Effects o follicular fluid oxidative status on human mural granulosa cells, oocyte competency and ICSI parameters

Effects of melatonin in polycystic ovary syndrome: is there Hippo pathway crosstalk?

OBJECTIVE

Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder among reproductive women, characterized by hyperandrogenism, oligo-ovulation and polycystic ovarian morphology. Incorporating complementary medicine alongside traditional lifestyle therapies for PCOS may offer additional benefits for affected women. Melatonin (MT), a hormone secreted by the pineal gland, has emerged as a potential treatment for regulating ovarian function in PCOS. However, the specific effects and underlying mechanisms of MT on PCOS need to be elucidated.

METHODS

This review consolidates evidence from randomized controlled trials, original research articles, systematic reviews, and meta-analyses regarding MT supplementation in PCOS, with a particular focus on its interaction with the Hippo pathway, to provide a comprehensive overview of current knowledge.

RESULTS

Current evidence suggests that MT plays a role in modulating PCOS through various mechanisms and is associated with the Hippo pathway. However, several uncertainties and key limitations in the existing literature must be addressed before these treatments can be integrated into standard clinical practice.

CLINICAL TRIAL NUMBER

Not applicable.

Oocytes Quality Assessment-The Current Insight: A Systematic Review

An overall in vitro fertilization (IVF) outcome is dynamic. Good oocyte quality is important for achieving a better IVF pregnancy. Various methods have been used for OQ assessment (OQA). However, due to inconclusive evidence, one method's superiority has not been proposed over others. Thus, OQA should be consolidated based on the current evidence for this matter. Our study aims to summarize the current OQA used and compare their recommended methods. Our results revealed that the optimal OQA for cost-effectiveness and clinical implementation is still via morphological assessment. The current method most opted for is total oocyte scoring. Although other methods-follicular fluid evaluation, mitochondria spindle assessment, or live zona imaging-can be applied with better precision, due to cost, additional tools, and expertise, and they should cater to research purposes and selected centers. Our results added value as a current strategy for optimizing OQA in IVF practice, aiming at cost-effectiveness and reproducibility for better clinical implementation.

Protective effect of afamin protein against oxidative stress related injury in human ovarian granulosa cells

BACKGROUND

Ovarian granulosa cells (GCs) play crucial roles in follicular growth and development. Their normal function is influenced by various factors, including oxidative stress, which is a significant factor. Afamin protein is a vitamin E-specific binding protein that acts as a vitamin E carrier in follicular fluid. Although the mechanism of the protective effect of afamin on human ovarian GCs is still unclear, there is evidence it has an antioxidant effect in neuronal cells.

METHODS

In this study, we investigated the protective effects of afamin proteins on testosterone propionate (TP)-induced ovarian GCs using a human ovarian tumor granulosa cell line (KGN).

RESULTS

The results showed that afamin reduced TP-induced oxidative stress in KGN cells by decreasing the levels of oxidative damage markers, enhancing the activity of antioxidant enzymes, and exerting a protective effect on GCs. Supplementation with afamin repaired mitochondrial dysfunction by improving mitochondrial membrane potential damage and ATP levels. It counteracted TP-induced apoptosis by decreasing the activity of Caspase-3 and upregulating the expression of the anti-apoptotic gene (BCL-2) while downregulating the expression of the pro-apoptotic gene BCL-2-associated X protein (BAX). In addition, afamin regulated the expression of genes related to ovarian steroid hormone synthesis, ameliorating the endocrine dysfunction observed in TP-induced KGN cells.

CONCLUSION

Therefore, Afamin proteins may serve as important complementary factors that protect GCs from other types of damage, such as oxidative stress, and may help improve ovarian follicle quality and female reproductive function.

Follicular oocyte as a potential target for severe acute respiratory syndrome coronavirus 2 infection

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported in December 2019 and rapidly became a pandemic as coronavirus disease 2019 (COVID-19). Apart from other organs, presence of specific receptor angiotensin-converting enzyme (ACE2) and corresponding proteases such as transmembrane serine protease 2, basigin and cysteine protease cathepsin L make follicular somatic cells as well as oocyte as potential targets for SARS-CoV-2 infection. The SARS-CoV-2 causes inflammation and hypoxia that generate reactive oxygen species (ROS) in critically ill patients. In addition, a large number of casualties and insecurity of life due to repeated waves of SARS-CoV-2 infection generate psychological stress and cortisol resulting in the further generation of ROS. The excess levels of ROS under physiological range cause meiotic instability, while high levels result in oxidative stress that trigger various death pathways and affect number as well as quality of follicular oocytes. Although, emerging evidence suggests that the SARS-CoV-2 utilises cellular machinery of ovarian follicular cells, generates ROS and impairs quality of follicular oocytes, the underlying mechanism of viral entry into host cell and its negative impact on the follicular oocyte remains poorly understood. Therefore, this review summarises emerging evidence on the presence of cellular machinery for SARS-CoV-2 in ovarian follicles and the potential negative impact of viral infection on the follicular oocytes that affect ovarian functions in critically ill and stressed women.

High Prolactin Concentration Induces Ovarian Granulosa Cell Oxidative Stress, Leading to Apoptosis Mediated by L-PRLR and S-PRLR

High prolactin (PRL) concentration has been shown to induce the apoptosis of ovine ovarian granulosa cells (GCs), but the underlying mechanisms are unclear. This study aimed to investigate the mechanism of apoptosis induced by high PRL concentration in GCs. Trial 1: The optimal concentration of glutathion was determined according to the detected cell proliferation. The results showed that the optimal glutathione concentration was 5 μmol/mL. Trial 2: 500 ng/mL PRL was chosen as the high PRL concentration. The GCs were treated with 0 ng/mL PRL (C group), 500 ng/mL PRL (P group) or 500 ng/mL PRL, and 5 μmol/mL glutathione (P-GSH group). The results indicated that the mitochondrial respiratory chain complex (MRCC) I-V, ATP production, total antioxidant capacity (T-AOC), superoxide dismutase (SOD), and thioredoxin peroxidase (TPx) in the C group were higher than those in the P group (p < 0.05), while they were lower than those in the P-GSH group (p < 0.05). Compared to the C group, the P group exhibited elevated levels of reactive oxygen species (ROS) and apoptosis (p < 0.05) and increased expression of ATG7 and ATG5 (p < 0.05). However, MRCC I-V, ATP, SOD, A-TOC, TPx, ROS, and apoptosis were decreased after the addition of glutathione (p < 0.05). The knockdown of either L-PRLR or S-PRLR in P group GCs resulted in a significant reduction (p < 0.05) in MRCC I-V, ATP, T-AOC, SOD and TPx, while the overexpression of either receptor showed an opposite trend (p < 0.05). Our findings suggest that high PRL concentrations induce apoptotic cell death in ovine ovarian GCs by downregulating L-PRLR and S-PRLR, activating oxidative stress and autophagic pathways.

Are ICSI results affected by months and seasons? A retrospective cohort study of fresh and frozen cycles

In present study, we aimed to investigate the effect of seasonal variation on ICSI results both in fresh and frozen embryo transfer cycles. Between January 2007 and December 2019, a total of 4039 ICSI cycles (3227 fresh and 812 frozen ET) which resulted in embryo transfer were included in the study. We found no significant difference in the pregnancy outcome among different seasons and months. The best results were obtained for spring (41.0%) and the least for winter (37.1%) in fresh cycles and the best for spring (42.5%) and the least for winter (29.7%) in FET cycles. In monthly distribution, the best results were obtained for September (57.0%) and the least for November (24.1%) in fresh cycles and the best for October (49.3%) and the least for December (20.2%) in FET cycles. Our study did not show any significant influence of the months or seasons on clinical pregnancy rates in either fresh and frozen embryo transfers. However, the difference among months in frozen cycles was notable although it did not reach statistical significance. It can be suggested that the strict control of reproductive hormones especially in fresh cycles as well as the standardized laboratory temperature minimize the influence of seasonal effect on ICSI outcome.

Study on the relationship between SlRTl and oxidative stress in aged patients undergoing in vitro fertilization and embryo transfer cycles

PURPOSE

Oxidative stress (OS) has been suggested to be involved in the pathogenesis of fertility reduction in aged patient. Silent Information Regulator 1 (SIRT1) is involved in antioxidant defense and also plays a role in regulation ovarian function. The purpose of this study was to evaluate SIRT1 and OS markers in follicular fluid (FF) and granulosa cells (GCs) for aged patient undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI).

METHODS

This single-center prospective cohort study was performed from May 2020 to October 2021, including 92 patients undergoing IVF/ICSI at authors' institute. The patients were grouped by age, including group A (< 35 year, n = 28, age range 24-29), group B (35-40 year, n = 33, age range 35-40), and group C (> 40 year, n = 31, age range 41-47). The outcomes included in vitro fertilization and embryo transfer (IVF-ET) results, OS markers and SIRT1 levels.

RESULTS

Women in group B and group C had a significantly lower estradiol (E₂) in the trigger day, retrieved oocytes, mature oocytes, two pronuclei (2PN) and Day3 available embryos than group A. Women in group C had a significantly lower implantation rate and clinical pregnancy rate than group A. The superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities and SIRT1 levels were lower in FF of the group B and group C, whereas the malondialdehyde (MDA) level was higher than that in the group A. Moreover, the MDA levels were correlated negatively with SIRT1 (r = -0.422, P=0.001),while the SOD and GSH-Px was positively correlated with SIRT1 (r = 0.409, P = 0.001 and r = 0.526, P = 0.001).

CONCLUSIONS

The oxidative stress may be related to the decrease of SIRT1 in aged patients undergoing IVF-ET.

IL-6 of follicular fluid and outcome of in vitro fertilization

The quality of an oocyte is influenced by its microenvironment, which includes cumulus cells and follicular fluid, as well as cells of the immune system and their products. The ovarian interleukins, which are secreted by the granulosa cells and other immune cells within the ovaries and follicles, regulate various functions between the cells. IL-6 is a cytokine that is present in the follicular fluid and may affect the quality of oocytes. There are some inconsistencies in the literature regarding the concentration of interleukin 6 in the follicular fluid. The main objective of this study was to examine whether the concentration of interleukin 6 in the follicular fluid affects the outcome of IVF. This study involved 83 patients who underwent IVF. Follicular fluid was used as the biological material for the analysis. Examination of the obtained follicular fluid and collection of oocytes under a stereomicroscope was performed in the embryological laboratory. The concentration of IL-6 in the follicular fluid was analyzed. IVF and ICSI methods were used as the fertilization methods. Pregnancy was confirmed by the positive serum β-hCG level. The software package SPSS 20 was used for statistical data processing. Analysis of the follicular fluid samples showed a correlation between the concentration of IL-6 in the follicular fluid and the outcome of IVF. The concentration of IL-6 in the follicular fluid was higher in patients with confirmed pregnancy (9.55 ± 7.47 ng/ml). Based on our results, we conclude that the concentration of IL-6 affects the outcome of IVF. If the range of IL-6 concentration is between 3,67 ng/ml and 10 ng/ml, we can expect good IVF outcome with vital pregnancy.

Altered redox homeostasis in steroid-depleted follicles attenuates hCG regulation of follicular events: Cross-talk between endocrine and IGF axis in maturing oocytes

Steroids and insulin-like growth factors (Igfs) are indispensable for folliculogenesis and reproductive fitness in the vertebrate ovary. The intrafollicular redox balance is also of immense importance for ovarian follicles wherein low levels of ROS are being utilized for cell signalling and regulation of gene expression; its excess may interfere with normal physiological processes leading to ovotoxicity. However, the functional relevance of ovarian steroidogenesis in maintaining the follicular microenvironment with coordinated redox homeostasis and intra-ovarian growth factors axis is relatively less understood. Using zebrafish full-grown (FG) ovarian follicles in vitro, our study shows that blocking steroid biosynthesis with anti-steroidal drugs, DL-aminoglutethimide (AG) or Trilostane (Trilo), prevents hCG (LH analogue)-induced StAR expression concomitant with a robust increase in intrafollicular ROS levels. Congruent with heightened intracellular levels of superoxide anions (O₂^•-) and hydrogen peroxide (H₂O₂), priming with AG or Trilo abrogates the transcript abundance of major antioxidant enzyme genes (SOD1, SOD2, and CAT) in hCG-stimulated follicles. Significantly, blocking steroidogenesis attenuates transcript abundance of HSP70 but elevates NOX4 expression potentially through ERα-mediated pathway. Importantly, disrupted redox balance in AG/Trilo pre-incubated FG follicles negatively impacts hCG-mediated activation of PKA/CREB signaling and transcriptional activation of igf ligands. Elevated ROS attenuation of antioxidant defense parameters and impaired endocrine and autocrine/paracrine homeostasis converge upon reduced p34cdc2 (Thr-161) phosphorylation, a reliable marker for MPF activation, and resumption of meiotic G2-M1 transition in hCG-treated follicles. Collectively, altered redox homeostasis in steroid-depleted follicles has a significant negative influence on GTH (LH) regulation of follicular events, specifically Igf synthesis, meiotic maturational competence and ovarian fitness.

The Differential Metabolomes in Cumulus and Mural Granulosa Cells from Human Preovulatory Follicles

This study evaluated the differences in metabolites between cumulus cells (CCs) and mural granulosa cells (MGCs) from human preovulatory follicles to understand the mechanism of oocyte maturation involving CCs and MGCs. CCs and MGCs were collected from women who were undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment. The differences in morphology were determined by immunofluorescence. The metabolomics of CCs and MGCs was measured by liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) followed by quantitative polymerase chain reaction (qPCR) and western blot analysis to further confirm the genes and proteins involved in oocyte maturation. CCs and MGCs were cultured for 48 h in vitro, and the medium was collected for detection of hormone levels. There were minor morphological differences between CCs and MGCs. LC-MS/MS analysis showed that there were differences in 101 metabolites between CCs and MGCs: 7 metabolites were upregulated in CCs, and 94 metabolites were upregulated in MGCs. The metabolites related to cholesterol transport and estradiol production were enriched in CCs, while metabolites related to antiapoptosis were enriched in MGCs. The expression of genes and proteins involved in cholesterol transport (ABCA1, LDLR, and SCARB1) and estradiol production (SULT2B1 and CYP19A1) was significantly higher in CCs, and the expression of genes and proteins involved in antiapoptosis (CRLS1, LPCAT3, and PLA2G4A) was significantly higher in MGCs. The level of estrogen in CCs was significantly higher than that in MGCs, while the progesterone level showed no significant differences. There are differences between the metabolomes of CCs and MGCs. These differences may be involved in the regulation of oocyte maturation.

A Histopathological Evaluation of Ovarian Hyperstimulation Syndrome on Reproductive and Vital Organs and the Role of the VEGF-PKA Pathway in a Mouse Model

Ovarian hyperstimulation syndrome (OHSS) is one of the most common and iatrogenic complications of in vitro fertilization therapy, which is an exaggerated response to excess hormones resulting in the development of a large number of maturing follicles. Although the complications of and reasons for the condition are well known, the overall histopathological effects on systemic organs and the extent of the damage have not been fully elucidated. Besides, the mechanism that underlies the situation is not very well known. The aim of the present work was to analyse the histopathological effects of OHSS on reproductive (uterus and ovary) and vital organs (liver and kidney) and the possible role of the VEGF-PKA pathway in triggering the condition. Balb/c mice were used to establish an OHSS model. The OHSS group were injected with overdose PMSG while the normal responder group were injected with an optimal dose. Histopathological evaluation was utilised in the liver, kidney, ovary, and uterus stained with hematoxylin and eosin, Masson's trichrome, and periodic acid-Schiff stain. The expression profiles of VEGF (vascular endothelial growth factor), PKA (protein kinase A), and p-PKA (an activated form of PKA) were detected with immunohistochemistry and Western blotting. OHSS was demonstrated to have a negative histopathological effect on all of the organs analysed. These effects were associated with an overall increase in the expression levels of VEGF, PKA, and p-PKA. OHSS has a serious histopathological negative effect on the systemic and reproductive organs and is proven to affect overall health, and thus should be considered a dangerous complication during ART techniques. The activation of the VEGF-PKA pathway, which is indicated by the expression levels of VEGF, PKA, and p-PKA, is demonstrated to accompany this complication, which should be further elucidated to understand the mechanisms underlying the condition.