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

Recurrent miscarriage (RM) remains unsolved in > 50% of patients and causes physical and psychological problems in women without specific risk factors for miscarriage. For a successful pregnancy, acceptance of the endometrium and invasion of trophoblast cells into the endometrium is necessary.

This study aimed to use computational analysis to identify key genes and related pathways in endometrial and trophoblast cells derived from RM samples.

In this bioinformatics study, we explored the differential expression of genes in endometrial and trophoblast cells by analyzing the GSE165004 and GSE76862 datasets, respectively with the limma package in R software. Subsequently, overlapped genes between 2 datasets were selected, gene ontology and Kyoto Encyclopedia of Genes and Genomes analyses were performed. The overlapped genes were integrated to construct a protein-protein interaction network and hub genes selection.

We observed 41 overlapped genes between endometrial and trophoblast cells, and future analysis was accomplished in overlapped and nonoverlapped genes. Kyoto Encyclopedia of Genes and Genomes analysis indicated that overlapped genes were significantly enriched in the complement and coagulation cascades, pluripotency of stem cells, and synthesis and degradation of ketone bodies. Gene ontology analysis suggested that the genes were enriched in the cell cycle, apoptosis, and cell division. The top 10 genes included: IRS1, FGF2, MAPK6, MAPK1, MAPK3, MAPK8, MAPK9, PLK1, PRKACA, and PRKCA were identified from the PPI network.

This study identified the key genes and potential molecular pathways underlying the development of RM. This could provide novel insights to determine the possible mechanisms and interventional strategies associated with miscarriage.

Immunotherapies targeting peripheral natural killer (pbNK) cells in unexplained recurrent miscarriage (uRM) remain controversial. We hypothesized that the change in pbNK cell count might be a result of innate immune responses rather than a cause. To explore whether the pbNK count is significantly different in women testing positive than those testing negative for commonly studied autoimmune markers. Peripheral blood samples were collected from 302 eligible patients with uRM for the antinuclear antibody (ANA) testing determined by the enzyme-linked immunosorbent assay (ELISA), anti-thyroid peroxidase antibody (TPO-Ab) testing and anti-thyroglobulin antibody (Tg-Ab) testing determined by the chemiluminescent immunoassay, and pbNK cell testing determined by flow cytometry. The patients were divided into two groups according to the pbNK normal range, and the comparative analysis entailed an examination of the prevalence rates of autoantibodies within the high pbNK group and the normal pbNK group, followed by a comprehensive investigation into the potential correlations between autoantibodies and pbNK cells. There was a positive association between TPO-Ab positivity and high pbNK cells (p=0.016, OR=5.097, 95% CI 1.356–19.159), while there was a negative association between ANA positivity and high pbNK cells (p=0.013, OR=0.293, 95% CI 0.111-0.773). TPO-Ab-positive patients had a higher pbNK cell count compared with TPO-Ab-negative patients, while ANA-positive patients had a lower pbNK cell count compared with ANA-negative patients. The change in pbNK cell count may be a consequence of immune responses, and there should be careful consideration in applying it as an immunotherapeutic index.

The purpose of the study was to determine the cut-off values for peripheral and uterine natural killer (pNK, uNK) cells in fertile controls and in women with recurrent implantation failure (RIF).

In this study, 50 women with RIF and 50 fertile controls were enrolled. Midluteal endometrial biopsy samples from both cases and controls were obtained for CD 56+ cell immunohistochemistry labeling to identify uNK cells. Peripheral venous blood was also taken during the biopsy to detect pNK cells in peripheral blood mononuclear cells using flow cytometry. Cut-off values were obtained from fertile controls. Using a non-parametric Mann-Whitney U-test, the medians of the data sets were compared.

The median values for uNK and pNK cell levels in the control group were 7% and 11.6%, respectively. The median value for uNK cells in RIF patients was 9%, which was higher than the one in controls but not statistically significant (pvalue of 0.689). The median pNK levels (11.6% vs. 12.4%) were comparable between the RIF group and the controls. Moreover, it was found that 68% of individuals had uNK cell counts below the reference value, while 32% had excessive levels exceeding 7%. Additionally, only 51.4% of the RIF group had increased pNK cells.

The pNK cell cut-off values need to be used with caution because there was no difference between fertile controls and RIF women. If immunotherapy is recommended for RIF women, uNK cell testing should be used as the preferred approach.

Recurrent miscarriage (RM) is a condition defined as having three or more consecutive pregnancy losses before the20 weeks of pregnancy. The present study was undertaken to investigate association of Interleukin-17A (IL-17A)rs2275913 polymorphism with RM. To this end, we searched the international databases (Web of Science, PubMed,Embase, and Scopus) and extracted studies investigating the association of IL-17A rs2275913 polymorphism withRM using the appropriate keywords. The collected data were analyzed with the random-effects model and STATA(version 14). A total of five studies met the eligibility criteria, and total sample size was 998 subjects. Mean ageof the cases and controls were 31.41 ± 4.16 and 30.56 ± 3.5 years, respectively. Our results disclosed a significantrelationship of the IL-17A rs2275913 AA genotype [odds ratio (OR)=1.68; 95% confidence interval (CI)=1.16-2.43; I2=19; P=0.294) with RM. There was no statistically significant correlation between IL-17A rs2275913 GGgenotype (OR=1.04; 95% CI=0.64-1.7; I2=59.5; P=0.042) and GA genotype (OR=0.85; 95% CI=0.65-1.12; I2=19.1;P=0.293) with RM. Our findings revealed that the IL-17A rs2275913 polymorphism is associated with RM, and theAA genotype of this polymorphism increased possibility of being involved in RM.

Recurrent pregnancy loss (RPL) or recurrent miscarriage is the failure of pregnancy before 20-24 weeks that influencesaround 2-5% of couples. Several genetic, immunological, environmental and physical factors may influenceRPL. Although various traditional methods have been used to treat post-implantation failures, identifying the mechanismsunderlying RPL may improve an effective treatment. Recent evidence suggested that gene expression alterationspresented essential roles in the occurrence of RPL. It has been found that long non-coding RNAs (lncRNAs) playfunctional roles in pregnancy pathologies, such as recurrent miscarriage. lncRNAs can function as dynamic scaffolds,modulate chromatin function, guide and bind to microRNAs (miRNAs) or transcription factors. lncRNAs, by targetingvarious miRNAs and mRNAs, play essential roles in the progression or suppression of RPL. Therefore, targetinglncRNAs and their downstream targets might be a suitable strategy for diagnosis and treatment of RPL. In this review,we summarized emerging roles of several lncRNAs in stimulation or suppression of RPL.

Recurrent pregnancy loss (RPL), as one of the most critical issues in reproductive health, is followed by emotional trauma, social problems, financial concerns, and disruption of marital relations. This study aimed to investigate sexual function in married women with a history of RPL.

This cross-sectional study was conducted on 130 women with a history of RPL who were referred to the recurrent miscarriage clinic of Avicenna Fertility Center in Tehran, Iran, from November 2018 to February 2019. Data were collected using the demographic characteristics form and the female sexual function index (FSFI). Statistical analysis was carried out using SPSS software, version 16. The Kruskal-Wallis and Mann-Whitney tests were used to determine the relationship between the sexual function of the women and their sociodemographic characteristics. The significance level was set at P<0.05.

The Mean±SD score of the female sexual function was 26.59±5.73, and 50% of the women had sexual dysfunction (score ≤28). Sexual desire was the most prevalent sexual disorder (72.3%), while vaginal lubrication had the lowest prevalence (5.4%). No relationship was found between the women’s sociodemographic characteristics and their sexual function (P<0.05). 

The results of this study confirm the need to provide sexual health-related counseling to women who suffer from RPL and refer them to fertility centers

If the pregnancy attempt fails, it may become a stressful event. Therefore, in many cases, problem solving can lead to greater satisfaction and cohesion of couples and prevent psychological and social harm to families. The aim of this study was to determine the significant difference in the expression of miR-146a miRNA in maternal blood between the control and observation groups and to determine whether the miRNA can be used as diagnostic biomarkers or not.

The present study is a basic and descriptive survey in terms of data analysis. The samples included pregnant women referred to Tabriz University of Jahad from September 2019 to February 2021. We used Exel, Spss v.21 and Roc software for data analysis. Data were prepared in Exel software with reference gene and by calculating CT. Were used in Roc software.

The results showed a difference between the control and observation groups. Early detection of recurrent miscarriage should be used in these mothers.

Through using diagnostic kits of the studied miRNAs, effective steps can be taken for early detection, prevention of abortion, and reducing the heavy psychological, economic, and social burden on families. Therefore, it is suggested that diagnostic kits be made for these biomarkers and used in infertility centers. Practical Implications. Among the practical implications of this study, we can mention the diagnosis and prevention of abortion, which can reduce the burden on families and society.

Much evidence suggests that increased uterine blood flow resistance (reduced uterine perfusion) raises the risk of Recurrent Miscarriage (RM). 

This study aimed at evaluating the efficacy of omega-3, -6, and -9 fatty acids, alone or in combination with aspirin, in reducing uterine blood flow resistance in women with a history of RM.

A total of 45 women with a history of two or more miscarriages and increased uterine artery blood flow resistance were included in this randomized clinical trial. They were randomly assigned to aspirin (80 mg/d) (group A, n=15), omega-3, -6, and -9 fatty acids (4800 mg/d) (group O, n=15), or combination therapy (group AO, n=15). The patients were visited after two months, and the uterine artery blood flow resistance was measured by Doppler sonography.

The Mean±SD age of participants was 32±3.5 years in group A, 32±3 years in group O, and 32.4±3 years in group AO. There was no significant difference between three groups in age (P=0.7), duration of marriage (P=0.55), duration of infertility (P=0.43) and number of previous miscarriages (P= 0.51). In all three groups, after two months of treatment, the average uterine artery blood flow resistance reduced considerably compared with the beginning of the trial (P=0.0001); however, there was no significant difference between the three groups (P=0.56). 

According to the study results, omega-3, -6, and -9 fatty acids can reduce uterine artery blood flow resistance and improve the uterine blood flow in women with RM, with equal efficacy to aspirin. Also, combination therapy offers no advantages over monotherapy.

Recurrent miscarriage is one of the most common problems during pregnancy and one of these factors that has been recently studied by researchers is vitamin D deficiency in pregnant women. Therefore, this study was performed to compare vitamin D levels in women with recurrent miscarriage and women with normal pregnancies. The present study is a descriptive-analytical and cross-sectional study conducted in 2020 on 120 pregnant women referred to infertility centers in Isfahan in two groups of women with at least one successful pregnancy and women with recurrent miscarriage. Vitamin D blood levels of women were extracted from the information in their file. Data were analyzedusing SPSS software. The mean concentration of vitamin D in the case group was 19.92±5.07 and in the control group was 23.33±4.20 showing a statistically significant difference between the two groups (P <0.05). Mean vitamin D was also significantly different between the two groups in terms of the number of previous children, number of pregnancies, abortion, and stillbirth (P <0.05). Serum vitamin D levels in women with recurrent miscarriage are lower than women with normal pregnancies. Therefore, low levels of vitamin D in the blood can be one of the causes of recurrent miscarriage in pregnant women.

Recurrent miscarriage (RM) is one of the major problems of public health globally. The thrombin-activatable fibrinolysis inhibitor (TAFI) gene is a plasma zymogen that regulates both fibrinolysis and inflammation. Genetic variants within TAFI gene are presumed to be associated with development of RM. This case-control study aimed to investigate the association of TAFI +505A>G polymorphism with RM in Iranian women referred to Meybod Genetic Center.

Fifty women with RM (at least 2 miscarriages) and 50 healthy women with no history of miscarriage or other fertility complications were participated in this study. The TAFI +505A>G polymorphism was genotyped by allele specific PCR (AS-PCR) assay.

The mean age of cases with RM and controls was 27.25 ± 4.31 and 28.42 ± 3.22 years, respectively. The frequency of GG genotype and G allele was 0.00% in patients and controls. There was no significant difference between RM cases and controls in terms of +505A>G genotypes and alleles.

This study results indicated that there was no significant relationship between the TAFI +505A>G polymorphism and RM risk in Iranian women. However, further rigorous, studies with a larger sample size and different ethnicity are necessary to confirm our findings.

Vascular endothelial growth factor A (VEGFA) plays a key role in angiogenesis during human placenta formation and its abnormal expressions have been reported in placental tissues of women with recurrent miscarriage (RM).

The aim of this study was to evaluate the correlation of polymorphism of VEGF1154 G/A gene in RM and In Vitro Fertilization (IVF) failures.

The peripheral blood samples of women with RM, IVF failures and healthy women with live born children, as control group were collected. DNA samples were isolated and VEGF 1154G/A polymorphism was evaluated by polymerase chain reaction and restriction fragment length polymorphism. Single nucleotide polymorphism scanning was done using MnII restriction enzymes for 1154 G/A.

The findings of this study showed that the VEGF 1154 A/A and VEGF 1154 G/A mutation frequencies in both RM and IVF failure groups were significantly higher than those in the control group (p=0.005). The homozygous AA mutant genotype frequency in the control group was 0, While in the RM and IVF failure groups it was 30% and 13.9%, respectively (p=0.005). Moreover, the heterozygous AG genotype frequencies were higher in the RM (66.7%) and IVF failure (77.8%) compared to those in the control group (58.3%).

It was concluded that VEGF 1154 A/A and VEGF 1154 G/A polymorphisms were associated with both RM and IVF failures. However, their relation with IVF failures was more common than RM in A/G genotype, while in A/A, the RM was higher than IVF failure.

Recurrent miscarriage is defined as two or more abortions happening consecutively within less than the twenty weeks of gestation or when the fetus’s weight is below 500 g. Numerous factors are involved in recurrent miscarriages, the most important of which are chromosomal abnormalities and females’ genetic clotting condition, thrombophilia, including Factor II, prothrombin, and mutation. The present study aimed at investigating the relationship between the couples’ chromosomal abnormalities and prothrombin mutation in women with recurrent miscarriages in the northwest of Iran.

In the present applied research, 100 couples referring for recurrent miscarriages were subjected to cytogenetic experiments via using the GTG banding. Deep vein thrombosis tests were also conducted on the women based on the restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR) method.

Ten out of 100 studied couples were diagnosed with chromosomal abnormalities. All these abnormalities were of structural type. Out of 100 women subjected to clotting factor II, only one heterozygous case was found while the remaining cases were healthy. The control group subjects (n=100) were also found healthy. No significant difference was evidenced between the control and patient groups.

Based on the results, 5% of the studied cases had structural chromosome abnormalities and this was in compliance with the results obtained in the prior research. As regards the prothrombin mutation, only one out of one hundred studied women was heterozygous whereas the remaining subjects were healthy; this is consistent with the results obtained in previous studies

Studies have shown that toll-like receptors (TLRs) play some important roles in reproductive processes such as ovulation, spermatogenesis, sperm capacitation, fertilization, and pregnancy to the best of our knowledge, no study has evaluated the expression and role of these molecules and their impairment in spermatozoa; accompanied by pregnancy complications such as recurrent spontaneous abortion (RSA). Therefore, this study investigates the alteration of toll-like receptor 2 (TLR2) and toll-like receptor 4 (TLR4) expression in spermatozoa in men whose spouse have unexplained RSA. Fifteen fertile couples and fifteen couples with unexplained recurrent spontaneous abortion (URSA) were included in this study. The level of TLR2 and TLR4 expression in untreated and lipopolysaccharide (LPS) or PAM3CYS in treated spermatozoa were examined by flow cytometry. The results showed reduced expression of TLR4 in untreated spermatozoa and decreased LPS or PAM3CYS levels in treated spermatozoa in the URSA group compared to the control group. No significant differences were found in TLR2 expression of untreated spermatozoa in RSA and control groups. After the treatment of spermatozoa with LPS, the TLR2 expression was decreased in both groups. After the treatment of spermatozoa with PAM3CYS, the level of TLR2 expression was significantly increased in the URSA group; while no significant differences were shown in the control group in comparison to untreated spermatozoa. We have concluded that decreased TLR4 expression and a differently increased TLR2 expression in response to ligand treatment in spermatozoa is associated with URSA.

The aim of this study was to evaluate the perception and experience of recurrent pregnancy loss through the perspective of women in the United Arab Emirates (UAE). This qualitative study was conducted in 2017 and 12 women with recurrent miscarriage were interviewed, using purposive sampling method, in the Medical and Health Clinic of the Department of Obstetrics and Gynecology under the supervision of the UAE Medical University. Transcribed interviews were analyzed using conventional content analysis. Data analysis led to the extraction of three main themes, including endless pregnancy, thirst for support and affirmation, and religious beliefs. Overall, the experience of recurrent miscarriage means endless pregnancy from Arab women’s perspective, which awakened a thirst for support and affirmation. In this regard, the utilization of religious beliefs greatly reduced their pain. Therefore, knowing the dangers and consequences of recurrent miscarriages in Arab women, adopting preventative measures, and improving the quality of care in these vulnerable women require special attention.