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Kuroshli Z, Novin MG, Nazarian H, Abdollahifar MA, Zademodarres S, Pirani M, Jahvani FA, Fathabady FF, Mofarahe ZS. The Efficacy of Vitamin D Supplement in the Expression and Protein Levels of Endometrial Decidualization Factors in Women with Recurrent Implantation Failure. Reprod Sci 2024; 31:675-686. [PMID: 37816991 DOI: 10.1007/s43032-023-01349-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/01/2023] [Indexed: 10/12/2023]
Abstract
Recurrent implantation failure (RIF) is a challenging situation for infertility specialists, and its treatment is introduced as a difficult case in the field of assisted reproductive technology (ART). Vitamin D (VD) is one of the supplements that have been suggested to improve the implantation process. In the present study, the effect of VD on the expression and protein levels of VD receptor (VDR), progesterone receptor (PR), prolactin (PRL), insulin-like growth factor binding protein-1 (IGFBP-1), and homeobox protein A10 (HOXA10) in the endometrial cells of unknown RIF women with and without VD deficiency were assessed by qRT-PCR and immunohistochemistry. Twelve women with unknown RIF and VD deficiency (≤ 20 ng/ml) and twelve women with unknown RIF without VD deficiency (≥ 30 ng/ml) from 2021 to 2022 were identified. Endometrial specimens were collected in the mid-luteal stage before treatment or pregnancy. In the group with VD deficiency, oral medication of VD 50,000 units was prescribed for 2 to 3 months and their serum levels of VD were re-measured, then an endometrial biopsy at the same stage of the menstrual cycle was performed. The expression and protein levels of VDR, PR, PRL, IGFBP1, and HOXA10 in RIF patients with VD deficiency were lower than the RIF patients without VD deficiency (P value < 0.05). Our findings suggest that VD can play a key role in the pregnancy process, especially during embryo implantation and decidualization of the endometrial cells.IRCT registration number: IRCT20220528055006N1, Registration date: 2022-10-15, Registration timing: retrospective.
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Affiliation(s)
- Zahra Kuroshli
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marefat Ghaffari Novin
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Nazarian
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad-Amin Abdollahifar
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahrzad Zademodarres
- Clinical Research Development Center, Mahdiyeh Education Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Pirani
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farideh Arab Jahvani
- Research and Clinical Centre for Infertility, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Fatemeh Fadaei Fathabady
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Shams Mofarahe
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Donayeva A, Amanzholkyzy A, Abdelazim I, Kurmangazin M, Khamidullina Z, Kurmanalina M, Sumanova A, Shabanbayeva Z, Baubekov Z, Bissaliyev B, Gubasheva G, Samaha I. The effect of vitamin D on adolescents' primary dysmenorrhea. J Med Life 2023; 16:1658-1662. [PMID: 38406787 PMCID: PMC10893579 DOI: 10.25122/jml-2023-0290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/17/2023] [Indexed: 02/27/2024] Open
Abstract
Vitamin D receptor (VDR) expression in the female reproductive tract explains the regulatory role of vitamin D on inflammatory cytokine and prostaglandin (PGD) synthesis. This study aimed to evaluate the effect of vitamin D on adolescents' primary dysmenorrhea and the relationship between Vit. D and adolescents' primary dysmenorrhea. Eighty-five adolescents were included in the current study. After a detailed evaluation, pelvic sonography was performed for all participants to rule out any pelvic pathology. Blood samples were collected to measure thyroid stimulating hormone (TSH), prolactin, glycosylated hemoglobin (HbA1C), and 25-hydroxyvitamin D (25[OH]D). Participants were administered vitamin D (50,000 IU weekly for five months), and their dysmenorrhea symptoms were evaluated before and after this period using the Visual Analog Scale (VAS) and the Verbal Multidimensional Scoring (VMS). The mean VAS and VMS scores of dysmenorrhea statistically decreased from 8.7±0.91 and 2.65±0.93 to 4.8±0.75 and 0.80±0.75, respectively, after vitamin D intake (p=0.03 and 0.025, respectively). Significant negative associations between 25(OH)D and VAS (R = -0.886; p<0.00001) and VMS of dysmenorrhea (R = -0.885; p<0.00001) were detected in this study. Vit. D could be a useful therapeutic option to reduce the severity of primary dysmenorrhea and could limit the use of non-steroidal anti-inflammatory drugs.
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Affiliation(s)
- Ainur Donayeva
- Department of Normal Physiology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Ainur Amanzholkyzy
- Department of Normal Physiology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Ibrahim Abdelazim
- Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Meirambek Kurmangazin
- Department of Normal Physiology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Zaituna Khamidullina
- Department of Obstetrics and Gynecology №, Astana Medical University, Astana, Kazakhstan
| | - Madina Kurmanalina
- Department of Therapeutic and Orthopedic Dentistry, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Aigul Sumanova
- Department of Therapeutic and Orthopedic Dentistry, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Zhanara Shabanbayeva
- Department of Therapeutic and Orthopedic Dentistry, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Zhenisbek Baubekov
- Department of Pediatric Surgery, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Bauyrzhan Bissaliyev
- Department of Pediatric Surgery, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Gulnara Gubasheva
- Department of Obstetrics and Gynecology №, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Ihab Samaha
- Department of Obstetrics and Gynecology, Faculty of Medicine, Helwan University, Cairo, Egypt
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Donayeva A, Amanzholkyzy A, Abdelazim I, Nurgaliyeva R, Gubasheva G, Saparbayev S, Ayaganov D, Kaldybayeva A, Samaha I. The impact of primary dysmenorrhea on adolescents' activities and school attendance. J Med Life 2023; 16:1462-1467. [PMID: 38313177 PMCID: PMC10835561 DOI: 10.25122/jml-2023-0247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/18/2023] [Indexed: 02/06/2024] Open
Abstract
Primary dysmenorrhea is the most commonly encountered menstrual issue among adolescents, often leading to significant school absenteeism. This study aimed to detect the impact of primary dysmenorrhea on adolescents' activities and school attendance. We conducted a cross-sectional comparative study involving 180 adolescents aged 12 to 18 who experienced primary dysmenorrhea. A comprehensive trans-abdominal pelvic sonography was performed to rule out any underlying pelvic conditions. The severity of dysmenorrhea was evaluated using the visual analog scale (VAS), categorizing adolescents into groups with mild dysmenorrhea (VAS ≥1 to ≤3), moderate dysmenorrhea (VAS >3 to ≤7), and severe dysmenorrhea (VAS >7 to ≤10). Adolescents were surveyed to determine whether the severity of dysmenorrhea had an adverse effect on their physical and social activities as well as their school attendance. We used one-way ANOVA to compare the groups. There was a significant positive relation between the severity of dysmenorrhea and its negative impact on adolescents' physical activities (r=0.395; p<0.00001) and social activities (r=0.658; p<0.00001). Additionally, there was a significant positive relation between the severity of dysmenorrhea and its negative impact on adolescents' school attendance (r=0.416; p<0.00001). The odds of a negative impact on adolescents' physical and social activities and school attendance were significantly higher in adolescents experiencing moderate and severe dysmenorrhea than in adolescents with mild dysmenorrhea.
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Affiliation(s)
- Ainur Donayeva
- Department of Normal Physiology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Ainur Amanzholkyzy
- Department of Normal Physiology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Ibrahim Abdelazim
- Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Roza Nurgaliyeva
- Department of Normal Physiology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Gulnara Gubasheva
- Department of Obstetrics and Gynecology №2, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Samat Saparbayev
- Department of Normal Physiology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Dinmukhamed Ayaganov
- Department of Neurology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Aiman Kaldybayeva
- Department of Normal Physiology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Ihab Samaha
- Department of Obstetrics and Gynecology, Faculty of Medicine, Helwan University, Cairo, Egypt
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Cochrane KM, Bone JN, Williams BA, Karakochuk CD. Optimizing vitamin D status in polycystic ovary syndrome: a systematic review and dose-response meta-analysis. Nutr Rev 2023:nuad117. [PMID: 37769789 DOI: 10.1093/nutrit/nuad117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023] Open
Abstract
CONTEXT Polycystic ovary syndrome (PCOS) is a common and complex endocrine disorder in women of reproductive age. Vitamin D supplementation is a promising complementary therapy for PCOS, yet there is no consensus on an optimal dose, leading to a lack of evidence-based supplementation guidelines. OBJECTIVE The objective of this study was to conduct a vitamin D dose-response meta-analysis among women with PCOS. DATA SOURCES MEDLINE, CINAHL, and EMBASE databases from inception to November 2022 were searched for relevant articles. DATA EXTRACTION Study screening and bias assessment were conducted by 2 independent reviewers. Eight relevant studies were identified; data for serum 25(OH)D (nmol/L) at baseline and at 12 weeks in each intervention group (mean ± SD) and vitamin D dose were extracted. DATA ANALYSIS Estimates across studies were used to create a pooled curve, using restricted cubic splines with knots at the 10th, 50th, and 90th percentiles of the distribution of doses, to estimate the mean difference in effect for serum 25(OH)D at each dose compared with 0 IU/day. Sensitivity analyses were conducted fixing knots at 4000 IU/day and 7000 IU/day, which were a priori identified as potentially important thresholds, and to assess model fit and estimate heterogeneity. The pooled analysis demonstrated strong evidence of a dose-response relationship (P < .001), suggesting an increasing effect with increasing dose. An initial increase in serum 25(OH)D was evident until doses of approximately 3000 IU/day; this was followed by a plateau in effect between approximately 3000 IU/day and 5000 IU/day. The effect of supplementation with >5000 IU/day was unclear, given the minimal data at higher doses. The curve produced robust results for moderate doses (3000 IU/day to 4000 IU/day), which were not sensitive to model specification. CONCLUSION Women with PCOS are responsive to vitamin D supplementation, but the benefit of providing doses of >3000 IU/day appears minimal. Further data is required to determine dose-response at doses of >5000 IU/day, and whether higher intakes provide a clinically meaningful advantage in this population. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021259396.
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Affiliation(s)
- Kelsey M Cochrane
- Food, Nutrition and Health, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, BC, Canada
- BC Children's Hospital Research Institute, The University of British Columbia, Vancouver, BC, Canada
| | - Jeffrey N Bone
- BC Children's Hospital Research Institute, The University of British Columbia, Vancouver, BC, Canada
- Department of Obstetrics and Gynaecology, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Brock A Williams
- Food, Nutrition and Health, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, BC, Canada
- BC Children's Hospital Research Institute, The University of British Columbia, Vancouver, BC, Canada
| | - Crystal D Karakochuk
- Food, Nutrition and Health, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, BC, Canada
- BC Children's Hospital Research Institute, The University of British Columbia, Vancouver, BC, Canada
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Choo SP, Lee I, Lee JH, Lee D, Park H, Park JH, Cho S, Choi YS. Transcriptomic patterns in early-secretory and mid-secretory endometrium in a natural menstrual cycle immediately before in vitro fertilization and embryo transfer. Obstet Gynecol Sci 2023; 66:417-429. [PMID: 37460099 PMCID: PMC10514596 DOI: 10.5468/ogs.22315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 05/06/2023] [Accepted: 06/04/2023] [Indexed: 09/21/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate the endometrial transcriptomic patterns in the early secretory phase (ESP) and mid-secretory phase (MSP) of the natural menstrual cycle before in vitro fertilization and embryo transfer (IVF-ET). METHODS Thirty patients whose endometrial tissues were obtained from the ESP or MSP of a natural menstrual cycle immediately before IVF-ET were included. Endometrial dating was histologically confirmed as ESP (cycle days 16-18) or MSP (cycle days 19-21), according to the noyes criteria. The patients were divided into two groups depending on the IVF-ET outcome: pregnant (n=14; 7 in ESP and 7 in MSP) or non-pregnant (n=16; 8 in ESP and 8 in MSP). Differentially expressed genes (DEGs) in the MSP, compared to the ESP, were identified using NanoString nCounter (NanoString Technologies, Seattle, WA, USA) data for both the pregnant and non-pregnant groups. RESULTS Thirteen DEGs in the pregnant group and 11 DEGs in the non-pregnant group were identified in the MSP compared to those in the ESP. In both groups, adrenoceptor alpha 2A, interleukin 1 receptor-associated kinase 2, a disintegrin and metalloproteinase with thrombospondin repeats 15 (ADAMTS15), serpin family E member 1, integrin subunit beta 3, transmembrane protein 252 (TMEM252), huntingtin associated protein 1, C2 calcium-dependent domain containing 4A, and integrin subunit alpha 2 were upregulated in the MSP, compared to the ESP. TMEM37, galactosidase beta 1 like 2, Rho family GTPase 3, and cytochrome P450 family 24 subfamily A member 1 were upregulated in the MSP only in the pregnant group. ADAMTS8 was downregulated and monoamine oxidase A was upregulated in the MSP only in the non-pregnant group. CONCLUSION Transcriptomic patterns in the endometrium immediately before IVF-ET appear to differ according to the IVF-ET outcome. These novel DEGs, which have not been previously studied, may have functional significance during the window of implantation and serve as potential biomarkers of endometrial receptivity.
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Affiliation(s)
- Sung Pil Choo
- Department of Obstetrics and Gynecology, Inha University Hospital, College of Medicine, Inha University, Incheon,
Korea
| | - Inha Lee
- Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul,
Korea
- Department of Obstetrics and Gynecology, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul,
Korea
| | - Jae-Hoon Lee
- Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul,
Korea
- Department of Obstetrics and Gynecology, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul,
Korea
| | - Dowon Lee
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul,
Korea
| | - Hyemin Park
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul,
Korea
| | - Joo Hyun Park
- Department of Obstetrics and Gynecology, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul,
Korea
- Department of Obstetrics and Gynecology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin,
Korea
| | - SiHyun Cho
- Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul,
Korea
- Department of Obstetrics and Gynecology, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul,
Korea
| | - Young Sik Choi
- Department of Obstetrics and Gynecology, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul,
Korea
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul,
Korea
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6
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Chen YC, Chiang YF, Lin YJ, Huang KC, Chen HY, Hamdy NM, Huang TC, Chang HY, Shieh TM, Huang YJ, Hsia SM. Effect of Vitamin D Supplementation on Primary Dysmenorrhea: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Nutrients 2023; 15:2830. [PMID: 37447156 DOI: 10.3390/nu15132830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/10/2023] [Accepted: 06/16/2023] [Indexed: 07/15/2023] Open
Abstract
Dysmenorrhea causes pain and inconvenience during menstruation. In addition to medication, natural compounds are widely used to relieve various types of pain. In this study, we aimed to assess the effects of vitamin D (vit. D) supplementation in relieving the symptoms of primary dysmenorrhea. A comprehensive systematic database search of randomized controlled trials (RCTs) was performed. Oral forms of vit. D supplementation were included and compared with a placebo or standard care. The degree of dysmenorrhea pain was measured with a visual analogue scale or numerical rating scale. Outcomes were compared using the standardized mean difference (SMD) and 95% confidence intervals (CIs) in a meta-analysis. RCTs were assessed using the Cochrane risk-of-bias v2 (RoB 2) tool. The meta-analysis included 8 randomized controlled trials involving 695 participants. The results of the quantitative analysis showed a significantly lower degree of pain in the vit. D versus placebo in those with dysmenorrhea (SMD: -1.404, 95% CI: -2.078 to -0.731). The results of subgroup analysis revealed that pain lessened when the average weekly dose of vit. D was over 50,000 IU, in which dysmenorrhea was relieved regardless of whether vit. D was administered for more or less than 70 days and in any dose interval. The results revealed that vit. D treatment substantially reduced the pain level in the primary dysmenorrhea population. We concluded that vit. D supplementation is an alternative treatment for relieving the pain symptoms of dysmenorrhea.
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Affiliation(s)
- Yi-Chun Chen
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 110301, Taiwan
- Department of Family and Community Medicine, Cheng Hsin General Hospital, Taipei 112401, Taiwan
| | - Yi-Fen Chiang
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 110301, Taiwan
| | - Ying-Jiun Lin
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 110301, Taiwan
| | - Ko-Chieh Huang
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 110301, Taiwan
| | - Hsin-Yuan Chen
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 110301, Taiwan
| | - Nadia M Hamdy
- Biochemistry Department, Faculty of Pharmacy, Ain Shams University, Abassia, Cairo 11566, Egypt
| | - Tsui-Chin Huang
- Graduate Institute of Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei 110301, Taiwan
| | - Hsin-Yi Chang
- Graduate Institute of Medical Science, National Defense Medical Center, Taipei 114201, Taiwan
| | - Tzong-Ming Shieh
- School of Dentistry, College of Dentistry, China Medical University, Taichung 40402, Taiwan
| | - Yun-Ju Huang
- Department of Biotechnology and Food Technology, Southern Taiwan University of Science and Technology, Tainan City 710301, Taiwan
| | - Shih-Min Hsia
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 110301, Taiwan
- School of Food and Safety, Taipei Medical University, Taipei 110301, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei 110301, Taiwan
- Graduate Institute of Metabolism and Obesity Sciences, College of Nutrition, Taipei Medical University, Taipei 110301, Taiwan
- TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei 110301, Taiwan
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Maaherra Armstrong P, Augustin H, Bärebring L, Osmancevic A, Bullarbo M, Thurin-Kjellberg A, Tsiartas P. Prevalence of Vitamin D Insufficiency and Its Determinants among Women Undergoing In Vitro Fertilization Treatment for Infertility in Sweden. Nutrients 2023; 15:2820. [PMID: 37375724 DOI: 10.3390/nu15122820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 06/14/2023] [Accepted: 06/19/2023] [Indexed: 06/29/2023] Open
Abstract
There is a lack of research on women with infertility in the northern latitudes, where vitamin D insufficiency is high. Therefore, this study aimed to assess the prevalence and determinants of vitamin D insufficiency (serum 25(OH)D concentration < 50 nmol/L) among women undergoing in vitro fertilization (IVF) treatment. Thus, 265 women scheduled for IVF/intracytoplasmic sperm injection (ICSI) between September 2020 and August 2021 at Sahlgrenska University Hospital in Gothenburg, Sweden, were included. Data on serum 25(OH)D concentration, vitamin D intake, and sun exposure were collected via questionnaires and blood samples. Approximately 27% of the women had 25(OH)D insufficiency, which was associated with longer infertility duration. The likelihood of insufficiency was higher among women from non-Nordic European countries (OR 2.92, 95% CI 1.03-8.26, adjusted p = 0.043), the Middle East (OR 9.90, 95% CI 3.32-29.41, adjusted p < 0.001), and Asia (OR 5.49, 95% CI 1.30-23.25, adjusted p = 0.020) than among women from Nordic countries. Women who did not use vitamin D supplements were more likely to have insufficiency compared with supplement users (OR 3.32, 95% CI 1.55-7.10, adjusted p = 0.002), and those who avoided sun exposure had higher odds of insufficiency compared to those who stayed "in the sun all the time" (OR 3.24, 95% CI 1.22-8.62, adjusted p = 0.018). Women with infertility in northern latitudes and those from non-Nordic countries who avoid sun exposure and do not take vitamin supplements have a higher prevalence of 25(OH)D insufficiency and longer infertility duration.
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Affiliation(s)
- Paulina Maaherra Armstrong
- Department of Obstetrics and Gynecology, Reproductive Medicine, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
| | - Hanna Augustin
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Linnea Bärebring
- Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Amra Osmancevic
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
- Department of Dermatology and Venereology, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
| | - Maria Bullarbo
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Ann Thurin-Kjellberg
- Department of Obstetrics and Gynecology, Reproductive Medicine, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
| | - Panagiotis Tsiartas
- Nordic IVF Solna, Eugin Group, 171 54 Solna, Sweden
- Department of Clinical Science, Intervention and Technology (CLINTEC), Division of Obstetrics and Gynecology, Karolinska Institute, 171 77 Stockholm, Sweden
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8
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Ciarambino T, Crispino P, Minervini G, Giordano M. Vitamin D: Can Gender Medicine Have a Role? Biomedicines 2023; 11:1762. [PMID: 37371857 PMCID: PMC10296422 DOI: 10.3390/biomedicines11061762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/15/2023] [Accepted: 06/19/2023] [Indexed: 06/29/2023] Open
Abstract
This narrative review aims to shed light on the role of gender differences, on the biological and molecular functions in the main pathological mechanisms that recognize the role of vitamin D. Vitamin D deficiency is widespread worldwide, but it is still very controversial whether the amount of vitamin D taken daily is actually the only problem related to its biological functions. Currently, the plasma concentration of 25-hydroxyvitamin D represents the only indicator of the circulating blood quota. The concept is that the biological function of vitamin D is not only linked to its circulating levels, but it is hypothesized that its biological functions depend, above all, on its total bioavailability. In particular, vitamin D circulates for the most part linked to albumin and vitamin D binding protein (DBP), which depend on various pathological conditions and physiologically, above all, the function of the latter is regulated by estrogens, glucocorticoids, and inflammatory cytokines. During her life, women undergo various changes in the hormonal and sexual sphere concerning menarche, possible pregnancies, and breastfeeding but also the use of contraceptives and, finally, the transition from the period of fertility to menopause. Each of these phases presents specific needs and, consequently, sometimes also specific criticalities. Studies on young women have shown that vitamin D deficiency is present in 58 to 91% of cases. Obesity, metabolic disorders, and variation in estrogen contraction may affect vitamin D deficiency due to the decreased bioavailability from dietary sources due to deposition in body fat compartments.
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Affiliation(s)
- Tiziana Ciarambino
- Internal Medicine Department, Hospital of Marcianise, ASL Caserta, 81037 Caserta, Italy
| | - Pietro Crispino
- Internal Medicine Department, Hospital of Latina, ASL Latina, 04100 Latina, Italy
| | - Giovanni Minervini
- Emergency Department, Hospital of Lagonegro, AOR San Carlo, 85042 Lagonegro, Italy
| | - Mauro Giordano
- Advanced Medical and Surgical Sciences Department, University of Campania, L. Vanvitelli, 81100 Naples, Italy;
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9
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Majid MA, Hassan WN, Ridha AF. Prevalence of 25-Hydroxyvitamin D (Vitamin D) Deficiency in a Group of Infertile Women from Baghdad City. Biochem Res Int 2023; 2023:6597730. [PMID: 37350868 PMCID: PMC10284658 DOI: 10.1155/2023/6597730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/24/2023] [Accepted: 06/05/2023] [Indexed: 06/24/2023] Open
Abstract
Background Infertility is a common issue affecting a large number of Iraqi women of reproductive age. The relationship between vitamin D deficiency and infertility has previously drawn the attention of gynecologists, and an increasing number of vitamin D testing has been requested. Methods 120 women were enrolled in this study between April 2019 and April 2020. Patients were divided into two groups comprising sixty women complaining of infertility, with the other 60 women being fertile and enrolled as controls. All patients were assessed for vitamin D level. Results In the fertile study group, patients with deficient, insufficient, and sufficient level of vitamin were 28%, 23%, and 48%, respectively (these numbers were rounded to the nearest whole digit, as the numbers for the infertile group were given with that level of precision), whereas the infertile study group showed a statistically significant (p value = 0.002) distribution of vitamin levels with 50%, 35%, and 15% of women being deficient, insufficient, and sufficient, respectively. Conclusions Vitamin D is significantly deficient in infertile patients which suggests a possible, positive impact if vitamin D is considered in the management of female infertility. Further study with more participants is highly recommended.
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Affiliation(s)
- Muthana Anad Majid
- Department of Basic Sciences, College of Dentistry, Mustansiryiah University, Palestine Street, Baghdad, Iraq
| | - Wafaa Nasser Hassan
- Department of Basic Sciences, College of Medicine, Ibn Sina University for Medical and Pharmaceutical Sciences, Qadisya District, Baghdad, Iraq
| | - Amna Fadhil Ridha
- Department of Obstetrics and Gynecology, College of Medicine, Mustansiryah University, Yarmouk Hospital, Baghdad, Iraq
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Kalaitzopoulos DR, Samartzis N, Daniilidis A, Leeners B, Makieva S, Nirgianakis K, Dedes I, Metzler JM, Imesch P, Lempesis IG. Effects of vitamin D supplementation in endometriosis: a systematic review. Reprod Biol Endocrinol 2022; 20:176. [PMID: 36578019 PMCID: PMC9795583 DOI: 10.1186/s12958-022-01051-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 12/18/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND There is a growing body of human, animal and in vitro studies on vitamin D (vit D) substitution in endometriosis. The aim of this systematic review is to critically appraise and qualitatively synthesize the results of the available studies that examine the supplementation of vit D for endometriosis treatment. METHODS A systematic search of the literature was conducted in four electronic databases (Medline, Cochrane, Scopus, Embase) and grey literature for original research articles on humans, animals and in vitro models published in any language. RESULTS Four human studies, four animal studies and four in vitro studies were included. Quantitative synthesis of human studies showed no significant effect of vit D intake for dysmenorrhea (2 studies, 44 vit D vs 44 placebo, mean -0.71, 95% CI -1.94, 0.51) and non-cyclic pelvic pain (2 studies, 42 vit D vs 38 placebo, mean 0.34, 95% CI -0.02, 0.71). Regarding reproductive outcomes in women with endometriosis after in vitro fertilization, the only available study showed no differences between women taking vit D and women taking placebo. Three of the four included animal studies showed regression of endometriotic implants when treated with vit D. The in vitro studies demonstrated that vit D decreases invasion and proliferation of endometriotic lesions without affecting apoptosis. CONCLUSIONS Although in vitro and animal studies suggest regression of the endometriotic implants and decrease of invasion and proliferation after vit D supplementation, this was not reflected in the results of the meta-analysis, which showed no benefit of vit D supplementation in patients with endometriosis and dysmenorrhea or non-cyclic pelvic pain as well as on the outcome of IVF treatment. However, given the heterogeneity and the diversity of the available studies, more research is required to shed light on the role of vit D supplementation in women with endometriosis.
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Affiliation(s)
- Dimitrios Rafail Kalaitzopoulos
- Department of Gynecology, University Hospital Zurich, Frauenklinikstr. 10, 8091, Zurich, CH, Switzerland.
- Division of Reproductive Endocrinology, University Hospital Zurich, Frauenklinikstr. 10, 8091, Zurich, CH, Switzerland.
| | - Nicolas Samartzis
- Department of Gynecology and Obstetrics, Cantonal Hospital Schaffhausen, Geissbergstrasse 81, 8208, Schaffhausen, Switzerland
| | - Angelos Daniilidis
- Department of Obstetrics and Gynecology, 2Nd University, Hippokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Brigitte Leeners
- Division of Reproductive Endocrinology, University Hospital Zurich, Frauenklinikstr. 10, 8091, Zurich, CH, Switzerland
| | - Sofia Makieva
- Division of Reproductive Endocrinology, University Hospital Zurich, Frauenklinikstr. 10, 8091, Zurich, CH, Switzerland
| | - Konstantinos Nirgianakis
- Department of Obstetrics and Gynecology, University Hospital and University of Bern, Friedbühlstrasse 19, 3010, Bern, Switzerland
| | - Ioannis Dedes
- Department of Gynecology, University Hospital Zurich, Frauenklinikstr. 10, 8091, Zurich, CH, Switzerland
| | - Julian Matthias Metzler
- Department of Gynecology, University Hospital Zurich, Frauenklinikstr. 10, 8091, Zurich, CH, Switzerland
| | - Patrick Imesch
- Department of Gynecology, University Hospital Zurich, Frauenklinikstr. 10, 8091, Zurich, CH, Switzerland
| | - Ioannis G Lempesis
- College of Medical and Dental Sciences, Institute of Metabolism and Systems Research (IMSR), University of Birmingham, Birmingham, UK
- Centre for Endocrinology, Diabetes and Metabolism (CEDAM), Birmingham Health Partners, Birmingham, UK
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, the Netherlands
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11
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Durá-Travé T, Gallinas-Victoriano F. Vitamin D status and parathyroid hormone assessment in girls with central precocious puberty. J Endocrinol Invest 2022; 45:2069-2075. [PMID: 35750999 PMCID: PMC9525390 DOI: 10.1007/s40618-022-01838-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/08/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE The objective of this study was to analyze vitamin D status and PTH concentrations in 6- to 8-year-old girls with central precocious puberty. METHODS A cross-sectional clinical and blood testing study (calcium, phosphorus, 25(OH)D and PTH) was carried out in 78 girls with central precocious puberty (CPP group), aged 6.1-7.9 years. A control group was recruited (137 prepubertal girls, aged 6.1-8.2 years). The criteria of the US Endocrine Society were used for the definition of hypovitaminosis D. RESULTS There were no significant differences in vitamin D status between both groups. There were no significant differences in 25(OH)D concentrations between CPP (25.4 ± 8.6 ng/mL) and control groups (28.2 ± 7.4 ng/mL). In contrast, PHT concentrations in CPP group (44.8 ± 16.3 pg/mL) were higher (p < 0.05) with respect to control group (31.0 ± 11.9 ng/mL). In CPP group, there was a positive correlation (p < 0.05) between PTH concentrations and growth rate, bone age, and basal estradiol, basal FSH, basal LH and LH peak concentrations. CONCLUSION Vitamin D status in 6- to 8-year-old girls with CPP is similar to that in prepubertal girls. PTH concentrations were significantly higher in girls with CPP, and this could be considered as a physiological characteristic of puberty and, in this case, of pubertal precocity.
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Affiliation(s)
- T. Durá-Travé
- Department of Pediatrics, School of Medicine, University of Navarra, Avenue Irunlarrea, 4, 31008 Pamplona, Spain
- Department of Pediatrics, Navarra Hospital Complex, Pamplona, Spain
- Navarrabiomed (Biomedical Research Center), Pamplona, Spain
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12
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Heidari S, Kolahdouz-Mohammadi R, Khodaverdi S, Mohammadi T, Delbandi AA. Changes in MCP-1, HGF, and IGF-1 expression in endometrial stromal cells, PBMCs, and PFMCs of endometriotic women following 1,25(OH)2D3 treatment. J Cell Mol Med 2022; 26:5634-5646. [PMID: 36259314 PMCID: PMC9667513 DOI: 10.1111/jcmm.17592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 09/22/2022] [Accepted: 09/30/2022] [Indexed: 11/30/2022] Open
Abstract
1,25(OH)2D3 has anti‐inflammatory and growth inhibitory effects. Our study explored the effect of 1,25(OH)2D3 treatment on the expression of monocyte chemotactic protein‐1 (MCP‐1), hepatocyte growth factor (HGF), and insulin‐like growth factor‐1 (IGF‐1) by peripheral blood mononuclear cells (PBMCs), peritoneal fluid mononuclear cells (PFMCs), endometrial stromal cells (ESCs), and its effect on the proliferation of PBMCs and PFMCs of patients with endometriosis compared with controls. PBMCs, PFMCs, and ESCs were obtained from 10 endometriosis patients and 10 non‐endometriotic individuals. After treating cells with 0.1 μM of 1,25(OH)2D3 for 6, 24, and 48 h, the gene and protein expression of mentioned factors were evaluated by real‐time PCR and ELISA methods, respectively. 1,25(OH)2D3 treatment significantly reduced the protein expression of MCP‐1, HGF, and IGF‐1 in PBMCs and PFMCs of endometriotic patients at 48 h (p < 0.05–<0.01). Also, this treatment significantly reduced MCP‐1, HGF, and IGF‐1 gene and/or protein expression in EESCs and EuESCs at 24 and 48 h (p < 0.05–<0.01). 1,25(OH)2D3 treatment also reduced the proliferation of PBMCs and PFMCs of endometriotic patients compared with controls (p < 0.01). 1,25(OH)2D3 can be considered as a potentially effective agent in the prevention and treatment of endometriosis along with other therapies.
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Affiliation(s)
- Sahel Heidari
- Immunology Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran.,Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Roya Kolahdouz-Mohammadi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Sepideh Khodaverdi
- Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Tahereh Mohammadi
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali-Akbar Delbandi
- Immunology Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran.,Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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13
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Menichini D, Ughetti C, Monari F, Di Vinci PL, Neri I, Facchinetti F. Nutraceuticals and polycystic ovary syndrome: a systematic review of the literature. Gynecol Endocrinol 2022; 38:623-631. [PMID: 35713558 DOI: 10.1080/09513590.2022.2089106] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
BackgroundThis study proposes a review of nutraceuticals used in the treatment of typical symptoms of Polycystic Ovary Syndrome (PCOS).The aim is to provide a classification of the most widely used nutraceutical supplements identifying the most effective nutraceuticals on glucose and insulin metabolism, the androgenic hormone profile, fertility, ovulatory capacity, inflammation, and oxidative stress.Material and MethodsWe included randomized controlled trials on PCOS patients undergoing administration of nutraceuticals, in particular vitamin D, vitamin E, probiotics, and inositols. These administrations are variable in terms of dosage, single supplementation, or combined with other compounds, dosage, and duration of the intervention.ResultsThe supplementation of inositols, at the physiologic ratio of 40: 1 of myo- and D-chiro-inositols, resulted to be the most effective in improving the glucose homeostasis and fertility, with a restoration of ovulatory capacity and menstrual regularity. Other nutraceuticals are particularly effective in reducing hyperandrogenism, with promising results demonstrated by the combinations of vitamin D and probiotics, vitamin E and coenzyme Q10, and the enrichment of inositol therapy with group B vitamins. An improvement in the inflammatory status and antioxidant capacity is obtained with the co-supplementation of probiotics and selenium or with vitamin E combined with omega 3.ConclusionsInositol supplementation is effective in the treatment of insulin resistance and fertility. Probiotics reduced hyperandrogenism, inflammatory and oxidative conditions, and resulted more effective when combined with selenium. Although these results proved to be satisfactory, further studies are needed with larger samples and a more homogeneous analysis of the outcomes.
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Affiliation(s)
- Daniela Menichini
- Obstetrics Unit, Mother Infant Department, University Hospital Policlinico of Modena, Modena, Italy
- International Doctorate School in Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Claudia Ughetti
- School of Dietistics, University of Modena and Reggio Emilia, Modena, Italy
| | - Francesca Monari
- Obstetrics Unit, Mother Infant Department, University Hospital Policlinico of Modena, Modena, Italy
| | - Pier Luigi Di Vinci
- Obstetrics Unit, Mother Infant Department, University Hospital Policlinico of Modena, Modena, Italy
- International Doctorate School in Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Isabella Neri
- Obstetrics Unit, Mother Infant Department, University Hospital Policlinico of Modena, Modena, Italy
| | - Fabio Facchinetti
- Obstetrics Unit, Mother Infant Department, University Hospital Policlinico of Modena, Modena, Italy
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Yokoyama E, Takeda T, Watanabe Z, Iwama N, Satoh M, Murakami T, Sakurai K, Shiga N, Tatsuta N, Saito M, Tachibana M, Arima T, Kuriyama S, Metoki H, Yaegashi N. Association of fish intake with menstrual pain: A cross-sectional study of the Japan Environment and Children’s Study. PLoS One 2022; 17:e0269042. [PMID: 35862448 PMCID: PMC9302766 DOI: 10.1371/journal.pone.0269042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 05/13/2022] [Indexed: 11/18/2022] Open
Abstract
The relationship between fish eating habits and menstrual pain is unknown. Elucidating this relationship can inform dietary guidance for reproductive age women with menstrual pain. The aim of this study was to clarify the relationship between fish intake frequency/preference and menstrual pain. This cross-sectional study was conducted at the Miyagi Regional Center as an adjunct study of the Japan Environment and Children’s Study, and 2060 eligible women (mean age, 31.9 years) participated. Fish intake frequency (“< 1 time/week,” “1 time/week,” “2–3 times/week,” or “≥ 4 times/week”), preference (“like,” “neutral,” or “dislike”), and menstrual pain (no/mild or moderate-to-severe) were assessed at 1.5 years after the last delivery through self-administered questionnaires. The association between fish intake frequency/preference and prevalence of moderate-to-severe menstrual pain was evaluated through logistic regression analyses. Our results show that, compared with the “< 1 time/week” (38.0%) group, the “1 time/week” (26.9%), “2–3 times/week” (27.8%), and “≥ 4 times/week” (23.9%) groups showed a lower prevalence of moderate-to-severe menstrual pain (p < 0.01). The prevalence of moderate-to-severe menstrual pain was 27.7%, 27.6%, and 34.4% in the “like,” “neutral,” and “dislike” groups, respectively. Multivariate logistic regression showed that frequent fish intake was associated with a lower prevalence of moderate-to-severe menstrual pain (“1 time/week”: odds ratio [OR] = 0.59; 95% confidence interval [CI], 0.41–0.86, “2–3 times/week”: OR = 0.64; 95% CI, 0.45–0.90 and “≥ 4 times/week”: OR = 0.52; 95% CI, 0.34–0.80; trend p = 0.004). Multivariate logistic regression showed no association between fish preference and moderate-to-severe menstrual pain (“dislike” vs “like”: OR = 1.16; 95% CI, 0.78–1.73). There was a significant negative association between fish intake frequency and menstrual pain. It is suggested that fish intake can reduce or prevent menstrual pain.
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Affiliation(s)
- Emi Yokoyama
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Takashi Takeda
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Division of Women’s Health, Research Institute of Traditional Asian Medicine, Kindai University, Osaka-Sayama, Osaka, Japan
- * E-mail:
| | - Zen Watanabe
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Noriyuki Iwama
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
| | - Michihiro Satoh
- Division of Public Health, Hygiene and epidemiology, Tohoku Medical and Pharmaceutical University Faculty of Medicine, Sendai, Miyagi, Japan
| | - Takahisa Murakami
- Division of Public Health, Hygiene and epidemiology, Tohoku Medical and Pharmaceutical University Faculty of Medicine, Sendai, Miyagi, Japan
| | - Kasumi Sakurai
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Naomi Shiga
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Nozomi Tatsuta
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Masatoshi Saito
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Department of Maternal and Fetal Therapeutics, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Masahito Tachibana
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Takahiro Arima
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Hirohito Metoki
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
- Division of Public Health, Hygiene and epidemiology, Tohoku Medical and Pharmaceutical University Faculty of Medicine, Sendai, Miyagi, Japan
| | - Nobuo Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Miyagi, Japan
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
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15
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Grzesiak M, Kaminska K, Bodzioch A, Drzewiecka EM, Franczak A, Knapczyk-Stwora K. Vitamin D3 Metabolic Enzymes in the Porcine Uterus: Expression, Localization and Autoregulation by 1,25(OH)2D3 In Vitro. Int J Mol Sci 2022; 23:ijms23073972. [PMID: 35409330 PMCID: PMC8999832 DOI: 10.3390/ijms23073972] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 03/28/2022] [Accepted: 04/01/2022] [Indexed: 12/01/2022] Open
Abstract
The role of vitamin D3 has been confirmed in female reproductive organs. This study aimed to examine vitamin D3 metabolic enzymes, i.e., CYP27B1 and CYP24A1, mRNA transcript and protein abundance, and protein localization in the uterus of pigs on days 2–5, 10–12, 15–16 and 18–20 of the estrous cycle. Additionally, we determined 1,25(OH)2D3 concentration in uterine flushings and the effect of 1,25(OH)2D3 (10, 50 and 100 ng/mL) in vitro on CYP27B1 and CYP24A1 mRNA transcript abundance in endometrial and myometrial slices. In the endometrium, a greater CYP27B1 mRNA transcript abundance was noted on days 10–12 and 18–20 than on days 15–16, whereas encoded protein abundance was greater on days 18–20 when compared to days 15–16. Endometrial CYP24A1 mRNA transcript abundance was greater on days 18–20 than on days 10–12 and 15–16. In the myometrium, CYP27B1 mRNA transcript abundance was greater on days 18–20 than on days 2–5 and 15–16, while protein abundance was larger in slices collected on days 18–20 than on days 15–16. Neither CYP24A1 mRNA transcript nor encoded protein abundance were detected in the myometrium. The highest 1,25(OH)2D3 concentration in uterine flushings was observed on days 18–20. Furthermore, the 1,25(OH)2D3 increased the abundance of the CYP24A1 mRNA transcript in endometrial slices. Overall, our results suggest that porcine uterus is an extra-renal site of vitamin D3 metabolism. Both the endometrium and the myometrium possess the ability to synthesize vitamin D3, while only the endometrium contributes to its catabolism.
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Affiliation(s)
- Malgorzata Grzesiak
- Department of Endocrinology, Institute of Zoology and Biomedical Research, Jagiellonian University in Krakow, Gronostajowa 9, 30-387 Krakow, Poland; (K.K.); (A.B.); (K.K.-S.)
- Correspondence:
| | - Kinga Kaminska
- Department of Endocrinology, Institute of Zoology and Biomedical Research, Jagiellonian University in Krakow, Gronostajowa 9, 30-387 Krakow, Poland; (K.K.); (A.B.); (K.K.-S.)
| | - Aleksandra Bodzioch
- Department of Endocrinology, Institute of Zoology and Biomedical Research, Jagiellonian University in Krakow, Gronostajowa 9, 30-387 Krakow, Poland; (K.K.); (A.B.); (K.K.-S.)
| | - Ewa M. Drzewiecka
- Department of Animal Anatomy and Physiology, Faculty of Biology and Biotechnology, University of Warmia and Mazury in Olsztyn, Oczapowskiego 1A, 10-718 Olsztyn, Poland; (E.M.D.); (A.F.)
| | - Anita Franczak
- Department of Animal Anatomy and Physiology, Faculty of Biology and Biotechnology, University of Warmia and Mazury in Olsztyn, Oczapowskiego 1A, 10-718 Olsztyn, Poland; (E.M.D.); (A.F.)
| | - Katarzyna Knapczyk-Stwora
- Department of Endocrinology, Institute of Zoology and Biomedical Research, Jagiellonian University in Krakow, Gronostajowa 9, 30-387 Krakow, Poland; (K.K.); (A.B.); (K.K.-S.)
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Cermisoni GC, Reschini M, Piccinni MP, Lombardelli L, Logiodice F, Sarais V, Giacomini E, Signorelli S, Cecchele A, Viganò P. OUP accepted manuscript. Hum Reprod Open 2022; 2022:hoac017. [PMID: 35475146 PMCID: PMC9024319 DOI: 10.1093/hropen/hoac017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 03/16/2022] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Is oral Vitamin D supplementation able to modify the intrauterine milieu in terms of cytokine/chemokine pattern? SUMMARY ANSWER No significant differences were detected in cytokine and chemokine levels in endometrial secretions between patients undergoing ART with or without Vitamin D supplementation. WHAT IS KNOWN ALREADY Cytokines and chemokines secreted into the intrauterine environment are fundamental for the molecular crosstalk between the endometrium and the preimplantation embryo. Whether Vitamin D can regulate these mediators in the endometrial environment is still unclear. STUDY DESIGN, SIZE, DURATION This study was an analysis of a secondary outcome from the Supplementation of Vitamin D and Reproductive Outcomes—SUNDRO—clinical trial, a multicenter randomized double-blinded trial designed to explore the effects of Vitamin D replacement in women with Vitamin D levels below 30 ng/ml undergoing autologous ART cycles. Uterine fluid samples were collected from both patients supplemented with Vitamin D (n = 17) and from the placebo group (n = 32). PARTICIPANTS/MATERIALS, SETTING, METHODS Based on cutoff points for Vitamin D insufficiency (20–29.9 ng/ml) or deficiency (<20 ng/ml), 67% of patients in the study were insufficient, and 33% deficient, in Vitamin D, although they were considered together for the analysis. Women received a single dose of 600 000 IU 25-hydroxyvitamin D or placebo from 2 to 12 weeks before oocyte retrieval. Inclusion criteria were female age 18–39 years, with a BMI between 18 and 25 kg/m2. Serum 25-hydroxyvitamin D was assessed at the time of hCG administration. Uterine fluid samples were collected during the secretory phase of the menstrual cycle preceding oocyte retrieval. The quantitative determination of 27 cytokines in endometrial secretion samples was performed by using a multiplex immunoassay. MAIN RESULTS AND THE ROLE OF CHANCE Uterine fluid samples were collected after a median (range) of 21 (12–41) days after the oral Vitamin D supplementation. Both the supplemented and placebo groups had Vitamin D serum levels below 30 ng/ml at baseline/time of randomization ((median 23.4 ng/ml (interquartile range 19.5–28.4) and 23.4 ng/ml (17.8–25.9), respectively). At the time of hCG administration, serum Vitamin D in supplemented subjects was significantly raised compared to the placebo group ((median 52.9 ng/ml (interquartile range 40.7–64.1) and 24.6 ng/ml (19.3–29.2), respectively, P < 0.001). Our data revealed no significant differences in uterine fluid cytokine/chemokine composition of Vitamin D-supplemented women compared with the placebo group. This finding remained when the concentrations of all mediators studied were normalized to total protein. In a further analysis, no significant differences were found in the content of cytokines/chemokines in uterine fluid from women who conceived (n = 19) compared with the nonpregnant group (n = 30). LIMITATIONS, REASONS FOR CAUTION Using a randomized study design (a single dose of 600 000 IU 25-hydroxyvitamin D versus placebo), we found no significant differences between groups. However, we cannot exclude that any benefit of Vitamin D supplementation may be specific for some subgroups of patients, such as those with an imbalance of T-helper 1 and T-helper 2 cell populations. The uterine secretions were collected during the menstrual cycle that preceded oocyte retrieval; therefore, it is possible the uterine fluid collection and analysis in the same cycle of the embryo transfer might have resulted in different conclusions. Moreover, the small sample size could limit the power of the study. WIDER IMPLICATIONS OF THE FINDINGS Our analysis of the uterine secretome profiling failed to show any significant difference in endometrial cytokine/chemokine patterns between women with oral Vitamin D supplementation and the placebo group. Vitamin D may act on the uterine environment through a different mechanism. STUDY FUNDING/COMPETING INTEREST(S) The study was funded by the Italian Ministry of Health following peer review in the competitive ‘Bando di Ricerca Finalizzata e Giovani Ricercatori 2013’ with reference code RF-2013-02358757. The authors declare that they have no conflict of interest. TRIAL REGISTRATION NUMBER EudraCT registration number: 2015-004233-27.
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Affiliation(s)
| | | | - Marie-Pierre Piccinni
- Department of Experimental and Clinical Medicine and Center of Excellence for Research, Transfer and High Education DENOTHE, University of Florence, Florence, Italy
| | - Letizia Lombardelli
- Department of Experimental and Clinical Medicine and Center of Excellence for Research, Transfer and High Education DENOTHE, University of Florence, Florence, Italy
| | - Federica Logiodice
- Department of Experimental and Clinical Medicine and Center of Excellence for Research, Transfer and High Education DENOTHE, University of Florence, Florence, Italy
| | - Veronica Sarais
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisa Giacomini
- Reproductive Sciences Laboratory, Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Simona Signorelli
- Obstetrics and Gynaecology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Anna Cecchele
- Infertility Unit, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Paola Viganò
- Correspondence address. Infertility Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via F. Sforza 28, 20122, Milan, Italy. Tel: +39-02-55034302; E-mail:
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Tian M, Zeng S, Cai S, Reichetzeder C, Zhang X, Yin C, Kuang W, Cheng K, Jiang Y, Tao M, Zeng Y, Lin G, Li J, Gong F, Hocher B. 25(OH)VitD and human endocrine and functional fertility parameters in women undergoing IVF/ICSI. Front Endocrinol (Lausanne) 2022; 13:986848. [PMID: 36105399 PMCID: PMC9464865 DOI: 10.3389/fendo.2022.986848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/09/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Vitamin D plays an important role in reproduction. Evidence shown that free 25-hydroxyvitamin D (25(OH)VitD) was more accurate than total 25(OH)VitD in reflecting the status of 25(OH)VitD during pregnancy. However, the relationship between free 25(OH)VitD and female fertility parameters has not been reported yet. Therefore, this study aims to compare the correlation of free and total 25(OH)VitD with fertility parameters in infertility females undergoing in vitro fertilization and embryo transfer (IVF-ET) or intracytoplasmic sperm injection (ICSI). METHODS According to the inclusion and exclusion criteria, 2569 infertility patients who received IVF-ET or ICSI treatment for the first time participated in this study. Five milliliter peripheral blood samples of the patients were collected on the day before embryo transfer (ET). Enzyme linked immunosorbent assay (ELISA) kits was used to detect free 25(OH)VitD and total 25(OH)VitD, and clinical information was collected. Spearman's rho was used to evaluate the association between the variables. RESULTS The median (IQR) of free 25(OH)VitD was 4.71 (4.11-5.31) pg/mL and total 25(OH)VitD was 19.54 (16.52-22.83) ng/m. The correlation between them, however, was week (rho=0.311). Compared to total 25(OH)VitD, free 25(OH)VitD was slightly better correlated with basal follicle-stimulating hormone (FSH) (rho=0.041, P=0.036), basal estradiol (E2) (rho=0.089, P<0.001), anti-Müllerian hormone (AMH) (rho=-0.057, P=0.004), antral follicle count (AFC) (rho=-0.053, P=0.007), E2 (rho=-0.080, P<0.001), number of oocytes retrieval (rho=-0.079, P<0.001) and progesterone (P)/E2 on hCG trigger day (rho=0.081, P<0.001). CONCLUSIONS Overall, there was only a rather weak correlation of free as well as total 25(OH)VitD with human endocrine and functional fertility parameters in women undergoing IVF/ICSI. Neither free nor total 25(OH)VitD seems to play a major role in human embryo implantation.
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Affiliation(s)
- Mei Tian
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Suimin Zeng
- Department of Pathology, The First Hospital of Traditional Chinese Medicine, Yiyang, China
| | - Sufen Cai
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, Hunan, China
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
| | - Christoph Reichetzeder
- Department of Nutritional Toxicology, Institute for Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Xiaoli Zhang
- Institute of Pharmacy, Freie Universität Berlin, Berlin, Germany
- Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology), University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Chenjun Yin
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Weihong Kuang
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Kexin Cheng
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Yao Jiang
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Mingqiu Tao
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Yuan Zeng
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Ge Lin
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, Hunan, China
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
- Key Laboratory of Stem Cells and Reproductive Engineering, Ministry of Health, Changsha, China
| | - Jian Li
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Fei Gong
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, Hunan, China
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
- Key Laboratory of Stem Cells and Reproductive Engineering, Ministry of Health, Changsha, China
- *Correspondence: Berthold Hocher, ; Fei Gong,
| | - Berthold Hocher
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
- Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology), University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
- Institute of Medical Diagnostics, IMD, Berlin, Germany
- *Correspondence: Berthold Hocher, ; Fei Gong,
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18
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Polanski LT, Baumgarten M. Endometrial Receptivity Testing and Therapy in Assisted Reproductive Treatment. Semin Reprod Med 2021; 39:27-33. [PMID: 34391208 DOI: 10.1055/s-0041-1730421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Assisted reproductive treatment (ART) gave numerous couples the chance to have their biological child. Improvement in laboratory and culture conditions allows for selection of embryos with the best developmental potential, although replacement of these top-quality embryos does not, however, guarantee reproductive success. Endometrial receptivity is essential for pregnancy establishment and may be the limiting factor for the observed pregnancy rates with ART. Multiple modalities have been in use to assess endometrial receptivity, with ultrasound assessment of the endometrial morphology most commonly used due to its noninvasive nature and availability. Utilization of various "omics" increases our understanding of endometrial receptivity and selectivity; however, significantly more work is required to develop clinically relevant and validated tests of endometrial receptivity and treatments which could improve a suboptimal endometrial milieu. Current evidence for and against use of various tests of endometrial receptivity in women undergoing ART is presented in this article.
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Affiliation(s)
- Lukasz Tadeusz Polanski
- Division of Obstetrics and Gynaecology, Department of Reproductive Medicine, Peterborough City Hospital, Peterborough, United Kingdom
| | - Miriam Baumgarten
- Department of Obstetrics and Gynaecology, Addenbrooke's Hospital, Cambridge, United Kingdom
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19
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Nuclear expression of VDR and AHR is mutually exclusive in glandular cells in endometriosis. Histochem Cell Biol 2021; 156:391-399. [PMID: 34155552 PMCID: PMC8550147 DOI: 10.1007/s00418-021-02005-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 11/03/2022]
Abstract
The vitamin D receptor (VDR) and aryl hydrocarbon receptor (AHR) are two nuclear receptors that exert their effects by binding with ligands and forming a molecular complex. These complexes translocate to the nucleus and activate the expression of a series of genes which have a response element to VDR or AHR. Both receptors have been identified in the pathogenesis of endometriosis, a common disease characterized by the formation of endometrium-like tissue in ectopic zones. Despite numerous therapies, there is no definitive cure for endometriosis at the pharmacological level. Our study aims to describe the location and the expression of VDR and AHR at the protein level. For this purpose, an evaluation was performed using tissue from the three normal phases of the endometrium (proliferative, early, and late secretory) and in endometriosis by immunohistochemistry, using anti-VDR and anti-AHR antibodies. We demonstrate that in the nuclei of glandular cells in endometriosis, the expression of VDR and AHR is mutually exclusive—when the expression of one receptor is high, the other one is low—suggesting a possible target in the treatment of endometriosis. We also identify a significant change in the expression of glandular cytoplasmic AHR between the proliferative and late secretory endometrium.
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20
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Vitamin D supplementation for primary dysmenorrhea: a double-blind, randomized, placebo-controlled trial. Obstet Gynecol Sci 2021; 64:353-363. [PMID: 34010550 PMCID: PMC8290151 DOI: 10.5468/ogs.20316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 04/26/2021] [Indexed: 11/29/2022] Open
Abstract
Objective Recent studies have shown a possible association between vitamin D deficiency and the severity of primary dysmenorrhea. The present study aimed to investigate the effect of vitamin D supplementation on pain and systemic symptoms in patients with primary dysmenorrhea. Methods This double-blind, randomized, placebo-controlled trial was conducted on female students aged 18 to 32 years with primary dysmenorrhea and vitamin D deficiency (25 [OH]D <30 ng/mL). The participants (n=116) received either 50,000 IU of vitamin D3 (cholecalciferol) or placebo capsules on a weekly basis for eight consecutive weeks. The outcomes were pain intensity (scored 0 to 10), number of days with pain, number of consumed pain-relief medications (per day), and severity of systemic symptoms (fatigue, headache, nausea/vomiting, and diarrhea; total score of 0 to 12). Results Compared with baseline, our participants who received vitamin D experienced significant reductions in pain intensity (−1.0 and −1.5 score at weeks 4 and 8, P<0.001), the number of days with pain (−1.0 day at weeks 4 and 8, P<0.001), the number of consumed pain-relief medications (−1.0 at weeks 4 and 8, P<0.001), and systemic symptoms severity (−1.0 score at weeks 4 and 8, P<0.001). No significant improvements were observed in the placebo group in terms of these outcomes. Conclusion Vitamin D supplementation in women with primary dysmenorrhea and vitamin D deficiency could improve systemic symptoms and reduce pain intensity, the number of days with pain, and the need for consuming pain-relief medications.
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21
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Menichini D, Forte G, Orrù B, Gullo G, Unfer V, Facchinetti F. The role of vitamin D in metabolic and reproductive disturbances of polycystic ovary syndrome: A narrative mini-review. INT J VITAM NUTR RES 2020; 92:126-133. [PMID: 33284035 DOI: 10.1024/0300-9831/a000691] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Vitamin D is a secosteroid hormone that plays a pivotal role in several metabolic and reproductive pathways in humans. Increasing evidence supports the role of vitamin D deficiency in metabolic disturbances and infertility in women with polycystic ovary syndrome (PCOS). Indeed, supplementation with vitamin D seems to have a beneficial role on insulin resistance and endometrial receptivity. On the other hand, exceedingly high levels of vitamin D appear to play a detrimental role on oocytes development and embryo quality. In the current review, we summarize the available evidence about the topic, aiming to suggest the best supplementation strategy in women with PCOS or, more generally, in those with metabolic disturbances and infertility. Based on the retrieved data, vitamin D seems to have a beneficial role on IR, insulin sensitivity and endometrial receptivity, but high levels and incorrect timing of administration seem to have a detrimental role on oocytes development and embryo quality. Therefore, we encourage a low dose supplementation (400-800 IU/day) particularly in vitamin D deficient women that present metabolic disturbances like PCOS. As far as the reproductive health, we advise vitamin D supplementation in selected populations, only during specific moments of the ovarian cycle, to support the luteal phase. However, ambiguities about dosage and timing of the supplementation still emerge from the clinical studies published to date and further studies are required.
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Affiliation(s)
- Daniela Menichini
- International Doctorate School in Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy.,Unit of Obstetrics and Gynecology, Mother-Infant Department, University of Modena and Reggio Emilia, Italy
| | | | - Beatrice Orrù
- Medical Affairs Department, Lo.Li. Pharma, Rome, Italy
| | - Giuseppe Gullo
- IVF Public Center, AOOR Villa Sofia Cervello, University Hospital, Palermo, Italy
| | - Vittorio Unfer
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Fabio Facchinetti
- Unit of Obstetrics and Gynecology, Mother-Infant Department, University of Modena and Reggio Emilia, Italy
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22
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Isbilen E, Ulusal H, Karaer K, Kul S, Yaman DM, Tepe NB, Kanbur HC, Tarakcioglu M, Ozyurt AB. VDR gene polymorphisms as a significant factor in unexplained infertility. GENE REPORTS 2020. [DOI: 10.1016/j.genrep.2020.100962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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23
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Altered vitamin D 3 metabolism in the ovary and periovarian adipose tissue of rats with letrozole-induced PCOS. Histochem Cell Biol 2020; 155:101-116. [PMID: 33095902 PMCID: PMC7847874 DOI: 10.1007/s00418-020-01928-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2020] [Indexed: 12/27/2022]
Abstract
Vitamin D3 (VD3) plays an important role in the ovary and its deficiency is associated with ovarian pathologies, including polycystic ovary syndrome (PCOS). However, there is no data related to VD3 metabolism in the ovary during PCOS. Herein, we investigated differences in the expression of VD3 receptor (VDR) and key VD3 metabolic enzymes, 1α-hydroxylase (CYP27B1) and 24-hydroxylase (CYP24A1), in the ovary and periovarian adipose tissue (POAT) of control (proestrus and diestrus) and PCOS induced by letrozole rats. Vdr, Cyp27b1 and Cyp24a1 mRNA expression was determined, their protein abundance was examined and immunolocalized. Furthermore, VD3 metabolite concentrations in plasma (25OHD) and tissues (ovary and POAT; 1,25(OH)2D3), and plasma calcium level were determined. 25OHD concentration decreased markedly in letrozole-treated rats in comparison with controls, whereas calcium concentration did not vary among the examined groups. The amount of 1,25(OH)2D3 decreased in both ovary and POAT of PCOS rats. In the ovary, we found decreased Cyp27b1 and increased Vdr mRNA expression in letrozole-treated and diestrus control group. Corresponding protein abundances were down-regulated and up-regulated, respectively but only following letrozole treatment. In POAT, only Cyp27b1 transcript level and CYP27B1 protein abundance were decreased in letrozole-treated rats. VDR was immunolocalized in healthy and cystic follicles, while CYP27B1 and CYP24A1 were found exclusively in healthy ones. Concluding, our results provide the first evidence of disrupted VD3 metabolism in the ovary and POAT of PCOS rats. The reduced 1,25(OH)2D3 concentration in those tissues suggests their contribution to VD3 deficiency observed in PCOS and might implicate in PCOS pathogenesis.
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24
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Walz NL, Hinchliffe PM, Soares MJ, Dhaliwal SS, Newsholme P, Yovich JL, Keane KN. Serum Vitamin D status is associated with increased blastocyst development rate in women undergoing IVF. Reprod Biomed Online 2020; 41:1101-1111. [PMID: 33012659 DOI: 10.1016/j.rbmo.2020.08.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/21/2020] [Accepted: 08/14/2020] [Indexed: 12/25/2022]
Abstract
RESEARCH QUESTION To determine the relationship between vitamin D (VitD) status and embryological, clinical pregnancy and live birth outcomes in women undergoing IVF. DESIGN Cross-sectional, observational study conducted at a university-affiliated private IVF clinic. A total of 287 women underwent 287 IVF cycles and received a fresh embryo transfer. Patients had their serum 25-hydroxyvitamin D2/D3 (VitD) determined on the day of oocyte retrieval, which was analysed in relation to blastocyst development rate, clinical pregnancy and live birth outcomes. RESULTS In stepwise, multivariable logistic regression models, increases in blastocyst development rate, number and quality, along with embryo cryopreservation and utilization rates were associated with women with a sufficient VitD status (≥20 ng/ml). For a single increase in the number of blastocysts generated per cycle or embryos cryopreserved per cycle, the likelihood for the patient to be VitD sufficient was increased by 32% (odds ratio [OR] 1.32, 95% confidence interval [CI] 1.10-1.58, P = 0.002 and OR 1.33, 95% CI 1.10-1.60, P = 0.004, respectively). Clinical pregnancy (40.7% versus 30.8%, P = 0.086) and live birth rates (32.9% versus 25.8%, P = 0.195) in the sufficient VitD group versus the insufficient group were not significantly different and VitD sufficiency was not significantly associated with these outcomes. CONCLUSION A strong relationship was observed between blastocyst development and VitD sufficiency. However, there was no association between VitD and clinical pregnancy or live birth outcomes. Further larger studies are needed to investigate whether the observed effect on blastocyst development may have downstream implications on subsequent clinical pregnancy or live birth rates, and on a potential mechanism where sufficient VitD concentrations are linked to improved IVF outcomes.
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Affiliation(s)
- Nikita L Walz
- School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin University, Bentley WA 6845, Australia; PIVET Medical Centre, Leederville, Perth WA 6007, Australia
| | | | - Mario J Soares
- School of Public Health, Faculty of Health Sciences, Curtin University, Bentley WA 6845, Australia
| | - Satvinder S Dhaliwal
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley WA 6845, Australia; Duke-NUS Medical School, National University of Singapore (NUS), Singapore
| | - Philip Newsholme
- School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin University, Bentley WA 6845, Australia
| | - John L Yovich
- School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin University, Bentley WA 6845, Australia; PIVET Medical Centre, Leederville, Perth WA 6007, Australia
| | - Kevin N Keane
- School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin University, Bentley WA 6845, Australia; PIVET Medical Centre, Leederville, Perth WA 6007, Australia.
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Cozzolino M, Busnelli A, Pellegrini L, Riviello E, Vitagliano A. How vitamin D level influences in vitro fertilization outcomes: results of a systematic review and meta-analysis. Fertil Steril 2020; 114:1014-1025. [PMID: 33012554 DOI: 10.1016/j.fertnstert.2020.05.040] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 05/28/2020] [Accepted: 05/29/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To investigate the impact of serum vitamin D level on in vitro fertilization (IVF) outcomes. DESIGN Systematic review and meta-analysis. SETTING Not applicable. PATIENTS Infertile women undergoing conventional IVF or intracytoplasmic sperm injection (ICSI). INTERVENTIONS Systematic search of PubMed, MEDLINE, EMBASE, Global Health, The Cochrane Library, Health Technology Assessment Database, and Web of Science from inception until July 2019 with cross-checking of references from relevant articles in English. Vitamin D levels were categorized into three groups: deficient (<20 ng/mL), insufficient (20-30 ng/mL), and replete (>30 ng/mL). Before starting the data extraction, we registered the review protocol in PROSPERO (CRD42019134258). MAIN OUTCOME MEASURES We consider clinical pregnancy rate (CPR), live birth rate (LBR), and/or ongoing pregnancy rate (OPR) as primary outcomes. Likewise, the miscarriage rate was considered as a secondary outcome. RESULTS Primary analysis showed that women with a replete level of vitamin D had higher CPR and LBR/OPR compared to those with a deficient of insufficient level of vitamin D. However, sensitivity analysis led to non-significant differences between the comparators for CPR (odds ratio 0.71, 95% confidence interval 0.47-1.08, I2 = 61%) and OPR/LBR (odds ratio 0.78, 95% confidence interval 0.56-1.08], I2 = 61%). Also, for miscarriage a statistically different rate was not reached. CONCLUSION Serum vitamin D levels do not influence IVF outcomes in terms of CPR, LBR/OPR, and miscarriage rate. Future large cohort studies are warranted to determine whether the threshold of vitamin D affects reproductive outcomes. Currently, there is a lack of consensus between the appropriate vitamin D threshold to predict reproductive outcomes compared to the one established for bone health. PROSPERO NUMBER CRD42019134258.
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Affiliation(s)
- Mauro Cozzolino
- IVIRMA, IVI Foundation, Valencia, Spain; Department of Obstetrics, Gynaecology and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut; Rey Juan Carlos University, Madrid, Spain.
| | - Andrea Busnelli
- Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Clinical and Research Center - IRCCS, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | | | - Emma Riviello
- Unit of Gynecology and Obstetrics, Department of Women and Children's Health, University of Padua, Padua, Italy
| | - Amerigo Vitagliano
- Unit of Gynecology and Obstetrics, Department of Women and Children's Health, University of Padua, Padua, Italy
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Kalaitzopoulos DR, Lempesis IG, Athanasaki F, Schizas D, Samartzis EP, Kolibianakis EM, Goulis DG. Association between vitamin D and endometriosis: a systematic review. Hormones (Athens) 2020; 19:109-121. [PMID: 31863346 DOI: 10.1007/s42000-019-00166-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 12/11/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Endometriosis is one of the most common gynecological diseases of reproductive age, with a prevalence of 5-10% and grave consequences for quality of life and fertility. Vitamin D (vit D), a classic regulator of plasma calcium concentration and skeleton mineralization, is also an effective modulator of the immune system. Several studies suggest that immunologic properties attributed to vit D along with vit D receptor (VDR) expression in reproductive tissues may be involved in the pathogenesis of endometriosis. OBJECTIVE To systematically review the literature for the association between components of vit D metabolism and endometriosis. MATERIALS AND METHODS A systematic review of the literature published in the Medline and Cochrane Central databases was conducted for original research articles on humans, published in any language. RESULTS Twenty-one studies were included in the systematic review. Among them, 12 examined the relationship of endometriosis with vit D metabolites, eight with vit D-binding protein (VDBP), three with VDR polymorphisms, and two with vit D regulatory enzymes. There are discrepancies between the outcomes of the available literature publications. CONCLUSIONS This is a systematic attempt to collect, evaluate, and present the known data on the association between vit D and endometriosis. Given the heterogeneity and the diversity of the present studies, more research is required to elucidate the association between vit D and endometriosis.
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Affiliation(s)
- Dimitrios Rafail Kalaitzopoulos
- Department of Gynecology and Obstetrics, Cantonal Hospital Schaffhausen, Geissbergstrasse 81, 8208, Schaffhausen, Switzerland.
- Society of Junior Doctors, Athens, Greece.
| | - Ioannis G Lempesis
- Society of Junior Doctors, Athens, Greece
- Section of Investigative Medicine, Division of Diabetes, Endocrinology & Metabolism, Department of Medicine, Imperial College London, London, UK
| | | | - Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | | | - Efstratios M Kolibianakis
- Unit for Human Reproduction, 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Vitamin D Effects on the Immune System from Periconception through Pregnancy. Nutrients 2020; 12:nu12051432. [PMID: 32429162 PMCID: PMC7284509 DOI: 10.3390/nu12051432] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/05/2020] [Accepted: 05/11/2020] [Indexed: 12/17/2022] Open
Abstract
Vitamin D is a well-known secosteroid and guardian of bone health and calcium homeostasis. Studies on its role in immunomodulatory functions have expanded its field in recent years. In addition to its impact on human physiology, vitamin D influences the differentiation and proliferation of immune system modulators, interleukin expression and antimicrobial responses. Furthermore, it has been shown that vitamin D is synthesized in female reproductive tissues and, by modulating the immune system, affects the periconception period and reproductive outcomes. B cells, T cells, macrophages and dendritic cells can all synthesize active vitamin D and are involved in processes which occur from fertilization, implantation and maintenance of pregnancy. Components of vitamin D synthesis are expressed in the ovary, decidua, endometrium and placenta. An inadequate vitamin D level has been associated with recurrent implantation failure and pregnancy loss and is associated with pregnancy-related disorders like preeclampsia. This paper reviews the most important data on immunomodulatory vitamin D effects in relation to the immune system from periconception to pregnancy and provides an insight into the possible consequences of vitamin D deficiency before and during pregnancy.
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28
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Karagul MI, Aktas S, Yilmaz SN, Yetkin D, Celikcan HD, Cevik OS. Perifosine and vitamin D combination induces apoptotic and non-apoptotic cell death in endometrial cancer cells. EXCLI JOURNAL 2020; 19:532-546. [PMID: 32483402 PMCID: PMC7257250 DOI: 10.17179/excli2019-1834] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 04/23/2020] [Indexed: 12/13/2022]
Abstract
Endometrial cancer is the most common cancer of the female reproductive system. Combination treatment with specific agents has been widely used as a targeted therapy for cancer. In this study, we aimed to investigate the anti-proliferative and apoptotic effects of varying concentrations of perifosine and vitamin D on the human endometrial cancer cell line (HEC-1A). HEC-1A cells were exposed to perifosine (10 μM, 30 μM), vitamin D (50 nM, 200 nM) and combinations of both for 48 h and 72 h. Monitoring of cell proliferation in a time-dependent manner was performed with the xCELLigence RTCA DP system. The levels of BCL2, BAX and P53 mRNA expression were examined using RT-qPCR. Apoptosis was determined using Annexin V, which were followed by flow cytometry analysis. Ultra-structural morphology of cells was analyzed by transmission electron microscopy (TEM) for 72 h. The anti-proliferative and apoptotic effects of the perifosine+vitamin D combination (30 μM + 200 nM at 48 h and 10 μM + 200 nM at 72 h) on HEC-1A cells were higher than in perifosine and vitamin D alone. It was observed that perifosine has increased the expression of BAX mRNA in HEC-1A cells in a dose-dependent manner. While perifosine+vitamin D combinations increased P53 mRNA expression in HEC-1A cells we did not find any significant change in BCL2, BAX mRNA expression levels. In TEM examinations of HEC-1A cells, perifosine appeared to lead autophagic cell death, whereas vitamin D caused paraptosis-like cell death and combination of perifosine+vitamin D caused apoptotic and non-apoptotic (paraptotic, autophagic and necrotic) cell death. Therefore, it is considered that the combination of both drugs in the treatment of endometrial cancer might be an alternative and effective treatment option through activating the apoptotic and non-apoptotic cell death mechanisms in cancer cells.
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Affiliation(s)
- Meryem Ilkay Karagul
- Department of Histology and Embryology, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Savas Aktas
- Department of Histology and Embryology, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Sakir Necat Yilmaz
- Department of Histology and Embryology, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Derya Yetkin
- Advanced Technology of Education, Research and Application Center, Mersin University, Mersin, Turkey
| | - Havva Didem Celikcan
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Ozge Selin Cevik
- Department of Physiology, Faculty of Medicine, Mersin University, Mersin, Turkey
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Guo J, Liu S, Wang P, Ren H, Li Y. Characterization of VDR and CYP27B1 expression in the endometrium during the menstrual cycle before embryo transfer: implications for endometrial receptivity. Reprod Biol Endocrinol 2020; 18:24. [PMID: 32183826 PMCID: PMC7079352 DOI: 10.1186/s12958-020-00579-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 02/26/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Molecular analyses of vitamin D in a typical cycling endometrium has received minimal research attention in the reproductive field. This study was designed to assess how expression of the endometrial vitamin D receptor (VDR) and CYP27B1, a vitamin D metabolizing enzyme, change during the menstrual cycle in women of reproductive age. In addition, this study explores the association between expression of vitamin D-VDR system and endometrial receptivity during the implantation window. METHODS Sixteen patients underwent standardized in vitro fertilization (IVF) treatment and freeze-all techniques. Before embryo transfer, total serum 25(OH) D levels were determined through blood samples and VDR, CYP27B1, HOXA10, and CYP19 expression were determined through endometrial samples. Endometrial receptivity was also assessed using an electron microscope. RESULTS We found that VDR protein expression was significantly lower throughout the endometrial secretory phase compared to the proliferative phase, while CYP27B1 expression remained constant during the menstrual cycle. During the implantation window, ultrastructural evaluation showed that higher serum vitamin D levels were associated with more mature pinopodes; VDR and HOXA10 protein expression were substantially elevated in pregnant women compared to non-pregnant women; and VDR protein levels were positively correlated with HOXA10 levels. In addition, serum vitamin D levels were positively correlated with VDR and HOXA10 protein levels in the endometrium. CONCLUSIONS Women with increased VDR expression in the endometrium, especially during the implantation window of the menstrual cycle, were significantly more likely to be pregnant than women with decreased expression. Our results support the hypothesis that the Vitamin D-VDR system performs a role during the development of endometrial receptivity.
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Affiliation(s)
- Jing Guo
- grid.411607.5Center for Reproductive Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Workers’ stadium South Road 8, Chao-yang district, Beijing, China
| | - Shan Liu
- grid.411607.5Center for Reproductive Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Workers’ stadium South Road 8, Chao-yang district, Beijing, China
| | - Peng Wang
- grid.411607.5Center for Reproductive Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Workers’ stadium South Road 8, Chao-yang district, Beijing, China
| | - Haiying Ren
- grid.411607.5Center for Reproductive Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Workers’ stadium South Road 8, Chao-yang district, Beijing, China
| | - Yuan Li
- grid.411607.5Center for Reproductive Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Workers’ stadium South Road 8, Chao-yang district, Beijing, China
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Yao X, Wang Z, El-Samahy MA, Ren C, Liu Z, Wang F, You P. Roles of vitamin D and its receptor in the proliferation and apoptosis of luteinised granulosa cells in the goat. Reprod Fertil Dev 2020; 32:335-348. [DOI: 10.1071/rd18442] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 06/16/2019] [Indexed: 12/27/2022] Open
Abstract
The objective of this study was to investigate the dose-dependent effect of 1α,25-(OH)2VD3 (Vit D3) on invitro proliferation of goat luteinised granulosa cells (LGCs) and to determine the underlying mechanisms of its action by overexpressing and silencing vitamin D receptor (VDR) in LGCs. Results showed that VDR was prominently localised in GCs and theca cells (TCs) and its expression increased with follicle diameter, but was lower in atretic follicles than in healthy follicles. The proliferation rate of LGCs was significantly higher in the Vit D3-treated groups than in the control group, with the highest proliferation rate observed in the 10nM group; this was accompanied by changes in the expression of cell cycle-related genes. These data indicate that Vit D3 affects LGC proliferation in a dose-dependent manner. Contrary to the VDR knockdown effects, its overexpression upregulated and downregulated cell cycle- and apoptosis-related genes respectively; moreover, supplementation with 10nM of Vit D3 significantly enhanced these effects. These results suggest that changes in VDR expression patterns in LGCs may be associated with follicular development by regulation of cell proliferation and apoptosis. These findings will enhance the understanding of the roles of Vit D3 and VDR in goat ovarian follicular development.
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zeynali M, Haghighian HK. Is there a relationship between serum vitamin D with dysmenorrhea pain in young women? J Gynecol Obstet Hum Reprod 2019; 48:711-714. [DOI: 10.1016/j.jogoh.2019.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 02/27/2019] [Accepted: 03/15/2019] [Indexed: 01/23/2023]
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Paffoni A, Somigliana E, Sarais V, Ferrari S, Reschini M, Makieva S, Papaleo E, Viganò P. Effect of vitamin D supplementation on assisted reproduction technology (ART) outcomes and underlying biological mechanisms: protocol of a randomized clinical controlled trial. The "supplementation of vitamin D and reproductive outcome" (SUNDRO) study. BMC Pregnancy Childbirth 2019; 19:395. [PMID: 31675919 PMCID: PMC6823943 DOI: 10.1186/s12884-019-2538-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 09/26/2019] [Indexed: 11/18/2022] Open
Abstract
Background Vitamin D plays an important role in human physiology and pathology. The receptor for vitamin D regulates 0.5–5% of the human genome. Accordingly, vitamin D insufficiency has been shown to increase the risk of several diseases. In recent years, based on growing evidence, on a role of vitamin D has been also postulated in reproductive health both in animals and humans, especially in female fertility female fertility. In vitro fertilization success was shown to be higher in women with appropriate reserves of vitamin D. However a causal relation has not been demonstrated and randomized controlled trials testing the effectiveness of vitamin D supplementation in IVF are warranted. Methods This is a multicenter randomized double blinded placebo controlled study aimed at determining the benefits of vitamin D [25(OH)D] supplementation in improving clinical pregnancy rate in women undergoing IVF. Eligible women with a serum level of 25-hydroxyvitamin D [25(OH)D] < 30 ng/ml will be randomized. Recruited women will be given the drug (either 600,000 IU of 25(OH) D or placebo in a single oral administration) at the time of randomization. Two centres will participate and the sample size (700 women) is foreseen to be equally distributed between the two. Patients will be treated according to standard IVF protocols. Discussion The primary aim of the study is the cumulative clinical pregnancy rate per oocyte retrieval. Clinical pregnancy is defined as the presence of at least one intrauterine gestational sac with viable foetus at first ultrasound assessment (3 weeks after a positive human chorionic gonadotropin [hCG] assessment). Secondary outcomes include: 1) clinical and embryological variables; 2) oocyte and endometrium quality at a molecular level. To investigate this latter aspect, samples of cumulus cells, follicular and endometrial fluids will be obtained from a subgroup of 50 age-matched good-prognosis cases and controls. Trial registration The protocol was included in EudraCT on 22nd September 2015 with the registration number assigned ‘2015-004233-27’; it was submitted through the database of the Italian “Osservatorio Nazionale della Sperimentazione Clinica (OsSC)” - (National Monitoring Centre of Clinical Trials) to the National Competent Authority on 8th March 2016 and approved on 23rd June 2016.
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Affiliation(s)
- Alessio Paffoni
- Obstetrics and Gynaecology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via M. Fanti 6, 20122, Milan, Italy
| | - Edgardo Somigliana
- Obstetrics and Gynaecology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via M. Fanti 6, 20122, Milan, Italy. .,Dipartimento di Scienze Cliniche e di Comunità, University of Milan, via Fanti 6, 20122, Milan, Italy.
| | - Veronica Sarais
- Obstetrics and Gynaecology Department, IRCCS San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy
| | - Stefania Ferrari
- Obstetrics and Gynaecology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via M. Fanti 6, 20122, Milan, Italy
| | - Marco Reschini
- Obstetrics and Gynaecology Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via M. Fanti 6, 20122, Milan, Italy
| | - Sofia Makieva
- Division of Genetics and Cell Biology, Reproductive Sciences Laboratory, IRCCS San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy
| | - Enrico Papaleo
- Obstetrics and Gynaecology Department, IRCCS San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy
| | - Paola Viganò
- Division of Genetics and Cell Biology, Reproductive Sciences Laboratory, IRCCS San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy
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Fichera M, Török P, Tesarik J, Della Corte L, Rizzo G, Garzon S, Carlea A, Di Angelo Antonio S, Zito G, Panella MM. Vitamin D, reproductive disorders and assisted reproduction: evidences and perspectives. Int J Food Sci Nutr 2019; 71:276-285. [PMID: 31928386 DOI: 10.1080/09637486.2019.1661978] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Vitamin D is an important nutrient involved in many fundamental health outcomes. However, its influence on female reproductive function remains ambiguous. Cholecalciferol seems to have a role in the reproductive processes and in the patients affected by polycystic ovary syndrome, endometriosis, uterine myomas and premature ovarian failure. Moreover, it may play an important role in the assisted reproductive techniques, given that it is capable of influencing oocyte quality, but also an adequate preparation of the endometrium for embryonic implantation. Although promising, available evidence is based on a limited number of in vitro, in vivo and clinical studies. We provide an overview of the association between vitamin D and female infertility reporting the most recent data published in the literature. Nevertheless, properly randomised clinical trials are mandatory to achieve more conclusive results about the promising role of vitamin D in the management of female assisted reproduction.
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Affiliation(s)
- Michele Fichera
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Péter Török
- Faculty of Medicine, Institute of Obstetrics and Gynaecology, University of Debrecen, Debrecen, Hungary
| | | | - Luigi Della Corte
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | | | - Simone Garzon
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
| | - Annunziata Carlea
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy
| | | | - Gabriella Zito
- Department of Obstetrics and Gynecology, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| | - Marco Marzio Panella
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
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Moghbeli M. Genetics of recurrent pregnancy loss among Iranian population. Mol Genet Genomic Med 2019; 7:e891. [PMID: 31364314 PMCID: PMC6732315 DOI: 10.1002/mgg3.891] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 07/08/2019] [Accepted: 07/15/2019] [Indexed: 01/15/2023] Open
Abstract
Background Recurrent pregnancy loss (RPL) is one of the most common reproductive disorders which is defined as the occurrence of recurrent miscarriage before 24 weeks of gestation and is observed among 1%–5% of women. Methods Various factors are associated with RPL such as immunological disorders, maternal age, obesity, alcohol, chromosomal abnormality, endocrine disorders, and uterine abnormalities. About half of the RPL cases are related with chromosomal abnormalities. Therefore, RPL genetic tests are mainly limited to karyotyping. However, there is a significant proportion of RPL cases without any chromosomal abnormalities that can be related to the single‐gene aberrations. Therefore, it is required to prepare a diagnostic panel of genetic markers besides karyotyping. Results In the present review, we have summarized all the significant reported genes until now which are associated with RPL among Iranian women. We categorized all the reported genes based on their cellular and molecular functions in order to determine the molecular bases of RPL in this population. Conclusion This review paves the way of introducing a population‐based diagnostic panel of genetic markers for the first time among Iranian RPL cases. Moreover, this review clarifies the genetic and molecular bases of RPL in this population.
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Affiliation(s)
- Meysam Moghbeli
- Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Olmos-Ortiz A, García-Quiroz J, Halhali A, Avila E, Zaga-Clavellina V, Chavira-Ramírez R, García-Becerra R, Caldiño-Soto F, Larrea F, Díaz L. Negative correlation between testosterone and TNF-α in umbilical cord serum favors a weakened immune milieu in the human male fetoplacental unit. J Steroid Biochem Mol Biol 2019; 186:154-160. [PMID: 30359690 DOI: 10.1016/j.jsbmb.2018.10.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 09/10/2018] [Accepted: 10/18/2018] [Indexed: 12/27/2022]
Abstract
Clinical and epidemiological evidence supports that pregnancies carrying a male fetus are more vulnerable to infections and preterm birth, probably due to testosterone immunosuppressive properties. In human placentas, testosterone lowers the expression of CYP27B1, the vitamin D (VD)-activating enzyme, diminishing cathelicidin synthesis, a potent VD-dependent antimicrobial peptide (AMP). VD also stimulates other AMPs, including defensins. To get insights into the increased male vulnerability mechanisms, we investigated the relationship between fetal sex and the immunoendocrine milieu at the fetoplacental unit. For this, umbilical vein serum and placental samples were collected from healthy newborns. In males' serum, testosterone levels were significantly higher and negatively associated with TNF-α, a cytokine that strengthens the immune response. Males showed lower serum TNF-α and increased levels and gene expression of the immunosuppressive cytokine IL-10. Only in female samples there was a positive association (P < 0.05) between AMPs and both TNF-α and CYP27B1 and between 25-hydroxyvitamin D3 and IL-1β serum levels. Accordingly, VD-metabolites (25-hydroxyvitamin D3, calcitriol) significantly stimulated IL-1β gene expression in cultured trophoblasts. Interestingly, IL-1β mRNA correlated positively with defensins (P < 0.05) in males, but not with cathelicidin expression, which was significantly diminished in comparison to females. Our data suggest that high umbilical serum testosterone and IL-10 in males could explain reduced TNF-α levels and lack of association between VD-dependent innate immunity markers and proinflammatory cytokines expression in the fetoplacental unit. Altogether, our observations imply a restricted basal immune milieu in males compared to females, which may help understand the higher male susceptibility to adverse perinatal outcomes.
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Affiliation(s)
- Andrea Olmos-Ortiz
- Departamento de Biología de la Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Belisario Domínguez Sección XVI, C.P. 14080, Ciudad de México, Mexico; Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Montes Urales No. 800, Lomas de Virreyes, C.P. 11000, Ciudad de México, Mexico
| | - Janice García-Quiroz
- Departamento de Biología de la Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Belisario Domínguez Sección XVI, C.P. 14080, Ciudad de México, Mexico
| | - Ali Halhali
- Departamento de Biología de la Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Belisario Domínguez Sección XVI, C.P. 14080, Ciudad de México, Mexico
| | - Euclides Avila
- Departamento de Biología de la Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Belisario Domínguez Sección XVI, C.P. 14080, Ciudad de México, Mexico
| | - Verónica Zaga-Clavellina
- Departamento de Inmunobioquímica, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Montes Urales No. 800, Lomas de Virreyes, C.P. 11000, Ciudad de México, Mexico
| | - Roberto Chavira-Ramírez
- Departamento de Biología de la Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Belisario Domínguez Sección XVI, C.P. 14080, Ciudad de México, Mexico
| | - Rocío García-Becerra
- Departamento de Biología de la Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Belisario Domínguez Sección XVI, C.P. 14080, Ciudad de México, Mexico; Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Av. Ciudad Universitaria 3000, Coyoacán 04360, Ciudad de México, Mexico
| | - Felipe Caldiño-Soto
- Jefatura de UTQ, UMAE Hospital de Gineco Obstetricia No. 4 "Luis Castelazo Ayala", IMSS, Av. Río Magdalena No. 289, Tizapán San Angel, C.P. 01090, Ciudad de México, Mexico
| | - Fernando Larrea
- Departamento de Biología de la Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Belisario Domínguez Sección XVI, C.P. 14080, Ciudad de México, Mexico
| | - Lorenza Díaz
- Departamento de Biología de la Reproducción Dr. Carlos Gual Castro, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga No. 15, Belisario Domínguez Sección XVI, C.P. 14080, Ciudad de México, Mexico.
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Abedi S, Taebi M, Nasr Esfahani MH. Effect of Vitamin D Supplementation on Intracytoplasmic Sperm Injection Outcomes: A Randomized Double-Blind Placebo-Controlled Trial. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2019; 13:18-23. [PMID: 30644240 PMCID: PMC6334020 DOI: 10.22074/ijfs.2019.5470] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 08/05/2018] [Indexed: 01/06/2023]
Abstract
Background Despite numerous studies indicating an imperative role for reproduction, however, the role of Vitamin
D supplementation on outcomes of assisted reproductive techniques remains controversial. This clinical trial was per-
formed to evaluate the effect of Vitamin D supplementation 6 weeks prior to intracytoplasmic sperm injection (ICSI)
on fertility indices. Materials and Methods The present study was a double-blind clinical trial conducted on infertile women was ran-
domly allocated into two groups: Vitamin D supplementation (42 participants) and placebo (43 participants). Serum
Vitamin D was measured before and six to eight weeks after treatment, on the day of ovum pick up. Results were
analyzed using SPSS16 and fertility indices were compared between the two groups. Results No significant difference was observed between the intervention and control groups regarding the mean
number of oocytes retrieved, percentage mature oocyte, fertilization rate and the rate of good quality embryos (all
P>0.05). But, percentages of the individual with suitable endometrium (7-14 mm thickness) were significantly higher
in the Vitamin D compared to control group (P=0.011). The rate of chemical (47.6 vs. 25.5%, P=0.013) and clinical
pregnancy rate (38.1 vs. 20.9%, P=0.019) were also significantly higher in the Vitamin D compared to control group. Conclusion The present study reveals that consuming Vitamin D for 6 weeks prior to ICSI improves quality of endo-
metrium, rate of chemical and clinical pregnancy (Registration Number: IRCT2015111124999N1).
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Affiliation(s)
- Sara Abedi
- Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahboubeh Taebi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.Electronic Address:
| | - Mohammad Hosein Nasr Esfahani
- Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran.Electronic Address:
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Cunningham TK, Allgar V, Dargham SR, Kilpatrick E, Sathyapalan T, Maguiness S, Mokhtar Rudin HR, Abdul Ghani NM, Latiff A, Atkin SL. Association of Vitamin D Metabolites With Embryo Development and Fertilization in Women With and Without PCOS Undergoing Subfertility Treatment. Front Endocrinol (Lausanne) 2019; 10:13. [PMID: 30761082 PMCID: PMC6361765 DOI: 10.3389/fendo.2019.00013] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 01/10/2019] [Indexed: 01/08/2023] Open
Abstract
Objective: The relationship between fertilization rates and 1,25-dihydroxyvitamin D (1,25(OH)2D3), 25-hydroxyvitamin D2 (25(OH)D2), 25-hydroxyvitamin D3 (25(OH)D3), 24,25-dihydroxyvitamin D (24,25(OH)2D3), and 25-hydroxy-3epi-Vitamin D3 (3epi25(OH)D3) concentrations in age and weight matched women with and without PCOS was studied. Methods: Fifty nine non-obese women, 29 with PCOS, and 30 non-PCOS undergoing IVF, matched for age and weight were included. Serum vitamin D metabolites were taken the menstrual cycle prior to commencing controlled ovarian hyperstimulation. Results: Vitamin D metabolites did not differ between PCOS and controls; however, 25(OH)D3 correlated with embryo fertilization rates in PCOS patients alone (p = 0.03). For all subjects, 3epi25(OH)D3 correlated with fertilization rate (p < 0.04) and negatively with HOMA-IR (p < 0.02); 25(OH)D2 correlated with cleavage rate, G3D3 and blastocyst (p < 0.05; p < 0.009; p < 0.002, respectively). 24,25(OH)2D3 correlated with AMH, antral follicle count, eggs retrieved and top quality embryos (G3D3) (p < 0.03; p < 0.003; p < 0.009; p < 0.002, respectively), and negatively with HOMA-IR (p < 0.01). 1,25(OH)2D3 did not correlate with any of the metabolic or embryo parameters. In slim PCOS, 25(OH)D3 correlated with increased fertilization rates in PCOS, but other vitamin D parameters did not differ to matched controls. Conclusion: 3epi25(OH)D3, 25(OH)D2, and 24,25(OH)2D3, but not 1,25(OH)2D3, were associated with embryo parameters suggesting that vitamin D metabolites other than 1,25(OH)2D3 are important in fertility.
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Affiliation(s)
- Thomas Keith Cunningham
- Hull IVF Unit, Women and Children's Hospital, Hull Royal Infirmary, Hull, United Kingdom
- Centre for Diabetes and Metabolic Research, Hull York Medical School, University of Hull, Hull, United Kingdom
| | - Victoria Allgar
- Department of Statistics, Hull York Medical School, University of Hull, Hull, United Kingdom
| | | | | | - Thozhukat Sathyapalan
- Centre for Diabetes and Metabolic Research, Hull York Medical School, University of Hull, Hull, United Kingdom
| | - Stephen Maguiness
- Hull IVF Unit, Women and Children's Hospital, Hull Royal Infirmary, Hull, United Kingdom
| | | | | | | | - Stephen L. Atkin
- Weill Cornell Medicine Qatar, Doha, Qatar
- *Correspondence: Stephen L. Atkin
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Kucukceran H, Ozdemir O, Kiral S, Berker DS, Kahveci R, Ozkara A, Atalay CR, Ates İ. The impact of circulating 25-hydroxyvitamin and oral cholecalciferol treatment on menstrual pain in dysmenorrheic patients. Gynecol Endocrinol 2019; 35:53-57. [PMID: 30044160 DOI: 10.1080/09513590.2018.1490407] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
This study aims to determine Vitamin-D level in patients with primary dysmenorrhea and investigate the effect of Vitamin-D replacement on symptoms. About 100 patients in the 18-30 age group followed-up with primary dysmenorrhea diagnosis were included in this observational study. The pain severity was assessed using the visual analog scale (VAS). 25-hydroxy vitamin D(25(OH)D) levels of the patients were measured and the replacement therapy was applied according to measurement results. The patients were followed for three months in total. At the end of the three-month period, the 25(OH)D level was measured and the VAS score was assessed once more after the therapy. 25(OH)D level was insufficient in 23.0%, deficient in 45.0%, and severely deficient in 32.0% of the patients. It was found that the VAS score increased as the 25(OH)D level decreased (r = -0.320; p = .002). A significant reduction was observed in VAS scores after Vitamin-D treatment in all three groups; the amount of reduction in VAS score was determined to be higher in the patients with severely deficient levels of 25(OH)D, compared to the patients with deficient or insufficient levels (p < .001). A significant and negative correlation was found between Vitamin-D and symptoms associated with dysmenorrhea in our study. The Vitamin-D replacement therapy led to a significant decrease in symptoms.
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Affiliation(s)
- Hatice Kucukceran
- a Ankara Provincial Health Directorate, Akyurt Family Health Center Number 3 , Ankara , Turkey
| | - Ozhan Ozdemir
- b Department of Obstetrics and Gynecology , Ankara Numune Education and Research Hospital , Ankara , Turkey
| | - Serkan Kiral
- c Department of Biochemistry , Kırşehir Kaman Hospital , Kırşehir , Turkey
| | - Dilek Sensoz Berker
- d Department of Endocrinology , Ankara Numune Education and Research Hospital , Ankara , Turkey
| | - Rabia Kahveci
- e Department of Family Medicine , Ankara Numune Education and Research Hospital , Ankara , Turkey
| | - Adem Ozkara
- e Department of Family Medicine , Ankara Numune Education and Research Hospital , Ankara , Turkey
| | - Cemal Reşat Atalay
- b Department of Obstetrics and Gynecology , Ankara Numune Education and Research Hospital , Ankara , Turkey
| | - İhsan Ates
- f Department of Internal Medicine , Ankara Numune Education and Research Hospital , Ankara , Turkey
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Expression of vitamin D receptor in the porcine uterus and effect of 1,25(OH) 2D 3 on progesterone and estradiol-17β secretion by uterine tissues in vitro. Theriogenology 2018; 125:102-108. [PMID: 30399506 DOI: 10.1016/j.theriogenology.2018.10.026] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 10/23/2018] [Accepted: 10/29/2018] [Indexed: 12/20/2022]
Abstract
Vitamin D3 acting via its nuclear receptor (VDR) was shown to target many reproductive tissues and regulate their function. Nevertheless, little is known about the role of vitamin D3 and VDR in the uterus. We hypothesized that VDR expression profile varies in the porcine uterus throughout the course of the estrous cycle, and 1,25(OH)2D3 influences uterine steroidogenic activity. The aim of this study was to investigate VDR mRNA expression, VDR protein abundance and immunolocalization in the porcine endometrium and myometrium harvested on Days 2-5, 12-13, 15-16 and 18-20 of the estrous cycle. Additionally, in studied pigs, 25OHD concentration in plasma and uterine flushings was determined by RIA. The effect of 1,25(OH)2D3 (10, 50 and 100 ng/mL) in vitro on progesterone (P4) and estradiol-17β (E2) release by endometrial and myometrial slices obtained on Days 12-13 of the estrous cycle was also examined. Nuclear VDR immunostaining was found in endometrial (luminal and glandular epithelium, stromal cells) and myometrial cells throughout examined days of the estrous cycle. In the endometrium, the highest VDR mRNA expression was observed on Days 12-13 and 18-20, whereas the greatest VDR protein abundance was noted only on Days 12-13 of the estrous cycle. In the myometrium, either VDR transcript or protein level was the greatest on Days 12-13. Interestingly, the highest 25OHD concentration in plasma and uterine flushings was shown also on Days 12-13 of the estrous cycle. 1,25(OH)2D3 did not affect P4 release by uterine slices while myometrial release of E2 was significantly increased in response to 1,25(OH)2D3 (10 and 50 ng/mL). Overall, obtained results indicate that porcine uterus is a target tissue for vitamin D3 throughout the entire estrous cycle. VDR mRNA expression and protein abundance altered within uterine tissues depending on studied days of the estrous cycle with the greatest protein abundance during mid-luteal phase of the estrous cycle in both uterine tissues. In addition, 1,25(OH)2D3 significantly increased myometrial release of E2 on Days 12-13 of the estrous cycle. These results suggest the role of vitamin D3-VDR system in the uterus, especially as a regulator of myometrial estrogenic activity in pigs during mid-luteal phase of the estrous cycle.
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Djurovic J, Stamenkovic G, Todorovic J, Aleksic N, Stojkovic O. Polymorphisms and haplotypes in VDR gene are associated with female idiopathic infertility. HUM FERTIL 2018; 23:101-110. [PMID: 30221569 DOI: 10.1080/14647273.2018.1515503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Unexplained infertility refers to the absence of a definable cause of reproductive failure. Vitamin D receptor (VDR) acts as a transcription factor and regulates a number of vitamin D-responsive genes, including those involved in the immune system. Recent finding that VDR is expressed in reproductive tissues suggests a possible importance of vitamin D in pregnancy. We conducted a case-control study to examine the association of polymorphisms in VDR gene with reproductive success. DNA from 117 female patients with unexplained infertility and 130 fertile controls was isolated from peripheral blood and VDR genotypes (FokI, BsmI, ApaI and TaqI) were detected by PCR-RFLP. Haplotypes were determined using Haploview software. Our results show significant association of FokI and BsmI polymorphisms with infertility (p < 0.05). The haplotype analysis confirmed strong linkage disequilibrium between closely positioned BsmI, ApaI and TaqI polymorphisms. Two haplotypes were associated with infertility: (i) haplotype bAT was increasing the risk for secondary infertility; while (ii) haplotype BAT had a protective role against primary infertility (p < 0.05). By changing the expression and the activity of VDR gene, which leads to the change in expression of vitamin D-responsive genes, these polymorphisms and haplotypes could possibly have an effect on immune system in the female reproductive tract.
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Affiliation(s)
- Jelena Djurovic
- Faculty of Medicine, Institute of Forensic Medicine, University of Belgrade, Belgrade, Serbia
| | - Gorana Stamenkovic
- Institute of Biological Research "Siniša Stanković", University of Belgrade, Belgrade, Serbia
| | - Jelena Todorovic
- Specialized Medical Practice in the Field of Internal Medicine "Teamed", Belgrade, Serbia
| | - Natasa Aleksic
- Faculty of Medicine, Institute of Forensic Medicine, University of Belgrade, Belgrade, Serbia
| | - Oliver Stojkovic
- Faculty of Medicine, Institute of Forensic Medicine, University of Belgrade, Belgrade, Serbia
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Karacin O, Mutlu I, Kose M, Celik F, Kanat-Pektas M, Yilmazer M. Serum vitamin D concentrations in young Turkish women with primary dysmenorrhea: A randomized controlled study. Taiwan J Obstet Gynecol 2018; 57:58-63. [PMID: 29458904 DOI: 10.1016/j.tjog.2017.12.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2016] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE This study aims to investigate the possible role of vitamin D deficiency in primary dysmenorrhea by assessing serum 25-hydroxyvitamin D3 levels in a cohort which includes young Turkish women with primary dysmenorrhea and healthy controls. MATERIALS AND METHODS A total of 683 women who were aged between 18 and 25 years and who were consecutively admitted to the study center were eligible. After the exclusion of 55 women, 184 women with primary dysmenorrhea were randomly assigned into the dysmenorrhea group and 184 women without dysmenorrhea were randomly allocated into the control group. RESULTS The dysmenorrhea group had significantly less consumption of dairy products (p = 0.001), lower serum calcium (p = 0.001), lower serum vitamin D (p = 0.001) and higher serum parathyroid hormone (p = 0.001) than those of the control group. Hyperparathyroidism was significantly less frequent whereas vitamin D deficiency was significantly more frequent in the dysmenorrhea group (p = 0.001 for each). The dysmenorrhea patients with vitamin D deficiency had significantly higher visual analogue scale (VAS) scores (p = 0.001). Depression, irritability, mood swings, fatigue, headache and breast tenderness were significantly more frequent in the vitamin D deficiency group (p < 0.05 for all). The VAS scores of the dysmenorrhea patients correlated positively and significantly with serum parathyroid hormone levels (r = 0.666, p = 0.001) whereas these VAS scores correlated negatively and significantly with serum vitamin D levels (r = -0.713, p = 0.001). DISCUSSION The significant and positive correlation between vitamin D levels and VAS scores and the significant reduction in serum vitamin D levels of the dysmenorrhea patients designate the possible role of vitamin D deficiency in the primary dysmenorrhea.
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Affiliation(s)
- Osman Karacin
- Department of Obstetrics and Gynecology, Afyon Kocatepe University Hospital, Afyonkarahisar, Turkey
| | - Ilknur Mutlu
- Department of Obstetrics and Gynecology, Novaart In Vitro Fertilization Center, Ankara, Turkey
| | - Mesut Kose
- Department of Obstetrics and Gynecology, Afyon Kocatepe University Hospital, Afyonkarahisar, Turkey
| | - Fatih Celik
- Department of Obstetrics and Gynecology, Afyon Kocatepe University Hospital, Afyonkarahisar, Turkey
| | - Mine Kanat-Pektas
- Department of Obstetrics and Gynecology, Afyon Kocatepe University Hospital, Afyonkarahisar, Turkey.
| | - Mehmet Yilmazer
- Department of Obstetrics and Gynecology, Afyon Kocatepe University Hospital, Afyonkarahisar, Turkey
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Cermisoni GC, Alteri A, Corti L, Rabellotti E, Papaleo E, Viganò P, Sanchez AM. Vitamin D and Endometrium: A Systematic Review of a Neglected Area of Research. Int J Mol Sci 2018; 19:E2320. [PMID: 30096760 PMCID: PMC6122064 DOI: 10.3390/ijms19082320] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/02/2018] [Accepted: 08/04/2018] [Indexed: 01/27/2023] Open
Abstract
Growing evidence supports a role of vitamin D (VD) in reproductive health. Vitamin D receptor (VDR) is expressed in the ovary, endometrium, and myometrium. The biological actions of VD in fertility and reproductive tissues have been investigated but mainly using animal models. Conversely, the molecular data addressing the mechanisms underlying VD action in the physiologic endometrium and in endometrial pathologies are still scant. Levels of VDR expression according to the menstrual cycle are yet to be definitively clarified, possibly being lower in the proliferative compared to the secretory phase and in mid-secretory compared to early secretory phase. Endometrial tissue also expresses the enzymes involved in the metabolism of VD. The potential anti-proliferative and anti-inflammatory effects of VD for the treatment of endometriosis have been investigated in recent years. Treatment of ectopic endometrial cells with 1,25(OH)₂D₃ could significantly reduce cytokine-mediated inflammatory responses. An alteration of VD metabolism in terms of increased 24-hydroxylase mRNA and protein expression has been demonstrated in endometrial cancer, albeit not consistently. The effect of the active form of the vitamin as an anti-proliferative, pro-apoptotic, anti-inflammatory, and differentiation-inducing agent has been demonstrated in various endometrial cancer cell lines.
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Affiliation(s)
- Greta Chiara Cermisoni
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, 20132 Milano, Italy.
| | - Alessandra Alteri
- Obstetrics and Gynaecology Department, IRCCS San Raffaele Scientific Institute, 20132 Milano, Italy.
| | - Laura Corti
- Obstetrics and Gynaecology Department, IRCCS San Raffaele Scientific Institute, 20132 Milano, Italy.
| | - Elisa Rabellotti
- Obstetrics and Gynaecology Department, IRCCS San Raffaele Scientific Institute, 20132 Milano, Italy.
| | - Enrico Papaleo
- Obstetrics and Gynaecology Department, IRCCS San Raffaele Scientific Institute, 20132 Milano, Italy.
| | - Paola Viganò
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, 20132 Milano, Italy.
| | - Ana Maria Sanchez
- Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, 20132 Milano, Italy.
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Ikemoto Y, Kuroda K, Nakagawa K, Ochiai A, Ozaki R, Murakami K, Jinushi M, Matsumoto A, Sugiyama R, Takeda S. Vitamin D Regulates Maternal T-Helper Cytokine Production in Infertile Women. Nutrients 2018; 10:nu10070902. [PMID: 30011861 PMCID: PMC6073370 DOI: 10.3390/nu10070902] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 07/02/2018] [Accepted: 07/10/2018] [Indexed: 12/31/2022] Open
Abstract
Vitamin D (VD) deficiency is associated with reproductive failure. However, the relationship between VD and maternal immunity remains unclear. We investigated the clinical efficacy of VD in maternal T-helper (Th) cytokines in 276 infertile women and examined for Th1 and Th2 cells based on the deficient, insufficient, and sufficient serum 25-hydroxyvitamin D3 (25[OH]VD) levels (<12, 12–30, and >30 ng/mL, respectively). Most infertile women had a low-level of VD (87.3%). Immunological tests of pre-/post-VD supplementation were performed in patients who were deficient and insufficient in VD. Of 23 patients, 11 (47.8%) exhibited sufficient VD levels after supplementation. Th1/Th2 cell ratio in patients with insufficient VD was significantly decreased after supplementation (p = 0.004). After supplementation, serum 25(OH)VD levels of the patients: 11 in the sufficient group showed significant decreases in Th1 cell level and Th1/Th2 cell ratio (p = 0.032 and 0.010, respectively), whereas no significant differences in Th1/Th2 cell ratio were recognized in the insufficient group. Furthermore, mid-luteal endometrial biopsies (n = 18) were processed for primary cultures and measured interferon [IFN]-γ and interleukin [IL]-4 in condition media. Decidualizing cultures with 1,25-dihydroxvitamin D3 (1,25[OH]2VD) decreased IFN-γ. Sufficient VD supplementation in women with insufficient VD may optimize maternal T-helper cytokines during pregnancy via rebalancing the Th1/Th2 cell ratio.
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Affiliation(s)
- Yuko Ikemoto
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine, Tokyo 1138421, Japan.
| | - Keiji Kuroda
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine, Tokyo 1138421, Japan.
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Tokyo 1160023, Japan.
| | - Koji Nakagawa
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Tokyo 1160023, Japan.
| | - Asako Ochiai
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine, Tokyo 1138421, Japan.
| | - Rie Ozaki
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine, Tokyo 1138421, Japan.
| | - Keisuke Murakami
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine, Tokyo 1138421, Japan.
| | - Makoto Jinushi
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine, Tokyo 1138421, Japan.
| | - Akemi Matsumoto
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine, Tokyo 1138421, Japan.
| | - Rikikazu Sugiyama
- Center for Reproductive Medicine and Implantation Research, Sugiyama Clinic Shinjuku, Tokyo 1160023, Japan.
| | - Satoru Takeda
- Department of Obstetrics and Gynecology, Juntendo University, Faculty of Medicine, Tokyo 1138421, Japan.
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Yilmaz N, Ersoy E, Tokmak A, Sargin A, Ozgu-Erdinc AS, Erkaya S, Ibrahim Yakut H. Do Serum Vitamin D Levels Have Any Effect on Intrauterine Insemination Success? INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2018; 12:164-168. [PMID: 29707935 PMCID: PMC5936616 DOI: 10.22074/ijfs.2018.5256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Accepted: 08/23/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND Recent studies have shown that vitamin D has an essential role in the reproductive system. In this study, we aimed to investigate the effect of vitamin D levels in patients undergoing ovulation induction (OI), and subsequent intrauterine insemination (IUI) procedure. MATERIALS AND METHODS One hundred and four infertile and one hundred and three fertile women were recruited in this cross-sectional study which was conducted in a tertiary level maternity hospital. Infertile patients were divided into pregnant and non-pregnant subgroups after treatment. Individual characteristics and 25-hydroxyvitamin D3 [25 (OH) D3] levels were compared between the groups. RESULTS The vast majority of our study population consisted of women who had vitamin D deficiency (96.6%). There was no statistically significant difference between infertile and fertile groups in terms of serum 25 (OH) D3 levels (P=0.512). Similarly, no significant difference was observed between the pregnant and non-pregnant subgroups of infertile patients regarding 25 (OH) D3 levels (P=0.267). CONCLUSION There is no association between female infertility and serum vitamin D levels. Vitamin D does not predict pregnancy in infertile women undergoing OI with IUI. Further research which will provide a comparison between much more women who have deficient and sufficient 25 (OH) D3 levels is warranted.
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Affiliation(s)
- Nafiye Yilmaz
- Department of Obstetrics and Gynaecology, Zekai Tahir Burak Women's Healthcare Training and Research Hospital, Ankara, Turkey
| | - Ebru Ersoy
- Department of Obstetrics and Gynaecology, Zekai Tahir Burak Women's Healthcare Training and Research Hospital, Ankara, Turkey. Electronic Address:
| | - Aytekin Tokmak
- Department of Obstetrics and Gynaecology, Zekai Tahir Burak Women's Healthcare Training and Research Hospital, Ankara, Turkey
| | - Ayla Sargin
- Department of Obstetrics and Gynaecology, Zekai Tahir Burak Women's Healthcare Training and Research Hospital, Ankara, Turkey
| | - A Seval Ozgu-Erdinc
- Department of Obstetrics and Gynaecology, Zekai Tahir Burak Women's Healthcare Training and Research Hospital, Ankara, Turkey
| | - Salim Erkaya
- Department of Obstetrics and Gynaecology, Zekai Tahir Burak Women's Healthcare Training and Research Hospital, Ankara, Turkey
| | - Halil Ibrahim Yakut
- Zekai Tahir Burak Women's Healthcare Training and Research Hospital, Ankara, Turkey
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Soave I, Occhiali T, Wenger JM, Pluchino N, Caserta D, Marci R. Endometriosis and food habits: Can diet make the difference? JOURNAL OF ENDOMETRIOSIS AND PELVIC PAIN DISORDERS 2018. [DOI: 10.1177/2284026518773212] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Endometriosis is a chronic, inflammatory, estrogenic-dependent disease characterized by the presence of endometrial glands outside the uterine cavity, affecting approximately 2%–10% of women in reproductive age and 30%–50% of women in general. Despite the high prevalence of the disease, not much is known about etiology, possible risk factors, and an adequate and satisfactory therapy. In the past years, many studies have focused on food intake (nutrients and food groups) and on its possible correlation with endometriosis, demonstrating how diet could be identified as a possible risk factor. Comprehensive searches in the largest medical information databases (Medline-PubMed, Embase, Lilacs, and Cochrane Library) were conducted using the Medical Subject Heading terms “diet,” “food,” “nutrition,” “fatty acids,” vitamins,” “fruit,” “vegetables,” “coffee,” “caffeine,” “fish,” “soy food,” “dairy products,” “tea,” “curcumin” combined with “endometriosis.” Purpose of this review is to revise the literature, in order to determine potential modifiable risk factors of the disease.
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Affiliation(s)
- Ilaria Soave
- Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea Hospital, Faculty of Medicine and Psychology, University of Rome “Sapienza,” Rome, Italy
| | | | - Jean-Marie Wenger
- Department of Obstetrics and Gynecology, University Hospital of Geneva, Geneva, Switzerland
| | - Nicola Pluchino
- Department of Obstetrics and Gynecology, University Hospital of Geneva, Geneva, Switzerland
| | - Donatella Caserta
- Department of Medical and Surgical Sciences and Translational Medicine, Sant’Andrea Hospital, Faculty of Medicine and Psychology, University of Rome “Sapienza,” Rome, Italy
| | - Roberto Marci
- Department of Obstetrics and Gynecology, University Hospital of Geneva, Geneva, Switzerland
- Department of Morphology, Surgery and Experimental Medicine, Section of Gynecology and Obstetrics, University of Ferrara, Ferrara, Italy
- WHO/RHR, Department of Reproductive Health and Research, Geneva, Switzerland
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47
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25-Hydroxyvitamin D Serum Levels and Endometriosis: Results of a Case–Control Study. Reprod Sci 2018; 26:172-177. [DOI: 10.1177/1933719118766259] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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48
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Arslan S, Akdevelioğlu Y. The Relationship Between Female Reproductive Functions and Vitamin D. J Am Coll Nutr 2018. [DOI: 10.1080/07315724.2018.1431160] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Sabriye Arslan
- Gazi Universitesi Saglik Bilimleri Fakultesi, Nutrition and Dietetics, Ankara, Turkey
| | - Yasemin Akdevelioğlu
- Gazi Universitesi Saglik Bilimleri Fakultesi, Nutrition and Dietetics, Ankara, Turkey
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Bikle DD, Patzek S, Wang Y. Physiologic and pathophysiologic roles of extra renal CYP27b1: Case report and review. Bone Rep 2018; 8:255-267. [PMID: 29963603 PMCID: PMC6021194 DOI: 10.1016/j.bonr.2018.02.004] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 02/06/2018] [Accepted: 02/23/2018] [Indexed: 01/13/2023] Open
Abstract
Although the kidney was initially thought to be the sole organ responsible for the production of 1,25(OH)2D via the enzyme CYP27b1, it is now appreciated that the expression of CYP27b1 in tissues other than the kidney is wide spread. However, the kidney is the major source for circulating 1,25(OH)2D. Only in certain granulomatous diseases such as sarcoidosis does the extra renal tissue produce sufficient 1,25(OH)2D to contribute to the circulating levels, generally associated with hypercalcemia, as illustrated by the case report preceding the review. Therefore the expression of CYP27b1 outside the kidney under normal circumstances begs the question why, and in particular whether the extra renal production of 1,25(OH)2D has physiologic importance. In this chapter this question will be discussed. First we discuss the sites for extra renal 1,25(OH)2D production. This is followed by a discussion of the regulation of CYP27b1 expression and activity in extra renal tissues, pointing out that such regulation is tissue specific and different from that of CYP27b1 in the kidney. Finally the physiologic significance of extra renal 1,25(OH)2D3 production is examined, with special focus on the role of CYP27b1 in regulation of cellular proliferation and differentiation, hormone secretion, and immune function. At this point the data do not clearly demonstrate an essential role for CYP27b1 expression in any tissue outside the kidney, but several examples pointing in this direction are provided. With the availability of the mouse enabling tissue specific deletion of CYP27b1, the role of extra renal CYP27b1 expression in normal and pathologic states can now be addressed definitively.
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Affiliation(s)
- Daniel D Bikle
- Department of Medicine, Endocrine Research Unit, Veterans Affairs Medical Center, University of California San Francisco, United States
| | - Sophie Patzek
- Department of Medicine, Endocrine Research Unit, Veterans Affairs Medical Center, University of California San Francisco, United States
| | - Yongmei Wang
- Department of Medicine, Endocrine Research Unit, Veterans Affairs Medical Center, University of California San Francisco, United States
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50
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Zhao J, Huang X, Xu B, Yan Y, Zhang Q, Li Y. Whether vitamin D was associated with clinical outcome after IVF/ICSI: a systematic review and meta-analysis. Reprod Biol Endocrinol 2018; 16:13. [PMID: 29426322 PMCID: PMC5807754 DOI: 10.1186/s12958-018-0324-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/17/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND There exist contradictive views on whether the vitamin D has association with clinical outcome of in vitro fertilization (IVF) and/or intracytoplasmic sperm injection (ICSI). The present meta-analysis aim to establish whether vitamin D was associated with clinical outcomes of IVF/ICSI. METHODS MEDLINE, Google Scholar and the Cochrane Library from database inception to March 2017 were searched. Clinical studies, which evaluated the association of vitamin D level and the clinical outcomes after IVF/ICSI, were included. The Main Outcome Measures were clinical pregnancy, ongoing pregnancy, and live birth. RESULTS In the analysis of clinical pregnancy, 9 cohort studies were included. Of which, 2 studies and 3 studies were identified in analyzing ongoing pregnancy and live birth, respectively. Meta-analysis showed trends toward lower clinical pregnancy [RR 0.91, (95% CI 0.77-1.07)] and higher ongoing pregnancy [RR 1.06, (95% CI 0.95-1.19)] for women with deficient level of vitamin D. The probability of live birth for women with deficient level of vitamin D was significantly lower than cases with sufficient level of vitamin D [RR 0.74, (95% CI 0.58-0.90)]. CONCLUSIONS Deficient vitamin D was associated with decreased probability of live birth after IVF/ICSI. So vitamin D should be supplied to women with deficient level vitamin D.
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Affiliation(s)
- Jing Zhao
- Reproductive Medicine Center, Xiangya Hospital, Central South University, 87 Xiang Ya Road, Changsha, Hunan, 410008, People's Republic of China
| | - Xi Huang
- Reproductive Medicine Center, Xiangya Hospital, Central South University, 87 Xiang Ya Road, Changsha, Hunan, 410008, People's Republic of China
| | - Bin Xu
- Reproductive Medicine Center, Xiangya Hospital, Central South University, 87 Xiang Ya Road, Changsha, Hunan, 410008, People's Republic of China
| | - Yi Yan
- Reproductive Medicine Center, Xiangya Hospital, Central South University, 87 Xiang Ya Road, Changsha, Hunan, 410008, People's Republic of China
| | - Qiong Zhang
- Reproductive Medicine Center, Xiangya Hospital, Central South University, 87 Xiang Ya Road, Changsha, Hunan, 410008, People's Republic of China
| | - Yanping Li
- Reproductive Medicine Center, Xiangya Hospital, Central South University, 87 Xiang Ya Road, Changsha, Hunan, 410008, People's Republic of China.
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