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Cryptorchidism (CO) or undescended testes is defined as the failure of one or both testes to be positioned inside the scrotum. Typically, cryptorchidism is detected at birth or shortly thereafter, and in humans, it is considered to be part of the testicular dysgenesis syndrome (TDS), a complex pathology regarding the male reproductive system that apparently involves the interaction of both genetic and environmental harmful factors, mainly during embryonic development. Serotonin (5-HT) is an ancient molecule that participates in a broad range of body functions, and in recent years, its importance in reproduction has started to be elucidated. In male pathologies such as infertility, varicocele, erectile dysfunction, and primary carcinoid tumors, an increase in 5-HT concentration or its metabolites in the blood, semen, and urine has been directly related; nevertheless, the role of 5-HT in CO remains unknown. In the present work, our goal was to answer two important questions: (1) whether some serotonergic system components are present in adult male Oryctolagus cuniculus (chinchilla rabbit) and (2) if there are changes in their expression in an experimental model of CO. Using histological, molecular, and biochemical approaches, we found the presence of some serotonergic system components in the adult chinchilla rabbit, and we demonstrated that its expression is downregulated after CO was pharmacologically induced. Although we did not test the role of 5-HT in the etiology of CO, our results suggest that this indoleamine could be important for the regulation of steroidogenesis and spermatogenesis processes in the chinchilla rabbit during adulthood. Finally, in parallel experimental series, we found downregulation of kynurenine concentration in COI rabbits when compared to control ones, suggesting that CO could be affecting the kynurenine pathway and probably testicular immune privilege which in turn could lead to infertility/sterility conditions in this disorder.

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Abstract Dill (Anethum graveolens L.) essential oil is wide spread in the food, beverage and pharmaceutical sectors. Dill is a member of the Apiaceae (Umbelliferae) family. It has the following biological activities: antioxidant, antifungal, antibacterial, antimicrobial, antihyperlipidemic, antihypercholesterolemic, antispasmodic, antiproliferative and anti-inflammatory. Aqueous extract of dill seed has reported effects on sex hormones and infertility potential. Moreover, boiled dill seed has an impact on reducing labor duration in giving birth. Implantation and placentation are necessary for a healthy pregnancy in the early stages. Angiogenesis is responsible for these essential processes. This study aimed to investigate dill seed oil's cytotoxic and antiangiogenic effects on rat adipose tissue endothelial cells (RATECs). Dill seed oil showed dose-dependent cytotoxicity on RATECs. It disrupted endothelial tube formation and depolymerized F-actin stress fibers. According to this study, depolymerization of F-actin stress fiber by dill seed oil could inhibit angiogenesis by suppressing endothelial cell proliferation, tube formation and motility. In other words, dill seed oil can be a new anti-angiogenic agent and a novel contraceptive.

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The process of freezing cells or tissues and depositing them in liquid nitrogen at -196 °C is called cryopreservation. Sub-zero temperature is not a physiological condition for cells and water ice crystals represent the main problem since they induce cell death, principally in large cells like oocytes, which have a meiotic spindle that degenerates during this process. Significantly, cryopreservation represents an option for fertility preservation in patients who develop gonadal failure for any condition and those who want to freeze their germ cells for later use. The possibility of freezing sperm, oocytes, and embryos has been available for a long time, and in 1983 the first birth with thawed oocytes was achieved. From the mid-2000s forward, the use of egg vitrification through intracytoplasmic sperm injection has improved pregnancy rates. Births using assisted reproductive technologies (ART) have some adverse conditions and events. These risks could be associated with ART procedures or related to infertility. Cryopreservation generates changes in the epigenome of gametes and embryos, given that ART occurs when the epigenome is most vulnerable. Furthermore, cryoprotective agents induce alterations in the integrity of germ cells and embryos. Notably, cryopreservation extensively affects cell viability, generates proteomic profile changes, compromises crucial cellular functions, and alters sperm motility. This technique has been widely employed since the 1980s and there is a lack of knowledge about molecular changes. The emerging view is that molecular changes are associated with cryopreservation, affecting metabolism, cytoarchitecture, calcium homeostasis, epigenetic state, and cell survival, which compromise the fertilization in ART.

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OBJECTIVE: This study was designed to investigate the Ocimum gratissimum (OG) effects on sperm quality and testicular cytoarchitecture in alloxan-induced diabetic rats. METHOD: Twenty male Wistar rats (150-200 g) were assigned into 4 groups (n=5) as A (control), B (OG), C (Dia) and D (Dia+OG). Groups A and B were normal animals receiving distilled water or OG (400 mg/kg), respectively while diabetes was induced by alloxan monohydrate (100 mg/kg) in groups C and D, followed by the administration of distilled water or OG, respectively for 28 days. Blood samples were obtained for fasting blood glucose (FBG) and fructosamine determination while, epididymis and testes were obtained for sperm quality assessment using computer-assisted sperm analyzer and testicular histomorphometry, respectively. Seminiferous tubule diameter and interstitial space distance were quantified in hematoxylin and eosin stained slides. Statistical analysis was done using ANOVA and student t-test at α0.05. RESULTS: Fructosamine and FBG were reduced in Dia+OG (80.11±3.80µmol/L and 132.0±8.41mg/dl, respectively) compared with Dia (139.66±4.29µmol/L and 285.6±26.69mg/dl, respectively). Sperm count was unchanged in Dia, but decreased in OG and Dia+OG; abnormal sperm cells increased in OG, Dia and Dia+OG. Mild vacuolation in the seminiferous tubule, disorganized germinal cells layer, arrested sperm maturation with empty spermatozoa in lumen, decreased seminiferous tubule diameter and increased interstitial space were found in the testes of OG, Dia and Dia+OG compared with control. CONCLUSION: Diabetes induces sperm impairments and distortions in testicular cytoarchitecture, which were aggravated by OG leaf extract in male Wistar rats.

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Kisspeptin is involved in the control of human reproduction bridging the gap between the sex steroid levels and feedback mechanisms that control the gonadotropin releasing hormone (GnRH) secretion; however, studies considering this peptide and infertility are limited. We conducted a review and critical assessment of available evidence considering kisspeptin structure, physiology, function in puberty and reproduction, its role in assisted reproduction treatments, kisspeptin dosage and the impact on KISS1 and GPR54 genes. Literature searches were conducted in PubMed using keywords related to: (i) kisspeptin or receptors, kisspeptin-1 (ii) reproduction or infertility or fertility (iii) gene and (iv) dosage or measurement or quantification or serum level, in human. Kisspeptin is a product of KISS1 gene that binds to a G-protein-coupled receptor (GPR54/KISS1R) stimulating the release of GnRH by hypothalamic neurons, leading to secretion of pituitary gonadotropins (LH and FSH) and sexual steroids, which in turn will act in the gonads to produce the gametes. Kisspeptin is being recognized as a crucial regulator of the onset of puberty, the regulation of sex hormone mediated secretion of gonadotropins, and the control of fertility. Inactivating and activating mutations in both KISS1 or GPR54 genes were associated with hypogonadotropic hypogonadism and precocious puberty. Despite this, studies considering kisspeptin and infertility are scarce. The understanding of the role of kisspeptin may lead to its use as a biomarker in infertility treatments and use in controlled ovarian hyperstimulation.

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OBJECTIVE: To study whether embryos derived from oocytes presenting a smooth endoplasmic reticulum cluster (SERC) are less likely to develop into blastocysts and implant. DESIGN: Transversal study. SETTING: Private university-affiliated in vitro fertilization (IVF) center. PATIENT(S): Total of 7,609 oocytes obtained from 743 intracytoplasmic sperm injection (ICSI) cycles. INTERVENTION(S): Oocytes split between the SERC-positive cycles (with at least one SERC-positive oocyte) and the SERC-negative cycles (only oocytes free of SERC). MAIN OUTCOME MEASURE(S): Embryo implantation. RESULT(S): A statistically significantly higher mean number of follicles (24.0 ± 10.5 vs. 19.6 ± 10.5), retrieved oocytes (17.8 ± 8.3 vs. 14.3 ± 8.0), and mature oocytes (13.5 ± 6.2 vs. 10.6 ± 5.9) were observed in the SERC-positive cycles as compared with SERC-negative cycles. The implantation rate was statistically significantly lower in SERC-positive cycles as compared with SERC-negative cycles (14.8% vs. 25.6%; odds ratio 0.61; 95% confidence interval, 0.44-0.86). When only cycles with in which none (0) or all the blastocysts transferred had implanted (100%) were analyzed, the mean implantation rate per transferred blastocyst in the SERC-negative group was 20.5%; no blastocysts derived from SERC-positive oocytes implanted. CONCLUSION(S): The occurrence of SERC impairs embryo implantation. Careful oocyte observation that takes into account the presence of SERC should be part of embryo selection strategy before transfer.

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The hypothalamic hormone GnRH has traditionally been viewed as a central driver of the hypothalamic-pituitary-gonadal axis. Pulsatile GnRH release is required for pulsatile gonadotropin secretion, which then modulates gonadal steroid feedback and brings about full fertility in the adult. Pathways governing GnRH ontogeny and physiology have been discovered by studying humans with disorders of GnRH secretion. In this chapter, the human genetics of the kisspeptin signaling pathway in patients with diverse reproductive phenotypes will be explored. The discovery of defects in the kisspeptin system in several reproductive disorders has shed light on the mechanisms involved in regulating GnRH secretion, revealing the critical role played by the kisspeptin signaling pathway in pubertal initiation and reproductive function.

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OBJETIVOS: caracterizar el comportamiento de la infertilidad en 11 consultorios del Policlínico Héroes de Girón del municipio Cerro. MÉTODOS: se realizó un estudio descriptivo de corte transversal. La selección de los consultorios fue por muestreo por criterios, y los de selección fueron: que tuvieran una distribución equitativa en los Grupos Básicos de Trabajo, así como la estabilidad y conocimiento profundo del área por el personal de enfermería (quien ejecutó la investigación, previa capacitación en el tema). Se aplicaron 2 instrumentos: un formulario a nivel del consultorio y una encuesta a las parejas con problemas por infertilidad. Como medida de resumen se utilizó el porcentaje. RESULTADOS: de un total de 700 parejas en edad fértil que se encontraron, 40 tenían problemas de infertilidad, para un 5,7 por ciento, y de ellas fueron entrevistadas 35. Existió predominio de los factores femeninos, principalmente el tubárico. La mayoría de las parejas estaban en edades óptimas para procrear, con relaciones matrimoniales estables y más de 2 años intentando tener descendencia. Predominó la infertilidad primaria. Más de la mitad de las parejas no tenían seguimiento por esta causa, y las que lo tuvieron, a pesar de ser por más de 3 años, conocen poco la causa de la infertilidad. CONCLUSIONES: la infertilidad en la población estudiada alcanza una mayor magnitud por los problemas de atención, que por la proporción numérica que representa. Se encontró fundamentalmente en edades óptimas para la reproducción, en relaciones estables, con una espera prolongada y con predominio de infertilidad primaria de causa tubárica. Las dificultades diagnósticas y terapéuticas y lo largo del proceso hacen que la mayor parte de las parejas se encuentren insatisfechas con el seguimiento que reciben.

OBJECTIVE: a descriptive cross-sectional study was conducted to characterize the behavior of infertility in 11 family physician's offices of "Héroes de Girón" Polyclinic in Cerro municipality. METHODS: the family physician's offices were chosen by criterion and selection sampling. The selection was based on an equitative distribution in the Basic Working Groups, as well as on the stability and deep knowledge of the area on the part of the nursing personnel that carried out the investigation after being trained on the topic. Two instruments were applied: a questionnaire at the family physician's office level and a survey to the couples with infertility problems, Percentage was used as a summary measure. RESULTS: of a total of 700 couples at fertile age, 40 had infertility problems, accounting for 5.7 percent. 35 of them were interviewed. It was observed a predominance of the female factors, mainly the tubal factor. Most of the couples were at optimal ages to procreate with steady marriage relations and they had been trying to have children for more than 2 years. Primary infertility prevailed. More than half of the couples were not followed up for this reason, and those who were, in spite of being followed up for more than 3 years, knew little about the cause of infertility. CONCLUSIONS: infertility in the studied population reaches a greater magnitude due to the problems of attention rather than for the figure it represents. It was mainly found at optimal ages for reproduction, in stable relations with a prolonged waiting and with predominance of primary tubal infertility. The diagnostic and therapeutic difficulties, as well as the long process make that most of the couples be unsatisfied with the follow-up they recieve.

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CONTEXT AND OBJECTIVE: Diagnoses of endometriosis are based on observation of endometriotic lesions by means of laparoscopy, along with the pathological findings. The aim of this study was to evaluate the sensitivity and specificity of the macroscopic findings in relation to the histopathological findings. More specifically, we aimed to test the efficacy of laparoscopy alone for diagnosing endometriosis and to evaluate the laterality of endometriosis among the study population. DESIGN AND SETTING: Cross-sectional study on women undergoing laparoscopy due to pelvic pain or infertility, in the Gynecology Department of Hospital Santa Cruz in Curitiba, Paraná, Brazil, and Pontifícia Universidade Católica do Paraná. METHODS: A total of 976 patients underwent laparoscopy and biopsy due to pelvic pain and/or infertility. We analyzed the laparoscopic and histopathological findings from patients with pelvic endometriosis (n = 468) and patients without endometriosis (n = 508). RESULTS: In 468 (47.95 percent) of the cases, the clinical and laparoscopic findings were consistent with endometriosis, and this was confirmed histopathologically in 337 (34.5 percent). Among the remaining 508 patients, although the laparoscopy was performed for other reasons relating to acute pelvic pain, eight were diagnosed with endometriosis from histopathological examination of the pelvic specimens obtained. Therefore, endometriosis was confirmed in 345 patients (35.3 percent). In comparison with the histopathology, laparoscopy alone presented 97.68 percent sensitivity, 79.23 percent specificity, 72 percent positive predictive value and 98.42 percent negative predictive value. CONCLUSION: Laparoscopy should be used in conjunction with histopathology for diagnosing endometriosis.

CONTEXTO E OBJETIVO: O diagnóstico da endometriose é determinado pela visualização dos implantes à laparoscopia e pela comprovação histológica. O objetivo deste trabalho foi avaliar a sensibilidade e a especificidade dos achados macroscópicos cirúrgicos e histopatológicos. Avaliou-se a eficácia da laparoscopia isoladamente no diagnóstico da endometriose e a lateralidade da doença. TIPO DE ESTUDO E LOCAL: Estudo transversal realizado no Serviço de Ginecologia do Hospital Santa Cruz em Curitiba, Paraná e na Pontifícia Universidade Católica do Paraná. MÉTODOS: Foram avaliadas 976 pacientes submetidas à videolaparoscopia por dor pélvica ou infertilidade e a biópsia. Foram analisados os achados laparoscópicos e histológicos de 468 pacientes com endometriose pélvica e de 508 pacientes sem endometriose. RESULTADOS: Foram selecionadas 468 (47,95 por cento) pacientes para inclusão no presente estudo por apresentarem quadro clínico e videolaparoscópico de suspeita de endometriose. As 508 (52,04 por cento) pacientes restantes tiveram indicação da cirurgia por outras causas relacionadas à dor pélvica e oito tiveram o diagnóstico de endometriose pelo anatomopatológico. A endometriose foi confirmada em 345 pacientes (35,3 por cento). Ao compararmos a análise histológica com os achados a videolaparoscopia, observou-se sensibilidade de 97,68 por cento, especificidade de 79,23 por cento, valor preditivo positivo de 72 por cento, valor preditivo negativo de 98,42 por cento. CONCLUSÃO: Laparoscopia deve ser usada em conjunto com histopatologia para o diagnóstico de endometriose.

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OBJECTIVE: To evaluate fertilization and pregnancy rates, and pregnancy outcome in women diagnosed with non-determined infertility, and its correlation with sperm head morphology anomalies. MATERIAL AND METHODS: Retrospective study (ANOVA) including 126 patients diagnosed with non-determined infertility, attended from January 2002 to December 2006, admitted to embryo transference fertilization program, both conventional in vitro and intracytoplasmatic sperm injection. Spermatic morphology was analyzed in accordance with Kruger's strict criterion. All of patients had spermatic morphology higher than 5%, with 7.17% average. They were divided into three groups, in accordance with sperm head morphology anomalies percentage: group 1, less than 30%; group 2, 31 to 39%, and group 3, more than 40%. All of them had oocyte insemination: half conventional in vitro and half intracytoplasmatic sperm injection. RESULTS: Group 1 had higher percentage of fertilization, over groups 2 and 3 (65.44, 49.5 and 57.23%, respectively; p = 0.002). Abortion numbers showed meaningful differences too; group 1 had no abortions, meanwhile groups 2 and 3 had 30.77 and 22.22%, respectively. CONCLUSIONS: Evaluation of sperm head morphology anomalies must be a prognostic factor in pregnancy evolution, in women with nondetermined infertility.

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