Astaxanthin ameliorates inflammation, oxidative stress, and reproductive outcomes in endometriosis patients undergoing assisted reproduction: A randomized, triple-blind placebo-controlled clinical trial

PurposeIn a randomized, triple-blind, placebo-controlled clinical trial (RCT) including 50 infertile women with endometriosis candidate for assisted reproductive techniques (ART), we studied the effect of Astaxanthin (AST) on pro-inflammatory cytokines, oxidative stress (OS) markers, and early pregnancy outcomes.MethodsBefore and after 12 weeks of AST treatment (6 mg per day), blood serum and follicular fluid (FF) samples were collected from 50 infertile women with endometriosis stage III/IV undergoing ART. Pro-inflammatory cytokines (IL-1β, IL-6, and TNF-α) and OS markers (malondialdehyde [MDA], superoxide dismutase [SOD], catalase [CAT], and total antioxidant capacity [TAC]) were measured in the serum and FF. ART outcomes were also compared between the groups.ResultsIncreased serum levels of TAC (398.661 ± 57.686 vs. 364.746 ± 51.569; P = 0.004) and SOD (13.458 ± 7.276 vs. 9.040 ± 5.155; P = 0.010) were observed after AST therapy in the treatment group. Furthermore, serum MDA (14.619 ± 2.505 vs. 15.939 ± 1.512; P = 0.031) decreased significantly following antioxidant treatment. In addition, significantly lower serum levels of IL-1β (4.515 ± 0.907 vs. 6.8760 ± 0.8478; P = 0.000), IL-6 (5.516 ± 0.646 vs. 5.0543 ± 0.709; P = 0.024) and TNF-α (2.520 ± 0.525 vs. 2.968 ± 0.548; P = 0.038) were observed after AST treatment. In addition, AST supplementation led to an improved number of oocytes retrieved (14.60 ± 7.79 vs. 9.84 ± 6.44; P = 0.043), number of mature (MII) oocytes (10.48 ± 6.665 vs. 6.72 ± 4.3; P = 0.041), and high-quality embryos (4.52 ± 2.41 vs. 2.72 ± 2.40; P = 0.024).ConclusionAST pretreatment can modulate inflammation and OS in endometriosis-induced infertile patients. ART outcomes also improved after 12 weeks of AST therapy. Our results suggest that AST can be a potential therapeutic target for infertile patients with endometriosis undergoing ART

Circulating and Endometrial Profiles of miR-145, miR-155-5p, miR-224, MPP-5, and PECAM-1 Expression in Patients with Repeated Implantation Failure: A Case Control Study

Objective: An association between microRNAs (miRNAs) and adhesion proteins expression with repeated implantationfailure (RIF) has been recently reported; however, these findings are controversial. This study aims to evaluatethe endometrial and circulating expressions of miR-145, miR-155-5p, and miR-224 in addition to the endometrialexpressions of membrane protein palmitoylated-5 (MPP-5) and endothelial cell adhesion molecule-1 (PECAM-1) inpatients with RIF compared to control subjects.Materials and Methods: This case-control study was carried out between June 2021-July 2022. Subjects included 17patients with RIF and 17 control subjects, who had previous spontaneous term pregnancy with a live birth, who referredto the Medical Centre of Arash Hospital, Tehran, Iran. Endometrial tissue samples were obtained via hysteroscopyand Pipelle catheter in the RIF and control subjects, respectively. Plasma samples were collected after ovulationin all subjects. The expression levels of MPP5, PECAM-1, miR-224, miR-145, and miR-155-5p were evaluated byquantitative real-time polymerase chain reaction (qRT-PCR). The student’s t test, chi-square, Mann-Whitney U, andanalysis of covariance (ANCOVA) were used for data analyses.Results: RIF patients had less endometrial miR-155-5p expression, and higher endometrial and circulating expressions ofmiR-145 and miR-224 compared to control subjects. Endometrial PECAM-1 and MPP5 expression significantly decreased inpatients with RIF compared to the control group. There was a positive correlation between circulating miR-224 and endometrialmiR-155-5p, and between circulating miR-155-5p and endometrial PECAM-1 expression levels in patients with RIF.Conclusion: The present study suggests that circulating miR-224, endometrial miR-145, and PECAM-1 can bereliable, novel biomarkers for diagnosis of RIF

Comparison of Serum Uric Acid, Iron and Total Iron Binding Capacity (TIBC) Levels in Pre-eclamptic and Normal Pregnant Women

Objective: The objective of our study was to compare uric acid, iron and TIBC levels in normal and preeclamptic pregnant women and determine their relations with maternal and fetal complications. Materials and methods: A case control study was conducted in 200 normal and preeclamptic pregnant women. At 32-40 weeks of pregnancy (third trimester) a blood test was taken in order to measure the uric acid, iron and TIBC and their relation with maternal and fetal complications. Results: Uric acid level showed significant difference (4.58 ± 0.73, 4.87 ± 0.58, p=0.002) between  two groups of pre-eclamptic and normal women.  The iron and TIBC level had no significant difference in either group. The uric acid level and iron had significant differences between two groups with and without maternal complication, respectively (4.69 ± 0.66, 5.05 ± 0.59, p<0.05) (387.42 ± 82,  405.24 ± 57, p<0.05). There was not any difference in three parameters between groups with and without fetal complication. The BMI was significantly higher in preeclamptic group and has positive relation with uric acid level. If we consider 29 as BMI cut-off point; it will be associated with 73% sensitivity and 67% specificity in preeclampsia determination. Using 4.55 as uric acid cut-off point, the sensitivity is 76% and specificity is 49%. Conclusion: Although the higher level of uric acid, higher BMI scale and positive roll-over test are associated with preeclampsia, but they are not very strong predictors as single test