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Huidrom Yaiphaba Meitei Division of Clinical Embryology, Department of Reproductive Science, Kasturba Medical College, Manipal. Manipal Academy of Higher Education, Manipal, India

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Shubhashree Uppangala Division of Reproductive Genetics, Department of Reproductive Science, Kasturba Medical College, Manipal. Manipal Academy of Higher Education, Manipal, India

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Vani Lakshmi R Department of Data Science, Prasanna School of Public Health, Manipal, Manipal Academy of Higher Education, Manipal, India

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Guruprasad Kalthur Division of Reproductive Biology, Department of Reproductive Science, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India

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Satish Kumar Adiga Division of Clinical Embryology, Department of Reproductive Science, Kasturba Medical College, Manipal. Manipal Academy of Higher Education, Manipal, India

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Concern about fertility impairment after vaccination is one of the reasons for vaccine hesitancy in the population. This retrospective observational study aims to understand the impact of Covishield™ (ChAdOx1 nCoV-19 corona virus vaccine, recombinant) COVID-19 vaccination on ejaculate quality in 53 patients undergoing semen analysis between 2018 and 2021. A baseline semen profile was recorded from the subjects during their visit before the vaccination for fertility work-up. Follow-up ejaculates were provided approximately 82 (Q1: 37, Q3: 124) days after the second dose of vaccination. Semen characteristics such as volume, sperm concentration, sperm motility, and morphological abnormalities were recorded. Of the 53 subjects, 33 (62%) had semen characteristics above the World Health Organization (WHO) reference. In general, no significant variations in the semen parameters were observed except for a moderate decline in sperm morphology (P <  0.05). The baseline semen characteristics in 20 (38%) subjects were below the WHO reference range; however, no significant decline in the ejaculate quality was observed in their follow-up samples. Further, none of the ejaculates in both study groups were azoospermic during the follow-up evaluation. Our results affirm that CovishieldTM vaccine is not detrimental to male fertility.

Lay summary

Concern about fertility impairment after vaccination is one of the reasons for vaccine hesitancy in the population. This study is aimed at understanding the impact of non-mRNA COVID-19 vaccination on ejaculate quality in 53 patients undergoing semen analysis who received Covishield™ (ChAdOx1 nCoV-19 corona virus vaccine, recombinant) vaccine. No significant variation in the semen characteristics was observed between the baseline and follow-up samples in the vaccinated subjects. Results from this study affirm that Covishield™ vaccination is not detrimental to male fertility.

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B Ogunlade Behavioral and Aging Lab, Human Anatomy Department, Federal University of Technology Akure, Ondo State, Nigeria

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S C Gbotolorun Anatomy Department, University of Lagos, Lagos, Nigeria

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O A Adedotun Behavioral and Aging Lab, Human Anatomy Department, Federal University of Technology Akure, Ondo State, Nigeria

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K Iteire Anatomy Department, University of Medical Sciences, Ondo City, Ondo State, Nigeria

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J Adejayi Behavioral and Aging Lab, Human Anatomy Department, Federal University of Technology Akure, Ondo State, Nigeria

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Graphical abstract

Abstract

Di-2-ethylhexyl phthalate (DEHP) is an extensively used plasticizer which has raised some concerns about its safety on human health. This study aimed at evaluating the effects of vanillic acid (VA) and vitamin C (VC) supplementation on DEHP-induced testicular toxicity. Thirty-five adult male Wistar rats were randomly divided into 7 groups (A–G) (n = 5) receiving distilled water; 250 mg/kg bw of DEHP only; 30 mg/kg bw of VA and 250 mg/kg bw of DEHP; 30 mg/kg bw of VC and 250 mg/kg bw of DEHP; 30 mg/kg bw of DEHP plus 30 mg/kg bw of VA and 30 mg/kg bw of VC; 30 mg/kg bw of VA only; and 30 mg/kg bw of VC only, respectively. At the end of the experiment, blood was taken from the heart via cardiac puncture and stored, semen was collected from the caudal epididymis for immediate sperm analysis, while the testes were excised and preserved for histological examination and biochemical analysis. The results showed a significant decrease (P < 0.05) in body weights, sperm motility, sperm volume, sperm viability and count, antioxidant levels, and reproductive hormonal levels, with a significant increase (P < 0.05) in sperm morphological defect and lipid peroxidation level in DEHP-only group compared with the control but was ameliorated after VA and VC administration compared to the DEHP-only treated animals. VA and VC supplementation attenuated the toxic effects of DEHP on the testicular functions, morphology, and semen characterization of the experimental adult male Wistar rats.

Lay summary

Male infertility is considered when identifiable female causes of infertility are excluded and semen quantity and quality fail to fulfil World Health Organization criteria. From conception through to adulthood, people are exposed to limitless environmental toxicants among which di-2-ethylhexyl phthalate (DEHP) commonly found in personal care products, cosmetics, and medical devices is prevalent. The present study elaborated on the importance of taking antioxidant-rich foods containing vitamin C and vanillic acid, such as those found in various fruits, olives, whole wheat, and cereal grains, in combating infertility caused by environmental toxicants. An experiment was carried out on rats to see the effect of vanillic acid and vitamin C supplementation on preventing DEHP-induced testicular toxicity. The testicles and semen were analyzed from five rats in each treated and control groups. The data led us to conclude that vanillic acid and vitamin C supplementation do have attenuating effects on DEHP-induced testicular toxicity, due to their high antioxidant and anti-inflammatory properties.

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Kate Anthony Department of Animal Science, The Pennsylvania State University, University Park, Pennsylvania, USA

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Tyler Bruce Garner Department of Animal Science, The Pennsylvania State University, University Park, Pennsylvania, USA
Integrative and Biomedical Physiology Program, Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA

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Ramesh Ramachandran Department of Animal Science, The Pennsylvania State University, University Park, Pennsylvania, USA
Integrative and Biomedical Physiology Program, Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA

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Francisco Javier Diaz Department of Animal Science, The Pennsylvania State University, University Park, Pennsylvania, USA
Integrative and Biomedical Physiology Program, Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA

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Ad libitum

feeding in broiler breeder (BB) hens causes reduced egg production, lower fertility, and improper eggshell deposition. Restricted feeding (RF) is the only effective intervention available to normalize ovarian function and improve reproductive efficiency. This study aimed to assess the transcriptional changes in ovarian cortex of BB hens with free access to feed compared to those on a RF diet. RNA was isolated from the ovarian cortex of Cobb 500 pullets raised to 10 and 16 weeks of age on either a full-feeding (FF) or RF diet. Microarray analysis identified 386 differentially expressed genes between the two feeding groups at 16 weeks of age. Gene ontology enrichment identified overrepresentation of Neuroactive ligand–receptor interaction pathways, Cell adhesion molecules, Steroid hormone biosynthesis, and various KEGG pathways. From these groups, 46 genes were selected for follow-up validation by quantitative PCR. The findings show that 33 of the 46 genes had significantly different abundance by age and/or feeding level. Most of these genes were repressed in RF hens and belonged to the steroid biosynthesis and neuropeptide signaling groups. The VIPR2 receptor was higher in the FF group leading us to hypothesize that vasoactive intestinal peptide (VIP) is an important regulator of small cortical follicles. Culture of hen cortical follicles with VIP increased Star, an indication of increased steroidogenic activity, although did not elevate Cyp11a1. These results offer insights and suggest the possible mechanisms and pathways responsible for the increases in cortical follicle growth associated with excess feed intake in BB hens.

Lay summary

Giving breeder hens unrestricted access to feed can lead to problems with their ovaries, including excessive growth of the ovary and reduced fertility. Giving a limited amount of feed is the only effective way to reduce this growth of the ovaries and improve fertility. This study aimed to assess the changes in the molecules that make proteins in the body in hens fed unrestricted and restricted diets. In the hens fed a limited amount of feed, there were more of one type of molecules, while there were more of another type in the ovaries of hens with unrestricted access to feed. These results show that how much a hen eats can alter the number of these molecules in the ovary and this could help us understand why their ovaries grow excessively and why their eggs are less fertile.

Open access
Annemiek Nap Department of Gynaecology and Obstetrics, Radboudumc, Nijmegen, the Netherlands

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Nicole de Roos Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands

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Endometriosis is the most prevalent benign gynaecologic disease with invalidating effects on the quality of life and decreased economic productivity. As pharmacologic and surgical treatment are only partially effective, women look for self-management strategies in order to control their symptoms. Many dietary interventions have been claimed successful. But it is unclear whether these effects are caused by the idea of taking control of the symptoms by adhering to a diet or by the dietary intervention itself. In order to gain more evidence with regard to the mechanisms behind the effect of dietary intervention in the management of endometriosis, a number of issues need to be addressed for future studies. First, we need clearly defined endpoints in our studies. Secondly, we have to be aware of the difference between the effects of diet on the risk of developing endometriosis and the effects of diet on symptoms in women with already established endometriosis. Thirdly, it may be difficult to strictly define the intervention diet and the control or placebo diet. Fourthly, we have to define endometriosis-related as well as patient-related factors that may influence the success of a dietary intervention. Fifthly, we have to understand the biological mechanisms behind the perceived effects of dietary interventions. These issues will be addressed in this opinion paper.

Lay summary

Endometriosis, defined as the presence of endometrium-like tissue located outside the womb, is a gynaecologic disease that affects many women. They experience severe pain, making it difficult for them to go to school or work. Medication or surgery is often not enough to relieve their pain. Therefore, these women look for ways to suppress their pain by changing their way of life. Changing their diet is an option that is often chosen by women with endometriosis. Many women experience that changing their diet helps to suppress pain symptoms. But it is not clear why changing the diet is effective. Processes in the body could be changed by taking or avoiding specific nutrients, but the effect could also be caused by the empowerment that women experience by adhering to a diet. If we want to learn more about the effect of diet on endometriosis, we have to pay attention to the following issues: first, it is important to exactly define the goal of a new study. Secondly, we have to realize that there is a difference between the study of the effect of diet on the risk of developing endometriosis and the effect of diet on endometriosis that has already developed. Thirdly, we have to realize that it can be difficult to define what the diet contains and how a control group should be defined. Fourthly, it is important to define factors that make it difficult to adhere to a diet. Fifthly, we need to try to understand what happens in the body that may cause the effect of a diet in endometriosis. In this opinion paper, these issues will be addressed.

Open access
Tamar Matitashvili Department of Obstetrics and Gynecology, The Jones Institute for Reproductive Medicine, Eastern Virginia Medical School, Norfolk, Virginia, USA

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Seifeldin Sadek Department of Obstetrics and Gynecology, The Jones Institute for Reproductive Medicine, Eastern Virginia Medical School, Norfolk, Virginia, USA

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Gerard Celia Department of Obstetrics and Gynecology, The Jones Institute for Reproductive Medicine, Eastern Virginia Medical School, Norfolk, Virginia, USA

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Lay summary

Embryo transfer is the most emotional part for patients during in vitro fertilization treatment. Over the last decade, the embryo transfer procedure has undergone numerous changes in the guidelines in order to increase pregnancy rates. One such procedure is the loading of the embryo into the catheter, a thin tube that helps us transfer embryo into the uterine cavity. Very few research studies looked closely at embryo-loading technique per se. Furthermore, different infertility laboratories use various techniques to load embryo. The aim of our study was to compare the two most popular embryo-loading techniques. In 249 women, we transferred embryo aspirated into the catheter with small droplets of air, and in the group of 244 patients, we filled catheter only with fluid. Our main outcome measured was the clinical pregnancy rate. Based on our results, we did not find that embryo-loading technique affected patient’s chances of achieving pregnancy.

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Cecile A Ferrando Center for Urogynecology & Pelvic Reconstructive Surgery, Women’s Health Institute, Center for LGBT Care, Cleveland Clinic, Cleveland, Ohio, USA

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Transmasculine people are assigned female at birth but identify as male. These patients often are prescribed testosterone therapy as part of their transition. This treatment can affect ovulation and stop menstrual periods. Endometriosis is a common condition that causes pelvic pain in some people born with female pelvic organs. Not a lot is known about transmasculine people and how often endometriosis affects them. Testosterone should help treat if not reduce the incidence of endometriosis. This commentary looks at the current literature in order to help clarify existing knowledge gaps. Transmasculine patients who present for hysterectomy as a surgery to help them affirm themselves in their self-identified gender sometimes report pelvic pain symptoms as well. There are many reasons why patients report pain before surgery, and this can be related to endometriosis, even though this diagnosis is less expected in this group. Providers caring for transmasculine patients should be aware of this.

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James Barrett Charing Cross Gender Identity Clinic, Tavistock and Portman NHS Trust, London, UK

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Transgender people are just as able to be good parents as anyone else. The treatment involved in addressing their gender dysphoria usually removes their natural fertility and if they want to preserve their fertility, they will need gamete storage. The technology needed to provide gamete storage for transfolk is not any different from anyone else but the clinic setup, human interactions and the approach used need to be sensitive and require everyone in the clinic to understand the issues and behave accordingly if high-quality service is to be provided.

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Sarah Simko Department of Obstetrics and Gynecology, Adventist Health White Memorial Medical Center, Los Angeles, California, USA

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Kelly N Wright Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California, USA

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Endometriosis has a large impact on the lives of patients, affecting nearly 90% of women with chronic pelvic pain and infertility. Unfortunately, diagnosis for this condition is often delayed by an average of 7 years, with adolescent patients experiencing disproportionate delays. This is in part due to the use of an invasive procedure for primary diagnosis and limited access to subspecialty care. While laparoscopy serves an important purpose in the diagnosis and management of endometriosis, it has been found to be less cost-effective than empiric medical therapy and puts an emphasis on the lesion as opposed to the patient and the disease process as a whole. As studies emerge, we gain a deeper understanding of the complex nature of this disease. Laparoscopy has been shown to have variable results, with high recurrence rates and varying improvement in symptoms over time. Additionally, studies have shown a poor correlation between patients’ pain and the stage and location of lesions, with laparoscopy showing greater benefit for later-stage disease and deep infiltrating endometriosis. This article seeks to evaluate the current standards for the management of endometriosis, discuss the place for diagnostic laparoscopy, and review future directions and alternatives.

Lay summary

Endometriosis is an inflammatory disorder that occurs when uterine tissue is found outside the uterus. This condition affects women of reproductive age and can have serious impacts on their lives, causing pain and difficulty getting pregnant. The primary method of diagnosis is surgical, which has associated risks and can delay care to patients. As further studies emerge, our understanding of this condition improves, and it is important to evaluate current practices. This article focuses on the pros and cons of using surgical methods to diagnose endometriosis and alternative options that may be safer and provide more timely care to patients.

Open access
Meihong Shi Centre de Recherche en Reproduction, Développement et Santé Intergénérationnelle, Département des Sciences Animales, Faculté des Sciences de l’Agriculture et de l’Alimentation, Pavillon INAF, Université Laval, Québec, Québec, Canada

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Marc-André Sirard Centre de Recherche en Reproduction, Développement et Santé Intergénérationnelle, Département des Sciences Animales, Faculté des Sciences de l’Agriculture et de l’Alimentation, Pavillon INAF, Université Laval, Québec, Québec, Canada

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Fatty acids (FA) are one of the substrates that can be oxidized for energy production. The blood concentration of all types of FA varies according to different nutrition conditions, and follicular fluid levels are generally in line with serum levels. Elevated levels of FA, especially non-esterified fatty acids (NEFA), are commonly found in females with metabolic issues, which are often related to subfertility in many species including humans, pigs, cattle, and mice. Long-time exposure to an excessive quantity of fatty acids impairs the cell structure and functions causing injuries in tissues and organs, resulting in lipotoxicity and eventually hampering health and fertility. High levels of saturated NEFA can have detrimental effects on granulosa cells, oocyte quality, and embryo development. Although the harmful effects of FA are established in reproductive tissues, how granulosa cells and cumulus cells respond and cooperate with oocytes when exposed to NEFA requires further understanding. This review provides a summary of the adverse impacts of exposure to NEFA during in vitro maturation on oocytes, follicular cells, and embryos. A comprehensive understanding of the effects of NEFA on oocytes in vitro would improve our understanding of the impacts of natural exposure in vivo.

Lay summary

Exposure to excess FAs affects the health of eggs, early embryos, and children born from these. The way different cell types react to excess FAs has not been studied very extensively, especially in pigs which provide a good model to investigate the impact of nutrition on the ovaries in humans. This review also looks at the way cells surrounding the egg react to FAs to help our understanding of the impact of excess fatty acids on female fertility.

Open access
Kendall A Hyde Animal Science, School of Agricultural Sciences, Southern Illinois University, Carbondale, Illinois, USA

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Francisco L N Aguiar Animal Science, School of Agricultural Sciences, Southern Illinois University, Carbondale, Illinois, USA
Department of Veterinary Medicine, Sousa Campus, Federal Institute of Education, Science and Technology of Paraíba, Sousa, Paraíba, Brazil

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Benner G Alves Animal Science, School of Agricultural Sciences, Southern Illinois University, Carbondale, Illinois, USA

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Kele A Alves Animal Science, School of Agricultural Sciences, Southern Illinois University, Carbondale, Illinois, USA

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Gustavo D A Gastal Animal Science, School of Agricultural Sciences, Southern Illinois University, Carbondale, Illinois, USA
Instituto Nacional de Investigación Agropecuaria, Estación Experimental INIA La Estanzuela, Colonia, Uruguay

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Melba O Gastal Animal Science, School of Agricultural Sciences, Southern Illinois University, Carbondale, Illinois, USA

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Eduardo L Gastal Animal Science, School of Agricultural Sciences, Southern Illinois University, Carbondale, Illinois, USA

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Characterization of the ovarian preantral follicle population is a necessary step to improve understanding of folliculogenesis and ovarian physiology. Therefore, in the present study, the preantral follicle population in the equine ovary in young and old mares was investigated according to follicular morphology, follicular class, distance from the geometric center using ovarian maps, and follicular density within ovarian portions (lateral vs intermediary) and regions (dorsal vs ventral). Ovaries were collected from an abattoir and histologically processed for evaluation, and the follicle population was calculated. Overall, in the current detailed study, a higher preantral follicle population per mare ovary (mean: 82,206 ± 50,022; range: 1477 to 773,091) than originally reported was identified. Additionally, a mare age effect was observed in the follicle population (young: 152,664 vs old: 11,750) and the spatial distribution of morphologically normal and abnormal follicles and the density and population of follicular classes. These results demonstrate that, in addition to the preantral follicle population in the mare ovary being comparable to that of other species, the location and spatial distribution of these follicles is dynamic and varies depending on mare age and follicle status (i.e. morphology and developmental stage). The characterization of the distribution and population of preantral follicles in the mare ovary provided by this study can potentially aid in improving reproductive studies and assisted reproductive techniques and may expand the understanding of mechanisms involving ovarian plasticity and follicular migration.

Lay summary

Knowledge of the distribution and population of immature eggs within follicles (preantral follicles) in the ovaries of mares can improve approaches to assisted reproductive techniques and fertility preservation. As the existing research on horse preantral follicle population was focused solely on large follicles, the present study provides an updated investigation of small and large preantral follicles in the mare, showing that the population is similar to those in other species. This study also shows that the way these follicles are distributed in the ovary varies depending on age and follicle characteristics. Results from this study may help to highlight which areas of the mare ovary should be looked at to find samples of good-quality follicles.

Open access