The World Health Organization defines obesity as an abnormal or excessive accumulation of fat that is harmful to health. Obesity and overweight have a negative effect not only on general health, but also on reproductive health. Obesity is associated with reduced fertility, more frequent pregnancy losses and other pregnancy complications. Due to an obesity pandemic, an increasing proportion of women seeking medical help for infertility will be overweight or obese. Obesity is involved in the pathogenesis of polycystic ovary syndrome (PCOS), approximately 40-70% of PCOS patients are overweight or obese. The risk of miscarriage is increased in obese women who become pregnant after in vitro fertilisation, regardless of whether their own oocytes or donated oocytes are used. In men, the link between obesity and reduced fertility is less well-studied than in women. Mechanisms by which obesity may affect spermatogenesis include thermal effects, hyperestrogenism, hypogonadotropic hypogonadism, diabetes mellitus, sexual dysfunction, and sperm epigenetic disorders. Obesity in both women and men negatively affects the results of assisted reproduction. Overweight or obese women should be informed about the overall health and obstetric risks and about the lower success rate of infertility treatment with assisted reproduction methods.

• Klíčová slova
• In vitro fertilization, Polycystic ovary syndrome, assisted reproduction, in vitro fertilization, infertility, obesity, overweight,
• MeSH
• lidé MeSH
• nadváha komplikace   MeSH
• obezita komplikace   MeSH
• rozmnožování MeSH
• sperma MeSH
• syndrom polycystických ovarií * komplikace   MeSH
• těhotenství MeSH
• ženská infertilita * etiologie   terapie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Polycystic ovary syndrome (PCOS) is a heterogeneous disorder, where the main clinical features include menstrual irregularities, sub-fertility, hyperandrogenism, and hirsutism. The prevalence of PCOS depends on ethnicity, environmental and genetic factors, as well as the criteria used to define it. On the other hand, metabolic syndrome is a constellation of metabolic disorders which include mainly abdominal obesity, insulin resistance, impaired glucose metabolism, hypertension and dyslipidaemia. These associated disorders directly increase the risk of Type 2 diabetes mellitus (DMT2), coronary heart disease (CHD), cardiovascular diseases (CVD) and endometrial cancer. Many patients with PCOS have features of metabolic syndrome such as visceral obesity, hyperinsulinaemia and insulin resistance. These place patients with PCOS under high risk of developing cardiovascular disease (CVD), Type 2 diabetes (DMT2) and gynecological cancer, in particular, endometrial cancer. Metabolic syndrome is also increased in infertile women with PCOS. The aim of this review is to provide clear and up to date information about PCOS and its relationship with metabolic syndrome, and the possible interaction between different metabolic disorders.

• Klíčová slova
• hypertension., insulin resistance, metabolic syndrome, polycystic ovary syndrome,
• MeSH
• diabetes mellitus 2. typu MeSH
• hyperandrogenismus MeSH
• infertilita MeSH
• inzulinová rezistence MeSH
• kardiovaskulární nemoci MeSH
• lidé MeSH
• metabolický syndrom epidemiologie   MeSH
• nádory ženských pohlavních orgánů MeSH
• rizikové faktory MeSH
• syndrom polycystických ovarií komplikace   epidemiologie   MeSH
• ženská infertilita MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

UNLABELLED: Polycystic ovary syndrome (PCOS) is a heterogeneous and complex endocrine disease which among the female population belongs to the most widespread endocrinopathies and it is the most frequent cause of hyperthyroidism, anticoagulation and infertility. Insulin resistance is one of the important diabetology factors impacting hyperglycaemia in a majority of women with PCOS (60-80 %). Clinical expressions of PCOS include reproduction disorders, metabolic characteristics and psychological implications. Reproduction disorders include hyperthyroidism, menstruation cycle disorders, infertility and pregnancy complications as well as early abortions, gestational diabetes and pregnancy induced hypertension. Long-term metabolic risks of PCOS include type 2 diabetes mellitus, dyslipidemia, arterial hypertension and endothelial dysfunction. The available data confirms higher incidence of cardiovascular diseases in women with PCOS. In particular among obese women PCOS is more frequently associated with non-alcoholic hepatic steatosis, sleep apnoea syndrome and endometrial cancer. The literature includes some controversial data about the relationship between PCOS and autoimmunity. Women with PCOS are more prone to suffer from insufficient confidence with higher incidence of anxiety, depression, bipolar disorder and eating disorders. KEY WORDS: autoimmunity - diabetes mellitus - pregnancy - insulin resistance - metabolic syndrome - menstrual disorders - polycystic ovary syndrome.

• MeSH
• autoimunita MeSH
• diabetes mellitus 2. typu komplikace   MeSH
• dyslipidemie komplikace   MeSH
• hyperglykemie komplikace   MeSH
• hypertyreóza komplikace   MeSH
• inzulinová rezistence MeSH
• kardiovaskulární nemoci komplikace   MeSH
• komplikace těhotenství etiologie   MeSH
• lidé MeSH
• menstruační poruchy komplikace   MeSH
• obezita komplikace   MeSH
• syndrom polycystických ovarií komplikace   imunologie   MeSH
• těhotenství MeSH
• ženská infertilita komplikace   MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

AMH levels are commonly measured in fertility clinics to assess ovarian reserve and give an indication of female fertility potential. AMH levels are useful in deciding on stimulation protocols for IVF cycles. High AMH levels are useful to confirm a diagnosis of polycystic ovaries. AMH is useful to predict ovarian response to stimulation. Currently AMH levels can not be used to predict a couples ability to conceive naturally.

• Klíčová slova
• AMH, fertility., ovarian reserve, ovarian stimulation,
• MeSH
• antimülleriánský hormon krev   MeSH
• dospělí MeSH
• fertilizace in vitro metody   MeSH
• indukce ovulace metody   MeSH
• lidé MeSH
• ovariální rezerva fyziologie   MeSH
• syndrom polycystických ovarií krev   diagnóza   MeSH
• výsledek terapie MeSH
• ženská infertilita krev   diagnóza   terapie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antimülleriánský hormon MeSH

The frequency of functionally relevant mutations of the leukaemia inhibitory factor (LIF) gene in infertile women is significantly enhanced in comparison with fertile controls. The objective of this retrospective cohort study was to evaluate the impact of LIF gene mutations on the outcome of the treatment in women with various causes of infertility. Fifteen infertile women with the G to A transition at position 3400 leading to the valine to methionine exchange at codon 64 were analysed. Group A was made up of women with diagnoses that are frequently accompanied by changes in humoral as well as cell-mediated immunity - idiopathic infertility and endometriosis (N = 7). Group B consisted of patients with polycystic ovary syndrome (PCOS), andrological factor, tubal factor and hyperprolactinaemia (N = 8). The control group comprised 136 infertile women with no LIF gene mutation diagnosed with idiopathic infertility and endometriosis (N = 37) (group C) and patients with PCOS, tubal and andrological factor (N = 99) (group D). Seven of the mutation-positive patients were successfully treated by in vitro fertilization (IVF), but nobody in this group was diagnosed with idiopathic infertility and only one with endometriosis, which means that there is a statistically significant difference in the pregnancy rates between groups A and B (P = 0.01, Fisher's 2 by 2 exact test) but no statistically significant difference when comparing patients with the LIF gene mutation (group A+B) to no LIF gene mutation (group C+D). The results suggest that in mutation-positive women the idiopathic infertility and endometriosis have a negative impact on the outcome of IVF treatment.

• MeSH
• dospělí MeSH
• endometrióza genetika   patofyziologie   MeSH
• fertilizace in vitro metody   MeSH
• kohortové studie MeSH
• leukemický inhibiční faktor genetika   fyziologie   MeSH
• lidé MeSH
• mutace MeSH
• mutační analýza DNA MeSH
• polymerázová řetězová reakce MeSH
• retrospektivní studie MeSH
• výsledek terapie MeSH
• ženská infertilita genetika   terapie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• leukemický inhibiční faktor MeSH

Ovarian follicle steroidogenesis associated with embryo quality results in a successful pregnancy. Each follicle consists of an oocyte surrounded by granulosa cells, which secrete several steroid and peptide hormones. Follicles harvested from women who conceived after assisted reproductive therapy (ART) had significantly higher estradiol levels in follicular fluids than the follicles from women who failed to conceive after ART. The higher follicular estradiol levels correlate well with successful fertilization following ART. Mitochondria are the central sites for steroid hormone biosynthesis. The first and rate-limiting step in the biosynthesis of steroid hormones occurs in the mitochondria of granulosa cells. In the present study, we hypothesized that the mitochondria in granulosa cells are critical for maintaining oocyte quality and fertility capacity. This study aims to clarify the relationship between mitochondrial function and granulosa cell steroidogenesis, and the relationship between hormone levels and fertility capacity. Sera, follicular fluids and granulosa cells were obtained from individuals undergoing IVF-ET treatment. The oocyte numbers, oocyte quality, fertilization rate, and pregnancy rate were also recorded. The patients who provided the granulosa cells were further classified into four groups: endometriosis, ovarian endometrioma, endometriosis without ovarian endometrioma, and polycystic ovary syndrome (PCOS); patients with other female factor infertility and male factor infertility were used as controls. We measured the levels of estradiol (E2) by radioimmunoassay. Concurrently, we analyzed the mitochondrial mass and membrane potential, and apoptosis by flow cytometry using nonyl acridine orange, TMRE, Annexin V-FITC and PI. Mitochondrial morphology was visualized by transfection with pLV-mitoDsRed. In addition, we assessed the protein levels of steroidogenic enzymes, steroidogenic acute regulatory protein (StAR) and 3β-hydroxysteroid dehydrogenase (3β-HSD) by Western blot. The results showed significantly decreased serum E2 and follicular E2 levels, and decreased IVF outcomes, in the patients with endometriosis. Reduced mitochondrial mass and decreased mitochondrial membrane potential were correlated with lower E2. Furthermore, a significant decrease in StAR and 3β-HSD was found in patients with ovarian endometrioma. The enzyme levels of StAR and 3β-HSD were highly correlated with E2 levels. Finally, elevated cumulus cell apoptosis was found in the patient group with ovarian endometrioma and PCOS. In conclusion, mitochondrial dysfunction of human granulosa cells may contribute to the decline of steroidogenesis, decreased fertilization rate, oocyte maturation rate, and oocyte quality, and it can ultimately jeopardize fertility.

• Klíčová slova
• 3β-HSD., StAR, estradiol, fertilization rate, granulosa cells, mitochondrial mass, progesterone, steroidogenesis,
• MeSH
• apoptóza MeSH
• biologické modely MeSH
• cysty patologie   MeSH
• dospělí MeSH
• endometrióza krev   komplikace   patologie   MeSH
• estradiol krev   MeSH
• fertilita * MeSH
• fertilizace in vitro MeSH
• folikulární buňky metabolismus   MeSH
• folikulární tekutina metabolismus   MeSH
• kumulární buňky metabolismus   MeSH
• lidé MeSH
• mitochondrie metabolismus   MeSH
• oocyty metabolismus   MeSH
• progesteron krev   MeSH
• steroidy biosyntéza   MeSH
• syndrom polycystických ovarií krev   komplikace   patologie   MeSH
• těhotenství MeSH
• výsledek těhotenství MeSH
• ženská infertilita krev   patologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• estradiol MeSH
• progesteron MeSH
• steroidy MeSH

BACKGROUND: The aim of the study was to determine the efficacy of in vitro fertilization and embryo transfer (IVF-ET) in patients with hyper-response to ovulation induction for intrauterine insemination (IUI). METHODS: Patients with polycystic ovary syndrome (PCOS) who were initially treated with IUI in our centre between Jan 2007 and Oct 2010 were retrospectively analyzed. The ovarian hyper-stimulation syndrome (OHSS) found in 50 patients was then treated with IVF-ET following informed consent. RESULTS: The fresh transfer had 42 cycles and a total of 87 embryos were transferred. Urine pregnancy tests were positive in 15 patients and fetal heart beat was detected in 12 patients by transvaginal ultrasound, from which 3 patients had two fetuses, 2 patients had three fetuses, and 7 patients had a single fetus. The overall clinical pregnancy rate was 28.5% (12/42) for the fresh embryo transfer. A total of 21 cycles of frozen embryo transfer with up to 55 embryos were conducted for patients who were not pregnant at the end of fresh embryo transfer cycles or who did not receive fresh embryo transfer in the first place. Urine pregnancy tests were positive in 10 patients and fetal heart beat was detected in 8 patients. The clinical pregnancy rate was 38.1% (8/21) for frozen embryo transfer. CONCLUSION: We conclude that IVF-ET is an effective method for patients with hyper-response to ovulation induction in IUI.

• MeSH
• dospělí MeSH
• fertilizace in vitro * MeSH
• indukce ovulace škodlivé účinky   MeSH
• lidé MeSH
• ovariální hyperstimulační syndrom etiologie   MeSH
• přenos embrya * MeSH
• těhotenství MeSH
• umělá inseminace * MeSH
• ženská infertilita terapie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

THE AIM: To study serum antibodies against annexin V and against other phospholipids in women with fertility failure. DESIGN: Prospective study. SETTING: Department of Gynecology and Obstetrics, Institute of Imunology and Alergology, Institute of Forensic Medicine, Charles University and Faculty Hospital, Pilsen, Czech Republic. PATIENTS AND METHODS: We investigated sera from a total of 1550 women aged 26-41 years who attended the Division for Infertility and Reproductive imunology, in the Department of Obstetrics and Gynecology, Charles University, and Faculty Hospital, Pilsen, Czech Republic. ELISA was used for detection of antibodies against annexin V, phosphatidic (ph)-acid, ph-ethanolamine, D-L glycerol, ph-inositol, L-serine, cardiolipine, beta-glycoprotein, and prothrombine), antibodies against zona pellucida by passive hemmagglutination. Antibodies against annexin V in ovulatory cervical mucus were studied only in 47, and in follicular fluid in 168 women. Eighty-four fertile healthy women were included in the control group. RESULTS: Antibodies against annexin V were found in 13% (in 170 infertile women). Anamnestic data showed two or more unexplained pregnancy losses in 48 (28.2%), 108 (63.5%) patients had two or more unsuccessfull in vitro fertilization, polycystic ovaries (PCO) was diagnosed in 3 (1.7%), and endometriosis in 11 (6.6%) of them. The increased levels of antibodies against ph-inositole (28.8%), and L-serine (19.4%) were detected. 353% of patients had positive levels against zona pellucida. In ovulatory cervical mucus only in six (6/47) antibodies against annexin V were detected, in 5.55% in follicular fluid (6/108). CONCLUSION: Our study also demonstrated serum positivity against annexin V as a significant risk factor mainly in patiens with repeated reproductive failure.

• MeSH
• annexin A5 analýza   imunologie   MeSH
• antifosfolipidové protilátky krev   MeSH
• autoprotilátky analýza   krev   MeSH
• cervikální hlen imunologie   MeSH
• dospělí MeSH
• habituální potrat imunologie   MeSH
• lidé MeSH
• těhotenství MeSH
• ženská infertilita etiologie   imunologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Názvy látek
• annexin A5 MeSH
• antifosfolipidové protilátky MeSH
• autoprotilátky MeSH

UNLABELLED: Anti-Müllerian hormone (AMH), insulin-like growth factor 1 (IGF1) and leptin are produced in the granulosa cells of follicles and play an important role in the growth and maturation of follicles. The aim of our study was to monitor AMH, IGF1 and leptin levels in a group of healthy women and compare them to a group of women with fertility disorders. The second aim was the evaluation of biomarker levels in relation to the identified cause of infertility. Totally, 146 females were enrolled into our study. Seventy-two healthy controls and seventy-four females with fertility disorders were divided into four subgroups: anovulation, endometriosis, fallopian tube damage, unknown reason. IGF1 was the only biomarker with significantly lower levels throughout the entire group with fertility disorders. We did not identify any statistically significant differences for AMH and leptin. Regarding subgroups, significant differences were only observed in the group of anovulatory women. AMH and leptin showed higher levels while IGF1 showed lower levels. In conclusion, levels of AMH, IGF1 and leptin found in follicular fluid are sensitive markers for anovulatory fertility disorders. AMH, IGF1 and leptin levels in follicular fluid have no relation to the fertility disorders caused by endometriosis, fallopian tube damage or disorders with unknown etiology. ABBREVIATIONS: AMH: anti-Müllerian hormone; IGF1: insulin-like growth factor 1; PCOS: polycystic ovary syndrome.

• Klíčová slova
• Follicular fluid, anti-Müllerian hormone, fertility disorders, insulin-like growth factor 1, leptin,
• MeSH
• anovulace metabolismus   MeSH
• antimülleriánský hormon metabolismus   MeSH
• biologické markery metabolismus   MeSH
• dospělí MeSH
• folikulární tekutina metabolismus   MeSH
• insulinu podobný růstový faktor I metabolismus   MeSH
• leptin metabolismus   MeSH
• lidé MeSH
• mladý dospělý MeSH
• studie případů a kontrol MeSH
• ženská infertilita etiologie   metabolismus   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• antimülleriánský hormon MeSH
• biologické markery MeSH
• IGF1 protein, human MeSH Prohlížeč
• insulinu podobný růstový faktor I MeSH
• leptin MeSH

Smooth endoplasmic reticulum aggregates (SERa) are a type of dysmorphism in oocytes derived from controlled ovarian stimulation (COS). The effect of SERa on assisted reproductive techniques (ART) outcomes is debatable. Based on some evidence, SERa-positive (SERa+) oocytes cause complications including newborn demise, and compromise the outcome of the unaffected oocytes of the same cycle. While other reports demonstrated equal developmental competence between SERa + and SERa-negative (SERa-) oocytes/cycles. We conducted a prospective cross-sectional study on 315 women candidates for ART and compared the outcome among SERa+ (N = 73) and SERa- cycles (N = 217). Furthermore, for the first time, we investigated the prevalence of SERa + cycles in women with various infertility etiologies. Our results indicated that SERa + patients presented higher levels of Estradiol on the day of ovulation triggering (p = 0.02). Regarding the ART outcome, there were no differences in the number of retrieved oocytes, oocyte maturation and fertilization rates among the groups. However, the quality of the unaffected oocytes (p = 0.03), the rates of day-3 top-quality embryos (p = 0.01, and p = 0.03 for grades A and B, respectively), and clinical pregnancy (p = 0.05) in SERa + group were significantly reduced. Moreover, the prevalence of SERa + cycles gradually increased among endometriosis, POI/POR, PCOS, normal women, tubal factor, and idiopathic groups. Our study suggests that suboptimal situations such as elevated levels of Estradiol can increase the occurrence of SERa + oocytes. This suboptimal phenomenon can negatively influence the outcome of the cycle. Thus, optimization of COS, particularly in vulnerable groups such as women with idiopathic infertility may lower the SERa + cycle occurrence, improving the ART outcome.

• Klíčová slova
• ART outcome., Assisted reproductive techniques, Infertility, Oocyte, Smooth endoplasmic reticulum aggregates,
• MeSH
• asistovaná reprodukce MeSH
• dospělí MeSH
• hladké endoplazmatické retikulum * metabolismus   patologie   MeSH
• indukce ovulace MeSH
• lidé MeSH
• oocyty * metabolismus   patologie   MeSH
• prospektivní studie MeSH
• průřezové studie MeSH
• těhotenství MeSH
• úhrn těhotenství na počet žen v reprodukčním věku MeSH
• ženská infertilita * etiologie   patologie   terapie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH