Showing papers in "Iranian Journal of Reproductive Medicine in 2007"

Anti-fertility effects of physalis alkekengi alcoholic extract in female rat

Abstract: Background: Physalis alkekengi (P. alkekengi)has been used as an abortive plant in Iranian traditional medicine for many years. Objective: To investigate the effects of P.alkekengi on the fertility rate in female rats. Material and Methods: In this experimental study, 40 female albino rats were divided randomly into two groups; group 1/for investigating the implantation sites and group 2/ for investigating the number and weight of neonates. In both groups, treated animals received plant extract at dose of 150 mg/kg on days 1-5 of pregnancy. In group 1, treated animals were euthanized at 7 th days of pregnancy and number of implantation sites were counted. In group 2, treated animals maintained till delivery time and after delivery, the number and weight of neonates were investigated. Results: Data showed that administration of P. alkekengi extract on days 1-5 of pregnancy significantly decreased the number of implantation sites, number and weight of neonates. Conclusion: These results suggest that the extract produced anti- fertility effect probably by inhibiting implantation.

Reactive Oxygen Species (ROS) level in seminal plasma of infertile men and healthy donors

Abstract: Background: Reactive Oxygen Species (ROS) are a group of free radicals that in excessive amounts have negative influence on sperm quality and function. Objective: We compared ROS levels in seminal plasma of infertile men with this level in healthy donors. We also determined the ROS level in semen of infertile men according to the etiology of infertility, and also the effect of smoking on its level. Materials and Methods: In total, 63 infertile patients and 63 healthy donors as control were selected. Complete physical examination, semen analysis, scrotal sonography and hormone assay were done for all patients. Azoospermic patients were excluded from the study. ROS level in semen was measured by chemiluminescence assay in both groups. Patients also were divided in two groups according to the etiology of infertility. Results: The mean age of normal subjects and infertile men were 30.78±3.73 years and 31.43±6.60 years respectively. The mean ROS level in normal men was 180.05 RLU (Relative light unit), while this was 1852.04 RLU in infertile patients, which is significantly higher in case group (p=0.000). Fifty patients had varicocele and in 13 patients no specific etiology was found. The mean ROS level in varicocele patients was 2215.42 RLU and in unknown group was 454.44 RLU (p=0.048). Conclusion: Our study showed that the level of ROS in seminal fluid of infertile men is significantly higher than fertile donors and also in infertile patients with varicocele it is higher than patients with unknown cause.

Colony formation ability of frozen thawed spermatogonial stem cell from adult mouse

Abstract: Background: The basis of spermatogenesis is the spermatogonial stem cells (SSCs). The concentration of SSCs is very small. However, a system that supports the proliferation and maintenance of SSCs in vitro could be used to preserve and expand SSCs numbers as well as increase success in transplantation. It is a new avenue to restore spermatogenesis in azoospermia subjects. Objective: Proliferation and enhancement of frozen-thawed SSCs numbers during in vitro culture. Materials and Methods: Both Sertoli and spermatogonial cells were isolated from adult mouse testes. Frozen-thawed spermatogonial cells were cultured in two groups: simple culture (Experimental 1) and co culture with Sertoli cells (Experimental 2). Also, Fresh cells were considered as control groups: simple culture (control1) and co culture with Sertoli cells (control 2).Assay of the spermatogonial-cell-derived colonies was carried out at the end of each week. Results: Results indicated that the viability rate of the frozen cells after thawing (68.4±10.2%) was influenced by cryopreservation procedure significantly (p ≤0.001). In addition, the number of the colonies and their diameters in the co-culture system with fresh cells (25.1±5.2 and 205.8±50 µm, respectively) were more than other groups and the differences were significant (pl0.001). Number of the colonies and their diameters in experimental 1(9.5±4.3 and 124±35.9 µm, respectively), experimental 2 (15.6±3.5 and 157.6±41.9µm, respectively) groups were better than control 1 group (3.1±2.2 and 87.5±30.6µm, respectively) and the differences were significant (pl0.001). Conclusion: We demonstrated that co-culture system with Sertoli cells can increase in vitro colony formation of adult fresh and frozen-thawed spermatogonial cells in mouse.

Karyotyping and counseling in bad obstetric history and infertility

Abstract: Background: Division of Human Genetics (DHG) is a referral center for karyotyping and counseling to the couples as well as to the individuals referred with bad obstetric history and infertility. Materials and Methods: From 1972 to 2003, overall 1666 couples and 131 female partners with bad obstetric history (BOH) such as; spontaneous abortions, live births with congenital malformations and still born and 73 infertile male partners have been referred for chromosomal analysis. Results: The chromosomal abnormality was found in 4.4% (83) of the sample studied. Chromosomal abnormality was seen in 56 couples (3.4%), 15 female (11.5%) and 12 male (16.4%) partners. The numerical chromosomal abnormality were seen in 34 (41%) and the structural abnormalities in 49 (59%) cases. The numerical chromosomal abnormalities were associated with sex chromosomes as follows (the number of cases are shown in parenthesis): 47, XXY (9); 46, XY/ 47, XXY (2); 46, XY/ 48, XXXY (1); 46, XY/ 47, XYY (2) and X mosaicism; 45, X/ 46, XX (14); 46, XX/ 47, XXX (6). The structural anomalies were 40 translocations and 9 duplication/ deletion/ marker/ iso chromosome for the X chromosome;

Evaluation of epididymal necrospermia following experimental chronic spinal cord injury in rat

Abstract: Background: Spinal cord injury (SCI) occurs most often to young men at the peak of their reproductive health. Only 10% of SCI men can father children without medical assistance due to potential impairments in ejaculation and sperm quality. Objective: The main objective of this experimental study was to evaluate the epididymal necrospermia- sperm death, after chronic SCI in rat. Materials and Methods: Forty-five adult Wistar rats were divided into 3 groups of SCI, sham, and control. Following laminectomy, SCI was induced onto exposed dura matter (T10) of anesthetized rats. Sham group underwent laminectomy of T10 only; while, control rats were not exposed to any type of injury or medication. The spermatozoa from cauda epididymis were aspirated after 50 days for analysis of necrospermia with three assays of Eosin-Y staining, Hypo-osmotic swelling (HOS), and Hoechst 33258 fluorescent dye. Results: The rate of necrospermia in SCI rats was significantly increased when compared with other groups (p<0.05). Also, the rates of necrspermia in SCI samples were similar with application of 3 assays (Eosin-Y: 46.11±9.41; HOS: 45.88±8.89; Hoechst: 46.76±9.31). Total necrospermia was not observed in any of the epididymal samples. Conclusion: The results showed that chronic SCI is associated with high rate of epididymal necrospermia in mammals such as rats. It is, therefore, recommended that an effective laboratory technique, such as Hoechst 33258 should be used for separation of live and motile sperms from necrospermic ones for assisted reproduction program.

The association of preterm labor with vaginal colonization of group B streptococci

Abstract: Background: Group B streptococcus is regarded as a potential factor for adverse outcomes of pregnancy such as preterm birth. Objective: To study the association of maternal vaginal colonization with group B streptococcus (GBS) and preterm labor. Materials and Methods: From April 2005 to May 2006, vaginal culture for GBS were conducted in 101 laboring women with a gestational age of 24-37 weeks and 105 women admitted for term delivery at maternity center of Afzalipour Hospital in Kerman,

The effects of sodium arsenite on the testis structure and sex hormones in vasectomised rats

Abstract: Background: Sodium arsenite and/ or vasectomy may cause variation in sex hormones which affect pathophysiology of reproductive organs. Objective: The aim was to investigate the morphological changes in structure of testis and hormonal imbalance in bilateral Vasectomised rats treated with sodium arsenite. Materials and Methods: Four groups of rats: bilateral vasectomy + sodium arsenite, bilateral vasectomy, sham operated + sodium arsenite and sham operated only were considered, and 8 mg/kg/ day of sodium arsenite was given for 8 weeks to the rats. The total volume of testis, volume of interstitial tissue, volume of seminiferous tubules, diameter of seminiferous tubules and germinal epithelium thickness were evaluated using stereological methods. Hormones were also measured and the results were analyzed using one way ANOVA. Results: A significant reduction of total volume of testis (p<0.01), mean volume of seminiferous tubules (p<0.002) as well as germinal epithelium thickness (p<0.05) in both vasectomy + sodium arsenite and vasectomy rats was seen compared to sham operated only. In addition a significant reduction of testosterone was observed in vasectomy + sodium arsenite group when compared to the other groups (p<0.001). LH level decreased significantly in vasectomy + sodium arsenite when compared to sham operated ones (p<0.05). Conclusion: Vasectomy and treatment with sodium arsenite affect the structure of testis with respect to its volume, volume of seminiferous tubules and thickness of germinal epithelium, which may be due to variation of LH and testosterone level in the rats.

Diagnostic value of hysteroscopy in abnormal uterine bleeding compared to pathology reports

Abstract: Background: According to age, history and physical examination findings, there are different diagnoses including anatomic lesions for abnormal uterine bleeding (AUB). In these conditions, hysteroscopy can be performed as a diagnostic and therapeutic procedure. Objective: The aim of this study was defining the diagnostic value of hysteroscopy in evaluating uterine cavity in patients with AUB compared to pathologic findings. Materials and Methods: This was a prospective descriptive-analytic study in which hysteroscopy was performed for 105 patients with AUB .The patients were in reproductive and perimenopausal (86.7%) or postmenopausal ages (13.3%). Hysteroscopy was done and biopsy was taken from any pathology. After removing of hysteroscope, dilatation and curettage were done. Both samples were sent for pathologist. At the end, reports of hysteroscopic findings were compared with pathologic results. Results: Diagnostic value of hysteroscopy in evaluation of uterine cavity showed 100% sensitivity, 80.5% specificity, 88.9% positive predictive value (PPV) and 100% negative predictive value (NPV). Sensitivity, specificity, PPV and NPV of the procedure for endometrial polyp were 93%, 100%, 100%, and 95.4%, respectively. These results were respectively 100%, 96.4%, 88% and 100% for submucosal myoma, and 25%, 89.7%, 12.5% and 93.3% for endometrial hyperplasia. Conclusion: The results of this study show that hysteroscopy is a reliable method for evaluation of AUB, especially in benign lesions such as endometrial polyp and submucosal myoma and it can be used as the first line diagnostic method for these abnormalities. However hysteroscopy without directed biopsy has insufficient value for diagnosing endometrial hyperplasia.

The effect of opium on serum LH, FSH and testosterone concentration in addicted men

Abstract: Background: Fertility is considered as a life conservative phenomenon among married couples which can be obliterated by various conditions affecting both males and females. In the other hand addiction is a problem which increasingly developed among the various populations throughout the world, and there are evidences that addiction may affect the hypothalamous-pituitary-gonadal axis and sexual functions.The precise pharmacological effects of chronic use of opium on serum level of gonadotropins and male sex hormones are not studied extensively. This study was conducted to investigate the changes in these parameters in opium addicted men. Materials and Methods: The blood samples from 46 opium addicts and 46 normal men were taken, and the testosterone, LH and FSH levels in serum were measured by radioimmunoassay (RIA) technique using a LKB gamma counter. Results: The result of this study showed that the serum testosterone in opium addicts were decreased significantly compared to the controls (p<0.01). This reduction was directly proportional to the duration of opium usage. The LH and FSH level in opium addicts showed also significant reduction compared to the controls (p<0.01and p<0.05 respectively). Conclusion: According to our findings the chronic use of opium can cause significant decrease in the functions of hypophysiol gonadal secretion which may led to sexual suppression and infertility which needs further investigations.

Genetics of polycystic ovary syndrome

Abstract: Polycystic ovary syndrome (PCOS) is a genetically based disorder which reflects multiple potential aetiologies and variable clinical presentations. It is clearly a heterogeneous syndrome, and current proposed diagnostic criteria include a number of disorders with similar phenotypes but radically different aetiologies. The lack of well-defined diagnostic criteria makes identification of PCOS confusing to many clinicians and seriously delayed the clarification of its genetics, aetiology, clinical associations and assessment of treatment. There is no universally accepted clinical definition for PCOS. In this review the genetic causes and diagnosis criteria of PCOS will be discussed.

Vitrification induced apoptosis in spermatozoa from fertile and subfertile men

Abstract: Background: Phospholipids are distributed asymmetrically between inner and outer leaflets of the plasma membrane of live cells. Early during apoptosis, this asymmetry is disrupted and phosphatidylserine becomes exposed on the outside surface of the plasma membrane. There is little information about the effects of vitrification on apoptosis. Objective: The aim of the present study was to evaluate the effect of vitrification on apoptosis of subfertile and fertile men. Materials and Methods: In this study, semen samples were collected from subfertile (n=20) and fertile men (n=10) after 48h abstinence of intercourse. After semen analysis according to WHO criterias, each semen sample was divided into two portions. First portion was assessed by Annexin V-flous staining kit for showing apoptosis in subfertile and fertile men and second portion was assessed after vitrification-thawing. Results were analyzed by Paired t-test and Independent t-test. Results: After vitrification-thawing, mean percentage of apoptotic spermatozoa has increased 6 and 3 times in subfertile and fertile men respectively. This difference is significant. Conclusion: Vitrification-thawing could disrupted membrane asymmetry and caused apoptosis. Therefore, it will cause reduction of functional spermatozoa in access of Assisted Reproduction Technologies (ART).

CA-125 in normal pregnancy and threatened abortion

Abstract: Background: CA-125 is a glycoprotein and its origin is uncertain during pregnancy It arises during the first trimester and return to a non-pregnancy range in late pregnancy Objective: The aim of this study was to compare CA-125 level in threatened abortion and normal pregnancy less than 20 weeks of pregnancy Materials and Methods: This was a prospective case study carried out on 50 healthy pregnant (group 1) and 50 threatened abortion women (group 2) We compared the levels of CA-125 in these groups and followed them to be informed of the outcome of pregnancy Results: Fifty percent of women were in 20-24 years old group, primigravida and in the first trimester of pregnancy The mean level of CA-125 in group 1 was 262 ± 325 IU/ml and in group 2 was 3744 ± 272 IU/ml The mean level of CA-125 in finally aborted patients was 5817±725 IU/ml and in normal pregnant women, who continue to term, was 2661±176 IU/ml The CA-125 level in threatened women,whose pregnancy continued and did not abort, was 3089 IU/ml There was statistically significant difference between mean serum CA-125 levels of two groups (p 01) In group 2, there was a statistically significant difference in the level of CA-125 between those who developed abortion and those whose pregnancy continued but not aborted (p < 005) Conclusion: Measurement of serum CA-125 may be an inexpensive, easily available, sensitive and specific predictor of outcome in threatened abortion, which results the loss of pregnancy

Human sperm dna damage in the context of assisted reproductive techniques

Abstract: Fertilization involves direct interaction of the sperm and oocyte, fusion of the cell membranes and union of male and female gamete genomes. The completion of this process and subsequent embryo development depend in part on the inherent integrity of the sperm DNA. Sperm genome quality has been emphasized for several years as playing a major role in early embryogenesis. There is clinical evidence showing that human sperm DNA damage may adversely affect reproductive outcomes and that spermatozoa of infertile men possess substantially more DNA damage than do spermatozoa of fertile men. Testing DNA integrity may help selecting spermatozoa with intact DNA or with the least amount of DNA damage for use in assisted reproductive techniques (ARTs). This review will focus on how sperm DNA is organized, what causes sperm DNA damage and what impact this damage may have on reproductive outcome.

In vitro maturation media, cysteamine concentration and glutathione level affect blstocysts development in mouse

Abstract: Background: Preparation of oocytes is one of the critical factors that determine the developmental competence of embryos produced by in vitro fertilization (IVF). Objective: In this study, the effect of cysteamine, type of media and glutathione (GSH) level on blastocysts development after in vitro maturation of mouse oocytes were investigated. Materials and Methods: Premature female mice were primed with pregnant mare stimulating gonadotrophin (PMSG), and germinal vesicle (GV) stage oocytes were obtained 45 hr later. GV oocytes were cultured in presence of 0, 50, 100, 200 and 500 µm cysteamine in TCM199 and MEME media. After IVM, MII oocytes were in vitro fertilized (IVF) and in vitro cultured (IVC) in order to observe embryo development. A group of In Vivo Ovulated (IVO) oocytes after priming with PMSG and HCG also were included in this study. 5,5-Dithio-bis (2nitrobenzoic acid) DTNB-recycling protocol was used for GSH assay. Results: Rate of IVM and IVF were improved in all oocytes treated with cysteamine in the two medium except 500 µm (81% MII rate in TCM and 64% MII in MEME). Rate of blastocyst in 100 µm cysteamine in TCM1199 and 200 µm in MEME was higher compared to control groups (In TCM 45% and in MEME 35%). In vivo MII and GV oocytes represented the highest and lowest GSH level respectively. Conclusion: Our results revealed that the media and concentration of cysteamine can affects on IVM, IVF and rate of blastocysts development on dose dependant manner.

The effect of in vitro culture on cleavage rates and morphology of the in vivo- developed embryos in mice

Abstract: Background: Research studies on reproductive mechanism of laboratory animals are essential for further advancement of assisted reproductive techniques (ART). One of these studies includes the assessment of in-vitro development of pre-implantation embryos. The objective was to compare the cleavage rates and morphology of in-vivo formed 2 to 8 cell embryos and blastocysts with in-vitro culture of the same embryos for 24 h. Materials and Methods: 6-8 weeks old female NMRI mice were superovulated with 8IU pregnant mare's serum gonadotropin (PMSG, ip). Two superovulated animals were caged with one male mouse for mating. Mated mice were killed by cervical dislocation at different time intervals to collect a total of 200 (50/ each) 2, 4, 8, and blastocyst embryos from uterine tubes and horns. Following morphological evaluation and cleavage rates, all embryos were incubated in Whittingham's T6 media+5% BSA for 24 h. Following incubation at 37oC in 5% CO2, the cleavage rates as well as morphological feature of each embryo was re-evaluated and compared with the original embryos. Results: The best quality embryos collected from uterine tubes were at 2-cells stage, which were reduced when compared with in-vivo developed 4-8 cells embryos. 88% and 52% of 2 and 8 cells embryos were respectively at grade A stage. 28 embryos out of 50 eight-cell embryos were at grades C and D after incubation. Following in vitro culture, the development of 16%, 24%, 24%, and 40% of the 2, 4, 8 cells, and blastocysts were arrested, respectively. Also, only 2 blastocysts (8%) reached the hatching stage which in comparison with in-vivo blstocysts were increased (P>0.05). Conclusion: In-vitro culture of the in-vivo formed embryos reduced their cleavage rates and morphology, especially at more advanced stages. Therefore, it becomes necessary to improve the in-vitro culture condition and to transfer the embryos at early stage to consequently improve the implantation rates.

The effect of hyaluronic acid on motility, vitality and fertilization capability of mouse sperms after cryopreservation

Abstract: Background: Various approaches have been used in the attempts to improve the quality of frozen–thawed mouse sperms. According to literatures, it seems that hyaluronic acid (HA) has an important role on the permeability and motility of sperms and their interaction with gametes. Objective: For evaluation of HA supplementation on sperm characteristics and fertilization capability, we investigated the effect of different doses of HA on mouse sperm morphology, motility, vitality and fertilization capability after freezing and thawing. Materials and Methods: The cauda epididymes was removed from 6 male mice with aseptic method. The sperm samples were frozen in 1.8 ml cryotubes with 18% raffinose and 3% skimmed milk containing cryo-protectant solution. HA at the concentration of 750, 1000 or 1250 µg/ml was supplemented to frozen-thawed sperms. Sperm motility was measured with microscope, and fertilization rate was evaluated after routine IVF by counting the fertilized oocytes. For sperm morphology, papaniclau staining was used while; Eosin B was used for the assessment of sperm viability rate. Results: HA supplementation (750 µg/ml) improved motility parameters (p < 0.05) and increased the fertility rate (p < 0.05). The effect of 1,000 µg/ml HA was also positive on the sperms. But 1,250 µg/ml HA had negative effect on above mentioned characteristic. On the other hand, none of these doses had any effect on sperm morphology. Conclusion: The dose of 750 µg/ml of HA has the greatest effect on the motility, vitality and fertility rate of sperms after cryopreservation.

Effects of melatonin on histopathological changes after experimental ovarian torsion-detorsion in cat

Abstract: Background: During the detorsion of a torsioned ovary, oxidant agents are released and melatonin as an antioxidant can reduce ischemia. We studied the histopathological changes after using melatonin on experimental torsioned ovary in cat. Objective: The aim of this experimental study was to investigate the effects of Melatonin on histopathological changes in torsion – detorsion injury in cat ovary. Materials and Methods: An adnexal torsion – detorsion model was created by using 20 adult cats randomly divided equally in to 2 groups of Saline and Melatonin. Ischemia was induced by iathrogenic 360° clockwise torsion of the cat adnex for 3 hr. Reperfusion was achieved for 3 hr. Melatonin or saline were injected intra peritoneally (10mg/kg) 30 min before ovarian detorsion in both groups. After 3 hr of ovarian detorsion, ovarian tissue was removed and fixed in 10% formalin solution, embedded in paraffin and evaluated for ischemic indices. Results: Histological examination showed a significant improvement in ovarian morphology in the melatonin treated cats. Edema and vasoconstriction in saline group were more severe than Melatonin group (p-value = 0.009). Hemorrhage and leukocyte infiltration were also more obvious in saline group (p-value 0.0018) Conclusion: Our results demonstrated that Melatonin administration reduced ovarian histopathological damage due to oxidative injury associated with torsion.

Non-puerperal uterine inversion in a virgin woman

Abstract: Background: Inversion of the uterus is very uncommon. Patients may present with pelvic pain, vaginal discharge, or hemodynamic shock. Case: We report a case of 35 years old women (virgin) who was admitted with profuse vaginal bleeding and cramps of uterus. In the vaginal examination at litothomy position a mass of 5×8 cm in size was protruded from the vagina. At first myomectomy was performed and after that laparotomy with total abdominal hysterectomy was done. Conclusion: Early diagnosis, immediate treatment of shock, and replacement are essential in uterine inversion.

From stem cells to germ cells and from germ cells to stem cells

Abstract: Germline and somatic stem cells are distinct types of stem cells that are dedicated to reproduction and somatic tissue regeneration, respectively. Germline stem cells (GSCs), which can self-renew and generate gametes, are unique stem cells in that they are solely dedicated to transmit genetic information from generation to generation. We developed a strategy for the establishment of germline stem cell lines from embryonic stem cells (ES). These cells are able to undergo meiosis, generate haploid male gametes in vitro and are functional, as shown by fertilization after intra-cytoplasmic injection into mouse oocytes. In other approach, we show that bone marrow stem (BMS) cells are able to trans-differentiate into male germ cells. BMS cell-derived germ cells expressed the known molecular markers of primordial germ cells. The ability to derive male germ cells from ES and BMS cells reveals novel aspects of germ cell development and opens the possibilities for use of these cells in reproductive medicine. Conversely, we showed that adult male germline stem cells, spermatogonial stem cells (SSCs), can be converted into embryonic stem cell like cells which can differentiate into the somatic stem cells of three germ layers. Understanding how SSC can give rise to pluripotent stem cells and how somatic stem cells differentiate into germ cells could give significant insights into the regulation of developmental totipotency as well as having important implications for male fertility and regenerative medicine.

A survey of anti-sperm antibodies in infertile couples

Abstract: The presence of anti-sperm antibodies (ASA) in semen or serum may impair sperm function leading to immunological infertility. The aim of this study was to investigate the presence of ASA on the surface of sperm and in circulating blood of infertile couples. In this cross sectional study, we studied 49 couples suffering from infertility for at least one year. Serum ASA (IgG and IgA classes) was examined by indirect SpermMAR test. Also, ASA (IgG and IgA classes) attached to the surface of spermatozoa were tested by direct SpermMAR method in ejaculates from infertile men. ASA were positive in 8% of semen samples (2% IgG, 4% IgA, 2% both IgG and IgA classes). Only in one woman, ASA of the IgG class was found in serum samples. The presence of ASA may impair fertilizing ability and is a serious factor which may prevent the success of various fertilization techniques. ASA assessment should be considered as an essential part of infertility management.

Association of inherited thrombophilia and antiphospholipid syndrome with severe preeclampsia

Abstract: Background: Severe preeclampsia is a quite well-known entity with high incidence of both maternal and fetal morbidity and mortality. Although little is known about its etiology, inherited disorders of hemostasis and antiphospholipid syndrome have been postulated as common causes. The present study was conducted to evaluate the association of these two entities with preeclampsia in a group of Iranian patients. Materials and Methods: A case-control study was performed on 26 parturients with severe preeclampsia and 26 healthy pregnant women who were matched according to the age, parity, gestational age and previous history of abortion. A 10cc blood sample was obtained and the following factors were measured: factor V Leiden, protein S, protein C, antithrombin III, anticardiolipin antibodies (IgM and IgG) and the presence of the lupus anticoagulant antibody. Results: We have not found any significant difference in the values of factor V Leiden, antithrombin III, protein C, protein S, and anticardiolipin-IgG between preeclamptic (case) and non-preeclamptic (control) parturients. Meanwhile, lupus anticoagulant antibody was detected in one case and one control. However, anticardiolipin IgM was shown to be significantly higher in the preeclamptic patients. Severe preeclamptic parturients were 4.4 times more likely to develop elevated levels of IgM (OR=4.4, 95% CI=1.9-10, p<0.05). Conclusion: Our results failed to reveal any significant association between preeclampsia and indices of inherited disorders of hemostasis, except for anticardiolipin IgM. Thus, routine screening of these indices are not recommended due to high expenses and shortness of reliability.

Effect of intramural uterine myoma on the outcome of ART cycles

Abstract: Background: Although the uterine fibroids are common, their influence on fertility remains controversial. The association of submucosal fibroid with subfertility is well recognized, but debate persists as to whether intramural fibroids can cause infertility and the evidence for its effect on pregnancy in cycles of assisted conception remains unclear. Objective: The purpose of present study was to determine the effect of intramural fibroids less than 6 cm not compressing uterine cavity on the outcome of ART cycles in patients undergoing IVF/ICSI cycles. Materials and Methods: In this prospective cohort study, 94 women with uterine intramural fibroids and 184 controls referred to Royan Institute between 2001 and 2002 were enrolled. The intramural fibroids and their location were detected by transvaginal ultrasound performed just before the ART cycle. All patients underwent long standard GnRH agonist protocol. Student t-test and Chi-square test were used for the statistical analysis. Results: The mean age of patients was 33.9 ±3.37 years in myoma group (n=94) and 33.28 ±3.59 years in control group (n=184). The total dose of gonadotropin used, estradiol level on day of hCG administration, the number of metaphase II oocytes retrieved, fertilization rate, number and quality of embryos developed and transferred, the clinical pregnancy and abortion rates were similar in two groups. Conclusion: The presence of intramural fibroids less than 6 cm not compressing endometrial cavity does not adversely affect clinical pregnancy rate in patients undergoing IVF or ICSI.

The relationship between passive smoking and ovarian response outcome in ART cycles

Abstract: Background: Smoking has negative effects on reproductive process. Exposing to cigarette smoking (passive smoking) may exert some effects as the direct smoking. Objective: The aim of this study was to evaluate the correlation between ovarian response and passive smoking in women who underwent ART cycles. Materials and Methods: One hundred-sixty patients who underwent ICSI between 2000 and 2001 were studied in a prospective cohort study. The case group included women whose husbands smoked at least 5 cigarettes daily for 1 year or more. The control group included women with nonsmoking husbands. Women with high FSH level (g12 IU/ml) were excluded. Long standard protocol with GnRH agonist and HMG were used in all patients. In vitro fertilization and embryo transfer was carried out in a standard fashion. Results: Eighty one women were in case group and 82 in control group. Ovarian response variables were not significantly different between two groups but there was a significant relation between passive smoking and fertilization (RR= 1.18, 95% CI: 1.07-1.31). However pregnancy rate was not significantly different between two groups. Moreover there were no significant differences between heavy and light smokers in ovarian response outcomes. Conclusion: This study showed no correlation between ovarian response parameters and passive smoking in women underwent ART cycles, whereas fertilization rate is significantly lower in this group compared to control group. It may be related to sperm quality than oocytes. Assessment of nicotin in follicular fluid and cytogenetic evaluation of embryo before transfer are recommended for more information and confirmation.

Endometrial nerve fibres in endometriosis

Abstract: Endometriosis is a common gynaecological disease that can cause severe pelvic pain such as dysmenorrhoea and dyspareunia, however the mechanisms by which pain is generated are not well understood. Nerve fibres in endometriotic plaques have been reported by several authors. We have recently demonstrated the presence of unmyelinated sensory nerve fibres (using the pan-neuronal marker PGP9.5) in the functional layer of endometrium in women with endometriosis and a significantly increased nerve fibre density in endometrium and myometrium in women with endometriosis compared with women without endometriosis. Sensory C nerve fibres were only detected in the functional layer of endometrium of women with endometriosis and never in women without endometriosis. This finding is so consistent that it may become an effective means of making the diagnosis of endometriosis. Nerve fibres expressing a range of neuronal markers and an over-expression of nerve growth factor (NGF) and nerve growth factor receptor (NGFRp75) were also demonstrated in peritoneal endometrial plaques in women with endometriosis. Effects of currently available medications for endometriosis on nerve fibres in eutopic endometrium in hormonally treated women have been also studied. This review will describe nerve fibres in eutopic endometrium and ectopic endometriotic plaques in women with endometriosis.

The effect of pentoxifylline on the growth of endometrial implants and leukocytes in rats

Abstract: Background: Immune system disturbances have an important role in endometriosis which may lead to infertility. It seems that inflammatory cytokines specially tumor necrosis factor alpha (TNF-α) which were produced by activated macrophages have an important role in pathology of endometriosis. Based on this theory, anti TNF-α drugs like pentoxifylline (PX) are suggested as new drugs for Endometriosis. Objective: This experimental study has been done on female rats to determine the effect of PX on the endometrial implants and leukocytes in serum. Material and Methods: In proestrous phase, one horn of rat’s bicorn uterus was removed surgically and the endometrium was implanted to different places as follows: subcutaneous, peritoneum and near ovaries. After two months observation, female rats divided into two groups randomly. In treated group (n=10) PX (5mg/kg twice a day) and in control group (n=10), normal saline (same dose) were injected subcutaneously. Then, via second laparotomy and in the same phase of the cycles, the size of implants and the amount of leukocytes in serum were measured. Results: In treated group compared with control, the size of implants was decreased significantly in right subcutaneous (8.05mm vs 13.50mm) p<0.01, left subcutaneous (7.64 mm vs 14mm) p<0.01, right ovary (6.64 mm vs 15.22mm) p<0.001 and left ovary (7.18 mm vs 14.56 mm) p<0.005. In treated group, the total leukocyte count (5259.54 ± 178.78 vs 15833.33 ± 259.27) p<0.02 was decreased. The number of esterous cycle was similar in both groups. Conclusion: PX can reduce the size of endometrial implants as well as leukocyte count.

Frequency distribution of pregnancy occurrence in infertile women after diagnostic-surgical hysteroscopy

Abstract: Background: Mullerian disorders are present in 5-25% of infertile women. Myoma, polyp and endometrial adhesions are among other involved factors in infertility. Objective: The aim of this study was to determine the frequency distribution of pregnancy occurrence in infertile women after the diagnostic-surgical hysteroscopy on selected infertile cases including those with abnormal uterine. Materials and Methods: One hundred and fifteen women with at least 12 months infertility who had abnormal uterine cavity and patients who had at least 4 unsuccessful ART cycles with no confirmed diagnosis of uterine cavity problem, underwent diagnostic hysteroscopy and if required hysteroscopic surgery. Follow up sonography and HSG performed 2-3 months later and all subjects were followed for pregnancy occurrence for 12 months. Results: Mean age of subjects was 32.65 ± 6.2 years and mean of infertility duration was 8.33 ± 5.25 years. Based on the sonography and HSG performed prior to the hysteroscopy, respectively 69.6% and 41.8% of the subjects had abnormality. In 65.2% of the cases, hysteroscopy showed septum, myoma, endometrial adhesion and irregularity and all of them underwent hysteroscopic operation. Among the operated cases, in 27 cases pregnancy occurred during the first 6 postoperative months and in 2 cases during the second 6 postoperative months of whom one case was EP. Conclusion: There was no significant difference in the rate of pregnancy occurrence between those who had abnormal hysteroscopy and those who were normal (p= 0.63). This can show the variation of infertility causes and the fact that infertility is not just due to uterine problems. Therefore, the repetition of therapeutic measures and longer follow up of infertile cases are necessary.

Does transabdominal ultrasound-guided embryo transfer improve pregnancy rates in art cycles?

Abstract: Background: Recent reports have suggested that ultrasound-guided embryo transfer (UG-ET) might improve pregnancy rates. Objective: To determine whether transabdominal UG-ET is a useful tool for increasing pregnancy and implantation rates in patients undergoing IVF or ICSI. Materials and Methods: A prospective randomized clinical trial was conducted in 180 patients in order to compare embryo transfer under abdominal ultrasound-guidance (n=90) with embryo transfer by clinical touch method (n=90). Results: The Clinical pregnancy rate was 21.1 % in the ultrasound-guided group and 15.5 % in the clinical touch group (p =0.3). The implantation rate in the ultrasound guided group was 11.1% while this was 7.2% in the clinical touch group (p =0.12). The percentage of difficult transfer was not significantly different in both groups, this was 8.9% in the ultrasound-guided group and 13.3% in the clinical touch group (p =0.47). Conclusions: Although the clinical pregnancy and implantation rate are higher in UG-ET group than the clinical touch group, but this difference was not statistically significant.

Effect of metronidazole on spermatogenesis, plasma gonadotrophins and testosterone in rats

Abstract: Metronidazole and its derivatives have both antiprotozoal and anti bacterial effects. The reproductive toxicity of metronidazole has been observed in some studies. The aim of this study was to determine the detrimental effects of metronidazole on spermatogenesis and testicular androgenesis in male adult rats. Eighteen male Wistar rats (70-90 days old) were randomly divided into three groups. Animals in group I (Control group) were administered with the water only. Animals in groups II and III were administered with metronidazol at the doses of 200 or 400 mg/kg/day for 60 days. Quantitative analysis of spermatogenesis was carried out by counting the relative number of each variety of germ-cells at the stage VII of the seminiferous epithelium cycle, i.e. type-A spermatogonia (ASg), pre-leptotene spermatocytes (pLSc), and step 7 spermatids (7Sd). Plasma follicle-stimulating hormone (FSH), luteinizing hormone (LH) and testosterone were measured by radioimmunoassay (RIA). In groups II and III, there was a significant decrease in the testes, accessory sex organ weights, plasma concentrations of LH, FSH and testosterone with massive degeneration of all the germ cells at stage VII. Our data concluded that metronidazole has a suppressive influence on spermatogenesis and sex hormones in rats.

Fallopian tube endometrioid carcinoma

Abstract: Background: Carcinoma of the fallopian tube is extremely uncommon neoplasm, accounting for only 0.3% of gynecologic cancers. Case: A 17-year-old female patient presented with clinical symptoms of right side deep pelvic pain. Ultrasound examination reveals right adenxal mass with breakdown suggesting neoplastic lesion or tubo-ovarian abscess. She was diagnosed clinically as tubo-ovarian mass for histopathological verification of its nature and prepared for surgery. There was a large soft tissue lesion arising in the middle of the right fallopian tube. Histopathological analysis of the specimen revealed neoplastic growth formed of malignant glands and acini of endometrioid pattern. Conclusion: Most tubal endometrioid carcinomas resemble the endometrial counterpart histologically. Involvement of tubal serosa, of the ovary or corpus uteri or other pelvic and abdominal structures indicate a poor prognosis.

In vitro application of Matrigel enhances human blastocyst formation and hatching

Abstract: Background: Matrigel (extracellular matrix) can improve the growth of many cell types in vitro. Objective: The aim of the present study was to determine the effect of Matrigel on the development of 2-4 cells human embryos in culture. Material and Methods: Surplus 2-4 cells human embryos, resulting from ICSI, were divided into two groups (control and test). Quality of embryos in both groups was morphologically similar. The test group (n=140) was cultured in Hams’ F10 supplemented with 10% human serum albumin and 150 µl liquid Matrigel. The control group (n=140) was cultured in the same medium devoid of Matrigel. Embryos were cultured for an additional 4 days and their morphology was assessed every 24 hours. Both groups were then statistically compared. Results: The percentage of the human embryos that reached the morula stage in the control and test groups were 79.2% and 80%, respectively (p>0.05). However, 36.4% of embryos reached the blastocyst stage in the test group as compared to 5.7% in the control group after 144 hours in culture. This difference was statically significant (p <0.01). In addition, culture of embryos on Matrigel and medium versus medium alone significantly improved in vitro hatching (25.7% versus 3.5%; p <0.01). Conclusion: Matrigel at low concentration enhances human blastocyst formation and hatching in vitro.