BackgroundEndometriosis has been described to impair fertility through various mechanisms. However, studies evaluating the reproductive outcomes of women undergoing assisted reproductive technologies show controversial results. The aim of this study is to assess whether the reproductive outcome is impaired among women with endometriosis-associated infertility undergoing IVF.MethodsA retrospective cohort study was performed, including women undergoing IVF reported by the Red Latinoamericana de Reproduccion Asistida (Redlara) registry, between January 2010 and December 2012. The study group included women with endometriosis-associated infertility, and the control group women with tubal factor, endocrine disorders or unexplained infertility. Women above 40 years, severe male factor and premature ovarian failure were excluded. The reproductive outcomes of between both groups were compared. The primary outcome was live birth. Secondary outcomes included clinical pregnancy, miscarriage, number of oocytes retrieved and number of fertilized oocytes. Outcomes were assessed after the first fresh IVF cycle, and were adjusted for age and number of embryos transferred.ResultsA total of 22.416 women were included (3.583 with endometriosis and 18.833 in the control group). Mean age of patients in the endometriosis group and control group was 34.86 (3.47) and 34.61 (3.91) respectively, p = 0.000. The mean number of oocytes retrieved were 8.89 (6.23) and 9.86 (7.02) respectively, p = 0.000. No significant differences were observed between groups in terms of live birth (odds ratio (OR) 1.032, p = 0.556), clinical pregnancy (OR 1.044, p = 0.428) and miscarriage rates (OR 1.049, p = 0.623). Women with endometriosis had significantly lower number of oocytes retrieved (incidence risk ratio (IRR) 0.917, 95% CI 0.895–0.940), however, the number of fertilized oocytes did not differ among the two groups when adjusting for the number of oocytes retrieved (IRR 1.003, p = 0.794). An age-stratified analysis was performed, and no differences were observed in the reproductive outcomes between groups for women aged under 35 and 35 to 40.ConclusionsReproductive outcomes among women undergoing IVF and diagnosed with endometriosis-associated infertility do not differ significantly from women without the disease. Although women with endometriosis generate fewer oocytes, fertilization rate is not impaired and the likelihood of achieving a live birth is also not affected.

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This study discusses, through bibliographic research, the recurrence of naturalization as basis for the medicalization of the female body, as a means of social control through biological reproduction, whereby behavioral standards, social class, ethnic and race differences are rearranged/redefined. Through this process, male patriarchal and class predominance is maintained and the rift of social and gender inequalities grow wider. It is important to identify the role of technological developments and their complexities -which do not allow lowerincome classes to take decisions in regard to their own bodies and reproductive health -and schooling, specially through science and physical education classes whereby upper-class predominance is sustained. This study is part of a literature review for the development of the doctoral thesis about infertility. However, it is important to clarify the historical process referred in our study. The XIII century brings the emergence of Medicine as an area of technical and scientific knowledge of male domain that since then, it is increasingly involved in the interests of population control, disciplinarization of the workforce and hygienization of space and social relations.But these concerns vary according to contexts and times. Thus, among the XIX and XX centuries, the existence of an overpopulated European continent should be considered in opposition to Americas, by demanding settlement, absorbed immigrants, and also, discussions and ideas from Europe. The Eugenic ideals, for example, characterize the colonial phase of European imperialism, ongoing since the end of the XIX century, are visible in Brazil only in the second decade of the XX century.However, discursively linked to the improvement of race and population development, the eugenics took so aggressive and destructive under the Nazi-fascism in Europe in the decades of 30-40 of the XX century, forms that covered the need for control of the industry workforce and the struggles of social classes for distribution of wealth and socialist ideals.In the global scenario of the XXI century, the spread of the reproduction issues in newspapers of great range, with headlines that highlighted the increased fertility in the slum, and the higher birth rate among adolescents in low-income classes, and illustrates the importance of this subject today and more: the perpetuation of a hierarchy of genders and maintenance of the biopolitic strategy mentioned by Foucault (1989), in which [...] The current forms of medicine organization and the complexity of the technology associated with them ... in many cases withdraw or increase the withdrawal of the participation of common people from decision-making regarding their own body, for their well-being and in the limit, the fate of their lives. (Corrêa, 2001, p.25).This study is part of a literature review for the development of the doctoral thesis of the Post-Graduate Program in Bioscience and Health Education -Oswaldo Cruz Institute (IOC) / Oswaldo Cruz Foundation (Fiocruz) on the recurrence o...

PurposeCalcitriol, or 1,25-hydroxycholecalciferol, is the active form of vitamin D. It binds and activates vitamin D receptor (VDR). Infertility and defective folliculogenesis have been observed in female vdr-knockout mice; however, whether VDR polymorphisms affect human ovarian responses to controlled ovarian stimulation (COS) remains unclear. We hypothesized that VDR polymorphisms are associated with infertility and COS responses. Thus, we evaluated the association between the TaqI, BsmI, and FokI VDR polymorphisms and ovarian responses in women undergoing COS.MethodsIn this study, we recruited a control group (n = 121) comprising volunteers with a history of natural conception and a second group of women undergoing COS (n = 70). TaqI, BsmI, and FokI genotyping was performed via restriction fragment length polymorphism analysis or TaqMan qPCR and Sanger sequencing. Intrafollicular 25(OH)D contents were measured in follicular fluid collected from COS patients during oocyte retrieval. Ovarian response parameters were obtained from patient medical records.ResultsThere were no significant differences in the genotype frequencies of VDR polymorphisms (TaqI, BsmI and FokI) between the control and COS groups. However, the allele frequency of TaqI (C allele) was significantly lower in the COS group than in the control group (p = 0.02). Follicle number but not oocyte number was lower in patients with TaqI polymorphic (TC/CC) genotypes (p = 0.03). Importantly, the ratio between the number of follicles retrieved and intrafollicular estradiol concentrations was higher in patients with the TC/CC TaqI genotypes (p < 0.02).ConclusionWe identified an association between the VDR TaqI polymorphism and reduced follicle number in women undergoing COS, suggesting that VDR signaling affects the ovarian response to stimulation via unknown mechanisms.

Objective: The aim of the study was quantify organochlorine compounds in women seeking for infertility treatment (n = 15) and in spontaneously pregnant ones (n = 21). Materials and methods: A questionnaire was applied regarding lifestyle, occupational and reproductive history. Blood samples were collected from both groups. Results: From the pesticides studied, pp'DDE was detected in 100% of infertile women, at higher mean levels than in pregnant women (3.02 mcg/L vs. 0.88 mcg/L; p = 0.001; power of 69%), without correlation with the etiology of infertility. Levels of the polychlorinated biphenyls (PCBs) were low, with positive samples in 100% in the infertile women for PCBs 138, 153, 180, while in pregnant women, they were 85.7% for congeners 138 and 153. Only PCB180 showed significance, with frequency of 71.4% (p = 0.019). Conclusions:The risk factors for female infertility were: age, consumption of untreated water and of canned foods. Exposure to the most prevalent organochlorine compounds described in literature was confirmed in the study, indicating that pp'DDE may adversely influence female fertility. Arq Bras Endocrinol Metab. 2013;57(5):346-53 Keywords Organochlorine pesticides; polychlorinated biphenyls; female fertility; endocrine disruptors RESUMO Objetivo: O estudo teve como objetivo quantificar as substâncias organocloradas em mulheres buscando tratamento para infertilidade (n = 15) e que espontaneamente engravidaram (n = 21). Materiais e métodos: Foi aplicado questionário considerando estilo de vida, história ocupacional e reprodutiva. Amostras de sangue foram obtidas em ambos os grupos. Resultados: Dos pesticidas, pp'DDE foi detectado em 100% das inférteis, com níveis maiores que nas grávidas (3,02 mcg/L vs. 0,88 mcg/L; p = 0,001; poder 69%), sem correlação na etiologia da infertilidade. Os níveis de detecção das bifenilas policloradas (PCBs) foram baixos, com 100% de positividade das amostras nas inférteis para os PCBs 138, 153, 180, e de 85,7% nas grávidas para os congêneres 138 e 153. Apenas PCB180 mostrou significância na frequência de 71,4% (p = 0,019). Conclusões: Os fatores de risco para infertilidade feminina foram: idade, consumo de água não tratada e alimentos enlatados. A exposição aos organoclorados mais prevalentes descritos na literatura foi confirmada no estudo, indicando que pp'DDE pode influenciar adversamente a fertilidade feminina. Arq Bras Endocrinol Metab. 2013;57(5):346-53 Descritores Pesticidas organoclorados; bifenilas policloradas; fertilidade feminina; desreguladores endócrinos