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The effect of excess body fat on female and male reproduction.

体脂肪过多对雌雄生殖的影响。

  • 影响因子:5.69
  • DOI:10.1016/j.metabol.2020.154193
  • 作者列表:"Mintziori G","Nigdelis MP","Mathew H","Mousiolis A","Goulis DG","Mantzoros CS
  • 发表时间:2020-06-01
Abstract

:The dramatic increase in the prevalence of obesity coincides with a decline in reproductive health indices in both sexes. Energy excess mediates changes to the regulatory mechanisms of the reproductive system. Obese individuals exhibit increased estrogen concentrations, due to the overexpression of aromatase in the adipose tissue; via a negative feedback loop, men present with symptoms of hypogonadotropic hypogonadism. These hormonal changes, along with increased oxidative stress, lipotoxicity and disturbances in the concentrations of adipokines, directly affect the gonads, peripheral reproductive organs and the embryo. Clinical evidence is somewhat contradicting, with only some studies advocating worse semen parameters, increased incidence of erectile dysfunction, increased doses of ovulation induction medications, and worse live birth rates in assisted reproductive technology (ART) cycles in obese individuals compared with those of normal weight. Similar conclusions are drawn about patients with insulin resistance syndromes, namely polycystic ovary syndrome (PCOS). As far as treatment options are concerned, lifestyle changes, medical therapy and bariatric surgery may improve the reproductive outcome, although the evidence remains inconclusive. In this review, we summarize the evidence on the association of obesity and reproductive health on both the molecular and the clinical level, and the effect of weight-loss interventions on reproductive potential.

摘要

: 肥胖患病率的急剧增加与两性生殖健康指数的下降相吻合。能量过剩介导了生殖系统调节机制的变化。由于脂肪组织中芳香化酶的过度表达,肥胖个体表现出增加的雌激素浓度; 通过负反馈回路,男性呈现低促性腺激素性性腺功能减退的症状。这些激素变化,以及增加的氧化应激,脂毒性和脂肪因子浓度的紊乱,直接影响性腺,外周生殖器官和胚胎。临床证据有些矛盾,只有一些研究主张与正常体重相比,肥胖个体的精液参数更差,勃起功能障碍发生率增加,促排卵药物剂量增加,辅助生殖技术 (ART) 周期中的活产率更差。关于胰岛素抵抗综合征,即多囊卵巢综合征 (PCOS) 的患者也得出了类似的结论。就治疗方案而言,生活方式的改变,药物治疗和减肥手术可能会改善生殖结果,尽管证据仍然不确定。在这篇综述中,我们总结了肥胖和生殖健康在分子水平和临床水平上的相关性的证据,以及减肥干预对生殖潜力的影响。

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影响因子:1.79
发表时间:2020-03-01
DOI:10.1080/00498254.2019.1616850
作者列表:["Hekim N","Gure MA","Metin Mahmutoglu A","Gunes S","Asci R","Henkel R"]

METHODS::1. Glutathione S-transferases (GST) and cytochrome P450s (CYPs) are xenobiotic metabolizing enzymes participating in the protection of cell. The present study aimed to investigate the relationship between polymorphisms of glutathione S-transferase M1 (GSTM1) null, glutathione S-transferase T1 (GSTT1) null, glutathione S-transferase P1 (GSTP1) Ile105Val, cytochrome P450 1A2 (CYP1A2) 734 C→A, cytochrome P450 2D6 (CYP2D6) 1934 G→A and male infertility.2. A total of 306 azoospermic or oligozoospermic infertile men and 129 normozoospermic or fertile controls were enrolled in the study. Multiplex polymerase chain reaction (PCR) or PCR-restriction fragment length polymorphism methods were used for genotyping. There was a significant relationship between male infertility and CYP2D6 GG genotype (p < 0.001). CYP1A2 AA genotype was slightly higher in the infertile group (p = 0.056).3. There was no association between GSTT1 null polymorphisms and male infertility (p = 0.068), GSTM1 null (p = 0.843) and GSTP1 Ile105Val (p = 0.192) genes. GSTM1 null genotype frequency was higher in azoospermic men (p = 0.009). Men carrying CYP1A2 AA genotype had higher risk of infertility risk (OR = 3.14; %95 CI = 1.16-8.54) in the smoker group.4. Our results demonstrated that polymorphisms of CYP2D6 and CYP1A2 may play a role in idiopathic male infertility in our sample population.

翻译标题与摘要 下载文献
影响因子:1.27
发表时间:2020-01-01
DOI:10.1111/ppc.12392
作者列表:["Safaei Nezhad A","Ebrahimi L","Vakili MM","Kharaghani R"]

METHODS:PURPOSE:This study evaluated the effect of counseling based on the choice theory on irrational parenthood cognition (IPC)- and marital quality in infertile women. DESIGN AND METHODS:This randomized controlled trial was conducted on 50 primary infertile women in Zanjan, Iran. Stratified block randomization was used to allocate participants to groups. The intervention group received counseling, but the control group received routine care. Data were collected using the IPC and marital relationships quality based on the Glasser's choice theory. FINDINGS:A statistically significant difference was found between the groups in IPC (P = 0.005), but the difference in marital quality was not statically significant ( P = 0.085). PRACTICE IMPLICATIONS:Counseling can be used for decreasing IPC, but more interventions are needed to increase marital quality.

翻译标题与摘要 下载文献
影响因子:2.14
发表时间:2020-02-01
DOI:10.1007/s11427-019-9526-2
作者列表:["Liu D","Yan J","Qiao J"]

METHODS::A decrease in cancer deaths has resulted in the possibility of child bearing for many young adult cancer survivors. Most antitumor treatment modalities are detrimental to female fertility, and methods for fertility preservation before gonadotoxic treatment, including cryopreservation of oocytes, embryos and ovarian tissue, have therefore been developed. This review focuses on the ovarian function of cancer patients, the safety and efficacy of fertility preservation methods, and the pregnancy outcomes of these patients. Breast cancer and hematological tumors constitute the majority of cancers in reproductive-aged female oncology patients. Ovarian function may not be impacted by breast cancer cells, while in patients with hematological malignancies, decreases in anti-Müllerian hormone and antral follicle counts have been demonstrated. In most cases, patients can undergo ovarian stimulation without delaying treatment, and a new stimulation protocol known as dual stimulation, which may be more efficient, has now been developed. Birth outcomes are also acceptable in cancer patients.

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不孕症方向

不孕症分为男性不育和女性不孕,其首要病因诊断依次是:排卵障碍、精液异常、输卵管异常、不明原因的不孕、子宫内膜异位症和其他如免疫学不孕。

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