Showing papers in "Iranian Journal of Reproductive Medicine in 2011"

How does lead induce male infertility

Abstract: An important part of male infertility of unknown etiology may be attributed to various environmental and occupational exposures to toxic substances, such as lead. The reproductive effects of lead are complex and appear to involve multiple pathways, not all of which are fully understood. It is still unclear, for example, if male reproductive issues in lead-exposed persons are mostly related to the disruption of reproductive hormones, whether the problems are due to the lead’s direct effects on the gonads, or both? This question has been difficult to answer, because lead, especially at high levels, may adversely affect many human organs. Although lead can potentially reduce male fertility by decreasing sperm count and motility, inducing abnormal morphology and affecting functional parameters; not all studies have been able to clearly demonstrate such findings. In addition, research has shown that the blood-testis barrier can protect testicular cells from direct exposure to high levels of blood lead. For these reasons and considering the wide spectrum of lead toxicity on reproductive hormones, the present review suggests that lead’s main influence on male reproduction probably occurs by altering the reproductive hormonal axis and the hormonal control on spermatogenesis, rather than by a direct toxic effect on the seminiferous tubules of the testes. As blood lead concentrations below the currently accepted worker protection standard may still adversely affect male fertility, future studies should aim to establish more concrete links between lead exposure (especially at low levels) and subsequent male infertility. Research should also pay more attention to lead’s effects on reducing male fertility rates based on not only hormonal axis alteration, but also on the changes in sperm characteristic among exposed subjects.

The status of depression and anxiety in infertile Turkish couples

Abstract: Background: Infertility is a major psychosocial crisis as well as being a medical problem. The factors that predict psychosocial consequences of infertility may vary in different gender and different infertile populations. Objective: The primary purpose of this study was to investigate whether Turkish infertile couples had higher levels of depression and anxiety when compared to noninfertile couples. Our secondary aim was to evaluate the relationship between sociodemographic characteristics and levels of depression and anxiety in Turkish infertile couples. Materials and Methods: We designed a descriptive cross sectional study of 248 infertile women and 96 infertile men with no psychiatric disturbance and 51 women and 40 men who have children to evaluate the depression and anxiety levels between infertile couples and fertile couples. A gynecologist evaluated participants for demographic data and then they were visited by a psychologist to perform questionnaire scales which were The Beck Depression Inventory and the State-Trait Anxiety Inventory for the evaluation of the degree of psychopathology. The data were statistically analyzed, with p<0.05 as the level of statistical significance. Results: We observed significant differences between the infertile couples and fertile couples with respect to state and trait anxiety (p<0.0001) while no difference was regarding with depression, both of women and men. Anxiety and depression were observed as independent from gender when infertile women and men were compared (p=0.213). Conclusion: We believed that the psychological management at infertile couples must be individualized with cultural, religious, and class related aspects.

Antioxidants and infertility treatment, the role of Satureja Khuzestanica: A mini-systematic review.

Abstract: Background: The use of antioxidants in the treatment of infertility has been suggested and recent studies have indicated that oral administration of Satureja Khuzestanica essential oil (SKEO) to rats induces significant antioxidative effects. Objective: This systematic review was conducted to evaluate the effectiveness of antioxidants in infertility and also to assess the effectiveness of Satureja Khuzestanica in infertility management. Materials and Methods: Pubmed, Scopus, and Cochrane Library were searched for relevant trials published from respective database inception dates to August 2010. Study selection, and data extraction were performed by authors. Results: Fifteen trials on evaluation of antioxidants in infertility and seven studies on the effectiveness of Satureja Khuzestanica were identified. Only 4 of the 15 trials were with application of allocation concealment and three studies were done in in-vitro environment. Despite the methodological and clinical heterogeneity of the trials, 14 of the 15 (93.33%) trials showed an improvement in either sperm quality or pregnancy rate after antioxidant therapy. The human and animal studies of Satureja Khuzestanica showed a significant antioxidative potential of the plant and its effectiveness for infertility improvement. Conclusion: The use of oral antioxidants in infertility could improve sperm quality and pregnancy rates. Improved fertility observed by SKEO in rats might be due to its antioxidative effect. Further studies and clinical trials in humans are necessary to evaluate SKEO effectiveness in fertility disturbances.

Infertility in Mazandaran province - north of Iran: an etiological study.

Abstract: Background: The prevalence and etiology of infertility are not similar in different parts of the world. There are only few reports of this topic in Iran. Objective: This study was conducted to determine the clinical patterns and major causes of infertility in Mazandaran province in north of Iran. Materials and Methods: The medical records of 3734 consecutive couples attending two infertility clinics in Mazandaran province, from 2003 to 2008, were reviewed. The couples had not had a viable birth after at least 1 year of unprotected intercourse and were fully investigated. Results: Of the entire samples, 78.7% had primary infertility and 21.3% had secondary infertility. The mean duration of infertility in couples was 5.7±4 years. The etiology of infertility in couples revealed; male factor in 38.9%, female factor in 34.7%, combined factors in 14.6% and undetermined cause in 11.8%. Conclusion: In this study, delayed attendance of infertile couples to the infertility clinic was found. Therefore, there is a need to revise public health program on infertility to focus on the education and prevention of infertility and its risk factors.

The correlation of factors affecting the endometrial thickness with pregnancy outcome in the IUI cycles.

Abstract: Background: Many studies have been carried out to understand the effect of endometrial thickness on the reproductive outcome while the factors affecting the pattern itself are still unknown. Objective: To determine the factors such as age and the number of follicles that could affect the endometrial thickness Materials and Methods: This study was conducted as a retrospective study on 680 infertile women considered for intrauterine insemination (IUI). IUI protocol was sequential regimen of clomid and gonadotropin. Endometrial thickness measurement was done on the day of HCG administration. Correlation between endometrial thickness and factors such as age, total follicle numbers, dominant follicle numbers, gonadotropine ampule numbers and pregnancy rate were assessed. Results: The mean endometrial thickness was 7.2±1.8 mm. The endometrium was thinner in older patients compared with younger ones. But in all age ranges pregnancy rate was higher in endometrial thickness 6< ET?10 mm (p<0.05). Conclusion: We did not find any correlation between age, number of follicles and gonadotropine ampoules with endometrial thickness but in all age ranges, there is a possibility of higher chance of pregnancy in endometrial thickness 6 < ET?10 mm. Article keywords: Endometrial thickness, Affecting factors, Intrauterine insemination, Pregnancy rate

Semen characteristics and sperm morphological studies of the West African Dwarf Buck treated with Aloe vera gel extract.

Abstract: Background: Aloe vera (Aloe barbadensis miller) is an evergreen perennial plant widely used in modern herbal practice and is often available in proprietary herbal preparations. Objective: This study was designed to investigate the semen picture and spermatozoa morphology of West African Dwarf (WAD) bucks treated with Aloe vera extract. Materials and Methods: Twelve sexually matured WAD bucks, weighing between 11 and 15 kg, were used for the study. The bucks were first used as control (pre-treatment) and later as two groups of six animals each. The first six bucks received 10 mls of the 3% extract while the other six received 10 mls of the 4% of the extract for a 7 day period. Semen was collected from both the 3 and 4% extract treated bucks for the control (pre-treatment), on days eight (first week post-treatment) and fifteen (second week post-treatment) in each case using the electroejaculation method. The spermiogram of the bucks were investigated using standard procedures. Data obtained were analyzed using two way ANOVA and significance reported at p<0.05. Results: The continuous administration of Aloe vera extract significantly (p<0.05) reduced sperm concentration, motility and percentage livability and resulted in increased sperm abnormalities in the WAD buck. Conclusion: Aloe vera adversely affected the spermiogram of bucks. The plant can reduce fertility in male animals and is therefore not recommended for medicinal purpose in male animals especially those used for breeding.

Incidence of sexual dysfunction in men after cardiac surgery in Afshar hospital, Yazd

Abstract: Background: Successful rehabilitation of cardiac surgery patients should include consideration of their sexual activity, but there is paucity of data regarding this matter. Objective: This study determined the incidence and type of sexual dysfunction in our patients. Materials and Methods: Two hundred-seventy nine men with age under 70 years old who had coronary artery bypass graft (CABG), valvular, or other types of cardiac surgery from Dec. 2006 until Dec. 2007 were enrolled in this descriptive-analytical study. They were interviewed before and 12 weeks after the operation in regard to the impact of surgery on their sexuality. The statistical methods used included analysis of variance, Kappa test, and chi-square analysis. Results: The mean age of the patients was 55.7 ± 10.66 (25-69) years. The incidence of sexual dysfunction was 20.1% before, and76.4%, 12 weeks after the operation. P-valueas tested by Kappa test was 0.0001, which means that cardiac surgery had adverse effect on sexual activity of the patients. Types of sexual dysfunction were impotence, premature ejaculation, and decreased or loss of libido in 6.5%, 4.3% and 9.3%, respectively before operation, and 34.8%, 21.5% and 20.1%, respectively 12 weeks after the operation. Concurrence of more than one dysfunction was not reported. Conclusion: Sexual dysfunction is common after cardiac surgery, and sexual counseling is still not being addressed adequately. The role and responsibility of the physician and the rehabilitation nurse becomes evident, together with the need for the patient’s partner to participate in counseling.

Maturation capacity, morphology and morphometric assessment of human immature oocytes after vitrification and in-vitro maturation

Abstract: Background: In general, 15% of oocytes collected in ART cycles are immature. These oocytes may be cryopreserved further for use in in-vitro maturation (IVM) program. Objective: The aim of this study was to determine maturation capacity, morphometric parameters and morphology of human immature oocytes in both fresh IVM (fIVM) and vitrified-IVM (vIVM) oocytes. Materials and Methods: 93 women who underwent controlled ovarian stimulation for ART were included. The immature oocytes (n=203) were divided into two groups: the first group (n=101) directly matured in vitro; and the second group (n=102) first vitrified, then matured in vitro. All oocytes underwent IVM in Ham’s F10 supplemented with LH+FSH and human follicular fluid. After 48h of incubation, the oocyte maturation rates, as well as morphometric and morphologic characteristics were assessed using cornus imaging and were compared. Results: Oocyte maturation rates were reduced in vIVM, (40.4%), in comparison with fIVM (59.4%, pl0.001). Following morphometric assessment, there was no difference in the mean oocyte diameters (µm) between fIVM and vIVM, 156.3±6.8 and 154.07±9.9, respectively. Other parameters of perimeters, egg areas, as well as oocyte and ooplasm volumes were similar in two groups. In addition, more morphologic abnormalities, such as, vacuole, and dark oocyte were observed in vIVM oocytes. Conclusion: fIVM was more successful than vIVM groups. No statistical differences were noticed in morphometry assessment in two groups. This suggests that morphometric parameters can not be applied as prognosis factor in oocyte maturation outcome in IVM program.

Local injury to the endometrium does not improve the implantation rate in good responder patients undergoing in-vitro fertilization

Abstract: Background: Despite numerous developments in the field of assisted reproduction the implantation rate remains low . Recent studies suggested that local injury to endometrium in controlled ovarian hyper stimulation cycle improves implantation rate. Studies have attempted to intervene in the development of endometrium. Objective: The aim of the present study was the exploration of the possibility that local injury of the endometrium increases implantation rate. Materials and Methods: In this interventional study, 100 good responders to hormone stimulation patients were divided into control group (n=50) and experimental group (n=50) which undergo endometrial biopsy by biopsy catheter )piplle) on day 21 of their previous menstrual cycle with use of contraceptive pills before the IVF-ET treatment. In total, 26 patients were removed from the study because the number of stimulated follicles were below 3, or there was no embryo or there was the risk of OHSS. The remaining patients were 33 in experimental group and 41 in the control group. Results: There were no significant differences between the two groups in terms of the age of the patients, duration of infertility and BMI, base line FSH level and responses to hormone stimulation. The rates of embryo implantation, chemical and clinical pregnancy in the experimental group were 4.9%, 18.2% and 12.1% with no significant differences with the control group (6.7%, 19.5%, 17.1%). Cancellation rate was 26%. Conclusion: In our study, endometrial biopsy didn‟t increase the chances to conceive at the following cycle of treatment.

High plasma homocysteine and insulin resistance in patients with polycystic ovarian syndrome

Abstract: Background: Polycystic ovarian syndrome (PCOS) is a common disease among women in fertility ages and cause severe insulin resistance. Hyperhomocysteinaemia is said to be among the features of PCOS that could influence its outcome. Objective: This study aimed to investigate whether hyperhomocysteinaemia exists in PCOS and if it is related to insulin resistance in the affected patients. Materials and Methods: This prospective study was carried out in a university based fertility clinic. Sixty four PCOS patients and 50 normo ovulatory controls were reviewed for fasting glucose, insulin, homocysteine, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) plasma levels in the blood sample of the 3 rd day of their menstrual cycle. Insulin resistance was determined with the fasting glucose (mmol/L) to insulin (mIU/L) ratio and HOMA-IR (Homeostasis model assessmentInsulin resistance). Independent-samples T-test and linear regression test were utilized to analyze the obtained data. Results: Homocysteine levels compared between PCOS patients and control group showed a significant difference. PCOS group was divided into insulin resistant (IR) (LogHOMA-IR≥0.57) and non insulin resistant (NIR) patients. The IR group had significantly higher homocysteine (p-value=0.02), fasting insulin and glucose levels (pvalue<0.001) rather than NIR group. Conclusion: PCOS patients have a leaning toward hyperhomocysteinaemia and insulin resistance. Insulin resistant patients are found to have higher homocysteine level.

Metformin-letrozole in comparison with Metformin-clomiphene citrate in clomiphene-resistance PCOS patients undergoing IUI

Abstract: Background: Polycystic ovary syndrome (PCOS) is associated with approximately 75% of women who suffer from infertility due to anovulation. Additionally, around 20– 25% of anovulatory women with PCOS do not respond at all to clomiphene citrate and are considered to be “clomiphene– resistant”. Aromatase inhibitors have been suggested as an alternative treatment to clomiphene as the discrepancy between ovulation and pregnancy rates with clomiphene citrate has been attributed to its anti-estrogenic action and estrogen receptor depletion. Objective: The aim of this study is to compare results of Metformin-letrozole with Metformin-clomiphene citrate in clomiphene resistance PCOS patients undergoing IUI. Materials and Methods: In this single blind randomized trial, ovarian cycles were studied in 100 clomiphene- resistant patients with PCOS. The inclusion criteria were patients who received 150mg clomiphene citrate daily for 3 cycles and failed to become pregnant. The patients were matched for their age, body mass index (BMI), and infertility period. They were randomly allocated to a metformin-letrozole group (n=50) and a metformin-clomiphene citrate group (n=50). Chemical and clinical pregnancies were assessed after IUI. Abortion rates were determined in both groups. Results: Regarding pregnancy rate, there was no significant difference between the two groups. One miscarriage (2%) occurred in the metformin-clomiphene citrate group, whereas none was seen in the metformin-letrozole group. Conclusion: There is no significant difference in pregnancy rate between clomiphene citrate and letrozole groups although it has been 2% in the former and 5% in the latter. Article keywords: Letrozole, Clomiphene citrate, Ovarian stimulation, PCO, IUI, Metformin

Antifertility activity of aqueous ethanolic extract of Hymenocardia acida stem bark in female rats.

Abstract: Background: Hymenocardia acida is traditionally used in African herbal medicine and has numerous therapeutic benefits. But little is known about its potentially negative effects on pregnant women. Objective: The aim of the present study was to evaluate the antifertility effect of aqueous ethanolic extract of Hymenocardia acida stem bark in female Wistar rats. Materials and Methods: Four groups of rats were administered orally aqueous ethanolic extract of Hymenocardia acida at doses of 100, 200 and 400 mg/kg body weight daily for 19 days. The control group received distilled water. On day 20 of gestation, each rat was laparatomised and number of corpora lutea of pregnancy, number of live fetuses as well as the postcoitum fertility index, weights of the foetuses and placentae were determined. Results: Oral administration of the extract from days 1 to 19 of gestation showed reduction (p<0.05) in the number of corpora lutea of pregnancy and number of live fetuses. Weights of fetuses of extract treated female rats were also smaller (p<0.05) compared with the control. Anti-implantation activity of the treatment groups were 41.4%, 48.3% and 51.7% for groups II to IV respectively, whereas antifertility activity of the groups was found to be 40%, 60% and 60% in the same order. Conclusion: The results suggest that aqueous ethanolic extract of Hymenocardia acida stem bark could induce negative effects on reproductive functions in female albino rats.

The pregnancy outcome in patients with minor β-thalassemia.

Abstract: Background: β-thalassemia is the most common hereditary disease in Iran and more than 2 million carriers of the β-thalassemia mutant gene are living in this country. Objective: To determine pregnancy outcome of women with β-thalassemia minor. Materials and Methods: In this retrospective, case-control study in two universities affiliated hospitals in Shiraz, all pregnancies occurred between 2006 and 2008 were included. Patients were divided in two groups regarding the presence of β-thalassemia minor. Patients in case and control groups were matched according to maternal age, gestational age and number of previous pregnancies. Cesarean delivery, hypertensive disorders, gestational diabetes mellitus, premature rupture of membranes and preterm labor were recorded in each group and were compared using the χ2 or Fisher exact tests. Results: Overall 510 β-thalassemia minor subjects and 512 healthy controls were studied. Cases with β-thalassemia minor had significantly higher prevalence of oligohydramnios (p<0.001) and cesarean section delivery (p=0.001). There was no significant difference regarding Apgar score in 1st (p=0.65) and 5th minute (p=0.25), IUGR (p=0.073), gestational diabetes mellitus (DM) (p=0.443) and preeclampsia (p=0.116) between two study groups. Conclusion: β-thalassemia minor does not significantly influence the pregnancy outcome in the negative way.

Evaluation of the general health of the infertile couples.

Abstract: Background: The prevalence of infertility is variable between 5-30% around the world In Iran, more than 2 million couples suffer from infertility Infertility causes depression, anxiety, social isolation and sexual dysfunction Objective: This descriptive study was undertaken to determine general health in infertile couples Materials and Methods: One hundred and fifty infertile couples attending Yazd Research and Clinical Center for Infertility were randomly selected during March till September 2009 The GHQ-28 questionnaires were completed by researchers, based on face to face interview It contains 28 items, which have been divided to four sub- items The results come out by scoring the patients answer from 0 to 84 All data were analyzed by Chi-square and t-test in SPSS software Results: GHQ scores of all sub-scales and total in women were more than men, which shows general health condition in women is worse than men There was no relation between the duration of infertility and general health scores Conclusion: This study suggests that the infertility has significant effect (p=0001) on health situation of infertile couples, especially infertile women They are at risk of somatic symptoms (p=00001), social dysfunction (p=00001) and severe depression (p=00001) GHQ could provided help and support in order to improve the health situation of infertile couples

Cotherapy of Tiron and selenium against vanadium induced toxic effects in lactating rats

Abstract: Background: Vanadium is an important environmental and industrial pollutant. It has a status of reproductive toxicant and is reported to cross placental barrier. Objective: The current study was performed to assess the therapeutic efficacy of Tiron and its combination with selenium against vanadium induced toxicity in lactating and suckling rats. Materials and Methods: Rats were exposed to vanadium at a dose of 7.5 mg/kg/day (p.o.) for 20 days from 0 day of post partom (p.p.). Tiron (606 mg/kg/day, i.p.) and selenium (0.5 mg/kg/day, p.o.) were administered for 5 days on 21-25 day PP. Results: Vanadium exposure decreased blood sugar level while serum transaminases and serum alkaline phosphatase showed increased values significantly (p<0.01). Elevation in glycogen content of liver and kidney of suckling and kidney of lactating rats was found after toxicant administration. Toxicant intoxication increased the enzymatic activity of acid phosphatase in liver of suckling and lactating and kidney of suckling rats. On the contrary alkaline phosphatase and adenosine triphosphatase activities were inhibited significantly (p<0.01) in all the organs. Lipid peroxidation was enhanced whereas glutathione was reduced significantly in liver of suckling and lactating rats (p<0.01). Vanadium also caused histopathological lesions. Therapies of Tiron per se and Tiron along with selenium maintained almost all blood and tissue biochemical parameters towards normal. Tiron along with selenium reduced vanadium induced lesions in lactating and sucklings rats. Conclusion: Tiron along with selenium is more effective than Tiron alone against vanadium induced toxic effect on lactating and suckling rats.

Tubo-ovarian abscess in a virgin girl.

Abstract: Background: Tubo-ovarian abscess as a serious complication of pelvic inflammatory disease is very uncommon in sexually inactive girls. Case: We report a case of tubo-ovarian abscess in a 24-year-old sexually inactive girl with transverse vaginal septum who was presented with abdominal pain and a pelvic mass and without prior surgical history and no evidences of appendicitis, inflammatory bowel disease, or cancer. A huge unilateral tubo-ovarian abscess was recognized at laparotomy. Unilateral salpingoophorectomy, hysterectomy and postoperative antibiotic therapy cured the patient. Conclusion: Early diagnosis and treatment are essential to prevent further sequel including infertility, ectopic pregnancy, and chronic pelvic pain which cause morbidity.

A case report of spontaneous pregnancy during hormonal replacement therapy for premature ovarian failure.

Abstract: Background: Premature ovarian failure (POF) is a common condition; its incidence is estimated to be as great as 1 in 100 by the age of 40 years. Physiologic replacement of ovarian steroid hormones seems rational until the age of normal menopause. Temporary return of ovarian function and pregnancy may occur rarely in women with POF. We report a case of POF who conceived during hormone replacement therapy. Case: A 30 years-old woman with confirmed POF after pelvic surgery and sever emotional stress conceived spontaneously. Conclusion: Return of ovarian function and achievement of pregnancy is possible in women with POF.

Outcome of assisted reproductive technology in women aged 40 years and older.

Abstract: Background: Human fertility has been declined all over the world. Advanced women’s age is one of the most important factors in determining the success of reproduction and ageing has negative impact on ART outcome and advanced female age decreases the chance of live birth rates achieved using ART, especially after 40 years of age. Objective: To evaluate ART outcomes regarding to pregnancy, abortion, cycle cancellation and live birth rates in women 40 years and older. Materials and Methods: A retrospective study was performed on three hundred-thirteen women undergoing ART cycles in the Madar Hospital in Yazd. Women with age ≥ 40 years who indicated for ART enrolled the study regardless of the infertility type or etiology. In this study, we used data from IVF or ICSI cycles using fresh embryo transfer. Follow up was performed in regard to pregnancy, abortion, cycle cancellation and live birth rates. Results: The mean age of women was 41.87±1.97 years. Chemical pregnancy rate was 8.6% (27/313) per cycle. Clinical pregnancy rate was 3.8% (12/313) per cycle. Spontaneous abortion was observed in 63% (17/27) of patients with positive pregnancy test. The overall cancellation rate was 23.3% per oocytes retrieval. The overall live birth rate per cycle for all women who initiated an ART cycle at age ≥40 years was 3.2% (10/313) that eight of those women were under 42 years old. Conclusion: Based on our results, we suggest that women with age 42 years and above should be advised to use other options, including oocyte donation or adoption.

Causes of delay in proper treatment of patients with undescended testis.

Abstract: Background: Undescended testis (UDT) is the most common endocrine disorder in male children. Delayed diagnosis and treatment of UDT lead to complications such as infertility, malignancy and testis rotation. Objective: The aim of this study was to evaluate the causes of delay in proper treatment of patients with undescended testis in our population. Materials and Methods: An observational, descriptive, cross sectional study of 143 male patients, who applied to Shahid Sadoughi University Hospitals for orchiopexy operation was performed. The maximum recommended age for orchiopexy was 18 months. Results: The mean age at referral was 5.34 years. Only 44 (30.8%) cases were operated on before the age of 18 months. The most common reasons of delay in treatment were absence of early diagnose (42.5%), parent's unawareness of surgery necessity and its complications associated (33.7%) and parent's disregard (23.5%). Only 19.6% of patients were diagnosed at born in the hospital. 49% of parents had the correct information for proper operation age and 40.6% of them had enough information about necessity of surgery and side effects of disease. Parent’s literacy, place of living and type of cryptorchidism had no significant relation with delay diagnosis (p> 0.05). Conclusion: These results revealed that late diagnosis by physician and lack of insight of parents are the main reasons in delayed diagnosis and treatment of UDT. Therefore, education of parents and careful physical examination of the babies at birth and regular follow-up until 18 months can prevent the delay in diagnosis.

The effect of morphine consumption on plasma corticosteron concentration and placenta development in pregnant rats

Abstract: Background: Previous studies have shown that morphine consumption during pregnancy may delay embryo development or cause abnormal nervous system function. Objective: The present study focused on the effect of maternal morphine consumption on development of placenta and blood corticosteron concentration in addictive pregnant mothers. Materials and Methods: 24 female rats, 170-200g weight, were used. The experimental groups after pregnancy received an oral dose of 0.05 mg/ml of morphine by tap water while the control group received only tap water. On 10 th and 14 th day of pregnancy, rats were anesthetized and placenta removed surgically, 1ml blood was collected from each pregnant mother from retro-orbital sinus, the concentration of blood corticosteron was determined by corticosteron Elisa kit after centrifugation. The fixed tissue was processed, sectioned and stained with hematoxylin and eosin. Placenta was studied microscopically according to the thickness of layers, area of blood cisterns, and the number of cells. Results: Comparing the plasma corticosteron concentration of the treatment and the control groups, not only a severe increase in the treatment group was detected, but also the thickness of maternal and embryonic portions of the placenta at day 10 th and 14 th of gestation was different significantly (p≤0.05). Furthermore, an increase in number of cells in maternal and embryonic portion of placenta and a decrease in blood cistern area were demonstrated in both the experimental and the control groups. Conclusion: The effects of morphine, including an increase in blood concentration of corticosteron, in dependent pregnant mothers were seen. Development of placenta in the experimental group was delayed.

How should painful cystic degeneration of myomas be managed during pregnancy? a case report and review of the literature.

Abstract: Background: Uterine myomas are common pelvic masses during pregnancy. The pain and rapid growth of myomas are among the most common complications during pregnancy. We evaluate management of painful cystic degeneration of myomas during pregnancy. Case: A 27-year-old primigravida had a pelvic mass. We have managed a case in which the diagnosis of cystic degeneration of uterine myomas could not be easily differentiated from an ovarian torsion or carcinoma. Differentiation between degenerative pain of the myoma and an ovarian malignancy or torsion was necessary. A complete aspiration of the cystic changes of the uterine myoma was performed without performing a myomectomy. Conclusion: We report a good result of aspiration of a cystic uterine myoma during pregnancy with a review of the literature published for twenty years since 1 January 1988.

Effect of benzene extract of Ocimum sanctum leaves on cauda epididymal spermatozoa of rats.

Abstract: Background: Recent studies have shown that benzene extract of Ocimum sanctum (O. sanctum) leaves induces the ultrastructural changes in the epithelial cells of the cauda epididymis, its subsequent recovery in the seminiferous epithelium and fertility of male albino rats. Objective: Our aim was to investigate the effect of benzene extract of O.sanctum leaves on the cauda epididymal sperm parameters, morphology and their organelles at the ultrastructural level in albino rats. Materials and Methods: Wistar male rats (n=20) were allocated into two groups of control (n=10) and test group (n=10). The test group received benzene extract of O.sanctum leaves (250mg/kg/day) for 48 consequence days. Five animals from each group were used for fertility test. Twenty-four hours after the last dose, the rest of the control (n=5) and treated (n=5) animals were sacrificed by cervical dislocation and then the cauda epididymal plasma was used for sperm analysis, scanning electron microscopy (SEM) and transmission electron microscopic (TEM) studies. Results: Sperm analysis of test group exhibited significant (p?0.001) decrease in the sperm count, motility, speed and increase in sperm anomalies when compare to control group. SEM and TEM observation in treated animals indicated the morphological changes in plasma membrane as well as in the acrosomal membrane of spermatozoa, formation of a balloon-like cytoplasmic lfontgdropl/fontglet in the mid-region of abnormal tail and disorganization or degeneration of mitochondria of sperm mitochondrial sheaths. Conclusion: The effects observed in this study may have resulted from a general alteration in the cauda epididymal milieu, probably due to androgen deficiency consequent to the anti-androgenic property of O.sanctum leaves.

Lipid peroxidation is not associated with adipocytokines in preeclamptic women

Abstract: Background: The association between lipid peroxidation biomarkers and adipocytokines is hypothesized in preeclampsia but little is known about it. Objective: The present study was undertaken to determine the association of lipid peroxidation biomarkers measured by the levels of 8-isoprostane and malondialdehyde with adipocytokines leptin and adiponectin in maternal serum of preeclamptic women. Materials and Methods: A cross-sectional study was designed. The study population consisted of 30 preeclamptic patients and 30 healthy pregnant women. Serum levels of 8-Isoprostane, total leptin and total adiponectin were assessed using commercially available enzyme-linked immunosorbent assay methods. The amount of malondialdehyde was determined by the thiobarbituric acid assay. Mann-Whitney U test and Spearman’s correlation coefficient were used for statistical analysis. Results: Both 8-Isoprostane and malondialdehyde were significantly higher in preeclamptic group than those in normal pregnant women. Serum levels of leptin were significantly increased in preeclamptic patients compared with normal group, while adiponectin levels were decreased. Serum levels of 8-Isoprostane and malondialdehyde did not show any significant correlation with leptin and adiponectin. Conclusion: In preeclamptic women, maternal serum levels of leptin and adiponectin were not correlated with lipid peroxidation

Comparison of maternal and neonatal serum leptin levels in preeclampsia and normal pregnancy.

Abstract: Background: Leptin is a protein product of obesity gene and is synthesized mainly by adipose tissue. Objective: The aim of this study was to determine maternal and neonatal serum leptin levels in term preeclamptic and normal pregnancies. Materials and Methods: This cross sectional study was performed on 37 preeclamptic and 40 normotensive term pregnant women without other disease. Serum level of leptin was measured in all of pregnant mothers and after delivery, their neonates. This study was performed in Babol Yahyanejad Hospital from March 2006 to December 2006. Results: Infants with preeclamptic mothers had significantly lower leptin level than control group (p=0.02). There was no significant difference in serum leptin levels between normal and preeclamptic women (p=0.749). Conclusion: According to the results, it would be concluded that leptin level in infants of preeclamptic mothers is lower than infants of normal mothers. This can only confirm the diagnosis of disease after birth but it cannot predict the preeclampsia

Controlled ovarian hyperstimulation and intrauterine insemination cycles in patients with unilateral tubal blockage diagnosed by hysterosalpingography.

Abstract: Background: Controlled ovarian hyperstimulation and intrauterine insemination (IUI) cycle is an ideal protocol for some subfertile patients. So, we decided to try this therapeutic protocol for the patients with unilateral tubal blockage diagnosed by hysterosalpingography (HSG). Objective: To evaluate the effect of unilateral tubal blockage diagnosed by HSG on cumulative pregnancy rate (CPR) of the stimulated IUI cycles. Materials and Methods: A cross-sectional analysis was performed between October 2006 and October 2009 in an academic reproductive endocrinology and infertility center. Two groups of patients undergoing stimulated IUI cycles were compared. Sixty-four infertile couples with unilateral tubal blockage diagnosed by HSG as the sole cause of infertility in the group (І), and two hundred couples with unexplained infertility in the group (II). The patients underwent 3 consecutive ovarian hyperstimulation (Clomiphen citrate and human menopausal gonadotropin) and IUI cycles. The main outcome measurements were the CPRs per patients for 3 consecutive stimulated IUI cycles. Results: Cycle characteristics were found to be homogenous between the both groups. CPRs were similar in group І (26.6%) and group II (28%) (p=0.87; OR=1.075; 95% CI: 0.57 -2.28). Conclusion: Unilateral tubal blockage (diagnosed on HSG) has no effect on success rate of stimulated IUI cycles, so COH and IUI could be recommended as the initial therapeutic protocol in these patients.

Effects of Tyrode's solution osmolarities and milk on bull sperm storage above zero temperatures.

Abstract: Background: Control of the medium osmolarity and temperature during long or short time sperm manipulation is essential. Objective: The objectives of the present study were to find the effects of different osmolarities of modified Tyrode's solution and milk on the bull sperm during incubation at above zero temperatures. Materials and Methods: Semen samples were collected twice from five Najdi bull. Centrifuged and most parts of seminal plasma were removed. First experiment: The concentrated semen were splited into nine aliquots to incubate in three different osmolarities (200, 300 and 400 mOsm) at three temperatures (5, 25 and 39°C) for 15 and 60 min of incubation. Second experiment: The semen samples were splited, mixed with the same volume of whole cow milk (5 and 25°C) and milk with 7% glycerol (5°C) and incubated for 15 and 60 min. Results: Sperm motility severely affected (p 0.05) by increasing temperature during 1 h of incubation. Milk can protect the sperm viability and motility at cool conditions and there is no beneficial effect of glycerol in combination of milk on sperm incubation at above zero temperatures (p<0.05). Conclusion: Iso- and hyper-osmotic solutions protect bull sperm motility and viability at 25 and 39°C, while milk can be used for protecting sperm at 5°C.

The effects of raloxifene treatment on oxidative status in brain tissues and learning process of ovariectomized rats.

Abstract: Background: The effects of estrogene on central nervous system are still controversial. Objective: We aimed to investigate the effects of raloxifene on the antioxidant enzyme [superoxide dismutase (SOD) and catalase (CAT)] activities and malondialdehyde (MDA) levels in brain homogenates of ovariectomized female rats and its effect on cognitive process of learning. Materials and Methods: Female Sprague Dawley rats (n=24) were divided into three groups. Three weeks after ovariectomy; nonovariectomized group (control group) (n=8) was given physiological saline (SP) as placebo. First ovariectomized group (n=8) received raloxifene 1mg/kg dissolved in a 1% solution of carboxymethylcellulose (CMC) subcutaneusly (sc) and second group of ovariectomized rats were given 1 % CMC 1mg/kg (sc) every day for 14 days. Learning behaviors of rats were evaluated in active avoidence cage with using sound and electrical stimulation. The levels of oxidative stress (MDA) and antioxidant enzymes (SOD, CAT) in different regions of the brain homogenates were compared between three groups of decapitated rats. Results: Raloxifene had a significant attenuating effect on the levels of MDA in brain tissues suggesting raloxifene’s effect against lipid peroxidation at the end of training days. With the comparison of brain regions, cortex showed the highest average activity of SOD and CAT and cerebellum had the lowest average levels for both. Its effects on learning and cognitive process with active avoidence task were considered insignificant. Conclusion: Raloxifene treatment may have preventive effects for the brain against oxidative stress and lipid peroxidation in rats.

Heterotopic pregnancy following induction of ovulation with clomiphene citrate

Abstract: BACKGROUND: Although heterotopic gestation is common in assisted reproductive techniques, it is very rare in natural conception and clomiphene induced pregnancy. Diagnosis and appropriate intervention of heterotopic pregnancy requires a high index of suspicious. CASE: In this paper a case of heterotopic pregnancy in a 30-year old woman with hemoperitoneum from ruptured tubal pregnancy with live intrauterine gestation at 9 weeks of gestation is reported. CONCLUSION: This case suggests that a heterotopic pregnancy must always be considered particularly after the induction of ovulation by clomiphene citrate or assisted reproductive technology. Every clinician treating women of reproductive age should keep this diagnosis in mind. It also demonstrates that early diagnosis is essential in order to salvage the intrauterine pregnancy and avoid maternal morbidity and mortality.

Evaluation of the effect of oral ritodrine on implantation rate in in-vitro fertilization-embryo transfer cycles

Abstract: Background: Pregnancy rate with IVF cycle is almost 22%. Many investigations perform to increase this rate in IVF. Various factors affect the result of IVF cycles. One of these factors could be uterine contractions that expel transferred embryo. Ritodrine is a beta mimetic agent that can block and decrease uterine contractions. Objective: The objective of this study was to determine ritodrine effectiveness for increasing the implantation rate in IVF cycles, and its probable mechanisms in decreasing uterine contractions as well. Materials and Methods: A total of 100 patients of IVF-ET cycles were divided randomly in two groups in a university hospital, Hamadan, Iran. The case group were prescribed ritodrine 10 mg / bid orally after oocyte retrieval until 10 days. The control group didn’t received ridotrine. Results: In ritodrine group 14% of patients and in control group 16% had positive ?-hCG test (p-valueg0.5). Conclusion: Ritodrine did not improve the implantation rate in IVF-ET cycles.

Correlation between the level of cholesteryl ester transfer protein in follicular fluid with fertilization rates in IVF/ ICSI cycles

Abstract: Background: Follicular fluid (FF) plays an important role in oocytes and embryo development, which may contribute to IVF/ICSI success rate. Objective: The aim of this study was to investigate the correlation between cholesteryl ester transfer protein (CETP) level in FF and the success rate of IVF/ICSI. Materials and Methods: In a cross-sectional study, FF samples, FF samples were obtained from 100 patients referred to Tabriz Alzahra Hospital. Seventy-nine subjects underwent IVF and the remaining 21 underwent ICSI. The levels of high-density lipoprotein cholesterol (HDL-C), apolipoprotein A-I and CETP were measured using enzymatic, turbidometric and ELISA methods respectively. Results: Analysis of the subgroups with different levels of CETP showed a significant lower level of CETP in the subgroup with the lowest number of mature oocytes (p 70% of this ratio. Conclusion: While no association was found for pregnancy, the amount of CETP in FF was associated positively to the maturity and the percentage of oocyte fertilization.