MyMedR

Displaying publications 21 - 26 of 26 in total

Abstract:

Sort:

Comparative analysis of IVF-ICSI outcomes between advanced and early stage of endometriosis stimulated with HMG

Arshad AH, Azrai Abu M, Ahmad MF, Abdul Karim AK

Med J Malaysia, 2022 Jan;77(1):1-5.
PMID: 35086987

INTRODUCTION: Endometriosis is a challenging disease to treat, and patients may eventually need in vitro fertilisation with Intracytoplasmic sperm injection (IVF/ICSI) to conceive after other modalities failed. There are inconsistent outcomes of IVF performance in patients with endometriosis especially with highly purified human menotropin gonadotrophin (hMG). This study was commenced to determine whether the use of hMG affects the IVF outcome in different stage of endometriosis.
MATERIALS AND METHODS: This is an observational study. Eighty-seven women who had endometriosis confirmed surgically and underwent IVF/ICSI treatment, stimulated with hMG alone were included. Based on the revised American Society for Reproductive Medicine (rASRM), the participants were classified as early endometriosis (I/II) (n=39) or advanced endometriosis (III/IV) (n=35). The main outcome measures used were clinical pregnancy rate.
RESULTS: Women with advanced endometriosis had a lower oocyte yield, less good quality day-3 embryos and lower clinical pregnancy rate compared with the mild endometriosis. However, higher fertilisation rate were recorded in advanced stage endometriosis compared to milder disease.
CONCLUSIONS: The rASRM classification of endometriosis is valuable in predicting IVF outcome as advanced endometriosis performs poorly compared to a milder disease. Highly purified hMG could be an alternative as an ovarian stimulation in endometriosis.
Fulltext Comparison of Treatment Outcomes among Sibling Oocytes Using Different Culture Systems-Conventional IVF versus INVOcell Device-And Evaluation of INVOcell User Satisfaction: The INVOcIVF Study

Yang Mohsin WS, Abdullah Chue NS, Abdul Hamid F, Abu MA, Othman S, Mat Jin N, et al.

Int J Environ Res Public Health, 2022 Sep 29;19(19).
PMID: 36231691 DOI: 10.3390/ijerph191912391

INVOcell is considered an alternative to conventional IVF proposed for intravaginal embryo culture; however, implementation is still low because evidence is scanty regarding its outcome and, most importantly, the device's user satisfaction. Thus, we aim to compare the embryo outcome of sibling oocytes following INVOcell culture with conventional IVF (cIVF) by assessing its clinical outcome (fertilization, blastulation rate, and good embryo quality) and the user satisfaction evaluation based on a local validation questionnaire. A prospective study was done at a university-setting hospital for 12 months (July 2021-2022). The oocytes collected were divided into INVOcell and cIVF groups equally. Inclusion criteria included <40 years old and body mass index (BMI) < 30 kg/m2. The pre- and post-satisfaction questionnaires were assessed. In total, 23 women were included following standard controlled ovarian stimulation (COS). The mean age was 32.9, and the mean BMI was 24.9 kg/m2. Most of them suffered from tubal factors. A total of 252 oocytes were collected and incubated accordingly (cIVF; 138, INVOcell; 114). The blastulation rate was superior in the INVOcell group (p = 0.16); otherwise, the fertilization rate and good embryo quality were not significantly different between both methods (p > 0.05). Overall, women were satisfied with the INVOcell device as they were adequately advised, follow-up was scheduled, and the lowest score was obtained for all side effects of the device. Although both methods produce similar fertilization rates and good-quality embryos, the blastulation rates were better in the INVOcell group. Functionally, it is a user-friendly device and tolerable. Therefore, INVOcell can be used as an alternative method for reproductive treatment in carefully selected patients without jeopardizing the IVF outcomes.
Fulltext Expression of HOXA10 Gene in Women with Endometriosis: A Systematic Review

Lazim N, Elias MH, Sutaji Z, Abdul Karim AK, Abu MA, Ugusman A, et al.

Int J Mol Sci, 2023 Aug 17;24(16).
PMID: 37629050 DOI: 10.3390/ijms241612869

The homeobox A10 (HOXA10) gene is known to be related to endometriosis; however, due to a lack of knowledge/evidence in the pathogenesis of endometriosis, the mechanisms that link HOXA10 to endometriosis still need to be clarified. This review addresses the difference in the expression of the HOXA10 gene in endometriotic women versus non-endometriotic women across populations by country and discusses its influences on women's fertility. An organized search of electronic databases was conducted in Scopus, ScienceDirect, PubMed, and Web of Science. The keywords used were (HOXA10 OR "homeobox A10" OR PL OR HOX1 OR HOX1H OR HOX1.8) AND ("gene expression") AND (endometriosis). The initial search resulted in 623 articles, 10 of which were included in this review. All ten papers included in this study were rated fair in terms of the quality of the studies conducted. The expression of the HOXA10 gene was found to be downregulated in most studies. However, one study provided evidence of the downregulation and upregulation of HOXA10 gene expression due to the localization of endometriotic lesions. Measuring the expression of the HOXA10 gene in women is clinically essential to predicting endometriosis, endometrial receptivity, and the development of pinopodes in the endometrium during the luteal phase.
Unexplained subfertility: active or conservative management?

Ahmad SM, Mat Jin N, Ahmad MF, Abdul Karim AK, Abu MA

Horm Mol Biol Clin Investig, 2023 Dec 01;44(4):379-384.
PMID: 38124670 DOI: 10.1515/hmbci-2022-0087

OBJECTIVES: Unexplained subfertility (UEI) describes a couple whose standard subfertility workout consider acceptable but unable to conceived.
METHODS: This retrospective study was conducted in the Advanced Reproductive Centre, UKM Hospital, Kuala Lumpur, from January 2016 to December 2019. The data of 268 UEI couples were obtained from the clinical database. Women aged 21-45 years old was included and further divided into four groups according to the female partner's age and subfertility duration: group A (age <35 years and subfertility <2 years), group B (age <35 years and subfertility >2 years), group C (age >35 years and subfertility <2 years), and group D (age >35 years and subfertility <2 years). All statistical analyses were performed using SPSS 22.0 for Windows.
RESULTS: A total of 255 cases were included in this study. The mean age of the women was 32.9 ± 4.04 years, and the mean subfertility duration was 5.04 ± 2.9 years. A total of 51 (20 %) cases underwent timed sexual intercourse, 147 (57.6 %) cases had intrauterine insemination (IUI), whereas 57 (22.4 %) cases opted for in vitro fertilization (IVF). A total of 204 cases underwent active management (IUI/IVF), which showed a significant difference (p<0.05). Out of eight clinical pregnancies, half of them were from group B.
CONCLUSIONS: Active management in younger women with a shorter subfertility duration revealed a better pregnancy outcome. Otherwise, individualized treatment should be considered in selecting a suitable treatment plan.
Infertility and cortisol: a systematic review

Karunyam BV, Abdul Karim AK, Naina Mohamed I, Ugusman A, Mohamed WMY, Faizal AM, et al.

Front Endocrinol (Lausanne), 2023;14:1147306.
PMID: 37455908 DOI: 10.3389/fendo.2023.1147306

INTRODUCTION: Stress and infertility form a complex relationship. In line with this, various stress-related biological markers have been investigated in infertility.
METHODS: This systematic review was performed using PRISMA guidelines (i) to report whether cortisol is highly present in infertile patients compared to fertile control; (ii) to report whether there is any significant difference in the cortisol level in infertile subjects that conceive and those that didn't at the end of assisted reproduction treatments. Original articles involving human (male and female) as subjects were extracted from four electronic databases, including the list of references from the published papers. Sixteen original full-length articles involving male (4), female (11), and both genders (1) were included.
RESULTS: Findings from studies that compared the cortisol level between infertile and fertile subjects indicate that (i) Male: three studies reported elevated cortisol level in infertile patients and one found no significant difference; (ii) Female: four studies reported increased cortisol level in infertile subjects and three studies found no significant difference. Findings from studies that measured the cortisol level from infertile patients that conceived and those that didn't indicate that (i) Male: one study reported no significant difference; (ii) Female: one study reported elevated cortisol in infertile patients that conceived, whereas two studies reported increased cortisol in infertile patients that was unable to conceive. Five studies found no significant difference between the groups.
DISCUSSION: In the present review we only included the cortisol value that was measured prior to stimulation or IVF treatment or during natural or spontaneous cycles, despite this, there are still variations in the sampling period, assessment techniques and patients' characteristics. Hence, at present, we are still unable to conclude that cortisol is significantly elevated in infertile patients. We warrant future studies to standardize the time of biological sample collection and other limitations that were addressed in the review to negate the unwanted influencing factors.
The spectrum of in vitro maturation in clinical practice: the current insight

Ahmad MF, Elias MH, Mat Jin N, Abu MA, Syafruddin SE, Zainuddin AA, et al.

Front Endocrinol (Lausanne), 2023;14:1192180.
PMID: 37455921 DOI: 10.3389/fendo.2023.1192180

In vitro oocyte maturation (IVM) has been used worldwide. Despite the long-term implementation, the uptake of this procedure to complement current in vitro fertilization (IVF) remains low. The main reason is likely due to the non-synchronization of protocol and definition criteria, leading to difficulty in collective proper outcome data worldwide and, thus, lack of understanding of the exact IVM procedure. The review aims to consolidate the current clinical practice of IVM by dissecting relevant publications to be tailored for a current spectrum of clinical practice. Nevertheless, the background theories of oocyte maturation were also explored to provide a comprehensive understanding of the basis of IVM theories. Additional discussion of other potential uses of IVM in the future, such as in ovarian tissue cryopreservation known as OTO-IVM for fertility preservation and among women with diminished ovarian reserve, was also explored. Otherwise, future collaboration among all IVM centers is paramount for better collection of clinical data to provide valid recommendations for IVM in clinical practice, especially in molecular integrity and possible DNA alteration if present for IVM offspring outcome safety purposes.