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Background: Women with diminished ovarian reserve (DOR) respond differently to gonadotropin medications., Objective: This study investigates the relationship between effective gene expression in the steroidogenesis pathway and gonadotropin responsiveness in DOR., Materials and Methods: In this case-control study , cumulus cells were obtained from women with DOR after gonadotropin administration (n = 20) and normal ovarian reserve (n = 20). They were divided into the following groups, oocyte number < 3 and oocyte number > 3. After RNA extraction and cDNA synthesis, quantitative polymerase chain reaction was performed to assess the expression levels of cytochrome P450 aromatase ( CYP19A1 ), protein kinase A( PKA ) , and glycogen synthase kinase 3 beta ( GSK3B )genes., Results: The women with DOR had statistically significant lower expression of CYP19A1 and PKA genes in their cumulus cells compared to control group (p = 0.04, and p < 0.001, respectively). There was also lower expression of the GSK3B gene in DOR compared to control group, but it was not significant. Although the expression of the CYP19A1 , PKA , and GSK3B genes was lower in women with < 3 oocytes compared to women with more oocytes, this difference was not statistically significant., Conclusion: In conclusion, DOR may be associated with lower expression of CYP19A1 and PKA genes. Also, considering the decrease in the expression of these genes in people with DOR, the expression of these genes can be used as a tool to predict the treatment., Competing Interests: The authors declare that there is no conflict of interest., (Copyright © 2024 Ahmadnia et al.)

Background: olycystic ovary syndrome (PCOS) is an endocrine disorder that can lead to major reproductive and metabolic complications. Management of glycemic parameters is an important step to improve the symptoms of PCOS., Objective: This study aims to evaluate the effects of the dietary approaches to stop hypertension (DASH) diet and curcumin (Cur) co-administration on glycemic parameters in normal weight and overweight/obese women with PCOS undergoing in vitro fertilization., Materials and Methods: In this double-blind randomized clinical study, 104 infertile women with PCOS were divided into 4 intervention groups considering treatment conditions and body mass index. They received 500 mg twice daily of Cur or placebo (Pls) along with DASH or a standard diet (St) based on macronutrient composition (52% carbohydrate, 18% protein, and 30% fat) for 12 wk, (DASH + Cur, DASH + Pls, St + Cur, St + Pls). The effect of these interventions on fasting blood sugar and insulin levels, insulin resistance (IR), and insulin sensitivity were determined., Results: Participants adhered to the intervention protocol ( > 80%). Insulin levels in the supplement intervention (Cur + diet) decreased significantly in the crude model. They remained significant even after adjusting for confounding variables in adjusted models (body mass index classification, energy difference, age, and physical activity levels at the baseline) ( β = -45.3, 95% CI [-73.23, -17.46], p = 0.002). Homeostasis model assessment of IR decreased significantly in the supplement intervention even after controlling for confounding factors in adjusted models. Changes in fasting blood sugar and insulin sensitivity were not significant in either the crude or adjusted models., Conclusion: The study results show that adding Cur to the diet can positively reduce insulin levels, improve IR, and lead to faster recovery of hyperinsulinemia. Cur supplementation with a healthy diet has synergistic beneficial effects on glycemic parameters. Larger clinical trials with longer durations are needed to confirm these results., Competing Interests: The authors declare that there is no conflict of interest., (Copyright © 2024 Zohrabi et al.)

Background: Although several genetic biomarkers have been reported in the tocilizumab (TCZ) response in rheumatoid arthritis, no studies have addressed the pharmacogenomics effect of TCZ in COVID-19., Methods: In this prospective longitudinal study, 95 individuals with severe COVID-19 were selected between 2020-2022. The recovery process was measured at 24 h, 48 h, and 10 days before and after taking TCZ. All participants were genotyped using RFLP-PCR. Different genotypes of FCGR2A rs1801274 and IL-6R rs2228145 were compared in terms of the recovery process., Results: 43.2% of patients were male and 56.8% were female with an average age of 58.20(± 16.214) years. The GA genotype for FCGR2A rs1801274 increased the risk of death (OR = 2.83, P = 0.038) and ventilation (OR = 2.71, P = 0.047) in TCZ-treated individuals. However, there was no risk of death and ventilation with IL-6R rs2228145 (P > 0.05). Additionally, docking analysis showed that not only IL6R but also FCGR2A can be a ligand for TCZ., Conclusion: This study provides valuable insights into the impact of genetic variations on the response rate of TCZ in COVID-19 patients. The GA genotype for FCGR2A rs1801274 was associated with poor treatment outcomes., (© 2024. The Author(s).)

Background: Diminished ovarian reserve (DOR) is a condition that affects fertility by reducing the reproductive potential of the ovary. The altered expression profile of cumulus cells (CCs) can negatively affect the quality and quantity of oocytes in the ovaries. Recent studies suggest that circulating miRNAs play a significant role in the ovary function, and their serum expression changes can be valuable biomarkers for predicting ovarian function., Objective: Investigating the expression levels of circulating miRNA-4463 and its target cytochrome P450 19A1 gene ( CYP19A1 ) in DOR-CCs in order to find a molecular pathway involved in DOR., Materials and Methods: In this case-control study, a total of 20 DOR-women and 20 women with normal ovarian reservation aged between 20-34 yr referred to Yazd Reproductive Science Institute, Yazd, Iran were included in the study. Serum and CCs were collected, and real time-polymerase chain reaction was performed to investigate the expression level of miR-4463 , and its target gene CYP19A1 ., Results: Our results showed an inverse relationship between miR-4463 and CYP19A1 expression levels. Therefore, the increase in the expression of miR-4463 was significantly evident in DOR-women compared to the control group (p = 0.0019), while the expression of its target gene, CYP19A1, has significantly decreased in these women (p = 0.001)., Conclusion: The present study suggests that miR-4463 and CYP19A1 pathways could regulate ovary function. Therefore, examination of this miRNA could be a promising parameter for predicting ovarian reserve and their response to stimulation protocols., Competing Interests: The authors declare that there is no conflict of interest., (Copyright © 2024 Yazdanian et al.)

The study was designed to assess the association of ACE I/D polymorphism with the severity and prognosis of COVID-19 in the Iranian population. Hence, 186 adult patients were categorized into three clinical groups based on the severity of COVID-19: 1) Outpatients or mildly symptomatic patients as control (n = 71); 2) Hospitalized patients or severe symptomatic cases (n = 53); 3) Inpatients led to ICU/death or critically ill patients needed mechanical ventilation (n = 62). The possible association of ACE I/D polymorphism with the risk of comorbidities and serum level of C-reactive protein was evaluated in two severe cases. The results showed that the frequency of D and I alleles are 69.35% and 30.65%, respectively, in the total population. The analysis of allelic frequencies via Fisher's exact test confirmed significantly higher frequency of D allele in both severe groups than that in the mild one, 78.31% in Hospitalized patients (OR = 2.56; 95% CI 1.46 to 4.46; p-value = 0.0011) and 74.19% in Inpatients led to ICU/death (OR = 2.04; 95% CI = 1.22 to 3.43; p-value = 0.0094) compared to 58.45% in Outpatients. The results of genotype proportions displayed an association between COVID-19 severity and DD genotype. Overall, our findings in Iranian patients supported the undeniable role of the DD genotype in the intensity of the disease, comparable to other populations. Furthermore, there is no definite evidence regarding the protective effect of the I allele in our inquiry., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Polycystic ovary syndrome is a common endocrine disorder in reproductive-age women. Accordingly, abnormal microenvironment may negatively influence oocyte developmental competence as a result of the altered expression profile of cumulus cells (CCs), mainly the key players of oocyte maturation, such as epidermal growth factor receptor (EGFR) and prostaglandin E receptor-2 (PTGER2). This study aimed to examine the expression levels of miR-514, miR-642b, and their candidate target genes (EGFR and PTGER2, respectively) in CCs of immature and mature oocytes in patients with PCOS. A total of 40 oocytes at germinal vesicle (GV) and 40 oocytes at metaphase II (MII) stages were retrieved from 30 PCOS women. Quantitative real-time PCR was performed to analyze the expression level of miR-514, miR-642b, EGFR, and PTGER2 in cumulus cells (CCS) of each oocyte. The expression level of miRNAs and their candidate target genes were compared between CCs of GV and MII oocytes. Our study suggests an inverse relationship exists between the expression levels of miR-514 and EGFR, and miR-642b and PTGER2. Furthermore, we observed that CCs of GV oocytes had higher levels of EGFR and PTGER2 mRNA and lower levels of miR-514 and miR-642b expression compared to those of MII oocytes. The present study demonstrated that miR-514 and miR-642b can regulate oocyte development by targeting EGFR and PTGER2, respectively. Therefore, examination of these miRNAs in CCs could be promising parameters to predict oocyte competence in PCOS patients., Competing Interests: Declaration of Competing Interest The authors declare that there is no conflict of interest regarding this article's publication and financial issues., (Copyright © 2024 Society for Biology of Reproduction & the Institute of Animal Reproduction and Food Research of Polish Academy of Sciences in Olsztyn. Published by Elsevier B.V. All rights reserved.)

Unexpected poor ovarian response (UPOR) occurs when nine or fewer oocytes are retrieved from a young patient with normal ovarian reserve. Bone morphogenetic protein15 (BMP15) and growth differentiation factor 9 (GDF9) are two oocyte-specific factors with pivotal role in folliculogenesis. The aim of this study was to assess the relation between BMP15 and GDF9 variants with UPOR. Hundred women aged ≤ 39 with AMH ≥ 1.27 IU/ml participated as UPOR and normal ovarian responders (NOR) based on their oocyte number. Each group consisted of 50 patients. After genomic DNA extraction, the entire exonic regions of BMP15 and GDF9 were amplified and examined by direct sequencing. Western blotting was performed to determine the expression levels of BMP15 and GDF9 in follicular fluid. Additionally, in silico analysis was applied to predict the effect of discovered mutations. From four novel variants of BMP15 and GDF9 genes, silent mutations (c.744 T > C) and (c.99G > A) occurred in both groups, whereas missense variants: c.967-968insA and c.296A > G were found exclusively in UPORs. The latter variants caused reduction in protein expression. Moreover, the mutant allele (T) in a GDF9 polymorphism (C447T) found to be more in NOR individuals (58% NOR vs. 37% UPOR (OR = 2.3, CI 1.32-4.11, p = 0.004).The novel missense mutations which were predicted as damaging, along with other mutations that happened in UPORs might result in ovarian resistance to stimulation. The mutant allele (T) in C447T polymorphism has a protective effect. It can be concluded that there is an association between BMP15 and GDF9 variants and follicular development and ovarian response., (© 2023. The Author(s), under exclusive licence to Society for Reproductive Investigation.)