Search Results (2,980)

Within the field of assisted reproductive technologies (ARTs), embryologists regularly face the critical task of identifying embryos with the highest likelihood of implantation and survival. To help aid and standardize this practice, many embryo selection strategies have been developed to give the best chance of pregnancy success. Over the years, there has been a large increase in experimental studies conducted within this area of research. This increase has allowed for the formation of significant and plausible theories of embryo development, especially in cases where the most prominent factors seem identical. These advancements have both expanded the typical process of traditional treatments and have even paved the way for new techniques. The exact combination of all these relevant factors has not been fully elucidated into a single all-encompassing scheme for embryo decision. Morphological, genetic, and developmental indicators are well-studied individually, but the exact methods that should be prioritized in each scenario may change with respect to an individual patient. Deciding whether factors like age, egg quality, lifestyle choices, or previous medical history should alter methods of embryo ranking can result in conflict, especially in the case where a choice is being made between two similar embryos. This article reviews the conventional methods along with emerging technologies that provide the tools for embryologists to evaluate and rank embryos with high implantation potential (HIP). By showcasing these methods, including their respective benefits and drawbacks, this article provides information to allow clinicians to make effective decisions by integrating multiple approaches to embryo selection. Full article

Background/Objectives: Thyroid autoimmunity, particularly anti-thyroid peroxidase antibodies (anti-TPO), has been implicated in reduced fertility and diminished ovarian reserve. However, the stratified effects of anti-TPO across age groups, body mass index (BMI) categories, and polycystic ovary syndrome (PCOS) status remain unclear. This study aims to investigate the association between anti-TPO positivity and ovarian reserve markers—antral follicle count (AFC), anti-Müllerian hormone (AMH), and follicle-stimulating hormone (FSH)—in euthyroid infertile women. Methods: This retrospective study included 1460 infertile women aged 18–45 years, evaluated between 2022 and 2025. Participants were categorized based on anti-TPO levels (≥9 vs. <9 IU/mL) using Beckman Coulter-DXI 800 analyzer, which uses chemiluminescent immunoassays to measure results. BMI (<30 vs. ≥30 kg/m²), and PCOS status. Age was categorized into five strata (18–25, 25–30, 30–35, 35–40, and 40–55 years), and <35 vs. ≥35 years. Linear regression models were used to assess the impact of anti-TPO on AMH and AFC within each subgroup. Additional logistic regression was performed to evaluate the odds of diminished ovarian reserve (DOR: AMH < 1 ng/mL or AFC < 5) after adjusting for age, BMI, and TSH. Results: Anti-TPO positivity (17.6% prevalence) was significantly associated with reduced AMH (1.47 ± 1.52 vs. 3.33 ± 3.03 ng/mL, p < 0.0001), reduced AFC (8.18 ± 5.06 vs. 15.88 ± 8.18, p < 0.0001), and elevated FSH (9.40 ± 6.21 vs. 8.06 ± 4.79 mIU/mL, p = 0.001). These associations remained significant in non-obese and PCOS-negative subgroups. Regression models revealed stronger associations in younger women (<35 years) and showed significant Anti-TPO × Age and Anti-TPO × BMI interactions. Logistic regression confirmed Anti-TPO ≥ 9 IU/mL as a strong predictor of diminished ovarian reserve (AMH < 1 ng/mL: OR = 3.13; AFC < 5: OR = 6.48). ROC analysis indicated modest predictive ability (AUC: 0.665–0.694), and path modeling confirmed direct effects of Anti-TPO on AMH and AFC independent of TSH or BMI. Conclusions: Elevated Anti-TPO levels are independently associated with diminished ovarian reserve in euthyroid women, particularly in younger, non-obese, and PCOS-negative individuals. Anti-TPO may serve as a useful biomarker in fertility risk assessment and personalized reproductive counseling, even in the absence of overt thyroid dysfunction. Full article

The oral microbiome may be an indicator of oral pathologies and hormonal fluctuations. Consequently, the proper identification of methods for studying microbial factors is essential. Because more than half of the components of the oral microbiome belong to species that are very difficult or even impossible to cultivate in the laboratory, the assessment of the oral microbiome nowadays is based on genetic sequencing, using techniques such as DNA hybridization, 16S rRNA sequencing, and metagenomics, mainly analyzing saliva and subgingival plaque. Variations in results may be caused by differences in sample type, analysis methods, accuracy in determining cycle phases, and biases introduced by DNA extraction techniques and technical variations. Choosing the right primers for the 16S rRNA gene and reference databases (like HOMD, Greengenes2) is essential for accurately identifying microorganisms. Metagenomic sequencing offers greater taxonomic and functional detail, but it is costlier and presents bioinformatics challenges, including contamination with human DNA. When the patients under study are women, we have to take into consideration the cyclical changes in the menstrual cycle. Studies suggest that estrogen influences local immune and inflammatory responses and can worsen existing gingival inflammation. Certain oral bacteria can even utilize estradiol and progesterone as growth factors. The composition of the oral microbiome is also affected by hormonal contraceptives, carbohydrate intake, smoking, age, body mass index, genetics, and oral hygiene—all factors that need to be controlled for in future studies. Interpreting the biological significance of the reported cyclic changes requires careful examination of the specific methods used in each study. Full article

Background: Maternal mortality remains a significant public health challenge in Brazil, reflecting persistent social, racial, and regional inequalities. Objectives: This study aimed to analyze trends and characteristics of maternal deaths in Brazil from 2000 to 2020, identifying sociodemographic and clinical risk factors. Methods: A retrospective, population-based study was conducted using secondary data from the Sistema de Informações sobre Mortalidade (SIM) of the Brazilian Ministry of Health. Descriptive and comparative statistical analyses were performed, including chi-square (χ²) goodness-of-fit tests and 95% confidence intervals calculated by the Wilson method. Variables were stratified by region, age, race, education, type and period of death, and investigation status. Results: A total of 40,907 maternal deaths were recorded. From 2000 to 2020, Brazil recorded 40,907 maternal deaths. The maternal mortality ratio decreased from approximately 74 deaths per 100,000 live births in 2000 to 57 per 100,000 in 2020, representing a 23% reduction over two decades. Most deaths occurred among young, Brown women with low education levels, particularly in the Southeast and Northeast regions. Direct obstetric causes accounted for two-thirds of cases, and most deaths occurred in hospital settings, mainly during the early puerperium. Conclusions: Despite progress, maternal mortality in Brazil remains above the WHO target and is strongly influenced by social inequities. Strengthening primary care, improving referral networks, expanding postpartum follow-up, and enhancing surveillance systems are essential for preventing avoidable deaths and achieving reproductive justice. Full article

Background/Objectives: Cervical cancer is one of the most frequent malignancies among women in Kazakhstan, where human papillomavirus (HPV) vaccination was initiated in 2024. Despite the implementation of vaccination and cytology-based screening programs, diagnostic limitations remain, and local evidence linking HPV infection to clinical outcomes is scarce. This study aimed to evaluate the correlation between HPV status, cervical cytology results, colposcopic impression, and biopsy results in a non-vaccinated female population. Methods: A cross-sectional study was conducted at the University Medical Center, Astana, between November 2024 and March 2025. A total of 396 women of reproductive age were enrolled. Cervical samples underwent liquid-based cytology and high-risk HPV testing with the RealBest assay. Colposcopy was performed following abnormal cervical cytology results, and colposcopy-guided biopsies were obtained where indicated. Sociodemographic characteristics were assessed, and associations between HPV genotype and clinical outcomes were analyzed using descriptive and inferential statistics. Results: HPV infection was detected in 140 women (35.4%). HPV-16 was the most common genotype (11.4%), followed by HPV-52 (6.6%) and HPV-33 (5.3%). Among 198 women evaluated by colposcopy, abnormal findings were observed in 72.2%, with HPV-16 showing a significant association with higher-grade abnormalities (p < 0.001). Biopsies were available for 40 participants: 12 had CIN I, 12 had CIN II, 10 had CIN III, and 4 had carcinoma in situ. HPV-16 was the only genotype significantly linked to CIN II/III lesions. Conclusions: HPV-16 was strongly associated with abnormal colposcopic findings and high-grade histology, underscoring its oncogenic importance. The prevalence of HPV-52 and HPV-33 further supports the need for HPV nonavalent vaccination. These findings highlight the importance of HPV-based screening, genotype-specific triage, and expanded vaccination to reduce cervical cancer incidence in Kazakhstan. Full article

Autosomal recessive (AR) disorders represent a significant public health challenge, as asymptomatic carriers are often unaware of their reproductive risks. This study provides the first comprehensive assessment of AR gene variant frequencies and their molecular landscape in a fertile Western Romanian population. Genetic results from 604 unrelated, unaffected Caucasian individuals of reproductive age, tested at a single genetic center between 2020 and 2024, were retrospectively analyzed. Next-generation sequencing (NGS) with a multi-gene panel targeting 300 AR-associated genes was used for molecular profiling. Variants were identified in 156 genes, with 75% of individuals carrying at least one AR variant (mean 1.77 variants/person). A subgroup with >3 pathogenic variants comprised 7.5%, posing a notable risk for future offspring. The most frequent variants were detected in HFE (1:5), CFTR (1:9), BTD (1:16), GJB2 (1:17), and CYP21A2 (1:19). Four variants (HFE, c.187C>G; BTD, c.1330G>C; CFTR, c.1210-34TG[11]T[5]; GALT, c.-119_-116del) were particularly prevalent, each exceeding 3% frequency. Considerable allelic heterogeneity was observed for distrinctive variants in CFTR (14), PAH (12), USH2A (12), and ATP7B (9). Several variants were linked to severe disorders, with CFTR, GALT, ATP7B, and SMN1 identified as “red zone” genes associated with high morbidity and mortality. Low-frequency variants formed a “long tail” (83.9%), reflecting marked population heterogeneity and potential hidden disease risks. The study reveals high allelic diversity and a strong prevalence of AR variants in Western Romania. Variant-based gene classification supports population-level screening, highlighting the public health value of a national program to identify carriers and prevent severe inherited disorders. Full article

Extracts of Cynanchi Auriculati Radix (RCA), derived from the roots of Cynanchum auriculatum Royle ex Wight. (CA), have been documented to possess anti-inflammatory and antioxidant properties. However, the molecular mechanisms of their anti-aging action remain unclear. The present study aimed to explore the potential anti-aging components and mechanisms of RCA. LC-MS/MS and network pharmacology were used to identify components and targets. In vitro, LPS-induced RAW264.7 macrophages were used to assess anti-inflammatory effects. In vivo, Caenorhabditis elegans models were employed to evaluate lifespan and stress resistance. Five bioactive components were identified. The ethyl acetate extract of RCA (RCAEA) inhibited LPS-induced M1 macrophage polarization by suppressing the expression of NO, PGE2, IL-1β, iNOS, COX-2, TNF-α, and IL-6 via the NF-κB pathway. In C. elegans, RCAEA extended lifespan and enhanced oxidative and heat stress resistance, without affecting reproduction. These benefits were mediated by the PMK-1/SKN-1 pathway, as confirmed using mutant strains. RCAEA is a promising anti-aging and anti-inflammatory agent, acting through NF-κB and PMK-1/SKN-1 signaling pathways. Full article

Although aging is an irreversible process, the rate of aging can be delayed by a reasonable diet. As a nutrient-dense natural product, royal jelly (RJ) has an enormous potential for applications in medicine and health promotion. However, the exact physiological activity of RJ with varying freshness and concentration has not been fully clarified, and more investigation is needed to determine their precise contributions. Here, fresh RJ (just produced recently) and RJ stored for 2 weeks at −20 °C, 4 °C or 25 °C were tested at concentrations of 100, 50, 25 and 12.5 μg/mL on Caenorhabditis elegans. Fresh RJ, with concentrations of 100 μg/mL, 50 μg/mL and 25 μg/mL, could extend the lifespan of C. elegans by 16.37%, 9.53% and 4.32%, while RJs stored at 4 °C and 25 °C were ineffective. In terms of body length, treatment with fresh RJ significantly enlarged the body size by around 48%. Although RJ stored at 4 °C and 25 °C could also promote nematode growth, its activity diminishes as storage temperature increases. RJs stored at −20 °C and 4 °C with concentrations of 100 μg/mL significantly increased the pumping rate of nematodes by 58% and 50%. But non-fresh RJ or low-concentration RJ (≤25 μg/mL) had no effects on the motility of C. elegans. In addition, fresh RJ could improve the reproductive capacity of C. elegans, with the highest increase reaching approximately 25%. Even when stored at 25 °C, RJ also significantly enhanced the reproductive capacity of C. elegans, increasing it by approximately 14.8%. Moreover, qPCR showed that RJ could significantly affect the expression of multiple genes associated with aging and vitality. Fresh RJ significantly up-regulated bec1 and hsp16.2 3.19- and 2.80-fold, while RJ stored at 25 °C significantly up-regulated sod3 and gpd1 3.80- and 3.40-fold. Our results suggested that the activity of RJ on C. elegans is related to its freshness and concentration, while RJ also contains active components that are independent of freshness. Therefore, it is necessary to explore effective methods for accurately assessing the freshness of RJ. Full article

Background/Objectives: Nutrition during the reproductive years shapes women’s immediate health, fertility, pregnancy outcomes, and long-term offspring well-being. This position paper narratively synthesizes and critically appraises evidence on how dietary patterns, macro-/micronutrients, and supplementation influence women’s health, female fertility, and reproductive outcomes, to inform practical recommendations. Methods: We narratively reviewed recent reviews, cohort studies, clinical trials, and public-health guidance on macronutrients, key micronutrients, dietary patterns (with emphasis on the Mediterranean diet), ultra-processed food (UPF) intake, and targeted supplementation relevant to menstrual, metabolic, cardiovascular, skeletal, and reproductive outcomes. Results: Balanced, diverse diets rich in whole and minimally processed foods support hormonal regulation, ovulatory function, healthy gestation, and chronic-disease risk reduction. Priority nutrients include iron, folate, calcium, vitamin D, zinc, vitamin B12, and long-chain omega-3s (DHA), with supplementation considered when dietary intake or bioavailability is inadequate. Evidence consistently links Mediterranean-style eating to improved metabolic health, insulin sensitivity, IVF success, lower gestational diabetes risk, and favorable neonatal outcomes. High UPF consumption is associated with poorer diet quality, inflammation, adverse pregnancy outcomes, and potential reproductive impairment, warranting a reduction in favor of nutrient-dense foods. Diet also influences cardiovascular and bone health through effects on lipids, glycemia, blood pressure, and mineral/vitamin status, with fiber-rich carbohydrates, unsaturated fats (notably olive oil), and adequate calcium–vitamin D emerging as central levers. Conclusions: For women of childbearing age, a Mediterranean-aligned, minimally processed dietary pattern—tailored to individual needs and complemented by prudent use of folate, iron, vitamin D, calcium, B12, and DHA when indicated—offers robust benefits across reproductive, metabolic, cardiovascular, and skeletal domains. Public-health actions should improve access to healthy foods, curb UPF marketing, and embed personalized nutrition counseling in routine care; further longitudinal research from preconception through postpartum is needed. Full article

Background: Endometrial cancer (EC) is a common malignancy found among women. It is ranked as the 6th most common cancer among women and the 15th most common cancer globally. Increasing prevalence of several factors like obesity and other metabolic disorders have caused a growing trend of prevalence of endometrial cancer. The standard approach of treatment with excellent prognosis is total hysterectomy with bilateral salpingo-oophorectomy (TH/BSO). However, due to its drawback of complete infertility, newer approaches of fertility-sparing approaches are emerging to combat this challenge. Clinicians must choose the most suitable candidates for fertility-sparing surgery (FSS) using the present existing conventional criteria with regard to the patient’s age, tumor characteristics, and fertility goals. The limitations using the conventional criteria can be eliminated by refining the criteria with molecular prognostic factors to ease the candidate selection process for FSS. Methods: Relevant literature regarding molecular subtypes, hormone therapy sensitivity, clinical assessment, and guidelines pertaining to fertility preservation in EC were retrieved from several electronic databases and articles addressing the role of molecular profiling in predicting patient response, guiding patient selection, and/or informing the development of therapies for fertility preservation in early-stage EC, particularly in women of reproductive age were included. Primary focus was on areas of consensus, emerging trends, and evidence gaps that warrant further investigation. This review will assess the integration of molecular prognostic factors to refine the patient selection criteria and guide FSS in early-stage EC. We will present existing clinical criteria, ongoing clinical trials, limitations, and the advantages of integrating molecular data on patient selection, treatment safety, and fertility outcomes. Results: Four distinct molecular subtypes have been classified which includes POLE-mut, MMR-d, p53-abn and NSMP. POLE-mut subtype had excellent prognosis with >95% patients achieving complete remission with <2% recurrence rate followed by MMRd and NSMP with intermediate prognosis and lastly p53-abn with poor prognosis of 60–70% achieving complete remission and 30–40% having recurrence. The data highlights the clinical value of molecular classification in selecting appropriate candidates for fertility sparing surgery (FSS). Conclusions: There is a lack of integration of molecular subtypes for clinicians to choose candidates for FSS and this gap should be addressed. Further research must be performed to follow personalized medicine to refine their treatment plan. Full article

Background/Objectives: Vortioxetine is a multimodal antidepressant that modulates serotonergic, noradrenergic, and dopaminergic systems, yet its effects on female reproductive physiology remain incompletely defined. This study investigated how short- and long-term vortioxetine exposure influences reproductive function in female rats, integrating measurements of oxidative-stress biomarkers, catecholamines, and endocrine endpoints (prolactin and corticosterone). Methods: Forty-two female Wistar albino rats were randomized into seven groups (n = 6): healthy control; short-term vortioxetine; long-term vortioxetine; and the same two regimens each combined with metyrosine or metyrapone. Metyrosine and metyrapone (50 mg/kg, oral gavage) were given 1 h before vortioxetine (10 mg/kg). Treatments lasted one week (short-term) or four weeks (long-term). Serum MDA, tGSH, SOD, CAT, adrenaline, noradrenaline, dopamine, serotonin, prolactin, and corticosterone were measured. Fertility outcomes were assessed by co-housing females with males for one month. Results: Vortioxetine increased MDA, catecholamines, and serotonin and decreased antioxidant markers and prolactin versus controls (p < 0.001). Long-term vortioxetine produced a marked rise in corticosterone that coincided with infertility and delayed parturition. Metyrosine lowered oxidative stress and catecholamines but did not reverse infertility. In contrast, metyrapone blunted corticosterone elevation and preserved reproductive capacity. Conclusions: Long-term vortioxetine induced infertility in female rats, likely mediated by corticosterone elevation consistent with hypothalamic–pituitary–adrenal axis dysregulation. These findings suggest the need to monitor reproductive risk when considering vortioxetine in women of reproductive age and warrant further mechanistic and translational studies. Full article

Skin aging is accelerated by both environmental factors—including ultraviolet (UV) radiation and pollution—and intrinsic processes such as chronic inflammaging. N-carbamylglutamate (NCG), an arginine precursor known for its benefits for gut and reproductive health, has not been extensively studied in dermatological applications. To explore its suitability as a multifunctional cosmetic ingredient, this study examines the protective role of NCG in counteracting UV-stimulated oxidative and inflammatory responses in skin cells. NCG significantly reduced UV-induced reactive oxygen species (ROS), indicating strong antioxidant properties. It also inhibited matrix metalloproteinase (MMP) activity, preserving collagen integrity and reducing wrinkle formation. In addition, NCG suppressed nitric oxide (NO) production and downregulated key inflammatory mediators—including cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6)—highlighting its anti-inflammatory potential. Furthermore, NCG reduced melanin production and the expression of melanogenesis-related factors such as the microphthalmia-associated transcription factor (MITF), tyrosinase-related protein 1 (TRP-1), and TRP-2. These findings support the role of NCG as a promising multifunctional cosmetic ingredient with antioxidant, anti-inflammatory, anti-wrinkle, and skin-brightening properties. Full article

Bovine respiratory disease is a significant health concern in dairy calves, impacting short-term growth and potentially long-term productivity. While previous studies have linked early-life lung consolidation, often subclinical and diagnosed by lung ultrasonography, to reduced preweaning average daily gain, its extended effects on production and reproductive parameters remain less studied, particularly in specific geographical contexts. This study presents a follow-up analysis on a cohort of dairy calves originally monitored weekly from birth to weaning for lung consolidation via TUS in an Iranian dairy herd. Two years post-weaning, comprehensive production and reproduction data were collected and analyzed for these same animals. Our objective was to investigate the long-term associations between early-life lung consolidation and subsequent outcomes, including mature equivalent milk yield, corrected milk yield, culling risk before and during lactation, age at first breeding, age at first calving, and reproduction parameters such as services per conception and conception rate (the percentage of cows or heifers that become pregnant after a single insemination or breeding attempt). Data analysis, employing descriptive statistics, survival analysis, and non-parametric tests, revealed that while early-life lung consolidation (defined by ≥1 cm or ≥3 cm depth, and number of episodes) did not show significant associations with culling probability or mature equivalent milk yield, interesting numerical trends were observed. The study highlights the complexities of establishing clear long-term links, suggesting that while subclinical BRD can have immediate growth impacts, its chronic effects on later production and reproduction may be subtle and require larger cohorts or more targeted analysis to achieve statistical significance. The findings reinforce the need for cautious interpretation of p-values in the context of multiple comparisons and underscore the challenges in quantifying long-term economic consequences of early-life respiratory health. Full article

Objectives: Pelvic organ prolapse (POP) disorders are a significant problem with a society-wide dimension, affecting the quality of life of many women around the world. The purpose of this study is to assess the influence of sociodemographic factors on health-preserving behaviors in relation to pelvic organ prolapse in women of reproductive age. Method: The survey was conducted using a questionnaire made available electronically and a paper questionnaire distributed to female patients of the Gynecology and Obstetrics Clinical Hospital of the Karol Marcinkowski Medical University in Poznan. In total, 160 women aged 15–49 years voluntarily participated in the study. The distribution of variables was assessed using the Shapiro–Wilk test. The Mann–Whitney U and Kruskal–Wallis ANOVA tests were used for comparisons between groups. Comparisons between assessment scores and self-assessment of knowledge were made using Wilcoxon’s paired rank order test and the Chi2 NW (highest reliability) test. A p-value < 0.05 was considered statistically significant. Results: The level of knowledge about POP prevention and conservative treatment methods is low. The group with a higher level of knowledge was characterized by younger age, higher education, and living in areas with a large population. Conclusions: The results suggest only a partial understanding of the topic of pelvic organ prolapse, while lacking full awareness of prevention. Full article

Background/Objectives: Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by impairments in social interaction and communication, as well as by repetitive behaviors, with a rising global prevalence. Concurrently, the use of Assisted Reproductive Technologies (ART) has increased among couples experiencing infertility. This study aimed to compare the frequency of ART-conceived children between those diagnosed with ASD and those with other neurodevelopmental disorders (nASD), and to examine differences in prenatal, perinatal and medical histories of ART- and spontaneously (non-ART)-conceived children within an ASD group. Methods: We retrospectively analyzed data from 507 children with a neurodevelopmental disorders (NDDs) diagnosis, classified into ASD (n = 234) and nASD (n = 273) groups. Subsequent analyses focused on the ASD group, further divided into an ART and non-ART group according to the conception mode. Results: ART-conceived children were more frequent in the ASD group than in the nASD group. Moreover, within ASD, ART was significantly associated with potential risk factors such as twin pregnancy, cesarean delivery, low birth weight and parental age. Logistic Binary Regression confirmed these results, suggesting that ART co-occurs with a cluster of perinatal and familial risk factors. Conclusions: Our results indicate that ART is not an independent causal exposure; however, given the retrospective design and the absence of a general population control group, causal inference cannot be drawn. The observed association with ASD appears to be mediated by perinatal and parental variables. These findings underscore the importance of improving obstetric management and care, and ensuring early developmental monitoring for ART-conceived children. Full article