicular sperm extraction between February 2017 to April 2019 were studied. The patient’s age, hormonal profile for FSH, LH and TT and testicular histopathology were recorded. The sperm retrieval rate according to histological findings norm-spermatogenesis (NS), hypo-spermatogenesis (HS), maturation arrest (MA) and Sertoli cell-only syndrome (SCOS) were recorded as follows: 100%, 75%, 44.4%, and 28.6% respectively. The cutoff value of FSH was (≤ 14.56 mIU/L) with an accuracy level of 73.0%, a sensitivity (66.7 %) and a specificity (79.3 %). The cutoff value of the serum level of LH was (≤ 9.37 mIU/L) with an accuracy level of 78.4%, a sensitivity level of 77.7 % and a specificity level of 72.4 %.
Background: Infertility is a common social and health problem. Male factor is a major cause in 30% of infertile couples. Smoking is common at reproductive age and its effect on fertilitiy is still in controversy. Studying its effect on fertility helps in the management of infertility. Objectives: To assess the effect of smoking on serum sex steroidal hormones as well as on seminal plasma (SP) IL-2, IL-6 and conventional semen parameters in infertile men and their correlations between each other. Methods: Seventy male partners of infertile couples (30 smokers and 40 non-smokers) were involved in this study. The man was considered smoker if he had history of smoking of more than 10 cigarettes per day for at least one year. Semen analysis was done according to world health organization (WHO) 2010. Specific kits were used for measurement of serum testosterone, serum estradiol II, SP IL-2, and SP IL-6. Results: The median of SP IL-2 was significantly (p<0.05) higher in smokers than in non-smokers group and positively correlated with SP IL-6 in them. In addition, IL-2 was negatively correlated with semen volume, sperm motility and morphology, while IL-6 was negatively correlated only with sperm motility. However, there was no significant difference of serum sex hormones level or on semen parameters between smokers and non-smokers. Conclusion: Cigarette smoking affect cytokine levels in the seminal plasma but has no effect on serum sex hormones level or semen parameters.
Background: Cadmium (Cd) is a heavy metal toxicant, present widely in our environment and workplaces.It is well known that cadmium causes adverse effects on male reproductive organs and reproductive functions in experimental animals. Objective: This experiment was designed to find out the effect of cadmium on some histological and hormonal parameters of the reproductive system of adult male rats. Methods: thirty mature albino male rat were used (Rattus rattus norvegicus albinus), as a mammalian model. these animals were divided into two groups, 15 rat / group after labeling them. The control group (G1) was orally administrated with distilled water during the 4 weeks period of the experiment and the experimental group (G2) was orally administrated with 20 ml cadmium chloride (200 mg/1L body weight) during the 4 weeks. First of all, the rat were anesthetized, after that blood aspiration using anesthetic cardiac puncture and the serum was separated and store at -20°C until assessment of FSH, LH and testosterone hormones. After that, the weight of reproductive organs (testis,epididymus and seminal vesicle) was recorded. These organs were fixed with 10% formal saline for histological study. Results: The statistical analysis shows a significant (P< 0.05) decrease in the weight of the testes and seminal vesicles when compared with control group. The results of the sperm parameters show a significant (P< 0.05) decrease in sperm concentration and a highly significant (p≤0.01) decrease in sperm motility in treated group as compared to control. The result of testicular sections in treated group shows a decrease in thickness of germ cells layer, widening of the central seminiferous tubules lumen and prominent germ cells population necrosis. Multiple vacuoles were seen within the tubules. Sertoli cells were abnormal in number and shape as compared to control. A peritubular fibrotic change had been seen also in the testicular sections. The result also shows a highly significant decrease in diameters of seminiferous tubules, primary spermatocytes, secondary spermatocytes, spermatids and increase in interstitial space when treated with cadmium compared with control group. The Levels of serum hormones shows a significant (P<0.05) decrease in the levels of testosterone and LH hormones mean in the treated group,while highly significant (ps0.01) increase in the FSH hormone mean in the treated group when compared to the levels mean of the hormone in the control group.. Conclusion: In conclusion, these findings suggest that cadmium administration with 20 ml cadmium chloride (200 mg/1L body weight) for 4 weeks during the adulthood induced damage in the reproductive organs and lead to impair the functions of sperm parameters and cause histological and hormonal alterations.
Bisphenol A (BPA) is one of the world's greatest produced chemicals. BPA is present in various consumer goods that are commonly used in daily life. It was considered an endocrine disruptor and effects on spermatogenesis and male fertility. To assessment the impact of BPA on male reproductive via evaluation the correlation the concentrations of BPA in blood serum with male reproductive hormone. The study was conducted on 28 men recorded at the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies /Al-Nahrain University, private clinic (AL-Zahawi) and Babel Teaching Hospital for Women and Children from January 2022 to April 2022. The blood serum was collected from men. The blood serum samples were assayed the FSH, LH, testosterone and prolactin hormones by mini VIDAS. The residual samples of blood serum were examined BPA concentrations. The measuring of BPA concentration in blood serum by using ELASA Kits. The result of hormones revealed that the correlation between concentrations of BPA and prolactin hormone was slightly positive in blood serum (r = 0.225). There is not detected relationship between BPA and FSH. The BPA concentrations were correlated a negative with testosterone in blood serum (r = - 0.599). Whereas, the LH was correlated slightly positive with blood serum BPA. This study indicated that the BPA in blood serum were highly concentration and there was proof that BPA could effect on male reproductive hormone.
Background: Polycystic ovary syndrome is the most common, yet complex, endocrine disorder with principal features of anovulation, amenorrhea, ovulation-related infertility, polycystic ovaries, and obesity. Number of metabolic aberrations is now well recognized as a growing public health problem in PCOS as glucose intolerance, hyperinsulinemia and dyslipidemia. Objective: To investigate and analyze the anthropometric, hormonal profile and metabolic abnormalities of obese and non-obese women with this disorder. Materials and Methods: Sixty-five healthy Iraqi women serves as the control group and eighty-four infertile women divided into two subgroups depending on the BMI (< and ≥30 kg/m2) were studied. BMI, waist to hip ratio and waist to thigh ratio were measured. Serum levels of luteinizing hormone, follicle stimulating hormone, estradiol, testosterone, fasting blood glucose, and oral glucose tolerance test, and total lipid profile were measured. Results: BMI, waist/hip, waist/thigh ratio were significantly higher in PCOS than control women. Lower FSH level, higher LH and E2 levels, LH/FSH ratio, and lower E2/testosterone ratio was found in obese and non-obese PCOS. Higher blood sugar level, high cholesterol, triglyceride, LDL, VLDL and lower HDL levels in PCOS compared to control women. Conclusion: Obesity is a common finding of women with PCOS, but it is not part of the diagnostic criteria. Women with PCOS usually have the so-called centralobesity (Visceral adiposity), and therefore tend to have an increased waist-hip ratio (WHR) and waist to thigh ratio, regardless of the weight factor (i.e., in obese and non-obese). PCOS patients exhibited abnormal hormonal status and biochemical indices also regardless of obesity.
Background: Male obesity is associated with physiological changes that can negatively affect male fertility. Obese men have demonstrated a 3-fold increase in the prevalence of oligozoospermia when compared with men with normal Body Mass Index (BMI). Objective: To find the correlation between Aromatase enzyme with the following hormones (follicle stimulating hormone(FSH), Luteinizing hormone(LH), Estradiol(E2), and testosterone) in the obese infertile male. Subjects, Materials and Methods: Seventy obese infertile male (patients) and twenty obese fertile male (control) are enrolled in this study. Aromatase enzyme, FSH, LH, E2 and testosterone hormones were measured in their serum. All serum samples were measured by ELISA method. Results: Median human cytochrome enzyme level was significantly higher in patients than in control group, 87.55+ 12.48 pg./ml versus 56.95+9.88 pg./ml, P= 0.014. In patients group, a significant positive correlation was found between human cytochrome enzyme, FSH, and LH. Conclusions: The present study showed clearly that male obesity negatively affects fertility through changes in hormone levels. The results suggest that increased estrogen because of aromatization in the fatty tissue, reflected through the increase in human cytochrome enzyme (aromatase), may be an important mechanism for the hypoandrogenemia and altered sperm parameters.
Background: Infertility is considered one of the main public health issues, as it affects about 15% of the couples of reproductive age. The male factor is involved in 40% - 50% of infertility cases. It is difficult to assess accurately the overall magnitude of the contribution of genetics to infertility as most, if not all, conditions are likely to have a genetic component. The genetic causes of infertility are varied and include chromosomal abnormalities, single gene disorders and phenotypes with multifactorial inheritance. Some genetic factors influence males specifically, whereas others affect both males and females. Frequently, however, in the clinic no clear cause for the observed infertility could be diagnosed which at least in part, it reflects our still poor understanding of the basic mechanisms that regulating and controlling the genetic networks of male infertility. Objective: To study the molecular identification of Azoospermic infertile patients by the gene sequencing of NR5A1. Subjects, Materials and Methods: A study carried out during the period from November 2014 to June 2015. Fifty specimens were collected from thirty azoospermic patients and twenty normal healthy subjects (normozoospermic subjects) as control their age ranged between 23 and 48 years old, the seminal fluid of cases indicated that liquefaction time, color and viscosity equal in normozoospermic subjects (control group) and patient group while there is significant difference P≥0.05 in sperm count reach to more than 20 million and motility reach to more than > 25% in control subjects while there is no sperm count found in azoospermic patients. Then blood was collected for hormonal assay, in azoospermic patients the results revealed a gradual decrease in serum testosterone levels with a concomitant increase in serum follicular stimulating hormone (FSH) level when compared with control subjects . NR5A1 gene were investigated in 30 samples of extracted DNA from azoospermic patients by using polymerase chain reaction (PCR) method it can directly detect the NR5A1 gene content after it had been molecularly identified then were sent successfully for sequencing analysis ,this study examined the presence of two transversion and one transition mutation of NR5A1 gene in azoospermic patients compared with control subjects, there’s no mutation in the same gene when compared with gene bank.
CA125 is a glycoprotein mucins (MUC16) tumor marker, used in screening, ovarian and endometrial malignancies and in monitoring therapy, early recurrences, and prognosis of these cancers. Hormonal induction for ovulation can elevate the risk of ovarian cancers so CA125 may be used for screening in PCOS as an unsafe group and the way of treatment may need to be changed in these patients. Polycystic Ovarian Syndrome (PCOS) is one of the most common hormonal disturbed diseases that can affect females in reproductive life. It has both metabolic and fertility impacts that can be seen in the reproductive period and post-menopausal life. To study the correlation between PCOS and CA125 level in relation to body weight in non-cancerous patients. 60 women were selected with age 18-42-year-old forty of them were diagnosed with PCOS according to Rotterdam criteria. They were divided into two groups according to BMI G1 was more than 25 kg/m 2 (overweight and obese) G2 was less than 25 kg/m 2 (normal) and the G3 was 20 healthy non-PCOS BMI less than 25 kg/m 2 . Blood samples were taken in the early follicular phase for assessing luteinizing hormone (LH), follicular stimulating hormone (FSH) and, free testosterone (FT) hormone. Other blood samples were taken at the late follicular phase to measure CA125 levels using Enzyme-Linked Immune Sorbent Assay (ELISA). PCOS G2 were significantly higher in the concentration of CA125 than PCOS G1 (p< 0.05), but there was no significant difference in CA125 level in groups when there is no significant difference in body mass index (BMI) between PCOS G1 and G2. P>0.05. The negative relation between CA125 concentration and weight. The tumor marker CA125 efficacy is decreased in obese women. Furthermore, PCOS not causes an increase in CA125 in the non-cancerous patient.
To assess the predictive value of different clinical, laboratory, and ultrasound parameters in Letrozole when used as an ovulation induction in anovulatory infertile PCOS women. The current study was done in the secondary-referral infertility clinic in AL-Yarmouk teaching hospital, and Al-Mustansiriyah medical college. Sixty-seven anovulatory infertile women with the polycystic ovarian syndrome. Letrozole was given orally on day 2 or 3 of the menstrual cycle for five days and repeated for three consecutive cycles. The primary outcome measures were to evaluate the response rate in the form of successful ovulation and clinical pregnancy. The ovulation rate was (64.2%), with clomiphene naïve vs. previous clomiphene use; it was 87.5%, 51.2% respectively, while pregnancy rate was (32.8%), 41.6% with clomiphene naïve vs. 27.9% with previous clomiphene use. Clinical (age, BMI, Waist circumference, cycle length and days between cycle, infertility period and type, previous reproductive outcome, androgen symptom and m-FG score), laboratory (E 2 , FSH, LH, testosterone, FAI, FBS, fasting insulin, HOMA – IR, and AMH) and ultrasound (mean ovarian volume, mean AFC and antral follicular diameter) parameters were founded to affect ovulation and pregnancy in different extent. After putting all variables in a scoring system, it was found that if the patients had > 26 points for the score, it's more likely that the woman becomes pregnant. A predictive pregnancy score was developed from basic clinical, laboratory, and ultrasound parameters. It may help the clinician to individualized ovulation induction protocol in PCOS women; however, external validation of this system is recommended in a more extensive prospective study.
Infertility is prevalent among couples in our community, and a considerable number of cases of infertility are caused by tubal factors. The hysterosalpingography (HSG) technique is one of the most important tools for determining the patency status of the tubes. Nevertheless, this method has certain drawbacks that can be addressed with a less invasive alternative, such as hysterosalpingo-contrast sonography (HyCoSy) and hysterosalpingo- foam sonography (HyFoSy) .By enrolling subfertile patients undergoing hysterosalpingo- foam sonography (HyFoSy) or hysterosalpingo-contrast sonography (HyCoSy) procedures and subsequently undergoing intrauterine insemination (IUI), this study sought to evaluate the pregnancy rate in a large single center prospectively . Between January 2024 and January 2025, 100 women who underwent IUI as a therapy modality for infertility at the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies in Kadhimiya city, Baghdad, were involved in this randomized controlled research. Those who underwent hysterosalpingo-contrast sonography with foam (HyFoSy) or HSG evaluation of the fallopian tube were included. The main results were a biochemical pregnancy test (blood test) and clinical pregnancy verified by ultrasonography at 6–8 weeks gestation . When comparing the HyFoSy and HyCoSy groups, the mean serum levels of estradiol, FSH, LH, prolactin, TSH, and testosterone did not differ significantly (p > 0.05). Differences in the mean length of infertility, the mean ova size, the mean ova count, the average endometrial width (ET), the average number of antral follicles (AFC), and the forms of infertility (p > 0.05). Sixty-eight percent of the HyFoSy group and forty percent of the HyCoSy group experienced successful pregnancies, with a significant difference (p = 0.005) . These results imply that HyFoSy might be better than HyCoSy when tubal evaluation is required before IUI, assuming they are validated in bigger multi-center trials. Future studies should investigate long-term results, such as live birth rates, and include a control group (IUI without prior tubal evaluation).
Background: Polycystic ovarian syndrome (PCOS) constitutes the most common endocrinopathy of women of reproductive age. Women with PCOS manifest hyperandrogenemia, hyperinsulinemia, and hypothalamic-pituitary-ovarian axis aberrations. Objective: The objective of the present study was to find the prevalence and the presenting features of PCO patients and associated manifestations in relation to biochemical and anthropometric parameters in adult obese women attending obesity research and therapy unit. Methods: Patients diagnosed as PCOS according to Androgen Excess and PCOS Society/2009 criteria were grouped into two groups: those with BMI less than 30kg/m2 and those with BMI 30kg/m2 and more. Blood was drawn for biochemical and hormonal assay. Information tabulated, means and percentages used, and the results were analyzed. Results: The number of adult females 20-40 years of age attending Obesity research and therapy unit (ORTU) during February 2013 to February 2014 was 756, (14.3%) of them had PCOS, (65%) were diagnosed during examination. (94.4%) had menstrual disturbances, (63.8%) had hirsutism and (91.7%) had PCOS ultrasound findings. Mean BMI of the patients with PCOS was 33.62 (SD 4.21). Mean LH exceeded mean FSH in patients with PCOS and it was more evident with increasing BMI where it was doubled in those with BMI more than 30 kg/m2. LH/FSH ratio for BMI above 30 was 2.1, and although testosterone level was elevated showed no statistical relation to BMI. The fasting glucose level, cholesterol and triglycerides levels showed the same pattern of elevation that with increasing BMI. Conclusions: The prevalence of PCOS in females (20-40y) attending ORTU was 14%, of them 65% were undiagnosed before, 63% had hirsutism, 94% had menstrual disturbances and 90% had ultrasonic features of polycystic ovary. These findings suggest the need to stress on diagnosing PCOS in adult female during management of obesity.
Background: Tribulus terrestris (TT), Phoenix dactilyfera (Pd) and Nasturtium officinale (No) were believed to have fertility-enhancing effects and given by herbalists in Baghdad to men who need to increase their fertility capacity. Objectives: To investigate the possibility that aqueous and ethanolic extracts of the plants mixture can counteract the adverse effect of theobromine on reproductive system of male mic. Materials and Methods: One hundred and twenty mature male mice were injected intraperitoneally with 250 mg/kg/day of theobromine for four weeks. Then the males were treated intraperitonially with different dose levels of aqueous and ethanolic extracts of a mixture of the three plants for four weeks to evaluate their effects on body weight, reproductive organs weight, sperm parameters, hormones level and reproductive performance. Results: Both extracts showed a significant enhancement in all parameters studied. Almost all these results showed a dose dependent pattem with the ethanolic extract being the more effective than aqueous extract in all parameters. Conclusions: Mixture of the three plants seems to counteract the action of theobromine on the reproductive system of male mice through enhancing the concentration and motility of spermatozoa, increasing epididymis and seminal vesicles weight which are an indicator of testosterone production which brought about the stimulation of all male reproductive organs.
Background: The effects of Lead and other essential metal like zinc and copper on the reproductive system have been previously reviewed. Objective: Our goal in this study was to estimate the levels of Lead, Zinc and Copper in patients with polycystic ovary syndrome and to confirm the effect of such metals on the female reproductive system at environmental exposure. Materials and Method: Fifty two women in their reproductive age (20-40) years old, which had been diagnosed as PCOS. Venous blood sample were taken from each patient and control, blood lead, zinc and copper were determined by atomic absorption spectrophotometer. Hormone assay were determined by ELISA (Enzyme Linked Immune Sorbet Assay) technique. Results: This study showed a significant increase of blood lead and serum zinc, copper (p<0.01), in addition to testosterone, lutenizing hormone, LH/FSH ratio and body mass index (BMI) (p<0.05) in patients with polycystic ovary syndrome when compared with control. Conclusions: On the basis of the observations of the present study, it can conclude that the increased levels of Lead as a result of the exposure to this metal may be a risk factor for the development of polycystic ovary syndrome in women and has adverse effects on female endocrine and reproductive function.
Inhibition of luteinizing hormone (LH) by gonadotropin releasing hormone (GnRH) antagonist may lead to suboptimal response during ovarian stimulation. In addition, several studies suggest that low level of LH is associated with lowered fertilization and implantation rate and increased early pregnancy loss rate. The aim of this study is to study the effect of adding low dose human chorionic gonadotropin (hCG - 200 IU), as an LH supplement, to recombinant follicle stimulating hormone (rFSH) in a GnRH antagonist cycles in women undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment. Sixty-three infertile women undergoing IVF were randomly divided into two groups. One group was stimulated with the conventional stimulation protocol (rFSH alone), while the second group received 200 IU hCG in addition to rFSH in the late follicular phase (hCG + rFSH). Both groups' results including pregnancy rate, total dose of rFSH required, duration of stimulation, endometrial thickness, oocytes and embryos characteristic, serum hormone levels (Testosterone, Estradiol, Progesterone, and LH) and level of epidermal growth factor (EGF) were compared. The results show that pregnancy rate among the group of women who received the low dose hCG was higher than those who did not receive hCG. However, this difference did not reach statistical significance. Furthermore, other cycle outcomes and hormonal values were comparable between the two stimulation protocols.