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Program of Ethics and Public Policies in Human Reproduction, Universidad Diego Portales, Santiago, Chile
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Premature ovarian insufficiency (POI) affects 1-3% of women under 40 years of age. The identified causes are highly heterogeneous, and 70% of the cases are idiopathic. The ovarian manifestation varies from a variable population of follicles that fail to develop (follicular POI) to the absence of follicles (afollicular POI) with a transition from one to the other over time. Previously, we have described a mouse model of POI that results from an oocyte-specific deletion of N- and O-glycans; Double Mutant (DM). DM females produce only one litter before undergoing POI due to ovarian dysfunction. In this study, we have characterised the gene expression profile of prepuberal (3 weeks), fertile (6 weeks) and infertile (9 weeks) DM ovaries. Up-regulation of cathepsin K (Ctsk, with unknown ovarian function) seems to trigger transcriptional changes in DM ovaries. Significant transcriptional changes then occur rapidly, associated with morphophysiological changes displayed by DM mice throughout the onset of POI. We identified genetic pathways such as extracellular matrix and immune response as candidates for the onset of POI in DM females. Remarkably, DM mice and POI women share a set of differentially expressed genes, including a functionally and co-expressed network of Mcm (minichromosome maintenance proteins) family members. The transcriptomic profile of the DM mouse model provides novel insight into the aetiology of POI.
Lay summary
Problems in ovary function lead to reduced fertility or infertility. One such condition is premature ovarian insufficiency (POI) which affects 1% of women under 40 years of age, and in over 70% of these, the cause of POI is unknown. To investigate POI, we have developed a mouse model. These mice are initially fertile but develop POI by 3 months of age. In this study, we investigated the changes in genes activated in the ovaries during the transition from fertility to POI, and we did this by comparing them to normal mice; gene activation leads to molecule production. A molecule known as cathepsin K seems to trigger changes during the onset of POI, followed by others related to structure and immune response pathways. In addition, some genes were identified that are similar between the POI mice and POI women.
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IMT International Limited, Tattenhall, Chester, UK
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Chester Zoo, Upton-by-Chester, UK
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Biodiversity is defined as the presence of a variety of living organisms on the Earth that is essential for human survival. However, anthropogenic activities are causing the sixth mass extinction, threatening even our own species. For many animals, dwindling numbers are becoming fragmented populations with low genetic diversity, threatening long-term species viability. With extinction rates 1000–10,000 times greater than natural, ex situ and in situ conservation programmes need additional support to save species. The indefinite storage of cryopreserved (−196°C) viable cells and tissues (cryobanking), followed by assisted or advanced assisted reproductive technology (ART: utilisation of oocytes and spermatozoa to generate offspring; aART: utilisation of somatic cell genetic material to generate offspring), may be the only hope for species’ long-term survival. As such, cryobanking should be considered a necessity for all future conservation strategies. Following cryopreservation, ART/aART can be used to reinstate lost genetics back into a population, resurrecting biodiversity. However, for this to be successful, species-specific protocol optimisation and increased knowledge of basic biology for many taxa are required. Current ART/aART is primarily focused on mammalian taxa; however, this needs to be extended to all, including to some of the most endangered species: amphibians. Gamete, reproductive tissue and somatic cell cryobanking can fill the gap between losing genetic diversity today and future technological developments. This review explores species prioritisation for cryobanking and the successes and challenges of cryopreservation and multiple ARTs/aARTs. We here discuss the value of cryobanking before more species are lost and the potential of advanced reproductive technologies not only to halt but also to reverse biodiversity loss.
Lay summary
The world is undergoing its sixth mass extinction; however, unlike previous events, the latest is caused by human activities and is resulting in the largest loss of biodiversity (all living things on Earth) for 65 million years. With an extinction rate 1000–10,000-fold greater than natural, this catastrophic decline in biodiversity is threatening our own survival. As the number of individuals within a species declines, genetic diversity reduces, threatening their long-term existence. In this review, the authors summarise approaches to indefinitely preserve living cells and tissues at low temperatures (cryobanking) and the technologies required to resurrect biodiversity. In the future when appropriate techniques become available, these living samples can be thawed and used to reinstate genetic diversity and produce live young ones of endangered species, enabling their long-term survival. The successes and challenges of genome resource cryopreservation are discussed to enable a move towards a future of stable biodiversity.
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Endometriosis is a benign disease that can cause pain and infertility in women. Debate exists over how endometriosis should best be diagnosed. On one hand, endometriosis can be diagnosed by directly examining pelvic anatomy via a surgical procedure known as diagnostic laparoscopy. On the other hand, the disease can be diagnosed via non-surgical means such as using medical imaging, the symptoms described by the patient and whether the patient responds to non-surgical therapies such as medication. In this debate article, we argue in favour of diagnostic laparoscopy. We review the safety of the procedure, compare the ability of diagnostic laparoscopy vs medical imaging to detect endometriosis and consider the benefits of formally diagnosing or ruling out the condition.
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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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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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Integrative and Biomedical Physiology Program, Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA
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Integrative and Biomedical Physiology Program, Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA
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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.
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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.
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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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Lay summary
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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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.
