Héctor Salvador Godoy Morales’s research while affiliated with Universidad del Pedregal and other places

Antecedentes: La hormona antimüllleriana (HAM) ha sido utilizada como marcador de reserva ovárica, lo cual ayuda a predecir el éxito. Se desconoce si valores de otros países son apicables a México. Objetivo: Determinar los valores de HAM en nuestra población para graficarlas acorde a grupos de edad y evaluar su comportamiento. Metodología: Estudio observacional, descriptivo, retrospectivo y transversal de pacientes del 2008 al 2018, con reporte de nivel de HAM excluyendo a pacientes con enfermedades que alteran su nivel, analizando por grupos de edad en un laboratorio. Resultados: 450 pacientes de 36.93 años, el rango del valor de la HAM fue desde 0.003 ng/ml hasta 9.4 ng/ml, con una media de 1.5, con una disminución anual a partir de los 40 años (0.1-0.3). Correlación de Spearman de -436 (p < 0.000) con una asociación leve entre la edad y el nivel de HAM, pero sí lineal (p < 0.000). Conclusiones: La HAM es útil y sirve para dar recomendaciones personalizadas, así como base de estudios epidemiológicos en pro de una medicina individualizada.

Background: Delaying maternity has been subject of controversy, data from the ESHRE, ASRM and the LARA network, show us that the pregnancy rate in people over 40 with IVF cycles are 6-10%, 20% and 15% respectively. Therefore, we decided to make a descriptive study of the main success rates when patients are treated by IVF cycles with their own ovules and to determine the characteristics of this population of advanced maternal age, who decide to undergo highly complex reproductive treatments. Objective: To determine the results of IVF treatments in women over 40 years of age with their own ovules in terms of pregnancy rate, live birth rate and implantation rate. Methodology: Observational, descriptive, retrospective and cross-sectional study in which we analyzed the records of patients treated with IVF with own ovules from year 2015 to 2017 at Hospital Angeles del Pedregal in Mexico City, aged 40 years or more, and treated with their own ovules, with complete files, through data collection and conventional non-probabilistic sampling. Results: the overall pregnancy rate was 22%, the live birth rate was 16%, the implantation rate was 22%, achieving 16% through fresh transfer and 6% through devitrification, the total percentage of ectopic, biochemical pregnancies and abortions was 27.5%. Conclusions: The pregnancy rate decreases according to age especially after 39 years, this study represents the general panorama of a very particular population in our country, where the attention of these patients continues to be a challenge due to the low reserve and ovarian response. Antecedentes: Postergar la maternidad ha sido tema de controversia, datos del ESHRE, ASRM y la red LARA, nos demuestran que la tasa de embarazo en mayores de 40 años con ciclos FIV son de 6-10%, 20% y de 15% respectivamente. Por ello decidimos hacer un estudio descriptivo de las principales tasas de éxito al ser sometidas a ciclos FIV con óvulos propios y determinar las caracteristicas de esta población de edad materna avanzada, que deciden ser sometidas a tratamientos reproductivos de alta complejidad. Objetivo: Determinar los resultados en tratamientos FIV en mujeres mayores de 40 años con óvulos propios en cuanto a tasa de embarazo, recién nacido vivo y de implantación. Metodología: Estudio observacional, descriptivo, retrospectivo y transversal en el cual se obtuvieron los registros de pacientes tratadas con FIV con óvulos propios en el año 2015 a 2017 en el Hospital Ángeles del Pedregal en la Ciudad de México de 40 años o más tratadas con óvulos propios, con expedientes completos, mediante recolección de datos y muestreo no probabilístico convencional. Resultados: La tasa de embarazo global fue de 22%, la tasa de récien nacido vivo fue de 16%, la tasa de implantación fue de 22%, logrando 16% por medio de transferencia en fresco y 6% por medio de desvitrificación, el porcentaje total de pérdidas o embarazos ectópicos o bioquímicos fue de 27.5%. Conclusiones: La tasa de embarazo disminuye conforme a la edad a partir de más de 39 años de edad, este estudio nos presenta el panorama general de una población muy particular en nuestro país, donde sigue siendo un reto la atención de estas pacientes debido a la baja reserva y respuesta ovárica.

This article reports the case of a 28-year-old female 31.6 weeks pregnant with twins diagnosed with SARS-CoV-2 infection, who delivered a boy and a girl. The newborns underwent RT-PCR testing for SARS-CoV-2; the male tested negative and the female newborn tested positive, in that the female placenta was SARS-CoV-2 positive and the male placenta negative. Clinical and laboratory findings evincing vertical transmission of SARS-CoV-2 were identified. Strict, multidisciplinary prenatal care is recommended for this group of patients. This case report alone does not provide statistical evidence of vertical transmission, but it is an account of a relevant matter.

Objective: Serum anti-Müllerian hormone (AMH) presents a strong positive correlation with quantitative aspects of the ovarian reserve, while its correlation with embryo quality is unclear. This study assessed the association between serum AMH as a marker of ovarian reserve and embryo quality, in women undergoing in vitro fertilization. Methods: This observational analytical retrospective study included patients seen between 2010 and 2018. In vitro fertilization patients with measured AMH levels were analyzed based on the following parameters: number of retrieved oocytes; number of metaphase II oocytes; embryo quality; and treatment outcome. Statistical analysis was performed using ANOVA, Mann-Whitney U test, linear regression, and Pearson and Spearman correlations. Results: We found a positive correlation between AMH levels, number of retrieved oocytes and number of metaphase II oocytes (r 0.649, p=0.000). The numbers of retrieved and metaphase II oocytes were predicted in 42% (R2: 429) of the cases based on AMH levels (p=0.000). Serum AMH levels were not associated with embryo quality on Day 3 (p=0.151); an association was seen between AMH levels and embryo quality on Day 5 (p=0.006). The distribution of AMH levels was the same across patients, regardless of whether they were able to achieve pregnancy (p=0.767). Conclusions: AMH levels correlated with embryo quality on Day 5; no association was found between AMH levels and embryo quality on Day 3 or pregnancy rate. The use of AMH levels to predict embryo quality still requires further studies; therefore, AMH should be used to assess the ovarian reserve only.

Objective: To study the importance of immunological screening (CH50, C3, C4) to determine the correlation between the ovarian reserve and complement pathway. Design: A cross-sectional multivariate study. Setting: Single tertiary referral center. Patients: 40 Women with infertility diagnosis who underwent In Vitro Fertilization (IVF). Intervention(s): Basal blood samples collected to measure complement pathway and antimüllerian hormone. Main Outcome Measure(s): To correlate complement pathways (CH50 levels) with AMH. Results: The complement system and ovarian reserve were studied in 40 women aged from 28-48 years (mean=37.87 years), finding the values of CH50 65-268 CAE (mean=153.2 CAE), C3 13.9- 183mg/dl (mean=128.52mg/dl), C4 11.5-106mg/dl (mean=29.86mg/dl), AMH 0.10-3.9ng/dl (mean=1.32ng/dl). A multivariate analysis comparison was also conducted yielding significant results: negative correlation between AMH and age (Spearman correlation -0.6; P=0.001), as well as between AMH and CH50 (Spearman correlation -0.4; P=0.0129). Conclusion: High CH50 levels are correlated with an AMH decrease and it could be accordingly associated with age-related chronic inflammation. Capsule: High levels of CH50 are correlated with a decrease in AMH levels and could also be considered as a marker of poor response in IVF cycles.

Objective: To compare approaches to myomectomy (laparotomic, laparoscopic, and robotic). To show the relationship between the number of fibroids and the reproduction diagnosis. Methods: Observational, analytical, retrospective, and cross-sectional study; where the surgical approach used, was evaluated in terms of surgical bleeding, time, number and weight of fibroids and reproductive results. Results: 69 patients were treated through different approaches and divided into 3 groups. The differences found among groups were in favor of laparotomic myomectomy in terms of the number (p=0.000) and weight of fibroids (p=0.004). Robotic surgery was also longer (p=0.000). In the analysis of the influence of the number of fibroids to achieve pregnancy, the result was in favor of the minimally invasive routes, after surgery, both in the group of < 6 fibroids (p=0.017), and that of > 6 fibroids (p=0.001), without differences in the time from surgery to pregnancy (p=0.979). Conclusions: The surgical approach decision should consider the number and size of resected fibroids, surgical time, and reproductive diagnosis. The minimally invasive route should be offered whenever possible due to its better outcome on achieving pregnancy, without forgetting the benefits of laparotomy, while also accrediting the recently introduced robotic-assisted approach.

Objective: This study aimed to examine the association between serum estradiol levels and number of metaphase II oocytes harvested after in vitro fertilization cycles used in embryo transfers and the subsequent impact on pregnancy rates. Methods: This observational analytical retrospective study was carried out in 2010-2018 at the Angeles del Pedregal Hospital. It included 181 cases and looked into the number of metaphase II oocytes to predict pregnancy rates. Statistical analysis was based on the calculation of correlations between variables and logistic regressions. Results: Estradiol levels increased with the number of oocytes by a median correlation (r=0.482, p=0.000). On the day of trigger, estradiol levels predicted the number of retrieved oocytes with 23% reliability (R2=0.232, p=0.000); a linear trend correlation of r=0.489, p=0.000 was found between estradiol levels on the day of trigger and number of metaphase II oocytes. Conclusions: Serum estradiol on the day of trigger as a predictor of metaphase II oocytes in antagonist cycles encourages greater oocyte maturity and fertilization, whereas, in isolation, it does not determine the pregnancy achievement.

Introduction: Maca (Lepidium meyenii) belongs to the Brassicaceae family and it grows in Peru´s central Andes above 4000 and 4500 meters of altitude from the sea level. The plant belongs to the brassica (mustard) family and the Lepidium genus. Its closest relatives are rapeseed, mustard, turnip, and cabbage. Maca has multiple clinical applications like proactive against cancer, libido maintenance, menopause, and fertility. There are several mechanisms the Maca could impact at fertility problems.The increase of Luteinizing hormone (LH), increase the semen quality and improve sexual development in male, and at female, increases the libido and improve menopause symptoms with a possible influence at germ cell quality. Objectives: To describe the impact of consuming Maca involve an improve at fertility. Methods: Literature search was performed in PubMed from January 2000 to May 2017 using the search terms child obesity and: infertility, Maca, ovulation, spermatogenesis. Keywords: Maca; Fertility; Germ cells Volume 6 Issue 5 - 2017 Research Article 1CSIHM Centro de Salud Integral del Hombre y la mujer, Mexico 2ART Reproduccion, México 3Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico Conclusion: Maca consumption can improve the quality of both germs cells enlightening the fertility. More clinical studies are need to know the doses and direct the effect of the microenvironment in germ cells having a positive impact on reproduction in both genders.

Introduction: Human spermatogenesis is regulated through paracrine and endocrine activity, cell interaction with Sertoli promotes and maturates the germ cell. These cell−cell signaling promotes the modification and expression of different type of proteins. That includes the Claudins family whose involved with sperm and Sertoli cells connections. The goal of this study is to demonstrate the presence and its localization of the Claudins family (1,3,4 and 6) at human testicle biopsies obtained by TESE. Objectives: Demonstrate the presence of Claudin family at TESE in human samples of infertile couples. Determine the location of expression and its correlation with pathology diagnosis. Methods: Testicular biopsies were obtained by TESE, with previous diagnosis of azoospermia, genetic causes were excluded. Claudin family expression was evaluated by immunohistochemistry. Evaluation the expression divided the sample in two groups (with germ cells and without germ cells) to evaluate Claudin family expression at stroma and tubules conducted by pathology evaluation. Results: We studied twenty testes biopsies of couples with infertility in TESE; They were divided in two groups: group 1: 7 patients with azoospermia and group 2: 13 with presence of spermatogenesis, immunohistochemically analysis of the biopsies was performed with monoclonal and polyclonal antibodies reactive to claudins 1,3,4 and 6. The results showed that claudin 1 express nuclear at Sertoli cells, and in positive in sperm cell at group 2. (Fig 1). Claudin 3 positive nuclear mark at Sertoli cells and germ cells, (Fig 2) Claudin 4 expression at the basal membrane with Sertoli cells. (Fig 3) Claudin 6 were negative mark. At azoospermia group, they were Claudin 3 negative mark the rest Claudin family expression were the same, independently the level of the arrest at germ cell. Conclusions: The claudin family is positive express at human testes. The interaction with Sertoli cells involve claudin 3 and 4. But also indicates that sperm have its personal claudin for interaction with Sertoli cells Claudin 1, claudin 6 negative mark at this experiment. Tight junctions indicate that sperm membrane modifies during its maturation improving sperm quality as a messenger for nuclear development.