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    Environmental influences in normal weight women with history of recurrent pregnancy loss
    (2013) Aborisade, O. B.; Charles-Davies, M. A.; Okunlola, M. A.
    Aim: The study investigated the possible relationship of luteal phase progesterone, toxic heavy metals and nutrients in normal-weight women with history of recurrent pregnancy loss for adequate management. Study Design: Cross sectional study. Place and Duration of Study: The Obstetrics and Gynaecology Clinic, University College Hospital, Ibadan, Olabisi Onabanjo University Teaching Hospital, Shagamu and State Hospital, Ijebu-Ode; the University of Ibadan and environs between April and September, 2009. Methodology: 90 apparently healthy women with normal weight aged 18-45years with regular and ovulatory cycles of 26-30 days were enrolled. They were 60 women with history of recurrent pregnancy loss (cases) age-matched with 30 women without history of recurrent pregnancy loss (controls). Demographic and anthropometric measurements were done by standard methods. Progesterone was determined by enzyme immunoassay (Immunometrics UK Ltd). Total cholesterol, triglyceride and high density lipoprotein were performed by enzymatic methods (Randox laboratories, USA) while low density lipoprotein was calculated using Friedwald’s formula. Zinc, selenium, chromium, manganese, iron, magnesium, copper, lead, and cadmium were estimated by atomic absorption spectrophotometry while Vitamin E was measured by high performance liquid chromatography. Statistical analysis was done using SPSS version 16.0. Results: Results showed significantly higher levels of triglycerides, cadmium and lead, and significantly lower levels of progesterone, iron, copper, magnesium, chromium, selenium and vitamin E in cases compared with controls (p<0.013). Conclusion: Oxidative stress mechanisms in normal-weight women with history of recurrent pregnancy loss were implicated. Healthcare policies should focus on pollution reduction and increase awareness on healthy diet for optimal periconceptional micronutrient requirements.
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    THE CONTRIBUTION OF ENDOCRINE DISRUPTING HEAVY METALS TO OESTRADIOL MODULATION AND SEMEN QUALITY NIGERIAN MEN
    (2011-06) CHUKUKA, OPURUM HAMILTON
    Declining male fertility is of global concern and has been linked to the effects of endocrine disruptors on the modulation of oestradiol. These disruptors are also recognised to be toxic to the testes. Selenium and zinc play specific roles in heavy metal detoxification, testosterone metabolism, sperm formation and motility. This study was aimed at identifying the possible contribution of cadmium, lead, selenium and zinc to oestradiol modulation and sperm defects in Nigerian men. One hundred and twenty males (20-54 years) were recruited after informed consent. These were age-matched 77 dyspermics and 43 normospermics recruited from the Urology Clinics of two teaching hospitals in Nigeria. Demographic and anthropometric indices were obtained using a structured questionnaire and standard methods respectively. Semen samples were collected from subjects by masturbation after 3-5 days of abstinence from sexual intercourse. Spermiogram and sperm morphological characteristics were done using WHO guidelines and Tygerberg strict criteria respectively. Ten milliliters of blood was obtained from each participant. Serum and seminal plasma were obtained by centrifugation of clotted blood and semen respectively. Testosterone, oestradiol, prolactin, luteinizing hormone and follicle stimulating hormone were estimated in serum while testosterone and oestradiol were estimated in seminal plasma by enzyme immunoassay method. Cadmium, lead, selenium and zinc were assayed in serum and seminal plasma by atomic absorption spectrophotometry. Data were analysed using t-test, ANOVA and multiple regressions at p=0.05. Forty-eight (62.3%) dyspermics had reduced sperm motility and abnormal morphology while 17 (22%) and 12 (15.6%) had oligospermia and azoospermia respectively. Seminal plasma UNIVERSITY OF IBADAN LIBRARY iii oestradiol was significantly lower in normospermics (0.7±0.04nmol/L) than dyspermics (1.1±0.07nmol/L) while testosterone/oestradiol ratio was significantly higher in normospermics (10.7±0.60) than dyspermics (7.3±0.70). Serum and seminal plasma cadmium were significantly higher in dyspermics (0.3±0.02μg/L; 2.0±0.07μg/L) than normospermics (0.1±0.01μg/L; 1.2±0.07μg/L) respectively. Serum and seminal plasma lead levels were also significantly higher in dyspermics (34.8±0.55μg/dL; 39.2±0.61μg/dL) than normospermics (28.2±0.74μg/dL; 31.9±0.87μg/dL), respectively. Serum and seminal plasma selenium were significantly higher in normospermics (0.9±0.01mg/L; 0.3±0.01mg/L) than dyspermics (0.8±0.01mg/L; 0.2±0.01mg/L) respectively. Serum and seminal plasma zinc were significantly higher in normospermics (7.9±0.16mg/L; 161.9±5.16mg/L) than dyspermics (7.2±0.12mg/L; 141.9±2.77mg/L) respectively. In dyspermic men, increased serum Cd was significantly associated with increased oestradiol in serum (β=0.42) and seminal plasma (β=0.52). Increased seminal plasma Cd was associated with decreased seminal plasma Zn (β =-0.21), decreased % motility (β =-1.03), increased % tail defects (β =0.08) and decreased sperm deformity index (β =-0.21). Increased serum Pb was significantly associated with serum FSH (β = 0.29). Increased seminal plasma Pb was significantly associated with increased serum FSH (β = 0.21). Increased sperm count was significantly associated with decreased serum oestradiol (β =-0.75) and testosterone/oestradiol ratio (β = -0.54); increased seminal plasma oestradiol (β =0.41) and testosterone/oestradiol ratio (β =0.38). Higher sperm deformity index was significantly associated with decreased serum Se/Pb ratio (β =-0.27). UNIVERSITY OF IBADAN LIBRARY iv Cadmium and Pb may cause depletion of Zn and Se which may account for the loss of their protective effect resulting in dyspermia through direct toxicity, oxidative stress, endocrine disruption or other yet unresolved mechanisms. Keywords: Oestradiol, Endocrine disruptors, Trace elements, Semen quality, Male fertility Word count: 494