Unexplained infertility diagnosis is made in the presence of a normal semen analysis when tubal patency and normal ovulatory function are established. Among several potential causes, unexplained infertility could be attributed to vaginal pH and cervical mucus abnormalities. Although the vaginal canal and the cervix generally function as effective barriers to sperm, and although the production of mucus is essential to transport them from the vagina to the uterine cavity, these factors receive little attention in the investigation of couples with unexplained infertility. A substantial reduction in sperm number occurs as they transverse the cervix. From an average of 200 to 300 million sperm deposited in the vagina, only a few hundred achieve proximity to the oocyte. Given this expected high spermatozoa loss, a slight modification in cervical mucus may rapidly transform the cervix into a "hostile" environment, which, together with changes in vaginal environment and cervix structure, may prevent natural conception and be a cause of infertility. In this review, we discuss the physiological role of the vaginal pH and cervical mucus in fertility, and describe several conditions that can render the cervical mucus hostile to sperm and therefore be implicated in the pathophysiology of unexplained infertility.

Background:In ethno-medicinal practices, the roots of Cissampelos pareira(Patha) are used in the treatment of various ailments related to urinary problems and skin infections, and in tumorinhibitor activity, antibacterial, antimalarial, diuretic activity,anticonvulsant activity etc., The main problem encountered in standardization of Ayurvedic drugs is proper identification of the source plant.Materials and Methods:The macroscopic features of each anatomical component have been observed by a high-resolution camera. The moisture content, total ash, acid-insoluble ash, and water—alcohol and ether extractive values of the powdered sampleswere determined by the method as per WHO guidelines. The phytochemical investigation of the methanolic extract of Cissampelos pareira root was performed by the standard chemical ltests and by TLC on silica gel G using solvent systems proposed by Harborne.Result:The microscopic characteristics showed the wavy epidermis with unicellular trichomes. Lignified xylem vessels, radial medullary rays, and prismatic calcium oxalate crystals had also been found. Phytochemical screening revealed that the Cissampelos pareira root extract contains terpenoids, alkaloids, tannins, amino acid proteins, and carbohydrates. Alkaloids and essential oil were detected in TLC of the Cissampelos pareira root extract developed using blends of methanol:concentrated ammonia (200:3) and n-butanol:acetone:water (3:1:1) and benzene:ethyl acetate:formic acid(9:7:4) as solvent systems for alkaloid whereas chloroform(100%), benzene (100%), chloroform:benzene(1:1),and ether:benzene(1:1) as solvent systems for essential oil.Conclusion:These findings will be useful toward establishing pharmacognostic standards on identification, purity,quality, and classification of the plant, which is gaining relevance in plant drug research.

Background To better understand the impact of low testosterone treatments on men with hypogonadism, data on treatment efficacy and safety must be combined with patient-reported outcomes measurements (PROMs). Whether these objective tools conceptualise and measure the impacts of hypogonadism in the same way, is not known. Aim To appraise the evidence on the item content of validated patient-reported outcome measures for hypogonadism evaluations and identify core domains of potential importance in this context. Methods We systematically reviewed tools (e.g., questionnaires, surveys, scales) in published quantitative or qualitative data of men with low testosterone and/or those using (or who had considered treatment). PROMs data extraction forms and data tables were generated for each stage of the extraction process to standardise the information recorded and aid analysis. Data was synthesised by classifying the items identified into domains determined by the nomenclature reported in included studies and the International Classification of Functioning, Disability and Health (WHO-ICF). Finally, a narrative synthesis of the instruments and their inter-related domains and subdomains was conducted to identify areas of both convergence and divergence. Results A total of nine tools measuring PROMs of men with low testosterone were included in this review. The included studies were set within the US (n=5), Canada (n=1), UK (n=1), Germany (n=1), Italy (n=1). The tools identified were: Androgen Deficiency in Aging Males (ADAM) Questionnaire, The Aging Males’ Symptoms (AMS) scale, ANDROTEST ©, The Age-Related Hormone Deficiency Dependent Quality of Life Questionnaire (A-RHDQoL)©, Hypogonadism Energy Diary (HED), Hypogonadism Impact of Symptoms Questionnaire (HIS-Q), HIS-Q-Short Form (HIS-Q-SF), Massachusetts Male Ageing Study (MMAS) questionnaire, Sexual Arousal, Interest, and Drive Scale (SAID). Only HED, SAID, and HIS-Q reported including patients while developing the tool. The number of items varied across instruments and ranged from 3 to 53 items (median=7) with a cumulative total of 98 individual items. The ten domains identified were: Cognition, Energy, General well-being, Mood, Pain, Physical-General, Role, Sexual, Sleep, Social. Across tools, the most frequently identified domain was the sexual domain. However, two of the PROMs, HED and MMAS, did not include any items that covered the sexual domain. Six of the nine tools were considered multi-dimensional, and three were considered unidimensional (i.e. only capturing one domain). The A-RHDQoL tool showed to be the most comprehensive tool across the PROMs included since this was the only one to include items that could be coded to all ten domains. Conclusions This study has demonstrated the considerable item concept variability across disease-specific PROMs for men with low testosterone regarding development and domain coverage. The dominant focus of these PROMs to date has centred around sexual function, but possibly to the detriment of other aspects that also matter to patients. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

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SUMMARYThe defatted methanol extract of Raphanus sativus Linn. (Cruciferae) seed (MERS) was evaluated for its antisteroidogenic potential in mature female Swiss albino mice. The methanol extract at the doses of 100 and 200 mg/kg body weight significantly elevated the levels of cholesterol and ascorbic acid contents which serve as a precursor for the synthesis of steroid hormones in ovaries. The extract also significantly inhibited glucose-6-phosphate dehydrogenase and Δ 5-3β-hydroxy steroid dehydrogenase, the two key enzymes involved in ovarian steroidogenesis. Hence the extract (MERS) exhibited significant antisteroidogenic activity.