Therapeutic advances in reproductive health最新文献

{"title":"The obligate need for accuracy in reporting preclinical studies relevant to clinical trials: autologous germline mitochondrial supplementation for assisted human reproduction as a case study.","authors":"Jonathan L Tilly,&nbsp;Dori C Woods","doi":"10.1177/2633494120917350","DOIUrl":"https://doi.org/10.1177/2633494120917350","url":null,"abstract":"<p><p>A now large body of work has solidified the central role that mitochondria play in oocyte development, fertilization, and embryogenesis. From these studies, a new technology termed autologous germline mitochondrial energy transfer was developed for improving pregnancy success rates in assisted reproduction. Unlike prior clinical studies that relied on the use of donor, or nonautologous, mitochondria for microinjection into eggs of women with a history of repeated <i>in vitro</i> fertilization failure to enhance pregnancy success, autologous germline mitochondrial energy transfer uses autologous mitochondria collected from oogonial stem cells of the same woman undergoing the fertility treatment. Initial trials of autologous germline mitochondrial energy transfer during - <i>in vitro</i> fertilization at three different sites with a total of 104 patients indicated a benefit of the procedure for improving pregnancy success rates, with the birth of children conceived through the inclusion of autologous germline mitochondrial energy transfer during <i>in vitro</i> fertilization. However, a fourth clinical study, consisting of 57 patients, failed to show a benefit of autologous germline mitochondrial energy transfer-<i>in vitro</i> fertilization <i>versus in vitro</i> fertilization alone for improving cumulative live birth rates. Complicating this area of work further, a recent mouse study, which claimed to test the long-term safety of autologous mitochondrial supplementation during <i>in vitro</i> fertilization, raised concerns over the use of the procedure for reproduction. However, autologous mitochondria were not actually used for preclinical testing in this mouse study. The unwarranted fears that this new study's erroneous conclusions could cause in women who have become pregnant through the use of autologous germline mitochondrial energy transfer during-<i>in vitro</i> fertilization highlight the critical need for accurate reporting of preclinical work that has immediate bearing on human clinical studies.</p>","PeriodicalId":75219,"journal":{"name":"Therapeutic advances in reproductive health","volume":"14 ","pages":"2633494120917350"},"PeriodicalIF":0.0,"publicationDate":"2020-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2633494120917350","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38027360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient perspectives and experiences with <i>in vitro</i> fertilization and genetic testing options.","authors":"Erin Rothwell,&nbsp;Brandy Lamb,&nbsp;Erin Johnson,&nbsp;Shawn Gurtcheff,&nbsp;Naomi Riches,&nbsp;Melinda Fagan,&nbsp;Maya Sabatello,&nbsp;Erica Johnstone","doi":"10.1177/2633494119899942","DOIUrl":"https://doi.org/10.1177/2633494119899942","url":null,"abstract":"<p><strong>Objective: </strong>Decision-making and patient experiences with embryo selection during <i>in vitro</i> fertilization often include genetic testing options. The purpose of this study was to gain insight about the experiences and perspectives of women using <i>in vitro</i> fertilization and genetic technologies.</p><p><strong>Methods: </strong>Interviews (<i>n</i> = 37) were conducted among female patients who had undergone <i>in vitro</i> fertilization, underwent expanded carrier screening, and were offered pre-implantation genetic testing for aneuploidy between July 2016 and July 2017. The interviews were transcribed and a content analysis was conducted on the transcripts.</p><p><strong>Results: </strong>Categories that emerged from the data analysis included unexpected outcomes, uncertainty, unanticipated emotional consequences, too much emphasis on the woman's contributions and questions about embryo viability. Patient experiences with genetic technologies during <i>in vitro</i> fertilization played a significant role within these results.</p><p><strong>Conclusion: </strong>The emotional and psychological impacts of infertility during <i>in vitro</i> fertilization were the primary concerns discussed by participants. Future research is needed to identify ways to help manage unexpected outcomes and continuous uncertainty, including the increasing use of genetic technologies, to not add to the psychological burden of infertility. There is a need to explore more support options or counseling services for patients struggling with infertility during <i>in vitro</i> fertilization treatment.</p>","PeriodicalId":75219,"journal":{"name":"Therapeutic advances in reproductive health","volume":"14 ","pages":"2633494119899942"},"PeriodicalIF":0.0,"publicationDate":"2020-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2633494119899942","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38027436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of polycystic ovary syndrome throughout life.","authors":"Yvonne V Louwers,&nbsp;Joop S E Laven","doi":"10.1177/2633494120911038","DOIUrl":"https://doi.org/10.1177/2633494120911038","url":null,"abstract":"<p><p>Polycystic ovary syndrome is the most common endocrine disorder in women of reproductive age. It is a complex disease in which genetic, endocrine, environmental, and behavioral factors are intertwined, giving rise to a heterogeneous phenotype with reproductive, metabolic, and psychological characteristics. Polycystic ovary syndrome affects women's health and their quality of life across the life course. During different life stages, the polycystic ovary syndrome phenotype can change, which requires a personalized diagnostic approach and treatment. Polycystic ovary syndrome is a major cause of anovulatory infertility; this disorder is also associated with hirsutism and acne. Diagnosing polycystic ovary syndrome during adolescence is challenging because the polycystic ovary syndrome criteria include normal physiological events that occur during puberty. With increasing age, the syndrome evolves from a reproductive disease to a more metabolic disorder. Along with metabolic disturbances, including insulin resistance and abnormalities of energy expenditure, polycystic ovary syndrome is recognized as a major risk factor for the development of type 2 diabetes and cardiovascular disease in later life. Moreover, there is evidence for familial clustering of endocrine and metabolic features of polycystic ovary syndrome. Environmental factors such as diet and obesity appear to contribute to the phenotype. Treatment should be tailored to the specific concerns and needs of the individual patient and involves restoring fertility, treatment of the metabolic complaints, treatment of androgen excess, and providing endometrial protection. The complexity of the disorder, and the impact on quality of life, requires a timely diagnosis, screening for complications, and management strategies for the long-term health issues associated with polycystic ovary syndrome. The syndrome remains underdiagnosed, and women experience significant delays to diagnosis.</p>","PeriodicalId":75219,"journal":{"name":"Therapeutic advances in reproductive health","volume":"14 ","pages":"2633494120911038"},"PeriodicalIF":0.0,"publicationDate":"2020-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2633494120911038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38027362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is new in the landscape of insulin-sensitizing agents for polycystic ovary syndrome treatment.","authors":"Daniela Romualdi, Valeria Versace, Antonio Lanzone","doi":"10.1177/2633494120908709","DOIUrl":"10.1177/2633494120908709","url":null,"abstract":"<p><p>Polycystic ovary syndrome, the most common gynecological endocrinopathy, is burdened with a state of hyperinsulinemia and insulin resistance in 50-80% of affected women. Wherever the origin of these metabolic abnormalities lies, their pathogenetic role in determining, perpetuating, and worsening the clinical traits of the syndrome is ascertained. Many studies have already highlighted possible mechanisms: hyperinsulinemia and insulin resistance may contribute to hyperandrogenemia, chronic anovulation, and other comorbidities of the syndrome by differentially affecting the endocrine glands (ovaries, adrenals, and pituitary) and peripheral tissues (fat mass and skeletal muscle). Based on these evidences, in the past years, thorough research has been focused on the possible role of insulin-sensitizing agents in the treatment of polycystic ovary syndrome. Many compounds were tested to verify their efficacy against polycystic ovary syndrome-related metabolic dysfunction, both relying on previous acquired experiences in the field of diabetes mellitus and experimenting new agents, in particular, those belonging to the class of nutraceuticals. We sought to summarize the most relevant aspects of insulin-sensitizing treatments in polycystic ovary syndrome, by reporting the relevant literature on this topic and by keeping an attentive eye on the newly published international guidelines on polycystic ovary syndrome 2018. This overview encompasses metformin, thiazolidinediones, inositols, alpha-lipoic acid, and GLP1-R analogues. Starting from the analysis of the mechanisms of action, we anchored to the state of the art of the use of these drugs in polycystic ovary syndrome, to the most recent evidences for clinical practice and to the remaining open questions around indications, dose, treatment schedules, and side effects.</p>","PeriodicalId":75219,"journal":{"name":"Therapeutic advances in reproductive health","volume":"14 ","pages":"2633494120908709"},"PeriodicalIF":3.1,"publicationDate":"2020-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c0/25/10.1177_2633494120908709.PMC7236839.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37958089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}