• Title/Summary/Keyword: unexplained infertility

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Cardiovascular risk may be increased in women with unexplained infertility

  • Verit, Fatma Ferda;Zeyrek, Fadile Yildiz;Zebitay, Ali Galip;Akyol, Hurkan
    • Clinical and Experimental Reproductive Medicine
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    • v.44 no.1
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    • pp.28-32
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    • 2017
  • Objective: Growing evidence suggests that increased cardiovascular disease (CVD) risk is associated with female infertility caused by conditions such as polycystic ovarian disease, obesity, thyroid dysfunction, and endometriosis. The aim of this study was to evaluate whether any relationship exists between CVD and unexplained infertility. Methods: Sixty-five women with unexplained infertility and 65 fertile controls were enrolled in the study. CVD risk markers such as low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), triglycerides (TG), insulin resistance (defined by the homeostasis model assessment ratio), and high-sensitivity C-reactive protein (hs-CRP) were assessed. Results: TG, TC, LDL, and hs-CRP levels were higher and HDL levels were lower in patients with unexplained infertility than in fertile controls (p<0.05 for all). Positive associations were found between unexplained infertility and TG, TC, LDL, and hs-CRP levels, and a negative correlation was found for HDL (p<0.05 for all). Multivariate logistic regression analysis showed that TG, HDL, and hs-CRP were independent variables associated with unexplained infertility. Conclusion: Our study showed that women with unexplained infertility had an atherogenic lipid profile and elevated hs-CRP levels, suggesting a higher risk of developing CVD in the future. Further studies with larger groups are needed to investigate the nature of this link.

Sperm chromatin structure assay results in Nigerian men with unexplained infertility

  • Faduola, Paul;Kolade, Charles Oluwabukunmi
    • Clinical and Experimental Reproductive Medicine
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    • v.42 no.3
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    • pp.101-105
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    • 2015
  • Objective: Several publications have established a relationship between sperm DNA damage and male factor infertility, based on data from America, Europe, and Asia. This study aimed to compare the extent of sperm DNA damage in sperm samples from Nigerian men with unexplained infertility and in sperm samples from a fertile group composed of sperm donors who had successfully impregnated a female partner naturally or through assisted conception. Methods: A total of 404 men underwent male fertility evaluation at Androcare Laboratories and Cryobank participated in this study. Semen analysis and a sperm chromatin structure assay (SCSA) were performed on all subjects. Results: The men in the unexplained infertility group were slightly older than the men in the fertile sperm group ($36{\pm}10$ years vs. $32{\pm}6$ years, p=0.051). No significant difference was observed between the two groups in semen analysis parameters ($p{\geq}0.05$). Men in the unexplained infertility group with normal semen parameters had a significantly higher DNA fragmentation index (DFI) than men in the fertile sperm group ($27.5%{\pm}7.0%$ vs. $14.1%{\pm}5.3%$, p<0.05). In the unexplained infertility group, 63% of the men had a DFI greater than 20%, compared to 4% in the fertile sperm group. In the unexplained infertility group, 15.2% of the subjects had a DFI greater than 30%, compared to 1% in the fertile sperm group. Conclusion: Our study showed that the SCSA may be a more reliable predictor of fertility potential than traditional semen analysis in cases of unexplained infertility.

The impact of an Unani Formulation in unexplained Secondary Infertility: A Case Report

  • Siddiqui, Sumaiya Mohammed Sabir;Shameem, Ismath
    • CELLMED
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    • v.12 no.3
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    • pp.12.1-12.6
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    • 2022
  • With a prevalence incidence of 8 % to 37%, unexplained infertility (Uqr) is by definition empiric because it does not address a particular defect or functional deficits. Couples with unexplained infertility have a higher than zero chance of becoming pregnant without treatment, but it is less likely than couples who are fertile. The ingredients in the Unani formulation, are baikh asgand (Withania somnifera Dunal), baikh piyabansa (Barleria prionitis Linn), gule dhawa (Anogeissus latifolia), and gule nilofar (Nymphaea alba Linn), were used to treat unexplained secondary infertility, possess the characteristics of muqawwi bah (Aphrodisiac), muqawwi Rahim (Uterotonic), muwallid-i-mani (ovulation-inducing), and mughalliz-i-mani (an agent which increases the viscosity of semen) beginning from the fifth day of the last menstrual cycle for five days with milk. The first cycle of treatment led to the conception of the women.

Factors affecting the Pregnancy Rate of Intra-Uterine Inseminations in Unexplained Infertile Couples in Korea: Focusing on Treatment Type for Inducing Ovulation (자궁내 인공수정 시술을 받은 원인불명 난임진단 여성의 임신성공 영향 요인: 배란유도 유형을 중심으로)

  • Jang, In Sun;Hwang, Na Mi;Park, Seungmi
    • Journal of Korean Biological Nursing Science
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    • v.17 no.2
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    • pp.211-217
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    • 2015
  • Purpose: The purpose of this study is to identify factors influencing the pregnancy rate among unexplained infertile couples who received treatments of assisted reproductive technology (ART) and intra-uterine inseminations (IUI). Methods: The medical records of 24,201 cases of unexplained infertility among a total of 31,684 intrauterine insemination treatment cases, (which benefited by 'National Medical-aid Program for ART in 2011') were used for this analysis. Results: Woman's age (OR=0.94), frequency of IUI (OR=0.86), and treatment type (OR=1.54) were significant factors on pregnancy rates in the logistic regression analysis. Conclusion: Factors, such as the age of the infertile woman, frequency of IUI, and treatment type used to induce ovulation were shown to positively influence pregnancy rate. However, the age of the spouse was not a significant variable. Infertile couples having unprotected sexual intercourse with unexplained infertility had priority. The results demonstrated that about 70% of infertile Korean couples had unexplained infertility. This was a higher rate of unexplained infertility than that of the clinical standard. Therefore, we should assess for causes through future studies. In addition, affective or emotional factors influencing unexplained infertility need to be researched further.

The Efficacy on the Immunotherapy with Patient Lymphocytes in Unexplained Infertility (원인불명의 불임환자에서 림파구 정맥주입에 의한 면역 치료의 효능에 관한 연구)

  • Jung, Byeong-Jun;Lee, Sang-Hoon;Hur, Min
    • Clinical and Experimental Reproductive Medicine
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    • v.24 no.3
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    • pp.293-300
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    • 1997
  • The aim of present study was to determine the efficacy of immunotherapy with paternal lymphocytes for unexplained infertility. It has been apparent that reproductive success may be affected by the presence of abnormal autoantibodies. Unexplained infertility and repeated pregnancy wastage has been reported in the presence of abnormal autoantibodies. These data suffest that abnormal immune function may be an important pathologic entity contributing subfertility in patients with unexplained infertility. Therefore, immunotherapy may be a possible treatment modality for patients with unexplained infertility. Some investigators have reported that a proportion of infertile couples with repeatedly unsuccessful ET showed close histocompatibility similar to those of spontaneous recurrent abortion. Recently, it has been noted that immunotherapy with paternal lymphocytes achieves a high efficacy in preventing subsequent abortion in women with primary recurrent abortion of unknown cause, which was mediated by immune reaction including blocking antibody. To substantiate the hypothesis, we applied immunotherapy preceding Peritoneal Oocyte and Sperme transfer (POST) to 43 patients, 47 cycles of 82 patients, 89 cycles with at least three previous IUI failure from April, 1993 to February, 1995. There were no significant differences between treatment and control group in clinical response and hormonal response to controlled hyperstimulation. there was no significant difference between treatment and control group in pregnant rates per cycles (42.6% versus 28.6%), but a significantly lower abortion rate per pregnancy in treatment group, with 10.0% (2/20) compared with 50.03% (6/12) in control group. This study may suggest that immune therapy for patients with unexplained infertility with paternal lymphocytes might be beneficial.

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A Case Report of Unexplained Secondary Infertility (원인불명으로 진단받은 속발성 불임환자 1례의 임상보고)

  • Jeong, A-Rong;Kim, Kyeong-Hye;Kim, Hyun-Jin;Jung, Eun-A
    • The Journal of Korean Obstetrics and Gynecology
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    • v.20 no.4
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    • pp.234-243
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    • 2007
  • Purpose: The purpose of this paper is to report the effect of oriental medicine to unexplained secondary infertility. Methods: The patient was 40 years-old female whose case was diagnosed as unexplained secondary infertility. On purpose to pregnant, she had being treated with IVF(in vitro fertilization) and oriental medicine at once. But she had failed IVF in twice, who was treated with oriental medicine only constantly. Results: On course of failing IVF again, the patient was treated with Oriental medicine constantly. After she had stopped IVF who was treated only oriental medicine. And she became pregnant. Conclusion: According to this result, we concluded that oriental medicine could improve fertility rate. After this paper, futher study and clinical approach based on oriental medicine will be needed about unexplained infertility.

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Sperm DNA fragmentation negatively influences the cumulative live birth rate in the intracytoplasmic sperm injection cycles of couples with unexplained infertility

  • Repalle, Deepthi;Saritha, Kallimakula Venkata Reddy;Bhandari, Shilpa
    • Clinical and Experimental Reproductive Medicine
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    • v.49 no.3
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    • pp.185-195
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    • 2022
  • Objective: This study aimed to determine the effect of sperm DNA fragmentation (SDF) on the cumulative live birth rate (CLBR) in intracytoplasmic sperm injection (ICSI) cycles in couples with unexplained infertility. Methods: We conducted a prospective study of 145 couples who underwent ICSI cycles for unexplained infertility. Based on the SDF rate, patients were categorized into a low SDF group (SDF ≤30%, n=97) and a high SDF group (SDF >30%, n=48). SDF was assessed using the acridine orange test on density gradient centrifugation prepared samples. The CLBR was calculated as the first live birth event per woman per egg collection over 2 years. Results: The high SDF group (SDF >30%) showed a significantly lower CLBR (p<0.05) and a significantly higher miscarriage rate (p<0.05) than the low SDF group (SDF ≤30%). No significant difference was observed in the implantation and cumulative pregnancy rates between the two SDF groups. The total number of embryo transfers was stratified further into fresh and frozen embryo transfers. In the fresh embryo transfers, there were significant differences in the implantation rates, clinical pregnancy rates, and live birth rates (p<0.05) between the low SDF and high SDF groups. However, in the frozen embryo transfers, there were no significant differences in clinical outcomes between the two groups. In the multivariable logistic regression analysis, SDF was a predictor of CLBR (p<0.05) when adjusted for possible confounding factors. Conclusion: High SDF was associated with a lower CLBR and a higher miscarriage rate in the ICSI cycles of couples with unexplained infertility.

Stimulated intrauterine insemination in women with unilateral tubal occlusion

  • Yi, Gwang;Jee, Byung Chul;Suh, Chang Suk;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.39 no.2
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    • pp.68-72
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    • 2012
  • Objective: To investigate the value of stimulated intrauterine insemination (IUI) in women with unilateral tubal occlusion. Methods: Superovulation and IUI was performed during 2003-2010 and the medical records were reviewed retrospectively. Thirty-seven infertile women (52 cycles) with unilateral tubal occlusion diagnosed by hysterosalpingography and without other causes of infertility were selected. One-hundred fourteen patients with unexplained infertility served as a control group (182 cycles). The main outcome was the clinical pregnancy rate per cycle. Results: The pregnancy rate per cycle was similar, 17.3% for the unilateral tubal occlusion group and 16.5% for the unexplained infertility group. The rate of miscarriage (11.1% vs. 23.3%) and ectopic pregnancy (11.1% vs. 6.7%) was similar between the two groups. The pregnancy rate was higher in patients with proximal occlusion (25.0%) compared with distal occlusion (13.9%) or unexplained infertility, but not statistically significant. Conclusion: Stimulated IUI can be suggested as the initial treatment option in women with unilateral proximal or distal tubal occlusion.

3 Cases of Infertility Patients based on Shanghanlun Six Differential Diagnostic System (『상한론(傷寒論)』 변병진단체계(辨病診斷體系)에 근거한 불임 환자 3례의 임상 보고)

  • Yun, Su-Min
    • 대한상한금궤의학회지
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    • v.6 no.1
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    • pp.37-54
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    • 2014
  • Objective : The purpose of this paper is to report the effect of three different herb medication based on Shanghanlun(傷寒論) six differential diagnostic system. Methods : According to six differential diagnostic system based on Shanghanlun provisions, they were diagnosed with Taiyang-byung(大陽病), Yangmyung-byung(陽明病), Gwoleum-byung(厥陰病). They took different herb medications more than 6weeks according to their diagnosis. This paper evaluated the results of treatment by pregnancy test result with improvement of symptoms. Results : The symptoms of three patients were improved and became pregnant. Conclusions : This case study suggests that herb medication based on Shanghanlun(傷寒論) six differential diagnostic system have effectiveness on unexplained infertility. And we need to have a diversified and new perspectives in women's position about pregnancy with this system.

Predictive value of sperm motility characteristics assessed by computer-assisted sperm analysis in intrauterine insemination with superovulation in couples with unexplained infertility

  • Youn, Joung-Sub;Cha, Sun-Hwa;Park, Chan-Woo;Yang, Kwang-Moon;Kim, Jin-Yeong;Koong, Mi-Kyoung;Kang, Inn-Soo;Song, In-Ok;Han, Sang-Chul
    • Clinical and Experimental Reproductive Medicine
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    • v.38 no.1
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    • pp.47-52
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    • 2011
  • Objective: To determine whether characteristics of sperm motility obtained by computer-assisted sperm analysis (CASA) could predict pregnancy after intrauterine insemination (IUI) in couples with unexplained infertility. Methods: Three hundred eighty-three cycles of intrauterine insemination with superovulation were retrospectively analyzed. Semen analysis was performed with CASA before and after swim-up and the parameters were compared between pregnant and non-pregnant women. Results: The pregnancy rate per cycle was 14.1%. Pregnant and non-pregnant women were comparable in terms of age, infertility duration, the number of dominant follicles. While sperm concentration, motility, and parameters such as average path velocity (VAP) and percentage rapid (RAPID) before semen preparation were significantly different between the pregnancy and non-pregnancy groups, there were no differences in sperm parameters when comparing the two groups after preparation. Using a receiver operating characteristic curve to measure sensitivity and specificity, the optimal threshold value for the predictors of pregnancy was revealed to be a concentration of ${\geq}111{\times}10^6/mL$, a motility of ${\geq}$ 51.4%, and RAPID ${\geq}$ 30.1% before preparation for IUI. Conclusion: Sperm parameters including concentration, motility, and RAPID before sperm preparation could have predictive value for pregnancy outcome after intrauterine insemination with superovulation in couples with unexplained infertility, and would be helpful when counseling patients before they make the decision to proceed with IVF/ICSI-ET.