Search Results (27)

Background: Obesity is a complicated, chronic condition that has a major impact on reproductive health, leading to infertility, anovulation, and poor pregnancy outcomes. It alters the hypothalamic–pituitary–ovarian (HPO) axis, promotes insulin resistance, and causes persistent low-grade inflammation, all of which result in hormonal abnormalities that compromise normal ovarian function. Because standard weight loss procedures frequently fail to provide significant and long-term reproductive benefits, bariatric surgery is becoming increasingly popular as a therapeutic option for obese women trying to conceive. However, continuous research is being conducted to determine the degree of its advantages and potential hazards to fertility and pregnancy outcomes. Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards and entered into the PROSPERO database. Comprehensive searches in the PubMed, Scopus, and Web of Science databases turned up relevant studies. Studies that examined the effects of bariatric surgery on female fertility, ovulatory function, pregnancy rates, and neonatal outcomes were considered. Methodological quality and risk of bias were evaluated using the Newcastle–Ottawa Scale (NOS) for observational studies and the Cochrane Risk of Bias Tool for randomized controlled trials. Results: This review comprised 34 studies. More than 75% of the studies analyzed showed improvements in ovulatory function, monthly regularity, or spontaneous pregnancy after bariatric surgery. Post-surgical pregnancies are related to a lower incidence of gestational diabetes, hypertension, and macrosomia. However, several studies raised concerns about nutritional inadequacies and the possibility of small-for-gestational-age newborns, particularly following Roux-en-Y gastric bypass. Studies suggest delaying conception for 12 to 18 months after surgery to reduce nutritional hazards and improve pregnancy outcomes. Variability in study design, follow-up duration, and surgical methods reduces the generalizability of findings, emphasizing the importance of uniform research protocols. Conclusions: Bariatric surgery is a highly effective treatment for increasing fertility and pregnancy outcomes in obese women, particularly those with PCOS. However, rigorous preconception planning, postoperative nutritional monitoring, and multidisciplinary follow-up are required to reduce the related hazards. Future research should concentrate on long-term reproductive outcomes, standardizing fertility assessment criteria, and improving clinical guidelines for managing post-bariatric pregnancies. These findings support the incorporation of bariatric surgery into fertility treatment regimens for obese women, and they may shape future revisions to clinical guidelines on reproductive care following weight loss surgery. Full article

Objectives. A case–control study was conducted to investigate the exposure levels to some specific chemicals, in women with infertility issues, compared with fertile women. Methods. A total of 186 cases and 196 controls were recruited. Each participant provided a urine sample for the determination of six phthalate metabolites (mono-ethyl phthalate, MEP; mono-n-butyl phthalate, MnBP; mono-n-ottyl phthalate, MnOP; monobenzyl phthalate, MBzP; and two metabolites of the diethyl-hexyl phthalate (DEHP): mono(2-ethyl-5-hydroxyhexyl) phthalate, MEHHP and mono(2-ethylhexyl) phthalate, MEHP) in addition to bisphenol A, BPA. Each woman also completed a questionnaire. The urine samples were analyzed using HPLC/MS/MS methods. Results. The analysis revealed significantly higher metabolite concentrations in cases than in controls for all metabolites, except MnOP. Stratification based on infertility factors, showed a significant association of MnBP, MBzP, BPA and DEHP with ovulatory and endocrine dysfunctions. Furthermore, higher mean concentrations of MEP and DEHP were observed in women with recurrent pregnancy loss (RPL) and idiopathic infertility, respectively. Conclusion. These findings suggest that some of the analyzed chemicals may play a role in female infertility. Exposure to DEP (diethyl phthalate) and DEHP appears to be associated with RPL and idiopathic infertility. Further investigation is required to explore potential sources of these risks. Full article

Polycystic ovary syndrome (PCOS) is a complex endocrine disorder that affects women of reproductive age and is characterized by hyperandrogenism, ovulatory dysfunction and polycystic ovarian morphology. PCOS is often associated with hormonal imbalances, metabolic dysfunction and comorbid psychiatric disorders, including eating disorders (EDs). The review identifies key hormonal factors—serotonin, leptin, insulin, ghrelin, kisspeptin and cortisol—and their roles in the pathophysiology of PCOS and associated psychiatric symptoms. Serotonin deficiency, commonly seen in PCOS patients, is associated with mood and eating disorders. Fluctuations in leptin, the satiety hormone, affect hypothalamic–pituitary–ovarian axis function and ovarian follicle maturation, increasing the risk of infertility. Elevated levels of kisspeptin in PCOS patients contribute not only to hormonal dysregulation but also to increased susceptibility to eating disorders such as bulimia and binge eating, likely due to its influence on the limbic system and glucose metabolism. Hyperinsulinemia and insulin resistance further impair reproductive and metabolic health, while promoting eating disorders such as binge eating and bulimia. Ghrelin and cortisol also emerge as significant factors. The review emphasizes the bidirectional relationship between PCOS and eating disorders, in which hormonal imbalances perpetuate psychiatric conditions, creating a vicious cycle. A multidisciplinary approach including gynecologists, endocrinologists, psychiatrists and nutritionists is recommended to ensure complex treatment. Early identification of those at risk through targeted screening and personalized interventions is key. Future research should focus on discovering the underlying hormonal mechanisms to improve treatment strategies and quality of life for women with PCOS. Full article

Background/Objective: The aim of this study was to outline the relationships between selected parameters connected with lifestyle and serum anti-Müllerian hormone (AMH) levels, i.e., a marker of ovarian reserve. By examining AMH levels in connection with nutrient intake and body composition parameters, this study aimed to provide a preliminary background for further studies focused on establishing dietary and lifestyle recommendations that could lead to improvements in fertility outcomes. Methods: The research involved 28 women, aged 26 to 42—both with and without ovulatory infertility—who were patients of the Reproductive Health Clinic at the Medical University of Białystok. The participants underwent a number of tests consisting of hormonal profiling, including AMH measurements, body composition analyses, and dietary assessments based on a 3-day food diary. Results: The findings of the study indicate that certain lifestyle factors are associated with changes in AMH levels. Most importantly, the multivariate linear regression model designed in the study shows that age, waist-to-hip ratio (WHR), as well as the intake of sucrose, iodine, and erucic acid explain variations in serum AMH levels. These results support the hypothesis that modifiable lifestyle factors can influence AMH levels, and thus ovarian reserve. Conclusions: The study underscores the potential for targeted lifestyle interventions to support fertility and calls for further research in the form of prospective studies performed in larger groups of patients to substantiate these associations and inform fertility care strategies. Based on the preliminary results of this study, certain dietary ideas that could positively influence fertility have been proposed, focused on the normalization of body weight and the reduction in excess fat tissue. Full article

Background/Objectives: Obesity is a growing global health concern, which increases the risk of various diseases and has seen a rising prevalence over time. The global prevalence of obesity among adults has doubled over time. Obesity significantly impacts health by increasing the risk of a range of severe medical conditions. Cardiovascular diseases, such as heart attacks and strokes, are more prevalent in individuals with obesity due to factors like high blood pressure and abnormal cholesterol levels. This systematic review and meta-analysis sought to establish the effectiveness of bariatric surgery in treating infertility in women. Methods: This systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. A broad electronic search was conducted through PubMed, Web Science, and Medline databases for studies published between April 2017 and October 2023. The search strategy used the following terms: bariatric surgery, metabolic surgery, bariatric surgical procedures, stomach stapling, infertility, and fertility issues. The data were analyzed using the Revman version 5.1.2 software. Results: The results of the study show that despite the heterogeneity found in the studies, irregular menstrual cycles were found to reduce significantly in patients who underwent bariatric surgery (p = 0.01), with an RR of 0.22, at a 95% CI (0.06, 0.74). With regards to infertility, the results indicate that bariatric surgery reduced the level of infertility among the patients significantly (p = 0.00001), with an RR of 0.55, at a 95% CI (0.45, 0.68). Further, the results show bariatric surgery reduced rate of miscarriages among patients (p = 0.01), with an RR of 0.51, at a 95% CI (0.30, 0.86). Moreover, bariatric surgery reduced the level of congenital malfunction, but the effect was not statistically significant (p = 0.16), with an RR of 0.39, at a 95% CI (0.10, 1.45). However, the overall effect of bariatric surgery on treating infertility was found to be significantly effective (p = 0.0001), with an RR of 0.54, at a 95% CI (0.43, 0.68). This implies that bariatric surgery helps in weight loss, which improves ovulatory dysfunction and irregular menstruation while boosting spontaneous conception. Conclusions: This study found that bariatric surgery helps infertile women of a reproductive age to lose weight, which improves ovulatory dysfunction and irregular menstruation while boosting spontaneous conception. On the other hand, the study noted that after bariatric surgery, spontaneous conception can occur because of a decreased rate of miscarriage, increased fertility, reduced levels of congenital malfunction, and the restoration of regular menstrual cycles. Therefore, this study highlights the need to offer adequate preconception care and counselling to women who are about to be pregnant, both before and after bariatric surgery. Further, based on the fact that this study focused on general bariatric surgery, future research should focus on specific types of bariatric surgery to establish the most effective type of bariatric surgery in treating infertility in women. Full article

Metabolic dysfunction-associated steatotic liver disease (MASLD) and polycystic ovary syndrome (PCOS) are prevalent conditions that have been correlated with infertility through overlapped pathophysiological mechanisms. MASLD is associated with metabolic syndrome and is considered among the major causes of chronic liver disease, while PCOS, which is characterized by ovulatory dysfunction and hyperandrogenism, is one of the leading causes of female infertility. The pathophysiological links between PCOS and MASLD have not yet been fully elucidated, with insulin resistance, hyperandrogenemia, obesity, and dyslipidemia being among the key pathways that contribute to liver lipid accumulation, inflammation, and fibrosis, aggravating liver dysfunction. On the other hand, MASLD exacerbates insulin resistance and metabolic dysregulation in women with PCOS, creating a vicious cycle of disease progression. Understanding the intricate relationship between MASLD and PCOS is crucial to improving clinical management, while collaborative efforts between different medical specialties are essential to optimize fertility and liver health outcomes in individuals with MASLD and PCOS. In this review, we summarize the complex interplay between MASLD and PCOS, highlighting the importance of increasing clinical attention to the prevention, diagnosis, and treatment of both entities. Full article

Prolactin (PRL) is a pleiotropic hormone released from lactotrophic cells of the anterior pituitary gland that also originates from extrapituitary sources and plays an important role in regulating lactation in mammals, as well as other actions. Acting in an endocrine and paracrine/autocrine manner, PRL regulates the hypothalamic–pituitary–ovarian axis, thus influencing the maturation of ovarian follicles and ovulation. This review provides a detailed discussion of the current knowledge on the role of PRL in the context of ovulation and ovulatory disorders, particularly with regard to hyperprolactinemia, which is one of the most common causes of infertility in women. Much attention has been given to the PRL structure and the PRL receptor (PRLR), as well as the diverse functions of PRLR signaling under normal and pathological conditions. The hormonal regulation of the menstrual cycle in connection with folliculogenesis and ovulation, as well as the current classifications of ovulation disorders, are also described. Finally, the state of knowledge regarding the importance of TIDA (tuberoinfundibular dopamine), KNDγ (kisspeptin/neurokinin B/dynorphin), and GnRH (gonadotropin-releasing hormone) neurons in PRL- and kisspeptin (KP)-dependent regulation of the hypothalamic–pituitary–gonadal (HPG) axis in women is reviewed. Based on this review, a rationale for influencing PRL signaling pathways in therapeutic activities accompanying ovulation disorders is presented. Full article

Endometrial receptivity is a complex process that prepares the uterine endometrium for embryo implantation; insufficient endometrial receptivity is one of the causes of implantation failure. Here, we analyzed the microRNA expression profiles of exosomes derived from both receptive (RL95-2) and non-receptive (AN3-CA) endometrial epithelial cell (EEC) lines to identify exosomal miRNAs closely linked to endometrial receptivity. Among the 466 differentially expressed miRNAs, miR-205-5p was the most highly expressed in exosomes secreted from receptive RL95-2 cells. miR-205-5p, enriched at the adhesive junction, was closely related to endometrial receptivity. ZEB1, a transcriptional repressor of E-cadherin associated with endometrial receptivity, was identified as a direct target of miR-205-5p. miR-205-5p expression was significantly lower in the endometrial tissues of infertile women than in that of non-infertile women. In vivo, miR-205-5p expression was upregulated in the post-ovulatory phase, and its inhibitor reduced embryo implantation. Furthermore, administration of genetically modified exosomes overexpressing miR-205-5p mimics upregulated E-cadherin expression by targeting ZEB1 and improved spheroid attachment of non-receptive AN3-CA cells. These results suggest that the miR-205-5p/ZEB1/E-cadherin axis plays an important role in regulating endometrial receptivity. Thus, the use of exosomes harboring miR-205-5p mimics can be considered a potential therapeutic approach for improving embryo implantation. Full article

FSH, estrogen and progesterone testing are widely utilized in clinical practice. Lateral flow assays (LFAs) are cost-effective tools used for diagnosing infectious diseases, pregnancy, and substance testing. The focus of this narrative review is the potential for the wider utilization of listed hormone LFAs. A search was conducted with PubMed, Google Scholar and Wiley online libraries using keywords without any limitation on the publication date; animal studies were excluded. Clinical guidelines for the related conditions were included. According to published data, E3G and PdG are used to determine ovulatory cycles and can be utilized for research purposes to establish the normal range of menstrual cycles, as there is currently disagreement among guidelines. FSH measurement in blood samples is utilized to predict oocyte yield in assisted cycles and to differentiate women with premature ovarian insufficiency from hypothalamic amenorrhea, and can be replaced with more convenient urine testing. PdG was tested to assess the risk of pregnancy complications, specifically miscarriage and ectopic pregnancy, and might become a screening tool for miscarriage in the future. PMS, PMDD and ovarian carcinogenesis could be extensively studied using LFAs to gain a better understanding of the biology behind these conditions. Before implementing these LFAs into clinical practice, the reproducibility of progesterone assays should be evaluated. The results are critical for treatment decisions, and universally recognized standards for estradiol measurement should be developed. Full article

Ovulatory infertility is a serious clinical problem whose direct causes are still largely unknown. In addition to pathologies that make it impossible for a couple to establish a pregnancy, there are a number of other factors that have a bearing on fertility, including lifestyle factors, and particularly diet. Although numerous studies have been performed linking such factors to ovulatory infertility, most of them lack the necessary clinical significance, instead focusing on observational data and suggesting or establishing associative relationships. This article consists of a literature review focusing on connections between lifestyle factors such as diet, physical exercise, oxidative stress, sleep, and supplementation, and ovulatory infertility. Special emphasis was given to issues such as obesity and insulin resistance and their mutual relationship with other factors linked to ovulatory infertility. In addition, based on the conclusions of the literature review, the authors have proposed a classification of relationships between ovulation disorders and lifestyle factors in ovulatory infertility within the framework of the WHO classification of ovulation disorders. Furthermore, areas that merit further research have been indicated as well as those that do not. WHO Group II disorders gained prominence in the results of the study as the number of links with lifestyle factors and ovulatory infertility found in the course of the review greatly exceeded those for Groups I and III. The data presented in the article show that the issues of proper diet and physical exercise are those that could benefit from robust clinical studies focused specifically on ovulation infertility, while studies concerning the relationship between oxidative stress, sleep, and supplementation and ovulatory infertility do not seem to be promising directions as far as clinical significance is concerned. Full article

(1) Background: Infertility is a prevalent issue that affects 10–18% of couples worldwide, and up to 30% in Eastern Europe. Infertility of unknown etiology is one of the most challenging forms of infertility. Vitamin D has recently been extensively studied and researchers are investigating its possible role in ovulation and pregnancy. While the evidence suggests a positive association between vitamin D and ovulation, more research is needed to understand the role that vitamin D plays in ovulation. (2) Methods: In this study, 86 infertile patients were studied retrospectively in a single center by analyzing their anthropometric (body mass index), biochemical (total cholesterol, insulin resistance) and hormonal data in correlation with their vitamin D status. (3) Results: It was found that the mid-luteal progesterone level was significantly related to the 25-hydroxy vitamin D level in a multivariate linear regression model. An analysis of subgroups of ovulatory and anovulatory patients suggests that serum 25-hydroxy vitamin D levels of approximately 20 ng/mL may be necessary to trigger ovulation or to support progesterone secretion. (4) Conclusions: Vitamin D deficiency should be considered when infertility of unknown etiology and progesterone-related disorders occur. Full article

Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder that affects 8–13% of women of reproductive age. It is one of the most common causes of infertility and is associated with hyperandrogenism in the form of hirsutism and acne, non-ovulatory cycles, and characteristic ovarian morphology. The available research on serum vitamin D deficiency in patients with PCOS and the appropriateness of vitamin D supplementation in this group of women is inconclusive, so we decided to investigate the influence of vitamin D on the incidence of metabolic syndrome and hormonal balance in patients with polycystic ovary syndrome. The study comprised 120 women aged between 18 and 42 years, who were divided into two groups: a group with diagnosed polycystic ovary syndrome (PCOS) and a group of regularly menstruating women without features of androgenisation, in whom polycystic ovary syndrome was excluded. Each patient underwent a history and physical examination, including a gynecological examination, anthropometric measurements were taken, including height, weight, waist, and hip circumference, and blood pressure was measured using the Korotkow method. In the female patients, the following parameters were also determined from the blood: follicle-stimulating hormone (FSH), luteinizing hormone (LH), oestradiol, TSH, ft4, prolactin (PRL), total testosterone, DHEASO4, 17-hydroxyprogesterone (17-OHP), sex-hormone-binding globulin (SHBG), androstendione, 25(OH) vitamin D3 metabolite. The majority of the patients with polycystic ovary syndrome were found to have deficient or suboptimal serum vitamin D levels, and the effects of vitamin D on the SHBG levels and free-androgen indices in these patients was examined. The effects of vitamin D on the incidence of metabolic syndrome and BMI, waist-to-hip ratio, waist circumference, and blood pressure in patients with polycystic ovary syndrome were also found. Full article

Polycystic ovary syndrome (PCOS) is a common endocrine disorder characterized by hyperandrogenemia of ovarian thecal cell origin, resulting in anovulation/oligo-ovulation and infertility. Our previous studies established that ovarian theca cells isolated and propagated from ovaries of normal ovulatory women and women with PCOS have distinctive molecular and cellular signatures that underlie the increased androgen biosynthesis in PCOS. To evaluate differences between gene expression in single-cells from passaged cultures of theca cells from ovaries of normal ovulatory women and women with PCOS, we performed single-cell RNA sequencing (scRNA-seq). Results from these studies revealed differentially expressed pathways and genes involved in the acquisition of cholesterol, the precursor of steroid hormones, and steroidogenesis. Bulk RNA-seq and microarray studies confirmed the theca cell differential gene expression profiles. The expression profiles appear to be directed largely by increased levels or activity of the transcription factors SREBF1, which regulates genes involved in cholesterol acquisition (LDLR, LIPA, NPC1, CYP11A1, FDX1, and FDXR), and GATA6, which regulates expression of genes encoding steroidogenic enzymes (CYP17A1) in concert with other differentially expressed transcription factors (SP1, NR5A2). This study provides insights into the molecular mechanisms underlying the hyperandrogenemia associated with PCOS and highlights potential targets for molecular diagnosis and therapeutic intervention. Full article

Nanotechnology has prompted new aspirations for managing modern human challenges. Furthermore, it has been utilized for aid in the prevention, diagnosis, and treatment of ovulatory disorders. Women with ovulatory issues may benefit from formulations using nanotechnology as an alternative possible treatment. Clomiphene citrate is a nonsteroidal, ovulatory stimulant that acts as a selective estrogen receptor modulator (SERM). It is a triphenyl ethylene stilbene derivative that is primarily used to trigger ovulation in female infertility cases where there is anovulation. Anovulatory infertility is most frequently caused by polycystic ovarian syndrome (PCOS), which is a gynecological endocrine disorder. Elevated serum concentrations of androgens, LH, and insulin are the main features of its endocrine profile. The primary goal of treating PCOS-related infertility is to increase the amount of FSH that is exposed to the ovary, either by antagonizing the estrogenic effects of clomiphene citrate in the hypothalamus or by directly affecting the ovary using recombinant follicle-stimulating hormone (FSH). In about 80% of treated individuals, ovulation is recovered by clomiphene citrate. In this review, we discuss the chemistry and pharmacology of clomiphene citrate, as well as the delivery of clomiphene citrate via nanosystems for improving solubility and limiting side-effects. The hyphenated techniques for analyzing and quantifying clomiphene citrate in solvents and biological samples are also overviewed. Full article

The endocrine disorder polycystic ovarian syndrome (PCOS) is complicated. In India, two out of every ten women have PCOS. PCOS can also be identified with a polycystic ovary morphology and an ovulatory hyperandrogenism. PCOS, defined as one of the most common female endocrine diseases, affects about 20–25% of women of reproductive age, and is thought to be one of the primary causes of female infertility. Metabolic abnormalities, irregular periods, hypertension, and increased insulin levels are more prone to occur in women with PCOS. In addition, there are more sub-follicular cysts and increased androgen production, including testosterone from the ovaries. Low vitamin levels in PCOS women place them at a high risk for developing severe COVID-19, a risk that may be increased by limited sun exposure brought on by COVID-19 quarantine measures. Therefore, there is a greater need for the public awareness of PCOS. PCOS is a treatable illness that can be treated with safe and effective natural remedies, including the use of various herbs and seeds. To decrease the cost, length, and side effects of current treatments, polyherbal formulations must be developed based on the aforementioned variables. By altering a woman’s diet, exercise, doing yoga asanas, and altering her lifestyle, PCOS can be controlled. An effort has been made to review the utilization of natural remedies for PCOS treatment. Full article