Is hyperemesis gravidarum associated with transient hyperthyroidism? A systematic review and meta-analysis

Emerging evidence suggests an association of hyperemesis gravidarum (HG) with transient hyperthyroidism and high HCG levels. For synthesizing the current evidence to determine the association between HG with hormones related to thyroid function, a comprehensive systematic search was performed in the electronic databases comprised Medline, Web of Science, Scopus, Embase, ProQuest, and Cochrane Library up to December 2021. All published observational studies that evaluated the association of hyperemesis gravidarum with transient hyperthyroidism were investigated considering the PICO method. The standardized Joanna Briggs Institute Meta-Analysis of Statistics, Assessment, and Review Instrument were applied to appraise the included studies. Twenty-nine studies consisted of 6525 women included in the systematic review. Among them, 28 studies with 2446 participants were included in the meta-analysis. There were significant associations of HG with fT3 (MD: 1.31 pg/mL, 95% CI: 0.61 to 2.01), fT4 (MD: 1.95 ng/dL, 95% CI: 1.17 to 2.73), TSH (MD: -1.22μIU/mL, 95% CI: -1.75 to -0.68), TT4 (MD: 0.56 nmol/L, 95% CI:-0.43 to 1.24), and HCG (MD: 1.90IU/L, 95% CI: 0.497 to 3.301). In conclusion, the serum levels of fT3, fT4, and TT4 increased but TSH decreased significantly in women with compared without HG, indicating the significant association of HG with GTT.

Protective Effect of Hydroalcoholic Extract of Orange Peel on PCNA and FSH-R Gene Expression in Histological Damage and Oxidative Stress Due to Ovarian Torsion in Adult Rats

Objectives: The aim of this study was to evaluate the protective effect of the hydroalcoholic extract of orange peel on proliferating cell nuclear antigen (PCNA) and follicle-stimulating hormone receptor (FSH-R) gene expression in histological injuries and acid stress caused by ovarian torsion in adult rats. Materials and Methods: In this experimental study, 32 adult female rats were randomly divided into 4 groups. In group 1 (Sham), the abdominal wall was cut without applying torsion and in group 2, ovarian torsion was performed for 2 hours, followed by detorsion for 2 weeks. The hydro-alcoholic extract of orange peel was added to their diet for two weeks in group 3, followed by ovarian torsion for 2 hours and detorsion for 2 hours. Group 4 received the orange peel extract for two weeks and after then ovarian resection for the evaluation of histological damage and blood sampling to examine the serum level of antioxidant enzymes, as well as the expression of PCNA and FSH-R genes in the ovarian tissue. Results: Histological changes in the ovary tissue of rats showed that torsion and detorsion have destructive effects on the ovarian tissue, and torsion/detorsion led to a reduction in the expression of PCNA and FSH-R (P < 0.05). Based on biochemical and hormonal results, the ovarian torsion resulted in an imbalance in the oxidative stress markers and hormone profile of rats. Finally, the administration of the hydroalcoholic extract of orange peel due to its high antioxidant properties improves these effects. Conclusions: In general, administering an appropriate dose of the hydroalcoholic extract of orange peel for two consecutive weeks in the diet had a protective effect on the ovarian tissue at the risk of torsion/detorsion.

The effect of clomiphene citrate, herbal mixture, and herbal mixture along with clomiphene citrate on clinical and para-clinical parameters in infertile women with polycystic ovary syndrome: a randomized controlled clinical trial

INTRODUCTION

To evaluate the effect of a herbal mixture (i.e., Mentha spicata, Zingiber officinale, Cinnamomum zeylanicum, and Citrus sinensis) alone and in combination with clomiphene citrate (CC) compared to CC on the treatment of polycystic ovary syndrome (PCOS).

MATERIAL AND METHODS

This single-blind randomized clinical trial was conducted on 60 infertile participants with PCOS who were randomly divided into three groups. After spontaneous or progestin-induced withdrawal bleeding, group 1 (n = 20) received routine treatment with CC (50-150 mg) for three menstrual cycles from the 3^rd to 5^th day of menstruation for 5 days while group 2 (n = 20) and group 3 (n = 20) received herbal mixture capsules 700 mg/day and the herbal mixture along with CC for 3 months, respectively. Finally, several related parameters were measured, including the level of sex steroids, homeostatic model assessment for insulin resistance (HOMA-IR), lipid profile (primary outcomes), thyroid hormones, and clinical features. The analysis was based on intention-to-treat analysis.

RESULTS

No statistically significant differences were observed between the groups in terms of socio-demographic characteristics. However, after adjustment for baseline, luteinizing hormone (aMD = 4.9; 95% CI: 3.7-6.2), luteinizing hormone/follicle-stimulating hormone (aMD = 0.9; 95% CI: 0.7-1.2), total testosterone (aMD = -0.12; 95% CI: -0.2 to -0.01) in group 2 and free testosterone (aMD = -6.0; 95% CI: -9.7 to -2.3) in group 3 revealed a significant difference compared to group 1. In addition, HOMA-IR in group 2 (aMD = -1.3; 95% CI: -2.4 to -0.2) decreased significantly compared to group 1. Further, total cholesterol, triglycerides, low-density lipoprotein cholesterol, and very low-density lipoprotein cholesterol decreased significantly in group 2 (aMD = -21.8; 95% CI: -31.5 to -12.1; aMD = -29.9; 95% CI: -47.9 to -12.0; aMD = -21.2; 95% CI: -31.3 to -11.1; aMD = -5.1; 95% CI: -7.5 to -2.7) and group 3 (aMD = -18.3; 95% CI: -27.4 to -9.2; aMD = -26.9; 95% CI: -43.8 to -9.9; aMD = -21.4; 95% CI: -31.1 to -11.7; aMD = -5.9; 95% CI: -8.3 to -3.6) compared to group 1, respectively. However, high-density lipoproteins cholesterol in group 2 (aMD = 6.8; 95% CI: 2.9-10.7) and group 3 (aMD = 10.7; 95% CI: 7.2-14.7) increased remarkably compared to group 1. Overall, clinical outcomes improved significantly in all groups (p < 0.05).

CONCLUSIONS

In general, the herbal mixture along with CC was found to improve free testosterone, HOMA-IR, lipid profile, and clinical features of PCOS women.

The Effect of Herbal Medicine Supplementation on Clinical and Para-clinical Outcomes in Women With PCOS: A Systematic Review and Meta-analysis

Objectives: The aim of this study is to assess the impact of Cinnamomum verum, Mentha spicata, Zingiberene officinal on polycystic ovary syndrome (PCOS) treatment. Materials and Methods: MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, Scopus, Web of Science, Google Scholar, ProQuest, Clinicaltrial.gov, and for Persian articles SID, Magiran, Irandoc, and Iranmedex were searched without any time limitation. Results: Thirteen randomized controlled trials (RCTs) consisting 668 women were entered in the meta-analysis. Significant differences in fasting blood sugar (FBS; weighted mean difference (WMD)=-3.69 mg/dL, 95% CI: -6.67 to -0.7, P=0.02; 241 participants), fasting insulin (WMD=-4.53 µIU/mL, 95% CI: -6.45 to -2.61, P<0.001;183 participants), triglyceride (TG; WMD=-17.97 mg/ dL, 95% CI: -30.51 to -5.43, P=0.005;183 participants), total cholesterol (TC; WMD=-14.60 mg/dL, 95% CI: -22.93 to -6.26, P=0.0006; 183 participants), low-density lipoprotein cholesterol (LDL; WMD=-16.58 mg/dL, 95% CI -23.91 to -9.24, P<0.001; 183 participants), malondialdehyde (MDA; WMD=-0.25 nmol/ml, 95% CI -0.41 to -0.09, P<0.002;124 participants), total testosterone (TT; WMD=-0.18 ng/mL, 95% CI -0.27 to -0.09, P<0.001; 116 participants), free testosterone (FT; WMD=-5.47 pg/mL, 95% CI -8.34 to -2.61, P=0.0002;78 participants) were obtained by using cinnamon alone and herbal mixture containing cinnamon in comparison to control. Conclusions: This meta-analysis showed that cinnamon alone and herbal mixture containing cinnamon improve level of FBS, fasting insulin, TG, TC, LDL, MDA, TT, and FT serum level.

Effects of Matricaria chamomilla Extract on Growth and Maturation of Isolated Mouse Ovarian Follicles in a Three-dimensional Culture System

BACKGROUND

The aim of this study was to design and assess the effects of hydroalcoholic extract of Matricaria chamomilla (MC) on preantral follicle culture of mouse ovaries in a three-dimensional culture system.

METHODS

Isolated preantral follicles were randomly divided into three main groups: the control group containing 10% fetal bovine serum without MC extract (G1), the first experimental group supplemented with 25 μg/ml hydroalcoholic extract of chamomile (G2), and the second experimental group supplemented with 50 μg/ml hydroalcoholic extract of chamomile (G3).

RESULTS

After 12 days of culture, the survival rate (P < 0.05), antrum formation (P < 0.01), metaphase two oocytes (P < 0.01), and the expression of PCNA (P < 0.05) and FSHR (P < 0.05) genes significantly decreased in G3 as compared with G1. On the other hand, at the last day of culture (day 12), the mean diameter of follicles cultured in the medium which was supplemented with 50 μg/ml hydroalcoholic extract of chamomile significantly decreased as compared with the G1 (P < 0.05). In addition, the levels of progesterone and dehydroepiandrosterone hormones significantly increased in the medium of G3 relative to G1 (P < 0.01), while in the medium of G1, the level of 17β-estradiol was significantly higher than that of other groups (P < 0.01). Reactive oxygen species levels of metaphase II oocytes were significantly decreased in G2 as compared with G1 (P < 0.01).

CONCLUSION

Adding chamomile extract to culture media appeared to decrease follicular function and development.

Effect of non-ionizing electromagnetic field on the alteration of ovarian follicles in rats

Introduction

In recent years, there has been an increase in the attention paid to safety effects, environmental and society’s health, extremely low frequency electromagnetic fields (ELF-EMF), and radio frequency electromagnetic fields (RF-EMF). The aim of this research was to determine the effect of EMF on the alteration of ovarian follicles.

Methods

In this experimental study at Tabriz Medical University in 2015, we did EMF exposures and assessed the alteration of rats’ ovarian follicles. Thirty three-month old rats were selected randomly from laboratory animals, and, after their ages and weights were determined, they were divided randomly into three groups. The control group consisted of 10 rats without any treatment, and they were kept in normal conditions. The second group of rats was influenced by a magnetic field of 50 Hz for eight weeks (three weeks intrauterine and five weeks ectopic). The third group of rats was influenced by a magnetic field of 50 Hz for 13 weeks (three weeks intrauterine and ten weeks ectopic). Samples were fixed in 10% buffered formaldehyde and cleared with Xylol and embedded in paraffin. After sectioning and staining, samples were studied by optic microscopy. Finally, SPSS version 17, were used for data analysis.

Results

EMF radiation increased the harmful effects on the formation of ovarian follicles and oocytes implantation. Studies on the effects of electromagnetic fields on ovarian follicles have shown that the nuclei of the oocytes become smaller and change shape. There were significant, harmful changes in the groups affected by electromagnetic waves. Atresia of ovarian follicles was significantly significant in both study groups compared to the control group (p < 0.05).

Conclusion

Exposure to electromagnetic fields during embryonic development can cause morphological changes in oocytes and affect the differentiation of oocytes and folliculogenesis, resulting in decreased ovarian reserve leading to infertility or reduced fertility.

The anti-oxidant effects of ginger and cinnamon on spermatogenesis dys-function of diabetes rats

BACKGROUND

Diabetes rats have been linked to reproductive dysfunction and plant medicine has been shown to be effective in its treatment. Antioxidants have distinctive effects on spermatogenesis, sperm biology and oxidative stress, and changes in anti-oxidant capacity are considered to be involved in the pathogenesis of chronic diabetes mellitus. Ginger and cinnamon are strong anti-oxidants and have been shown to reduce oxidative stress in the long-term treatment of streptozotocin (STZ)-induced diabetes in animal models. The present study examined the influence of combined ginger and cinnamon on spermatogenesis in STZ-induced diabetes in male Wistar rats.

MATERIALS AND METHODS

Animals (n = 80) were allocated randomly into eight groups, 10 each: Group 1: Control rats given only 5cc Normal saline (0.9% NaCl) daily;Group2: rats received ginger (100mg/kg/rat) daily; Group 3: rats received cinnamon (75mg/kg) daily; Group 4: rats received ginger and cinnamon, (100mg/kg/rat ginger and 75mg/kg cinnamon) daily; Group 5: Diabetic control rats received only normal saline. Group 6: Diabetic rats received 100mg/kg/day ginger; Group 7: Diabetic rats received 75mg /kg/ day cinnamon; Group 8: Diabetic rats received ginger and cinnamon (100mg/kg/day and 75mg/kg /day). Diabetes was induced with 55 mg/kg, single intra-peritoneal injection of STZ in all groups. At the end of the experiment (56th day), blood samples were taken for determination of testosterone, LH,FSH, total anti-oxidant capacity, and levels of malondialdehyde, SOD, Catalase and GPX. All rats were euthanized, testes were dissected out and spermatozoa were collected from the epididymis for analysis.

RESULTS

Sperm numbers, percentages of sperm viability and motility, and total serum testosterone increased in ginger and cinnamon and combined ginger and cinnamon treated diabetic rats compared with control groups. Serum testosterone, LH and FSH were higher compared to control group and also serum anti-oxidants (TAC, SOD, GPX and catalase) all were increased at the end of treatment. Combined ginger and cinnamon showed more intense increase in all parameters compare to ginger and cinnamon alone. Most of the results were significant (P<0.05).

CONCLUSION

We concluded that combined ginger and cinnamon have significant beneficial effects on the sperm viability, motility, and serum total testosterone, LH,FSH and serum anti-oxidants' level and could be effective for maintaining healthy sperm parameters and male reproductive function in diabetics.

Effect of rosmarinic acid on sertoli cells apoptosis and serum antioxidant levels in rats after exposure to electromagnetic fields

Rosmarinic acid belongs to the group of polyphenols; it has antioxidant, anti-inflammatory and antimicrobial activities and help to prevent cell damage caused by free radicals. The objective was to study the effect of Rosmarinic acid on sertolli cells apoptosis and serum antioxidant levels in rats after they were exposed to electromagnetic fields. Male Wistar rats (n=40) were allocated into three groups: control group (n=10) that received 5 cc normal saline (0.9% NaCl) daily by gavage method, Rosmarinic acid group that received 5mg/rat (gavage) (n=10), electromagnetic fields (EMF) group that had exposure with 50 hz (n=20) which was subdivided to two groups of 10; EMF group and treatment group. Treatment group received 5mg/rat (gavage) Rosmarinic acid daily for 6 weeks, respectively. However, the control group just received an equal volume of distilled water daily (gavage). On the 42nd day of research, 5 cc blood was collected to measure testosterone hormones, total antioxidant capacity (TAC), levels from whole group's analysis. Level of malondialdehyde (MDA) levels and sertoli cells apoptosis significantly decreased in the group that received 5mg/rat of Rosmarinic acid (P<0.05) in comparison with experimental groups. Level of testosterone, total antioxidant capacity (TAC), significantly increased in groups that received Rosmarinic acid (P<0.05). Since in our study 5mg/rat of Rosmarinic acid showed significantly preventive effect on cell damages especial sertoli cells apoptosis that caused with EMF, it seems that using Rosmarinic acid as food additive can be effective for supporting people living under EMF environmental pollution.