RESUMO
OBJECTIVE: Women undergoing IVF who have had a previous c-section (CS) have a lower live birth rate than those with a previous vaginal delivery. However, the precise underlying mechanisms need clarification. Does a previous CS affect the pattern of uterine contractility?. METHODS: Prospective evaluation in patients undergoing frozen blastocyst embryo transfer in medicated endometrial preparation cycles. Twenty patients were included in groups: A/nulliparous. B/previous vaginal delivery. C/ previous CS without a niche, whereas fifteen patients were recruited in group D (CS and a niche). Patients employed estradiol compounds and 800 mg vaginal progesterone. A 3D-scan was performed the transfer-day where uterine contractility/minute was recorded. RESULTS: Baseline characteristics (age, BMI, smoking, endometrial thickness) were similar. Mean frequency of uterine contractions/minute was similar between groups (1.15, 1.01, 0.92, and 1.21 for groups A, B, C, and D, respectively). There was a slight increase in the number of contractions in patients with a sonographic niche versus controls, not reaching statistical significance (p=0.48). No differences were observed when comparing patients with a previous C-section (regardless of the presence of a niche) to those without a C-section, either nulliparous (p=0.78) or with a previous vaginal delivery (p=0.80). The frequency of uterine contractions was similar between patients who achieved a clinical pregnancy and those who did not (1.19 vs. 1.02 UC/min, p=0.219, respectively). CONCLUSIONS: Our study found no significant difference in the frequency of uterine contractility between patients with or without a previous C-section or sonographic diagnosed niche. Further investigation is necessary to understand the physiological mechanisms affecting implantation in patients with isthmocele.
RESUMO
Statins are 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase inhibitor drugs that lead to serum-cholesterol-lowering effects. Rosuvastatin, a third-generation statin, has shown better results in reducing cholesterol concentrations when compared to other widely prescribed statins. Recent studies by our group reported that rosuvastatin impairs reproductive function in rats possibly by disrupting the reproductive-endocrine axis. In this study, we evaluated whether rosuvastatin presents estrogenic or antiestrogenic effects, by an in vivo uterotrophic assay in rats, and investigated the direct effect of this drug upon rat uterine tissue contractility both in non-gravid and gravid periods. Rosuvastatin exposure in vivo at doses of 0 (control), 3, and 10 mg/kg/d was not associated with estrogenic or antiestrogenic effects on uterine tissue. However, in vivo (doses of 0, 3, and 10 mg/kg/d) and ex vivo (concentrations of 0, 1, 10, and 100 µg/mL) exposures to this drug were related to alterations in uterine basal contraction pattern. Furthermore, in vivo and ex vivo rosuvastatin exposures potentially modulate the action of uterine contraction inducers carbachol, norepinephrine, and prostaglandin E2. Thus, rosuvastatin can affect uterine physiology not necessarily by an endocrine mechanism related to the estrogen signaling, but possibly by its pleiotropic effects, with indirect tissue and cellular interactions, since in vivo and ex vivo exposures of uterine fragments to rosuvastatin presented different responses in uterine contractile parameters, which require further studies upon the precise mechanism of action of this drug in female reproductive function.
Assuntos
Estrogênios , Inibidores de Hidroximetilglutaril-CoA Redutases , Animais , Colesterol , Estrogênios/toxicidade , Feminino , Inibidores de Hidroximetilglutaril-CoA Redutases/toxicidade , Gravidez , Ratos , Ratos Wistar , Rosuvastatina Cálcica/toxicidadeRESUMO
Were used 30 virgin female Wistar rats that were mated with adult male rats and vaginal smears were made to detect pregnancy. The pregnant rats were subdivided into pre-treated group with ethanol extract of M. urundeuva (EEMU) at doses of 125, 250 and 500mg/kg PO for 13 days and the untreated group that receiving distilled water being the extract at concentrations of 125, 250 and 500µg/mL added directly to the bath tub for isolated organ. Rats were euthanized by anesthetic overdose and the uterine strips were placed in the bath tub for isolated organ and subjected to contraction with 80mM KCl, oxytocin (16.8IU/mg) and Carbachol (0.3µM). Treatment with EEMU and its direct application did not interfere with uterine contractility of pregnant rats.
Assuntos
Feminino , Animais , Ratos , Etanol/análise , Fitoterapia/métodos , Fitoterapia/veterinária , Ratos Wistar/microbiologia , AnacardiaceaeRESUMO
Were used 30 virgin female Wistar rats that were mated with adult male rats and vaginal smears were made to detect pregnancy. The pregnant rats were subdivided into pre-treated group with ethanol extract of M. urundeuva (EEMU) at doses of 125, 250 and 500mg/kg PO for 13 days and the untreated group that receiving distilled water being the extract at concentrations of 125, 250 and 500µg/mL added directly to the bath tub for isolated organ. Rats were euthanized by anesthetic overdose and the uterine strips were placed in the bath tub for isolated organ and subjected to contraction with 80mM KCl, oxytocin (16.8IU/mg) and Carbachol (0.3µM). Treatment with EEMU and its direct application did not interfere with uterine contractility of pregnant rats.(AU)