Single-cell transcriptomic atlas of goat ovarian aging

Background The ovaries are one of the first organs that undergo degenerative changes earlier in the aging process,and ovarian aging is shown by a decrease in the number and quality of oocytes.However,little is known about the molecular mechanisms of female age-related fertility decline in different types of ovarian cells during aging,especially in goats.Therefore,the aim of this study was to reveal the mechanisms driving ovarian aging in goats at single-cell resolution.Results For the first time,we surveyed the single-cell transcriptomic landscape of over 27,000 ovarian cells from newborn,young and aging goats,and identified nine ovarian cell types with distinct gene-expression signatures.Functional enrichment analysis showed that ovarian cell types were involved in their own unique biological processes,such as Wnt beta-catenin signalling was enriched in germ cells,whereas ovarian steroidogenesis was enriched in granulosa cells(GCs).Further analysis showed that ovarian aging was linked to GCs-specific changes in the antioxidant system,oxidative phosphorylation,and apoptosis.Subsequently,we identified a series of dynamic genes,such as AMH,CRABP2,THBS1 and TIMP1,which determined the fate of GCs.Additionally,FOXO1,SOX4,and HIF1A were identified as significant regulons that instructed the differentiation of GCs in a distinct manner during ovarian aging.Conclusions This study revealed a comprehensive aging-associated transcriptomic atlas characterizing the cell typespecific mechanisms during ovarian aging at the single-cell level and offers new diagnostic biomarkers and potential therapeutic targets for age-related goat ovarian diseases.

Efficacy and safety of minimally invasive laparoscopic surgery under general anesthesia for ovarian cancer

BACKGROUND Ovarian cancer is one of the most common malignant tumors in female reproductive system in the world,and the choice of its treatment is very important for the survival rate and prognosis of patients.Traditional open surgery is the main treatment for ovarian cancer,but it has the disadvantages of big trauma and slow recovery.With the continuous development of minimally invasive technology,minimally invasive laparoscopic surgery under general anesthesia has been gradually applied to the treatment of ovarian cancer because of its advantages of less trauma and quick recovery.However,the efficacy and safety of minimally invasive laparoscopic surgery under general anesthesia in the treatment of ovarian cancer are still controversial.AIM To explore the efficacy and safety of general anesthesia minimally invasive surgery in the treatment of ovarian cancer.METHODS The clinical data of 90 patients with early ovarian cancer in our hospital were analyzed retrospectively.According to the different surgical treatment methods,patients were divided into study group and control group(45 cases in each group).The study group received minimally invasive laparoscopic surgery under general anesthesia for ovarian cancer,while the control group received traditional open surgery for ovarian cancer.The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30),clinical efficacy and safety of the two groups were compared.RESULTS The intraoperative blood loss,length of hospital stay,postoperative gas evacuation time,and postoperative EORTC QLQ-C30 score of the study group were significantly better than those of the control group(P<0.05).The incidence of postoperative complications in the study group was significantly lower than in the control group(P<0.05).The two groups had no significant differences in the preoperative adrenocorticotropic hormone(ACTH),androstenedione(AD),cortisol(Cor),cluster of differentiation 3 positive(CD3+),and cluster of differentiation 4 positive(CD4+)indexes(P>0.05).In contrast,postoperatively,the study group's ACTH,AD,and Cor indexes were lower,and the CD3+and CD4+indexes were higher than those in the control group(P<0.05).CONCLUSION Minimally invasive laparoscopic surgery under general anesthesia in patients with early ovarian cancer can significantly improve the efficacy and safety,improve the short-term prognosis and quality of life of patients,and is worth popularizing.

Ovarian Tumors in Senegalese Women: Impact of D-Loop Mutations between Healthy and Cancerous Tissues

In Senegal in particular, ovarian cancer, which is one of the most common gynecological cancers, accounts for 2.8% of deaths. The most important risk factor is genetic, with 10% of cases occurring in a context of genetic predisposition. The sequencing of the human genome, which has led to the discovery of millions of sequence variations, makes it possible to study variations within sequences. These variations are limited to Single Nucleotide Polymorphisms (SNPs) and this common form of polymorphism occurs approximately every 1000 bases in the human genome and 1.8 million SNPs are currently listed according to [1]. The aim of this study is to gain a better understanding of the impact of mutations in the D-loop region of mtDNA on ovarian cancer in Senegalese women. This study involved searching for mutations in our study population after DNA extraction and sequencing. Mutations were found after a comparison of our sequences with the Cambridge reference sequence (NC_012920). The mutations found in the DNA studied extend from position 7 to position 16568 and most of these mutations are located in the hypervariate zones (HV1 and HV2). Heteroplasmy with three mutant alleles was also found in certain variants. Common mutations were found in both healthy and cancerous tissues, with almost identical frequencies in both types of tissue. This enabled us to understand the spread of tumor cells throughout the ovary.

Efficacy of intraovarian autologous platelet-rich plasma administration in women with low ovarian reserve: A systematic review and meta-analysis

Objective:To conduct a systematic examination and meta-analysis of the most reliable data from experimental studies evaluating the efficacy of autologous platelet-rich plasma(PRP)on low ovarian reserve.Methods:A comprehensive search was performed utilizing pertinent search terms across electronic databases,including PubMed,Cochrane,and Google Scholar.We included studies that assigned infertile women with low ovarian reserve in experimental studies.Ovarian reserve parameters were measured before and after PRP injection into ovaries.The data of each study was retrieved and subsequently compiled.Results:Of 301 articles collected and reviewed,six studies were finally included in the meta-analysis.Following PRP injection,infertile women showed a non-significant increase in anti-Mullerian hormone(AMH)level(MD=0.10;95%CI-0.04,0.23),a significant increase in antral follicular count(AFC)(MD=1.88;95%CI 0.47,3.29),and a non-significant reduction in follicle-stimulating hormone(FSH)level(MD=-0.22;95%CI-8.32,7.87).Conclusions:Autologous PRP may increase AFC,but not AMH.Although it is found beneficial in enhancing ovarian reserve(AFC),further research with strong evidence is still required.

Combining genome-wide association study and transcriptome analysis to identify molecular markers and genetic basis of population-asynchronous ovarian development in Coilia nasus

Coilia nasus,a migratory fish species found in the middle and lower reaches of the Yangtze River and along offshore areas of China,possesses considerable aquacultural and economic potential.However,the species faces challenges due to significant variation in the gonadal development rate among females,resulting in inconsistent ovarian maturation times at the population level,an extended reproductive period,and limitations on fish growth rate due to ovarian prematurity.In the present study,we combined genome-wide association study(GWAS)and comparative transcriptome analysis to investigate the potential single nucleotide polymorphisms(SNPs)and candidate genes associated with population-asynchronous ovarian development in C.nasus.Genotyping of the female population based on whole-genome resequencing yielded 2120695 high-quality SNPs,39 of which were suggestively associated with ovarian development.Of note,a significant SNP peak on LG21 containing 30 suggestively associated SNPs was identified,with cpne5a determined as the causal gene of the peak.Therefore,single-marker and haplotype association analyses were performed on cpne5a,revealing four genetic markers(P<0.05)and seven haplotypes(r2>0.9)significantly associated with the phenotype.Comparative transcriptome analysis of precociously and normally maturing individuals screened out 29 and 426 overlapping differentially expressed genes in the brain and ovary,respectively,between individuals of different body sizes.Integrating the GWAS and transcriptome analysis results,this study identified genes and pathways related to hypothalamic-pituitary-gonadal axis hormone secretion,extracellular matrix,angiogenesis,and gap junctions involved in population-asynchronous ovarian development.The insights gained from this study provide a basis for a deeper understanding of the molecular mechanisms underlying ovarian development in fish and may facilitate the genetic breeding of C.nasus strains exhibiting population-synchronous ovarian development in the future.

Development of immature ovarian teratoma after mature teratoma in a girl with familial ovarian teratoma:A case report

BACKGROUND Immature ovarian teratoma is a rare and aggressive neoplasm that affects young women.This report is the first to describe the development of immature teratoma after ovarian cystectomy for mature teratoma of the ovary in an adolescent female with a family history of ovarian teratoma.CASE SUMMARY A 16-year-old girl who had undergone bilateral ovarian cystectomy for mature teratomas 3 years ago showed bilateral adnexal tumors during her regular ultrasonography follow-up every 6 months.She received laparoscopic bilateral ovarian cystectomy,and final histopathology showed grade-1 immature teratoma of the left ovary and mature teratoma of the right ovary.Laparoscopic left salpingo-oophorectomy and staging procedures were performed again.Her mother,maternal aunt,and maternal grandmother had also received surgeries for mature ovarian teratomas.CONCLUSION It is important to have guidance on management of patient and family members with familial ovarian teratomas.

TGF-β-regulated different iron metabolism processes in the development and cisplatin resistance of ovarian cancer

The impact of different iron metabolism processes(DIMP)on ovarian cancer remains unclear.In this study,we employed various gene chips and databases to investigate the role of DIMP in the initiation and development of ovarian cancer.cBioPortal was used to determine mutations in DIMP-associated genes in ovarian cancer.Kaplan-Meier plotter was used to examine the influence of DIMP on the prognosis of ovarian cancer.By analyzing 1669 serous ovarian cancer cases,we identified a range of mutations in iron metabolism genes,notably in those coding for the transferrin receptor(19%),melanotransferrin(19%),and ceruloplasmin(10%)in the iron import process,and glucose-6-phosphate isomerase(9%),hepcidin antimicrobial peptide(9%),metal regulatory transcription factor 1(8%),and bone morphogenetic protein 6(8%)in the iron regulation process.Compared to the unaltered group,the group with gene alterations exhibited a higher tumor mutation burden count(43 vs.54)and more advanced histologic grade(78.19%vs.87.90%).Compared to the normal ovarian counterparts,a reduction in expression was observed in 9 out of the 14 genes involved in iron utilization and 4 out of the 5 genes involved in iron export in ovarian cancer;in contrast,an increase in expression was observed in 2 out of the 3 genes involved in iron storage in ovarian cancer.Furthermore,in cisplatin-resistant cells compared to cisplatin-sensitive ones,the expression of all genes in iron storage and 13 out of 14 genes in iron import was decreased,while that of 8 out of the 10 genes in iron utilization was increased.In addition,survival curve analysis indicated that a higher expression in the majority of genes in the iron import process(12/21),or a reduced expression in most genes in the iron export process(4/5)correlated with poor progression-free survival.Additionally,TGF-βcould regulate the expression of most iron metabolism-associated genes;particularly,expression of genes involved in the iron storage process(2/2)was inhibited after TGF-β1 or TGF-β2 treatment.In conclusion,DIMP plays multifaceted roles in the initiation,chemo-resistance,and prognosis of ovarian cancer.Therapeutically targeting DIMP may pave the way for more tailored treatment approaches for ovarian cancer.

Metabolomic-based analysis reveals bile acid-mediated ovarian failure induced by low temperature in zebrafish

As ectotherms, fish are highly sensitive to temperature fluctuations, which can profoundly impact their reproductive cycles. In this study, we investigated the fertility and histological characteristics of zebrafish(Danio rerio) ovaries exposed to a temperature gradient ranging from the thermopreferendum temperature of the species,27℃, to lower temperatures of 22℃, 20℃, and 13℃ over a period of two weeks. Comparative metabolomic(six biological replicates for each temperature) and transcriptomic(four biological replicates for each temperature) analyses were conducted under the four temperature conditions. Results indicated that lower temperatures inhibited oocyte development and differential metabolites were involved in steroid hormone production,antioxidant function, and lipid and protein catabolism.Disrupted reproductive hormones, increased proteolysis,and lipid degradation significantly impeded oocyte development and egg maturation. Notably, a significant increase in bile acid content was noted in the ovaries of the cold-treated fish, indicating that bile acids play a critical role in ovarian failure. Overall, these findings provide valuable insights into the mechanisms governing the reproductive response of fish to cold stress.

Exploring the molecular mechanisms and potential therapeutic strategies of ferroptosis in ovarian cancer

The morbidity rate of ovarian cancer,a malignant tumour in gynaecological tumours,is rising,and it is considered to be the most lethal cancer.The majority of patients are typically diagnosed during the advanced stages of the illness due to the elusive characteristics of ovarian cancer and an absence of highly sensitive and specific diagnostic indicators.Surgical excision of the lesions,along with chemotherapy,is the conventional treatment for ovarian cancer;however,resistance to platinum-based chemotherapeutic drugs and molecular targeted therapies frequently arises.Improving the survival rate and prognosis of patients with end-stage or recurring ovarian cancer requires the identification of new therapeutic targets due to the absence of efficient medications,and this has emerged as a highly demanding issue.Studies have demonstrated that ferroptosis effectively hinders the proliferation of ovarian cancer and induces the demise of malignant cells.Ferroptosis is composed of the cystine/glutamate antiporter system(the system Xc-)and glutathione peroxidase 4(GPX4).Solute carrier family 7 member 11(SLC7A11)and solute carrier family 3 member 2(SLC3A2)play crucial roles in the regulation of ferroptosis by facilitating the uptake of cystine into cells and the efflux of glutamate out of cells,respectively.In cells,GPX4 is the exclusive enzyme employed for reducing liposomal peroxide through glutathione peroxidase activity.The occurrence of ferroptosis in ovarian cancer is strongly associated with three main pathways,namely,the GPX4-glutathione(GSH)protective pathway,the ferroptosis suppressor protein 1(FSP1)-coenzyme Q10(CoQ10)protective pathway,and the guanosine 5'-triphosphate cyclohydrolase I(GCH1)protective pathway.In ovarian cancer cells,the postsynaptic density-95,discs-large,zona occludens 1(PDZ)-binding motif-angiopoietin-like 4-nicotinamide adenine dinucleotide phosphate oxidases 2(TAZ-ANGPTL4-NOX2)pathway can be regulated by Yes-associated protein(YAP)/TAZ,a downstream component of the Hippo pathway,leading to the modulation of ferroptosis.By targeting microRNA-587,lncRNA ADAMTS9 antisense RNA 1(ADAMTS9-AS1)can modulate the expression of SLC7A11 and reduce the occurrence of ferroptosis.Although ferroptosis holds promise in overcoming the resistance mechanism,there remain obstacles in utilizing it as a cancer treatment,including the potential harm of drugs to healthy cells.Hence,additional investigations are required to formulate safer and more efficient chemotherapy protocols for the treatment of ovarian cancer and other malignancies.

Ovarian Reserve in a Population of Obese Infertile Patients in Kinshasa

Background: The ovarian reserve, which is an important marker in the management of couple infertility, undergoes depletion over time. This depletion could accelerate in the presence of certain circumstances, such as obesity. The contradictory results of studies on the impact of obesity on the ovarian reserve throughout the world accelerated ovarian ageing in infertile women from Kinshasa, as well as the high rate of obese women in this population, seemed necessary to undertake this study to find out if this obesity impacted the ovarian reserve of Kinshasa women. The objective of this study was to identify the profile of markers of ovarian reserve in obese infertile patients according to certain characteristics. Method: A case-control study with retrospective data collection on 439 obese infertile patients (cases) and 439 normal-weight infertile patients (controls) who had consulted for the desire to conceive at the University Hospital of Kinshasa and the Edith Medical Center between January 2016 and December 2021. Results: The average age of the patients was 33.6 years ± 4.3 years, with 47.8% of patients aged at least 35 years. Menarche and menstrual duration were correlated with AMH in linear regression (p = 0.043 and 0.021, respectively). Late menarche and irregular cycle were risk factors for ovarian ageing [OR: 4.6;95% CI: (1.052 - 20.636);p = 0.043 and OR: 4.8;95% CI: (1.633 - 14.566);p = 0.005] while PCO was a protective factor for ovarian ageing [OR: 0.109;95% CI: (0.182 - 0.652);p = 0.015]. Conclusion: Within the limits of our study, we found that the more obese the patients were, the faster the ovaries aged.

Beta-HCG Levels and Ovarian Ultrasonography Results among Non-Pregnant Women of Reproductive Age in Port Harcourt, Nigeria: A Cross-Sectional Study

Background: Certain ovarian cancers that were previously common in postmenopausal women are now increasingly observed in women of reproductive age. The research on using β-HCG as a diagnostic biomarker for ovarian cancer in women of reproductive age is ongoing. Aim: This study assessed the level of serum β-HCG in non-pregnant women of reproductive age and determined its potential association with suspicious ovarian ultrasonography results. Methods: The study was conducted in Port Harcourt, Nigeria. This study adopted a cross-sectional design on a quota sample of 224 case notes of women aged 18 - 40 years obtained from eight diagnostic centres. A data extraction form was used for data collection. Data analysis employed descriptive statistics, Chi-square, Fisher’s exact test, and Odds Ratio at 95% confidence and 5% significance levels. Results: About 5.8% of the participants exhibited detectable levels of serum β-HCG above 5 IU/L (World Health Organization reference) at a mean concentration of 5.87 (±1.75) IU/L. About 4.0% of the participants had suspicious ovarian lesions identified through ultrasonography. Participants with elevated serum β-HCG levels above the WHO reference were 59 times more likely to have suspicious ovarian lesions (Odds ratio: 59.4, 95%CI: 12.3 - 287.8, p β-HCG level and age (p = 0.041) as well as parity (p Conclusion: Serum β-HCG levels above the WHO reference in non-pregnant women were associated with suspicious ovarian lesions. More rigorous primary research, systematic reviews, and meta-analyses are needed to confirm the findings of this study.

Polycystic Ovarian Syndrome (PCOS): Exploring Its Impact on Obstetrical Outcomes

Polycystic ovarian syndrome (PCOS) disrupts ovulation leading to both infertility and miscarriage;yet, its impact on obstetrical outcomes remains largely uncertain due to conflicting findings. We analyzed data from the CDC Pregnancy Risk Assessment of Monitoring System, specifically Standard Core and Phase 8 responses, with 9549 respondents across the United States through SPSS 28 software in this cross-sectional study. Two variables assessed PCOS status in respondents: history of PCOS and PCOS during pregnancy. With a history of PCOS, there were significantly increased odds of diabetic (OR 1.665, p < 0.001), hypertensive disorders (OR 1.589, p < 0.001) during pregnancy, neonatal mortality (OR 1.550, p < 0.001), cesarean section (C/S) (OR 1.489, p < 0.001), and preterm prelabor rupture of membranes (PPROM) (OR 2.081, p < 0.001). With PCOS diagnosed during pregnancy, there were significantly greater odds of diabetes (OR 3.278, p < 0.001), hypertensive disorders (OR 2.935, p < 0.001) during pregnancy, and significantly decreased risk for small for gestational age (2 standard deviations) (OR 0.337, p = 0.024). PCOS is a significant risk factor that contributes to maternal morbidity. Our results support the hypothesis that PCOS’ impact extends well into a woman’s obstetrical journey, with varying degrees of associated adverse maternal and fetal risks. Preliminary pathophysiologic explanations associated with PCOS gestational diabetes include pre-existing insulin resistance. Meanwhile, altered placentation and endovascular changes associated with PCOS secondary to a baseline deranged metabolic environment predispose patients to developing hypertensive disorders, PPROM, and preterm delivery. Associations between neonatal mortality and C/S can be attributed to elevated maternal body mass index. The pathophysiologic link between PCOS and the above obstetrical outcomes still remains unknown, necessitating further investigation;however, this study identifies the outcomes that require the most attention at this time.

Comparison of ovarian preservation versus oophorectomy on fertility outcomes in patients with endometriosis post-laparoscopic surgery:A prospective study

BACKGROUND Endometriosis is a chronic inflammatory condition affecting a significant proportion of women of reproductive age.Although laparoscopic surgery is commonly the preferred treatment,the decision to preserve or remove the ovaries remains controversial.Previous studies have yielded inconsistent results regarding the impact of ovarian preservation vs oophorectomy on fertility outcomes and disease recurrence.This prospective study aimed to address this knowledge gap by comparing the effects of these surgical approaches on spontaneous pregnancy rates,time to pregnancy,recurrence rates,and postoperative pain in patients with endometriosis.AIM To compare the reproductive outcomes and recurrence rates between ovarian preservation and oophorectomy in women undergoing laparoscopic surgery for endometriosis.METHODS This study was conducted at a tertiary care hospital between January 2019 and December 2023.A total of 312 women aged 18 to 40 years,diagnosed with endometriosis and undergoing laparoscopic surgery,were included.The patients were categorized into the ovarian preservation group(n=204)and the oophorectomy group(n=108).The primary outcome measure was the achievement of spontaneous pregnancy within 24 months post-surgery.Secondary outcomes included time to spontaneous pregnancy,recurrence rates,and postoperative pain scores.RESULTS The ovarian preservation group exhibited a significantly higher spontaneous pregnancy rate than that in the oophorectomy group(43.6%vs 28.7%,P=0.006).Moreover,the median time to spontaneous pregnancy was shorter in the ovarian preservation group(8.2 months vs 11.4 months,P=0.018).Nonetheless,endometriosis recurrence was more prevalent in the ovarian preservation group(22.1%vs 11.1%,P=0.014).The postoperative pain scores demonstrated similar improvements in both groups,with no significant differences observed.Subgroup analyses indicated that the benefit of ovarian preservation on spontaneous pregnancy rates was more evident among younger women(≤35 years)and those with advanced-stage endometriosis.CONCLUSION Ovarian preservation is associated with a high spontaneous pregnancy rate and a short time to pregnancy.However,because of the increased risk of recurrence,the decision should be based on age,fertility aspirations,and disease severity.

Primary ovarian cancer combined with primary fallopian tube cancer:A case report

BACKGROUND Low grade serous carcinoma of the ovary(LGSOC)is a rare type of epithelial ovarian cancer with a low incidence rate.The origin of ovarian cancer has always been a hot topic in gynecological oncology research,and some scholars believe that the origin of ovarian malignant tumors is the fallopian tubes.Primary fallopian tube cancer is the lowest incidence of malignant tumors in the female reproductive system.There are only a few reports in the literature,but the mortality rate is very high.But in clinical practice,fallopian tube cancer is very common,but in most cases,it is classified as ovarian cancer.CASE SUMMARY We report a 54 years old postmenopausal woman who was hospitalized with a lower abdominal mass and underwent surgical treatment.The final pathological confirmation was low-grade serous carcinoma of the right ovary and low-grade serous carcinoma of the left fallopian tube.No special treatment was performed after the surgery,and the patient was instructed to undergo regular follow-up without any signs of disease progression.CONCLUSION The prognosis of LGSOC is relatively good,over 80%of patients still experience disease recurrence.

Immune pathway through endometriosis to ovarian cancer

Endometriosis is an estrogen-dependent inflammatory disease,defined by the presence of functional endometrial tissue outside of the uterine cavity.This disease is one of the main gynecological diseases,affecting around 10%-15%women and girls of reproductive age,being a common gynecologic disorder.Although endometriosis is a benign disease,it shares several characteristics with invasive cancer.Studies support that it has been linked with an increased chance of developing endometrial ovarian cancer,representing an earlier stage of neoplastic processes.This is particularly true for women with clear cell carcinoma,low-grade serous carcinoma and endometrioid.However,the carcinogenic pathways between both pathologies remain poorly understood.Current studies suggest a connection between endometriosis and endometriosis-associated ovarian cancers(EAOCs)via pathways associated with oxidative stress,inflammation,and hyperestrogenism.This article aims to review current data on the molecular events linked to the development of EAOCs from endometriosis,specifically focusing on the complex relationship between the immune response to endometriosis and cancer,including the molecular mechanisms and their ramifications.Examining recent developments in immunotherapy and their potential to boost the effectiveness of future treatments.

Deciphering resistancemechanisms and novel strategies to overcome drug resistance in ovarian cancer:a comprehensive review

Ovarian cancer is among the most lethal gynecological cancers,primarily due to the lack of specific symptoms leading to an advanced-stage diagnosis and resistance to chemotherapy.Drug resistance(DR)poses the most significant challenge in treating patients with existing drugs.The Food and Drug Administration(FDA)has recently approved three new therapeutic drugs,including two poly(ADP-ribose)polymerase(PARP)inhibitors(olaparib and niraparib)and one vascular endothelial growth factor(VEGF)inhibitor(bevacizumab)for maintenance therapy.However,resistance to these new drugs has emerged.Therefore,understanding the mechanisms of DR and exploring new approaches to overcome them is crucial for effective management.In this review,we summarize the major molecular mechanisms of DR and discuss novel strategies to combat DR.

Application of mesenchymal stem cell therapy for premature ovarian insufficiency: Recent advances from mechanisms to therapeutics

The incidence of premature ovarian insufficiency(POI)is increasing worldwide,particularly among younger women,posing a significant challenge to fertility.In addition to menopausal symptoms,POI leads to several complications that profoundly affect female reproductive function and overall health.Unfortunately,current clinical treatment strategies for this condition are limited and often yield unsatisfactory outcomes.These approaches typically involve hormone repla-cement therapy combined with psychological support.Recently,mesenchymal stem cell(MSC)therapies for POI have garnered considerable attention in global research.MSCs can restore ovarian reproductive and endocrine functions through diverse mechanisms,including controlling differentiation,promoting angiogenesis,regulating ovarian fibrosis,inhibiting apoptosis,enhancing autocrine and paracrine effects,suppressing inflammation,modulating the immune system,and genetic regulation.This editorial offers a succinct summary of the application of MSC therapy in the context of POI,providing evidence for groundbreaking medical approaches that have potential to enhance reproductive health and overall well-being for women.

Current Status of Stem Cells in the Treatment of Premature Ovarian Failure

Premature ovarian failure (POF) is a prevalent cause of female infertility. POF features include estrogen hypofunction, amenorrhea, infertility, and high gonadotropin levels. The etiology of POF is genetic diseases, autoimmune diseases, enzyme defects and environmental factors. The development of Regenerative medicine has made stem cell and exosome (EXOs) therapy effective for POF. This review discusses POF stem cell research and development.

Management of a Huge Ovarian Cyst in Pregnancy at the Douala General Hospital, Cameroon: A Case Report and Review of the Literature

Background: Ovarian cysts in pregnancy are common and are usually small benign functional cysts (corpus luteum and theca-lutein cysts) that usually resolve spontaneously between 14 and 16 weeks of gestation. However, large ovarian cysts are rare in pregnancy, with an incidence of 0.2% - 2%, and most of them are benign. The first-line diagnostic modality is ultrasonography. Complications of ovarian cysts in pregnancy include miscarriage, ovarian torsion, cyst rupture, etc. Laparotomy is the treatment modality commonly used in our setting, and histopathologic diagnosis is important for the prognosis of the treatment. Case Presentation: MC is a 32-year-old G3P2002 married housewife of the Bakweri tribe who was referred to our department because of progressive abdominal discomfort and shortness of breath for 1 month’s duration. Her medical history is consistent with two normal vaginal deliveries at term and the use of implants (for contraception) until one month prior to the index pregnancy. Her booking visit was at 16 weeks gestation at a primary (missionary) healthcare facility, and she underwent ultrasonography and was diagnosed with a singleton viable intrauterine pregnancy and a simple septate cystic mass measuring 17 cm situated on top of the uterus, appearing to originate from the left ovary. She was referred to seek the expertise of an obstetrician-gynecologist, but she came to our department at 35 weeks gestation and underwent cesarean birth at 37 weeks gestation. In the pathological review, serous cystadenoma was diagnosed, and there were no positive findings in peritoneal cytology. Conclusion: The ultrasonographic diagnosis of the huge ovarian cyst in the index case was after 16 weeks gestation because of her late booking visit at 16 weeks gestation. The index case deferred referral to the obstetrician because of a lack of finances, came to our department at 35 weeks gestation because of abdominal pain that may have resulted from a torsion of the ovarian cyst, and underwent cesarean birth because of malpresentation and fear of cyst rupture during labor. We recommend cesarean section in such cases because of suboptimal antenatal care uptake and histopathology of the specimen to exclude malignancy. .

The Effect of Uterine Artery Occlusion with Tourniquet on Ovarian Reserve during Open Myomectomy at a University Teaching Hospital in Southern Nigeria

Background: The most common surgical treatment for symptomatic uterine fibroids, particularly in women with fertility concerns, is open myomectomy. Given the high vascularity of the uterus, haemorrhage during the procedure is a serious risk that is often mitigated with a uterine tourniquet. Aim and Objectives: To evaluate the effect of uterine artery occlusion with a tourniquet during open myomectomy on ovarian reserve using serial anti-Mullerian hormone (AMH) measurements. Materials and Methods: This was a prospective longitudinal study with a quasi-experimental design and a convenient sampling technique. The study enrolled 47 women who had abdominal myomectomy between September 1, 2021, and March 31, 2022, at the University of Port Harcourt Teaching Hospital. Blood samples were collected before anaesthesia was administered in theatre, on day two, and three months after open abdominal myomectomy for anti-Mullerian hormone assay. The data was collected using a semi-structured proforma, entered into an Excel spreadsheet, and analyzed using SPSS version 25.0 with a 95% confidence interval. Statistical significance level was set at 0.05. Results: The pre-surgery AMH mean value was 1.67 ± 1.44 ng/ml, while the values after using a uterine tourniquet at myomectomy on the second day and three months later were 1.22 ± 1.24 ng/ml and 1.59 ± 1.43 ng/ml, respectively. There was no statistically significant change in AMH levels, and there was no statistically significant relationship between blood loss and tourniquet time and AMH after open abdominal myomectomy. Conclusion: The use of a uterine tourniquet and blood loss during open myomectomy has no effect on ovarian reserve.