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1.
Artigo em Inglês | MEDLINE | ID: mdl-38978302

RESUMO

BACKGROUND: Congenital uterine anomalies include a wide diversity of uterine malformations that can compromise reproductive potential. Uterus transplantation (UTx) proposes an innovative treatment for absolute uterine factor infertility; however, there is a lack of standardized protocols to guide clinical management among this population. OBJECTIVES: To describe recipient and donor characteristics and obstetric outcomes in patients undergoing UTx. SEARCH STRATEGY: We performed a literature search using the PubMed database to retrieve available scientific articles. We analyzed the references of included articles to assess additional articles that could be eligible to be included in the review. Likewise, we identified further studies using other methods, including Google Scholar. SELECTION CRITERIA: Titles and abstracts were screened in duplicate to select original reports with information available for the outcomes of interest. DATA COLLECTION AND ANALYSIS: This review assessed the advantages and disadvantages of the techniques used, patient characteristics, obstetric and non-obstetric complications, functional duration of the organ, and neonatal outcomes. MAIN RESULTS: Among the 36 reports included in this review we found 55 pregnancies and 38 live births following UTx and a higher success rate for in vivo uterine donations. The most common obstetric complications reported included miscarriage, pre-eclampsia, and gestational hypertension. The most common non-obstetric complications reported include episodes of rejection, acute kidney injury, anemia, and cholestasis. Living donors required a comprehensive preoperative workup, decreasing organ rejection, infection, and vascular complications. CONCLUSIONS: More studies are needed to standardize the UTx procedure and improve obstetric, fetal, and neonatal outcomes. Further understanding of which recipient and donor characteristics minimize complications will significantly decrease the risk of adverse outcomes.

2.
Heliyon ; 10(10): e31396, 2024 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-38818201

RESUMO

Introduction: Genital tuberculosis (GT) is an infection that can affect the female reproductive system, including the uterus, cervix, and ovaries. Objective: To perform a scientometric exploration to analyze the spatiotemporal trend, evolution, and emerging patterns of scholarly output on GT and female infertility. Methods: An observational, descriptive, retrospective study employing a scientometric methodology was carried out. Metadata from scholarly articles spanning the years 1990-2022 were extracted from the Web of Science. The metadata from the chosen articles, totaling 172 manuscripts, were exported on May 17, 2023, in plain text format, which will allow the analysis and integration of the data in the software used. Results: We found at 111 sources and found 172 documents on tuberculosis and female infertility. We observed an average annual growth rate of 7.46 %, and the average age of the documents was 10.4 years. The dual overlay map showed the distribution of scientific publications on tuberculosis and female infertility. Journals on the left side of the map are cited mainly in the journals on the right. We found that Clinical Infectious Diseases and Lancet journals condensed patterns and trends in 1995, while the Indian Journal of Tuberculosis did so in 1996. Dheda K., Joubert JJ., and Wang Y. were the authors who had India, Iran, and China as their main affiliation, respectively, and they mainly published their studies in the "American Journal of Respiratory and Critical Care Medicine" and "Tropical Doctor," among others. Conclusions: This bibliometric study examined different sources and found an average annual growth rate of 7.46 %. Each article received an average of 16.48 citations. Different collaborative networks between countries were observed. In addition, there was a steady growth in published research in the field of tuberculosis and female infertility.

3.
Int J Gynaecol Obstet ; 164(1): 242-248, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37491876

RESUMO

OBJECTIVE: To verify whether low-molecular-weight heparin (LMWH) could increase pregnancy rates and/or decrease abortion rates in women with thrombophilia undergoing assisted reproduction cycles. METHODS: Cross-sectional study with patients undergoing in vitro fertilization (IVF) (N = 104). Women without thrombophilia (control group, n = 20), women with thrombophilia who did not receive LMWH (untreated group, n = 30), and women with thrombophilia, treated with daily enoxaparin from the day of embryo transfer until week 36 of gestation (treated group, n = 54). All women underwent controlled ovarian hyperstimulation. IVF was performed by intracytoplasmic sperm injection, and embryos were transferred on day 3. Pregnancy was detected by ß-human chorionic gonadotropin (biochemical pregnancy) and fetal heartbeat at week 5 to 6. Ongoing pregnancy was determined by ultrasound on week 12. RESULTS: Patients in the untreated thrombophilia group presented with significantly lower ongoing pregnancy rates and live birth rates and significantly higher early pregnancy loss and abortion rates when compared with the control and the treated thrombophilia groups. CONCLUSIONS: In women with diagnosed coagulation disorders, use of LMWH is important to avoid miscarriages.


Assuntos
Aborto Espontâneo , Trombofilia , Gravidez , Humanos , Masculino , Feminino , Heparina de Baixo Peso Molecular/uso terapêutico , Estudos Transversais , Sêmen , Fertilização in vitro , Taxa de Gravidez , Trombofilia/complicações , Trombofilia/tratamento farmacológico
4.
Rev. homeopatia (São Paulo) ; 85(1): 29-31, 2024.
Artigo em Português | LILACS, HomeoIndex - Homeopatia, MOSAICO - Saúde integrativa | ID: biblio-1562966

RESUMO

A infertilidade afeta milhões de mulheres em todo o mundo, sendo quase metade dos casos decorrentes de fatores tuboperitoneal, destacando- se a endometriose como doença de grande prevalência. Este artigo apresenta um caso clínico bem-sucedido de tratamento homeopático para infertilidade, resultando em rápida desobstrução da tuba uterina e gravidez em um ciclo ovulatório. O tratamento incluiu simillium (Nux vomica) e constitucional (Calcarea phosphorica), além de medicamento episódico (Eupion, Borax veneta e Endometrium).


Infertility affects millions of women worldwide, with nearly half of the cases attributed to tuboperitoneal factors, with endometriosis being a prevalent condition. This article presents a successful clinical case of homeopathic treatment for infertility, resulting in rapid unblocking of the fallopian tube and pregnancy in one ovulatory cycle. The treatment included simillium (Nux vomica) and constitutional (Calcarea phosphorica) remedies, along with episodic medication (Eupion, Borax veneta and Endometrium).


Assuntos
Humanos , Feminino , Adulto , Terapêutica Homeopática , Infertilidade Feminina/tratamento farmacológico , Calcarea Phosphorica/uso terapêutico , Eupionum/uso terapêutico , Materia Medica , Strychnos nux-vomica , Endométrio
5.
JBRA Assist Reprod ; 2023 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-37768816

RESUMO

OBJECTIVE: To assess whether follicular fluid (FF) from infertile women with endometriosis in advanced stages [moderate/severe (EIII/IV) without or with endometrioma (Endometrioma)] induce more oocyte damages than in early stages (minimal/mild: EI/II); and whether supplementation with L-carnitine (LC) and omega 3 (n3) can prevent these oocyte damages. METHODS: Experimental study using bovine oocytes (obtained of ovaries from slaughterhouse), and human FF (samples were obtained during oocyte recovery for ICSI). Bovine oocytes were submitted to in vitro maturation (IVM) divided into 9 groups: no FF(No-FF), with 1% FF from infertile women without endometriosis (FFC), with EI/II, EIII/IV and Endometrioma, and with (or not) LC+n3 addition. After IVM, oocytes were fluorescently labelled and visualized by confocal microscopy to analyze chromosomes and spindle. RESULTS: FF from endometriosis decreased rate of normal MII (spindle assembly and chromosome alignment) compared to No-FF (87.2%) and FFC (87.2%). FFEIII/IV (80.7%) and FFEndometrioma (69.3%) decreased total MII rate compared to No-FF (91.9%) and FFC (89.2%), and FFEndometrioma had lower total MII rate compared to other groups. LC+n3 increased MII rate in the FFEIII/IV (80.7% vs. 90.8%) and the Endometrioma (69.3% vs. 86.4%), and it prevented damages in spindle and chromosomes in MII oocytes in the FFEI/II group (62.2% vs. 84.5%) and the FFEIII/IV group (70.2% vs. 84.1%). CONCLUSIONS: FF of endometriosis damaged the meiotic spindle of bovine MII oocytes. EIII/IV led to impaired nuclear maturation; FF from women with endometrioma had further negative impact in oocyte maturation. LC+n3 completely prevented the effects of FF from women with endometriosis on oocyte.

6.
Clin Transl Oncol ; 25(7): 1893-1905, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36689055

RESUMO

Female infertility is a significant health issue worldwide with a rising incidence. Anti-cancer therapy is one of the most important reasons for increasing infertility. Although anti-cancer treatment increases the rate of survival, it decreases the quality of life through its side effects. The most substantial side effects are sexual dysfunction and infertility. Breast cancer is the most common cancer. The first-line treatment of breast cancer is chemotherapy by alkylating agents like cyclophosphamide, which leads to infertility. For instance, persistent chemotherapy-induced amenorrhea among breast cancer patients could affect almost half of the patients that undergo such therapy. However, some agents or therapeutic methods can ameliorate these intoxicating effects. Chemotherapy plus gonadotropin-releasing hormone agonist, in breast cancer patients, can not only improve overall survival but also reduce ovarian toxicity. Age plays an essential role in chemotherapy-induced amenorrhea. Chemotherapy at a younger age can reduce the risk of infertility. Gynecological cancers including uterine and ovarian cancer, which have high mortality rates, are the most related cancers to infertility. Surgery is the primary treatment of gynecological cancers. Studies demonstrated that fertility-sparing surgery is a better option than radical surgery. In addition, neoadjuvant chemotherapy is mostly a better option than primary cytoreductive surgery in terms of survival and fertility. Immune checkpoint inhibitors (ICIs) have recently played a major role in treating various cancer types. However, ICIs are associated with hypophysitis, which affects ovaries and can lead to infertility. There are some options for ovarian preservation such as embryo cryopreservation, oocyte cryopreservation, ovarian transposition, ovarian tissue cryopreservation, and ovarian suppression by GnRH agonists. Anti-müllerian hormone level can be utilized to monitor the ovarian reserve. Moreover, to avoid fertility loss, approaches such as using transplantation of human placenta mesenchymal stem cells, administrating anti-inflammatory agents and hormone therapy are under investigation.


Assuntos
Antineoplásicos , Neoplasias da Mama , Preservação da Fertilidade , Infertilidade Feminina , Gravidez , Humanos , Feminino , Infertilidade Feminina/terapia , Infertilidade Feminina/tratamento farmacológico , Antineoplásicos/efeitos adversos , Amenorreia/induzido quimicamente , Amenorreia/complicações , Amenorreia/tratamento farmacológico , Qualidade de Vida , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/complicações
7.
JBRA Assist Reprod ; 27(1): 97-111, 2023 03 30.
Artigo em Inglês | MEDLINE | ID: mdl-35916467

RESUMO

The development of assisted reproductive technology has allowed offspring in infertile couples, and specifically, allowed infertile men to conceive through Intracytoplasmic Sperm Injection (ICSI). Despite the proven efficacy of In Vitro Fertilisation (IVF) and ICSI, many factors can influence its success. In this review we present an analysis on the effect of Female age, Ovarian Reserve, Male age and Male factor on the outcomes of IVF/ICSI, to determine if and which can be applied to the practical context. A literature search on PubMed, EMBASE and MEDLINE for relevant articles was elaborated until July 2021, leading to the selection of 234 articles based on their titles. After reading through the abstracts, those that evaluated IVF/ICSI predicting factors were selected. Finally, only those approaching female age, ovarian reserve, male age and male factor were considered in this review. Higher female age and baseline ovarian markers alterations such as lower anti-Müllerian hormone and antral follicular count, and higher basal follicle-stimulating hormone, were associated with poorer outcomes. The predictive value of Male age and Male factor presented varied results across literature. The multifactorial nature of male fertility makes evaluation difficult. Although the first assessment of male infertility is based on sperm concentration, motility and morphology, semen parameters have shown low prognostic value, whilst sperm DNA alterations gain importance. Nevertheless, results remain controversial. While some factors have proven to predict IVF/ICSI success, other need to be further studied to be applied to practical context to allow the best prognosis possible.


Assuntos
Reserva Ovariana , Injeções de Esperma Intracitoplásmicas , Masculino , Feminino , Humanos , Injeções de Esperma Intracitoplásmicas/métodos , Sêmen , Fertilização in vitro/métodos , Resultado do Tratamento
8.
Gynecol Endocrinol ; 38(10): 874-878, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36067792

RESUMO

Objective: Evaluate histomorphometry of ectopic and eutopic endometrial tissues in receptor mice. Method: Eighteen female Balb/c were divided into 3 groups, 6 animals each: GI Control, no procedure; GII - Sham, animals that had the same procedures as GIII without receiving the ectopic endometrial implant. Instead, they received saline solution; GIII - endometriosis model, animals had surgical intervention with an ectopic endometrial implant. GI and GIII mice were treated with 17ß-estradiol, 100 µg/kg each. All animals were euthanized to collect uterine horns, which were fixed in 4% paraformaldehyde, embedded in paraffin, stained with Hematoxilin and Eosin and submitted to histomorphometric analyzes. Data underwent one-way ANOVA followed by Tukey's test. Results: Local tissue growth, showing important lesions and adhesions, as well as dark cysts were noticed. In GIII group, there was an increase in number of blood vessels and glands (GIII ≥ GI and GIII p > .001). Thickening of the GIII endometrial epithelial was also evident (GIII ≥ GI and GIII. p > .001). We also noticed an increase in the number of eosinophils (GIII (GIII ≥ GI and GIII. p > .001). Conclusion: Easy to perform model, capable of reproducing morphological endometriosis characteristics. From our findings, there was an increase of endometrial thickness as well as an increase in the eosinophils population.


Assuntos
Endometriose , Humanos , Feminino , Camundongos , Animais , Endometriose/patologia , Endométrio/patologia , Útero/patologia , Estradiol , Epitélio
9.
JBRA Assist Reprod ; 26(1): 105-122, 2022 01 17.
Artigo em Inglês | MEDLINE | ID: mdl-34338482

RESUMO

It is well known that female reproduction ability decreases during the forth decade of life due to age-related changes in oocyte quality and quantity; although the number of women trying to conceive has today increased remarkably between the ages of 36 to 44. The causes of reproductive aging and physiological aspects of this phenomenon are still elusive. With increase in the women's age, during Assisted Reproductive Technologies (ART) we have perceived a significant decline in the number and quality of retrieved oocytes, as well as in ovarian follicle reserves. This is because of increased aneuploidy due to factors such as spindle apparatus disruption; oxidative stress and mitochondrial damage. The aim of this review paper is to study data on the potential role of the aging process impacting oocyte quality and female reproductive ability. We present the current evidence that show the decreased oocyte quality with age, related to reductions in female reproductive outcome. The aging process is complicated and it is caused by many factors that control cellular and organism life span. Although the factors responsible for reduced oocyte quality remain unknown, the present review focuses on the potential role of ovarian follicle environment, oocyte structure and its organelles. To find a way to optimize oocyte quality and ameliorate clinical outcomes for women with aging-related causes of infertility.


Assuntos
Infertilidade Feminina , Oócitos , Adulto , Envelhecimento , Feminino , Humanos , Folículo Ovariano , Reprodução
10.
Clin Transl Oncol ; 24(2): 227-243, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34635959

RESUMO

Infertility is one of the main sequelae of cancer and its treatment in both children and adults of reproductive age. It is, therefore, essential that oncologists and haematologists provide adequate information about the risk of infertility and the possibilities for its preservation before starting treatment. Although many international clinical guidelines address this issue, this document is the first Spanish multidisciplinary guideline in paediatric and adult oncological patients. Experts from the Spanish Society of Medical Oncology, the Spanish Fertility Society, the Spanish Society of Haematology and Haemotherapy, the Spanish Society of Paediatric Haematology and Oncology and the Spanish Society of Radiation Oncology have collaborated to develop a multidisciplinary consensus.


Assuntos
Preservação da Fertilidade/normas , Infertilidade/prevenção & controle , Neoplasias , Humanos , Infertilidade/etiologia , Comunicação Interdisciplinar , Neoplasias/complicações
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