جستجوی مقالات مرتبط با کلیدواژه « Recurrent abortion » در نشریات گروه « پزشکی »

 One of the reproductive medicine challenges is to determine the role of hyperhomocysteinemia in the pathogenesis of polycystic ovary syndrome (PCOS), especially in women with recurrent pregnancy loss (RPL).

 Determine the correlation between hyperhomocysteinemia and pregnancy outcome in women with PCOS.

 This case-control study involved 245 women (20-30 yr) and was conducted in Georgia, Tbilisi from 2019-2022. Of these, 175 were women with PCOS (study group) and 70 were healthy women (control group). Women with PCOS were divided into- group I with RPL (n = 90), and group II with live births (n = 85). Group I was divided into subgroups A and B with and without insulin resistance. The investigation measured homocysteine (Hcy), follicle-stimulating, luteinizing, anti-Mullerian hormones, total and free testosterone were determined. To determine the ovarian volume and antral follicle count, participants also underwent an ultrasound examination.

 In women with PCOS, the average Hcy level was significantly higher than in the controls, p < 0.05. In group I, the average Hcy level was significantly higher than in group II and controls, p < 0.05. There was no significant difference in average Hcy level between group II and controls. The average Hcy level in group I, subgroup A was significantly higher than in subgroup B, p < 0.05. The average total, free testosterone levels, and homeostatic model assessment-insulin resistance levels (HOMA-IR) in group I was significantly higher than in group II and controls. HOMA-IR in group II and controls did not differ significantly. The average anti-Mullerian hormone levels in women with PCOS were significantly higher than controls, p < 0.05. No significant difference was observed in average anti-Mullerian hormone level, ovarian volume, antral follicle count, and body mass index between the comparison groups of PCOS. In group I, a positive correlation between Hcy with HOMA-IR was detected.

 Serum Hcy levels are elevated in women with PCOS and RPL, which correlates with their insulin resistance status.

Despite of long-lasting efforts, in more than 50% of cases, the etiology of recurrent spontaneous abortion (RSA) remains unknown. Leukemia inhibitory factor (LIF) has an essential role in the reproductive process, such as modulating inflammatory responses. This study aimed to evaluate the relationship between the LIF gene expression as well as serum levels of inflammatory cytokines and occurrence of RSA in infertile women with a history of RSA. In this case-control study, the relative gene expression levels of LIF, concentrations of tumor necrosis factor-alpha (TNF-α), and interleukin (IL)-17 were measured in peripheral blood and serum of women with a history of RSA (N=40) compared with non-pregnant and fertile women as the control group (N=40) using quantitative real-time polymerase chain reaction and the enzyme-linked immunosorbent assay, respectively. The mean age of patients and controls was 30.1 ± 4.28 and 30.03 ± 4.23, respectively. Patients had a history of at least 2 and at most 6 abortions. The mRNA levels of LIF were significantly lower in the women with RSA in comparison with the healthy participant (P=0.003). Regarding cytokine levels, no significant difference was seen between the two groups (P≥0.05). There was no correlation - between the LIF mRNA levels and TNF-α and IL-17 serum concentrations. The U-Mann-Whitney test and the Pearson correlation coefficient were applied to comparison variables between groups as well as a correlation between LIF mRNA and cytokine levels in serum. Despite a significant reduction in the LIF gene mRNA level in patients with RSA, it was not associated with increases in inflammatory cytokines. Dysfunction in the production of LIF protein may be involved in the onset of RSA disorder.

Abortion is the most common complication in the first trimester of pregnancy. Infections are reported as the etiology of abortions. Some species of Mycoplasmas are seen in the lower genital tract. The aim of this study was to investigate the frequency and the molecular identity of Mycoplasma species in women with a history of idiopathic recurrent abortion.

This study was carried out on 68 women with a history of recurrent abortion. Detecting 16S rRNA to identify the infection of Mycoplasma was done by polymerase chain reaction (PCR) on cervical samples. Furthermore, the sequencing of positive samples was performed to identify the species of Mycoplasma.

The results showed that only one woman with history of three times abortions was infected by Mycoplasma. Her gestational age was six weeks and she had apparent signs of infection. After sequencing, Mycoplasma genitalium was diagnosed as the infectious agent. The prevalence rate of Mycoplasma was 1.47% and 0% in the case and control groups, respectively. There was no significant association betweenabortion and Mycoplasma infection.

It seems more studies are necessary to evaluate the relationship between Mycoplasma infection and abortion. Moreover the increase in the level of public health due to better education and the improvement of contraceptive methods compared to the past has created a significant reduction in Mycoplasma infection.

 Recurrent abortion is a worldwide issue. Anticardiolipin antibodies (ACA) are found to be among the most important factors related to recurrent spontaneous early pregnancy loss. This study aimed to investigate the prevalence of anticardiolipin IgM and IgG antibodies in women with recurrent abortion in Kurdistan Region of Iraq. The present study was conducted in Duhok and Zakho cities for the period from April 2014 to May 2019. A total of 1230 women aged between 18 to 46-year-old were included in this study. ELISA was used for the detection of anticardiolipin antibodies. Among the studied subjects, the prevalence of anticardiolipin antibodies was 74 (6.02%) for ACA IgM and 56 (4.6%) for ACA IgG. It was also observed that 16 (1.3%) subjects were positive for both ACA IgM and IgG antibodies. Additionally, the highest anticardiolipin antibody positivity rates were recorded in patients older than 30-year-old (P<0.01). The IgM ACA positivity was higher in Zakho city 45 (7.2%) when compared to Duhok city 29 (4.6%) (P<0.04). In conclusion, anticardiolipin antibodies can have a positive association among women with recurrent abortion. Therefore, it is suggested that women with recurrent abortion should be screened for anticardiolipin antibodies; this could increase fetal survival by initiating early anticoagulant therapy when other causes of abortion are excluded.

The acetylcholine receptor (AChR) is a member of the superfamily of transmitter-gated ion channels having a critical role in controlling electrical signals between nerves and muscle cells. Disruptive mutations in genes encoding different subunits of AChR result in multiple pterygium syndrome (MPS), which can be associated with a severe prenatally lethal presentation. This study aimed to investigate the etiology of lethal MPS (LMPS) in two consanguineous families with a history of miscarriages. DNA was extracted from a tissue sample of two aborted fetuses (probands) from two different families with a history of spontaneous miscarriages. Parental peripheral blood samples were collected for confirmatory analysis and follow-up testing. Whole-exome sequencing (WES) was performed on DNA from the probands. The results were confirmed and segregated by Sanger sequencing. Moreover, protein structure evaluations were accomplished. We identified a homozygous frameshift mutation of c.753_754delCT (p.V253fs*44) and a homozygous missense mutation of c.715C>T (p.Arg239Cys) in the CHRNG gene. Both aborted fetuses had pterygium, severe arthrogryposis, and fetal hydrops with cystic hygroma, being compatible with LMPS. The heterozygous state was confirmed in parents for both CHRNG variants. Likewise, CHRNG mutation was predicted to display the damaging effects by lowering the number of helixes and modifying the surface electrostatic potential. The present study identified rare sequence variants in the CHRNG gene in aborted fetuses from consanguineous couples with recurrent miscarriage history. WES is a comprehensive and cost-effective approach to study heterogeneous diseases including MPS. Such findings can improve our knowledge of MPS databases, particularly for genetic counseling of high-risk families and preimplantation genetic diagnosis.

Uterine septum is one of the most common congenital abnormalities in women that leads to numerous gynecological problems and adverse obstetrics outcomes. This study aimed to evaluate the effects of Hysteroscopic Resection on pregnancy outcomes in women undergone the surgery.

In this quasi-experimental study, 90 women were included from April 2016 to June 2018 from patients attending to Rasoul Akram hospital of Tehran. The inclusion criteria included: the age lower than 35 years old, primary infertility, idiopathic recurrent spontaneous abortion, BMI between 19 and 30, and having informed consen. Septum was resected by scissor upward and lateral. After 10 months of follow-up in average, we assessed rate of live births, abortions, birth weight and presentation.

82 individuals were assessed for occurrence of conception (response rate=91%). The mean age of patients was 30.01 ± 6.76 years and the mean BMI was 26.25 ± 4.88. Out of 82 patients, 36 patients were pregnant, of whom 16 (44.4%) had abortions. 5 (14.9%) of the pregnancies ended with preterm birth, and 6 (17%) ended with stillbirth.

The present study showed that the infertile patients with uterine septum and with no other causes of infertility were more likely to be pregnant compared to other patients with idiopathic infertility. Our study showed that post-operation fertility following Hysteroscopic Resection was lower than that in previous reports. According to the findings of this study, scissors may be safe, effective and cost-effective method for removing uterine septa.

Cytomegalovirus (CMV) is a species of Herpesviridae showing no clinical symptoms in the earlier stage of infection in pregnant women. Nevertheless, it can be transmitted to the baby through saliva, body fluids, blood and cervical secretions. The aim of this study is a systematic review of the effects of CMV on abortion. Data were collected from Web of Science (ISI), PubMed, Scopus, Ovid, and EMBASE databases published by May 2018. The keywords used included abortion, current abortion, B19, Cytomegalovirus, spontaneous abortion, and placenta. The National Institutes of Health's Quality Assessment Tool was used for quality assessment. Fifteen papers from 1993 to 2018 were reviewed 11 of which were descriptive-analytic and the remaining 6 were case-control. In the case-control studies, the control group consisted of healthy pregnant women with no history of abortion. The case group comprised women who had experienced abortion and recurrent abortion. The maximum sample size included 779 and the minimum included 17 cases of abortion. The highest incidence of CMV infection in abortion was 100% reported by Saraswathy and 97% in the study of Tarokhian. The lowest was observed by Oliveira with 0.04% and by Kakru with 16%.The results of most studies indicate that CMV infection can lead to abortion by transfer through body fluids activation of the uterine inflammatory response and immune response, as well as transfer into embryonic tissues.

Due to the paucity of studies, association between the morphology and function of sperm and recurrent miscarriage (RM) is not yet completely known. Increased reactive oxygen species and decreased antioxidant levels in men have been shown to be associated with RM. Recently it has been accepted that antioxidant therapy can approve sperm parameters. The goal of this study was to evaluate the effect of paternal factor and antioxidant therapy on sperm parameters in the couples with RM.
Sixty ejaculate samples with RM patients were analyzed before and after 3 months of vitamin E and selenium therapy. Sperm chromatin assay was assessed by cytochemical tests including aniline blue, chromomycin A3, and toluidine blue. To measure DNA fragmentation index, terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) test was used. Data were analyzed by SPSS software.
Patients had significantly higher percentage of sperm parameters (p Our study demonstrates that antioxidants can improve sperm parameters and chromatin condensation in recurrent miscarriage male partner.

Recurrent spontaneous abortion has high incidence rate. The etiology is unknown in 30-40%. However high uterine artery resistance is accounted as one of the recurrent abortion reasons.

The objective of the current study was to determine the impacts of vitamin E and aspirin on the uterine artery blood flow in women having recurrent abortions due to impaired uterine blood flow.

This randomized clinical trial was conducted on 99 women having uterine pulsatility index (PI) more than 2.5 and the history of more than two times abortions. The candidates were categorized into three groups; receiving aspirin, only vitamin E, and aspirin븫媚 E. After 2 months, uterine PIs were compared with each other.

All drug regimens caused an enhancement in uterine perfusion with a significant decline in uterine artery PI value. The women receiving vitamin E in accompanied with aspirin had the least mean PI of the uterine artery (p

Vitamin E, aspirin and especially their combination are effective in improving uterine artery blood flow in women with recurrent abortion due to impaired uterine blood flow. More well-designed studies are needed to find out whether the enhancement of uterine perfusion may lead to a better pregnancy outcome.

Spontaneous abortion is considered as the most complex problem during pregnancy. Thrombophilia is resumed as a cause of recurrent pregnancy loss (RPL). Glycoprotein IIIa (GPIIIa) gene is involved in thrombosis and abortion. Angiotensin converting enzyme (ACE) converts angiotensin I to angiotensin II and is involved in thrombosis. The most common polymorphism in this gene is the insertion/deletion (I/D).

In this study, we analyzed the association between ACE I/D and GPIIIa c.98C >T polymorphisms in women with unexplained RPL from the north of Iran.

Sample population consisted of 100 women with unexplained RPL and 100 controls. The ACE I/D and GPIIIa c.98C>T polymorphisms were genotyped by TETRA-ARMS PCR. The association between genotypes frequency and RPL were analyzed using χ2 and exact fisher tests. Associated risk with double genotype combinations was also investigated by binary logistic regression.

There was significant association between ACE DD genotype and RPL (OR=2.04; 95% CI=0.94-4.44; p=0.036). ACE D Allele was also significantly associated with the RPL (OR=1.59; 95% CI=1.05-2.41; p=0.013). No significant association was observed between GPIIIa c.98C>T polymorphism and RPL.

ACE I/D polymorphism may probably be a prognostic factor in female family members of women with the history of recurrent abortion.

Miscarriage is one of the most common pregnancy complications for which various causes have been defined, such as genetic factors, infectious, metabolic, endocrine systemmal function and immune system undesired responses. The early development of embryo occurs in oviduct and uterine tube from which some factors such as growth factors, glyco-proteins and factors those stimulate development of embryo are secreted. The ETF3 embryotrophic factor which is a complex of C3 complements and its derivatives i.e., iC3b, enhances the development of trophectodermas a consequence of which expression of relevant genes are affected embryo. There are various response elements in C3 gene promoter region such as, estrogen response regions (ERE). Steroids such as estrogen and progesterone are secreted in early steps of embryonic period along with C3 secretion and cause increase in C3 expression through interaction with regulatory elements in promoter region of this gene. In this study the polymorphism in ERE regions of C3 gene promoter was investigated in women suffering from recurrent miscarriage.
In this study, assuming that polymorphism in ERE regions is correlated with recurrent miscarriage during early months of pregnancy, 40 blood samples were collected from female patients admitted to an Infertility Clinic, Isfahan, Iran. DNA was extracted, amplification of regions harboring ERE with a pair of specific primer was done using Polymerase Chain Reaction-Single Strand Chain Polymorphism (PCR-SSCP) for studying possible polymorphisms in this region.
Results and The results indicated a specific symptomless infertility among the women, however there was no correlation between the ERE polymorphism and symptoms in control and cases.

Recurrent pregnancy loss (RPL) has been defined as two or more miscarriages before 20th week of gestation. It seems that IL-27 may reduce inflammatory responses and affect the survival of the embryo during human pregnancy. IL-27 polymorphisms may influence RPL by altering the levels or the activity of gene product.

We studied for the first time the association of IL-27 -964 A>G single nucleotide polymorphism (SNP) with RPL in Iranian women.

A case-controlled study was performed on two groups consisting of 150 healthy women with at least one delivery (control group) and 150 women with two or more primary RPLs history (RPL group). The -964 A>G SNP in IL-27 gene was determined by PCR-RFLP technique. Genotype and allele frequencies were compared using c2 tests between two groups.

There was no difference between the two groups regarding age of women (29±4.4 [control] vs. 30.84±5.2 years [case]). In the RPL group, the genotype frequencies of -964 A>G polymorphism were AG (49.3%), AA (40%), and GG (10.7%), and in the control group, they were AG (43.3%), AA (48.7%), and GG (8%). There was no significant difference between the genotypes of AA, AG, and GG in two groups (p=0.23). As the frequency of allele A was 64.7% in the RPL group and 70.3% in the control group, the difference in frequency of allele A in -964 A>G between two groups was not significant (p=0.19).

Our findings indicate that SNP of -964 A>G in IL-27 gene is not a risk factor for RPL in Iranian women.

Most maternal cardiac disease in Western societies is now congenital in origin. This relates to the significant improvements in congenital cardiac surgery during the last years. Some patients will present for the first time in pregnancy with symptoms and learn that they have congenital heart disease. So all patients should have a detailed evaluation and appropriate counseling before pregnancy. Ebstein anomaly is a rare and complex congenital heart disorder occurring in 1 per 200 000 live births and, first described by a German physician Wilhelm Ebstein in 1866 in a report titled, “Concerning a very rare case of insufficiency of the tricuspid valve caused by a congenital malformation. This anomaly accounts for 0.5%–0.7% of cases of congenital heart disease. The average life duration of patients with Ebstein’s anomaly is 25–30 years. The malformation consists of apical displacement of the tricuspid valve with resultant regurgitation and enlargement of the right heart chambers, resulting in arrhythmias and heart failure. The common cardiac anomalies associated with the condition are atrial septal defect (ASD) in 90% of patients, anatomic or functional tricuspid atresia in 30%, Wolff-Parkinson-White (WPW) syndrome in 15% and less commonly ventricular septal defect (VSD), pulmonic stenosis or atresia and mitral valve prolapse. Survival into adulthood is common and patients present with cyanosis, dyspnea and palpitations.