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Showing papers in "Iranian Journal of Reproductive Medicine in 2013"


Journal Article
TL;DR: The results revealed that the main socio-cultural challenges to sexual health education for adolescents in Iran are affected by taboos surrounding sexuality, and it seems that cultural resistances are more important than religious prohibitions, and affect more the nature and content ofSexual health education.
Abstract: Background: Despite clear reasons for necessity of sexual health education for adolescents, it is a contested issue and has faced challenges in most cultures. Providing sexual education for non-married adolescents is culturally unacceptable in most Muslim societies. Objective: This qualitative study addressed socio-cultural challenges to sexual health education for female adolescents in Iran. Materials and Methods: Qualitative data from female adolescents (14-18 yr), mothers, teachers, authorities in health and education organizations, health care providers and clergies were collected in two large cities of Iran including Mashhad and Ahvaz through focus group discussions and individual in-depth interviews. Data were analyzed using conventional qualitative content analysis with MAXqda software. Results: Our results revealed that the main socio-cultural challenges to sexual health education for adolescents in Iran are affected by taboos surrounding sexuality. The emergent categories were: denial of premarital sex, social concern about negative impacts of sexual education, perceived stigma and embarrassment, reluctance to discuss sexual issues in public, sexual discussion as a socio-cultural taboo, lack of advocacy and legal support, intergenerational gap, religious uncertainties, and imitating non-Islamic patterns of education. Conclusion: It seems that cultural resistances are more important than religious prohibitions, and affect more the nature and content of sexual health education. However, despite existence of salient socio-cultural doubtful issues about sexual health education for adolescents, the emerging challenges are manageable to some extent. It is hoped that the acceptability of sexual health education for adolescents could be promoted through overcoming the cultural taboos and barriers as major obstacles.

110 citations


Journal Article
TL;DR: The prevalence of sexual dysfunction is high during pregnancy and reaches higher levels in the third trimester, therefore, pregnant women and their partners need counseling about physical and psychological changes in pregnancy.
Abstract: Background: Sexuality is an important part of women’s health, quality of life, and general well-being. There are many factors influencing the female sexual function, including psychological, physiological, couple relationship, and socio-cultural factors. Pregnancy plays an important role in the sexual function and behavior of women. Objective: This study aims to evaluate the sexual function and determine the prevalence of sexual dysfunction among women during pregnancy. Materials and Methods: The present cross-sectional study was conducted on 257 healthy pregnant women aging between18-40 years who had attended the antenatal clinic, Paymaneh Hospital, Jahrom, Iran between April and October 2011 Female Sexual Function Index (FSFI) questionnaire was used for assessing the sexual function Results: The mean age of the participants was reported as 26.45±4.49 years. In addition, 143, 69, and 45 subjects were in their 1st, 2nd, and 3rd trimesters, respectively. Comparison of the second and the third trimesters revealed a significant difference in the scores of all FSFI domains and the mean total FSFI score was reported as 19.9±22.45. Among the study subjects, 197 ones (79.1%) had sexual dysfunction (FSFI score <26.5), while only 52 (20.9%) had normal sexual function (FSFI score ≥26.5). The sexual dysfunction among pregnant women was rated as 23.4%, 30.5%, and 46.2% in the 1st, 2nd, and 3rd trimesters, respectively. Conclusion: The prevalence of sexual dysfunction is high during pregnancy and reaches higher levels in the third trimester. Therefore, pregnant women and their partners need counseling about physical and psychological changes in pregnancy.

81 citations


Journal Article
TL;DR: The results showed that STZ-induced diabetes mellitus may influence the male fertility potential via affecting sperm parameters and DNA integrity in mice, but according to the data, the diabetes doesn’t have any detrimental effects on histone-protamines replacement during the testicular phase of sperm chromatin packaging.
Abstract: Background: Diabetes mellitus (DM), primary or idiopathic is a chronic disorder of the carbohydrate, lipid and protein metabolism. DM may impact male reproductive function at several levels. It is shown that DM has detrimental effects on sperm parameters in human and experimental animals. Objective: The aim of this study was to observe the effects of diabetes on sperm parameters (viability, count, morphology and motility) and evaluation of sperm chromatin quality in mice. Materials and Methods: Totally twenty adult male Syrian mice were divided randomly into 2 groups (n=10). The animals of group A were considered as controls while group B mice were diabetic that received a single dose (200 mg/kg) streptozotocin (STZ) intra peritoneally. After 35 days, the cauda epididymis of each diabetic mouse was dissected and placed in culture medium for 30 min. The swimout spermatozoa were analyzed for count, motility, morphology and viability. The sperm chromatin quality and DNA integrity, was evaluated with Aniline Blue (AB), Toluidine blue (TB), Acridine orange (AO) and Chromomycin A3 (CMA3) staining. Results: In sperm analysis, the diabetic mice had poor parameters in comparison with control animals (p=0.000). Regarding sperm chromatin quality, the results of TB and AO tests showed statically significant differences between two groups, but in AB and CMA3 staining, we didn’t see any differences between them. Conclusion: The results showed that STZ-induced diabetes mellitus may influence the male fertility potential via affecting sperm parameters and DNA integrity in mice. However, according to our data, the diabetes doesn’t have any detrimental effects on histone-protamines replacement during the testicular phase of sperm chromatin packaging.

79 citations


Journal Article
TL;DR: The cytotoxicity of ZnO NPs is dose and time dependent, and there were significant differences in cell viability after 180 minutes vs. 45 and 90 minutes.
Abstract: Background: The extensive use of different nanoparticles has raised great concerns about their occupational and biological safety. Objective: The aim of this study was to evaluate the cytotoxic effect of zinc oxide nanoparticles (ZnO NPs) on viability of spermatozoa. Materials and Methods: Semen samples were obtained from 15 healthy persons, and were analyzed using WHO guidelines. Each semen sample was separately incubated with different concentrations of ZnO NPs (10, 100, 500, and 1000 μg/mL) at 37PoPC for 45, 90, and 180 minutes. Then, the cell death percentage of spermatozoa was measured by MTT assay. Mann-Whitney test was used for comparison of different times and concentrations. Results: The maximum cell death percentage was 20.8%, 21.2%, and 33.2% after 45, 90, and 180 minutes, respectively. In case of concentration, the highest concentration (1000 μg/mL) of ZnO NPs led to the highest toxicity for all incubation times. Statistically, there were significant differences in cell viability after 180 minutes vs. 45 and 90 minutes. Conclusion: This study indicated that cytotoxicity of ZnO NPs is dose and time dependent.

61 citations


Journal Article
TL;DR: The cytoprotective role of nano-zinc oxide through its antioxidant potential is illuminated in DOX-induced male gonadotoxicity in rats treated with DOX.
Abstract: Background: Doxorubicin (DOX), an anthracycline antibiotic, is a widely used anticancer agent. In spite of its high antitumor efficacy, the use of DOX in clinical chemotherapy is limited due to diverse toxicities, including gonadotoxicity. Objective: We investigated the protective effect of nano-zinc oxide (nZnO) as an established antioxidant on DOX-induced testicular disorders. Materials and Methods: In this experimental study 24 adult male Wistar rats were divided into four groups including one control and three experimentals (6 rats per group). They received saline (as control), DOX alone (6 mg/kg body weight, i.p.), nZnO alone (5 mg/kg body weight, i.p.), and nZnO followed by DOX. Animals were sacrificed 28 days after treatment and evaluations were made by sperm count and measuring sex hormone levels in plasma. Also total antioxidant power (TAP) and lipid peroxidation (LPO) in plasma were tested. Data was analyzed with SPSS14 and one way ANOVA test. P<0.05 were considered to be statistically significant. Results: In the DOX-exposed rats significant differences were found compared with the control group (p=0.001) in plasma total antioxidant power (TAP) (425.50±32.33 vs. 493.33±18.54 mmol/mL), Lipid peroxidation (LPO) (3.70±0.44 vs. 2.78±0.68 μmol/mL), plasma testosterone (3.38±0.69 vs. 5.40±0.89 ng/dl), LH (0.26±0.05 vs. 0.49±0.18 mlU/mL), sperm count (157.98±6.29 vs. 171.71±4.42×10 6 /mL) and DNA damage (11.51±3.45 vs. 6.04±2.83%). Co-administration of nZnO significantly improved DOX-induced changes (p=0.013) in plasma TAP (471.83±14.51 mmol/mL), LPO (2.83±0.75 μmol/mL), plasma testosterone (5.00±1.07 ng/dl), LH (0.52±0.08 mlU/mL), sperm count (169.13±5.01×10 6 /mL) and DNA damage (7.00±1.67%). Conclusion: At the dose designed in the present investigation cytoprotective role of nano-zinc oxide through its antioxidant potential is illuminated in DOX-induced male gonadotoxicity.

61 citations


Journal Article
TL;DR: The emotional well-being of the patients presenting with the syndrome needs to be recognized more fully, particularly in relation to the low self-esteem, poor body image, and struggles with weight, menstrual irregularities, hirsutism and infertility.
Abstract: Background: Most previous research has focused on polycystic ovary syndrome (PCOS) characteristics and their association with psychological disorders, such as anxiety and depression. Objective: In the present study, our aim was to study whether PCOS characteristics are associated with several aspects of psychological well-being namely self-esteem and body satisfaction. Materials and Methods: This was a cross-sectional study of 300 women with PCOS that was carried out in Kashan, Iran. Main outcome measures were the Body Image Concern Inventory (BICI) and the Rosenberg’s Self-Esteem Scale and clinical information of PCOS. Major clinical PCOS features including obesity (BMI), excessive body hair (hirsutism score), acne, menstrual cycle disturbances and infertility. Results: The findings of regression analysis indicated that infertile women had lower levels of self-esteem (=-0.11, p=0.049) and poorer body satisfaction (=0.121, p=0.036) compared with PCOS women without infertility. Furthermore, hirsute women experienced poorer self-esteem than women without hirsutism (=-0.124, p=0.032). Women with menstrual irregularities had higher body dissatisfaction (=0.159, p=0.005). Moreover, women with higher body mass index scores had poorer body satisfaction (=0.151, p=0.009) but were not associated with self-esteem. Conclusion: The emotional well-being of the patients presenting with the syndrome needs to be recognized more fully, particularly in relation to the low self-esteem, poor body image, and struggles with weight, menstrual irregularities, hirsutism and infertility. The results of this study raise implications for clinical practice and suggest that a multidisciplinary approach to the management of women with PCOS. This article extracted from Ph.D. thesis. (Fatemeh Bazarganipour)

59 citations


Journal Article
TL;DR: It was concluded that testis of host infertile rats accepted transplanted MSCs and could differentiate into germinal cells in testicular seminiferous tubules and also to the interstitial cells between tubules.
Abstract: Background: Mesenchymal stem cells (MSCs) are undifferentiated cells that can differentiate and divide to other cell types. Transplantation of these cells to the different organs is used for curing various diseases. Objective: The aim of this research was whether MSCs transplantation could treat the sterile testes. Materials and Methods: In this experimental study, Donor MSCs were isolated from bone marrow of Wistar rats. The recipients were received 40 mg/kg of busulfan to stop endogenous spermatogenesis. The MSCs were injected into the left testes. Cell tracing was done by labeling the MSCs by 5-Bromo-2- Deoxy Uridine (BrdU). The immunohistochemical and morphometrical studies were performed to analysis the curing criteria. Results: The number of spermatogonia (25.38±1.57), primary spermatocytes (55.41±1.62) and spermatozoids (4.95±1.30)×10

53 citations


Journal Article
TL;DR: It seems that Ag NPs have acute and significant effects on sperMatogenesis and number of spermatogenic cells and also on acrosome reaction in sperm cells.
Abstract: Background: Nanoparticles have wide range of application while there are some reports regarding their probable effects on male reproductive system and spermatozoa. Objective: The aim of this study was to evaluate the effect of different doses of silver nanoparticles (AgNPs) (70nm) on acrosome of rat spermatozoa and number of spermatogenic cells. Materials and Methods: In this experimental study, in experimental group, 32 male wistar rats (8 rats/group) received oral feeding AgNPs every 12 hr in one spermatogenesis period (48 days) by means of gavages in 25, 50 , 100 and 200 mg/kg concentration (experimental groups 1-4, respectively). The control group (8 rats) was treated on schedule with distilled water. Spermatozoa were stained by triple staining protocol for acrosome reaction. Histological evaluation on testis sections was performed using tissue processing and hematoxylin-eosin (H&E) staining. Results: There was significant difference between the control group and the experimental group 1 for acrosome reaction (11.00±0.00 and 24.25±3.68, respectively, p=0.01). There was only significant reduction in spermatogonia cells in experimental group 4. Experimental groups 2, 3 and 4 showed a significant reduction in the number of primary spermatocytes and spermatids as well as spermatozoa. But there were no significant differences between different groups for Sertoli cell number and seminiferous tubule diameter. Conclusion: It seems that Ag NPs have acute and significant effects on spermatogenesis and number of spermatogenic cells and also on acrosome reaction in sperm cells. More experimental investigations are necessary to elucidate better conclusion regarding the safety of nanoparticles on male reproduction system.

50 citations


Journal Article
Zhihong Zhang1, Hai Bo Zhu1, Lei Lei Li1, Yang Yu1, Hong Guo Zhang1, Liu Rz1 
TL;DR: Findings suggest that smoking leads to a significant decline in semen quality and higher levels of leukocytes, thus smoking may affects the fertilization efficiency.
Abstract: Background: Previous researches about the effect of smoking on semen quality are contradictory, and the mechanism behind the harmful effect of smoking on semen quality still remains unclear until today. Objective: The objectives of this study are evaluation of the relationship between smoking and fertility, investigation of the effects of cigarette smoking on sperm parameters and detection of presence of leukocytes within the semen of idiopathic infertile men from Northeastern China. Materials and Methods: A retrospective study of 1512 infertile patients who visited affiliated hospitals of Jilin University from 2007-2010 were enrolled in this study. Patients were assigned into one non-smoking and one smoking group which was divided into mild, moderate and heavy subgroups. Sperm parameters (including leukocytes) and sperm morphology analysis were performed using standard techniques. Results: Compared with non-smokers, smokers had a significant decrease in semen volumes (p=0.006), rapid progressive motility (p=0.002) and sperm viability (p=0.019); moreover, smokers had a significant increase in the levels of immotile sperms (p=0.005) and semen leukocytes (p=0.002); pH and sperm concentration were not statistically significant (p=0.789 and p=0.297 respectively). Sperm motion parameters were all lower in the smokers except for beat-cross frequency (Hz) (BCF). Further, the percentage of normal morphology sperm was decreased significantly in smokers (p=0.003), the sperm morphology was worse with increasing degree of smoking. Conclusion: These findings suggest that smoking leads to a significant decline in semen quality and higher levels of leukocytes, thus smoking may affects the fertilization efficiency.

48 citations


Journal Article
TL;DR: The routine use of oral sildenafil citrate is recommended in patients with a previous failure of assisted reproduction technology cycles due to poor endometrial thickness and the study shows that it is a good way to improve the endometricrial receptivity.
Abstract: Background: Sildenafil citrate may increase endometrial thickness and affect the outcome of frozen-thawed embryo transfer cycles. Objective: The aim of this study was to estimate the effect of sildenafil citrate on ultrasonographic endometrial thickness and pattern and to investigate the estrogen level on the day of progesterone administration, the implantation rate and chemical pregnancy rate in frozen embryo transfer cycles. Materials and Methods: This randomized controlled trial was conducted on 80 patients who had an antecedent of poor endometrial response and frozen embryos. 40 patients were given estradiol by a step up method with menstruation to prepare the endometrium, and the other 40 were given sildenafil citrate tablets (50 mg) daily in addition to the above treatment protocol from the first day of the cycle until the day progesterone was started. This was discontinued 48-72 hours prior to the embryo transfer. Results: The endometrial thickness was significantly higher in the sildenafil citrate group (p<0.0001), the triple line patterns of the endometrium were significantly higher in the sildenafil citrate group (p<0.0001), while the intermediate patterns of the endometrium were not significantly different in the two groups. The echogen patterns of the endometrium were significantly higher in control group (p<0.0001). Finally, implantation rate and the chemical pregnancy rates were higher in the sildenafil citrate group but not significantly. Conclusion: As our study shows, the oral use of sildenafil citrate is a good way to improve the endometrial receptivity. We recommend the routine use of oral sildenafil citrate in patients with a previous failure of assisted reproduction technology cycles due to poor endometrial thickness.

48 citations


Journal Article
Ying Zhang1, Hong Cao1, Zheng Yu1, Hai-Ying Peng1, Chang-Jun Zhang1 
TL;DR: It is found that E2 is important in ectopic endometrium, and epithelial cell is in dominant position with E2 secretion, and curcumin was able to suppress the proliferation of endometrial cells by reducing the E2 value.
Abstract: Background: Endometriosis is a complex estrogen-dependent disease that is defined as the presence of endometrial gland and stroma outside the uterine cavity. Although the exact mechanism for the development of endometriosis remains unclear, there is a large body of research data and circumstantial evidence that suggests a crucial role of estrogen in the establishment and maintenance of this disease. Objective: This study is an attempt to assess the effect of curcumin on inhibiting endometriosis endometrial cells and to investigate whether such an effect is mediated by reducing estradiol production. Materials and Methods: Endometriotic stromal cells, normal endometrial stromal cells, endometriotic epithelial cells and normal endometrial epithelial cells were isolated and cultured. E2 value of cells and the effect of curcumin on cell proliferation were evaluated. Finally, effect of curcumin on E2 assay was detected. Results: Electrochemiluminescence immunoassay results showed that E2 value of endometriotic epithelial cells was higher than the endometriotic stromal cells (p=0.037), while the expression of E2 in normal endometrial stromal and epithelial cells was extremely low. WST-8 result showed, compared with endometrial stromal cells, ectopic endometriotic stromal cells had a higher growth rate. After intervene with curcumin (10μmol/L, 30μmol/L and 50μmol/L) for 0-96h, the number of endometriotic stromal cells was reduced and cells growth slowed, compared with 0μmol/L group. Compared with 0μmol/L group, E2 level was lower after treatment with curcumin, especially in 30μmol/L and 50μmol/L group. Conclusion: In summary, in this study we found that E2 is important in ectopic endometrium, and epithelial cell is in dominant position with E2 secretion. Curcumin was able to suppress the proliferation of endometrial cells by reducing the E2 value.

Journal Article
TL;DR: PDLSCs, DPSCs and PAFSCs exist in various tissues of the teeth and can use as a source of mesenchymal stem cells for developing bioengineered organs and also in craniomaxillofacial reconstruction with varying efficiency in differentiation and proliferation.
Abstract: Background: Human dental stem cells have high proliferative potential for selfrenewal that is important to the regenerative capacity of the tissue. Objective: The aim was to isolate human dental pulp stem cells (DPSC), periodontal ligament stem cells (PDLSC) and periapical follicle stem cells (PAFSC) for their potential role in tissue regeneration. Materials and Methods: In this experimental study, the postnatal stem cells were isolated from dental pulp, preapical follicle and periodontal ligament .The cells were stained for different stem cell markers by immunocytochemistry. To investigate the mesenchymal nature of cells, differentiation potential along osteoblastic and adipogenic lineages and gene expression profile were performed. For proliferation potential assay, Brdu staining and growth curve tests were performed. Finally, all three cell types were compared together regarding their proliferation, differentiation and displaying phenotype. Results: The isolated cell populations have similar fibroblastic like morphology and expressed all examined cell surface molecule markers. These cells were capable of differentiating into osteocyte with different capability and adipocyte with the same rate. PAFSCs showed more significant proliferation rate than others. Reverse transcriptase PCR (RT-PCR) for nanog, oct4, Alkaline phosphatase (ALP) and glyceraldehydes-3-phosphate dehydrogenease (GADPH) as control gene showed strong positive expression of these genes in all three isolated cell types. Conclusion: PDLSCs, DPSCs and PAFSCs exist in various tissues of the teeth and can use as a source of mesenchymal stem cells for developing bioengineered organs and also in craniomaxillofacial reconstruction with varying efficiency in differentiation and proliferation.

Journal Article
TL;DR: The study recommended an educational program to have optimal birth intervals and ideal number of children per family for the prevention of adverse prenatal outcomes.
Abstract: Background: Short birth intervals have been associated with adverse health outcomes, including infant, child and maternal mortality. Objective: We aimed to investigate the duration and determinants of inter birth intervals among women of reproductive age in Yazd, Iran. Materials and Methods: A cluster sampling technique was used to select 400 ever-married women aged 15-49 years in Yazd, Islamic Republic of Iran. Data were obtained by interview questionnaire and analyzed with life table, Kaplan-Meier survival and Cox regression analyses. Results: The mean duration of inter birth interval was 49.76 (standard error 1.82) months (95% CI: 46.19-53.34 months) with a median of 39. In 28.5% of women the birth interval was <2 years, in 28% it was 3-5 years and in 25.5% it was ≥6 years. Among explanatory variables of interest, age of marriage, and woman's education were significant predicators of the birth interval. Women who stated an ideal preference of two children constituted 59.9% of the sample and 16% had 3 children as well as 10.7% had an ideal preference for 4 or 5. Conclusion: The study recommended an educational program to have optimal birth intervals and ideal number of children per family for the prevention of adverse prenatal outcomes.

Journal Article
TL;DR: It seems the use of L-carnitine and THT decreases side effects of busulfan on the male reproductive system, and leads to the recovery testis structure and sperm parameters after treatment with busesulfan.
Abstract: Background: Busulfan (Bus) is a chemotherapy drug that is widely used for cancer treatment. However, administration of busulfan may cause temporary or permanent sterility in male patients. Therefore, reduction of this side is necessary. Objective: evaluation of the protective effects of L-carnitine and testis homogenized tissue (THT) on sperm parameters and the testis structure after busulfan treatment. Materials and Methods: Twenty rats were divided four groups. Group I (Control) received a single dose of DMSO and 1mL of distilled water (I.P.). Group II (Bus) received a single of busulfan (10 mg/kg) plus 1 ml of the distilled water (I.P.). Group III (Bus+THT) received busulfan plus 1mL of THT daily by oral gavages. Group IV (Bus+L-car) received a single dose of busulfan plus 100 mg/kg/day Lcarnitine (I.P.). After 48 dayst, the Stereological technique was used for the estimating volume and diameter of testis, seminiferous tubules and interstitial tissue, flagella length, germinal epithelium height and spermatoginic cell number. Semen analysis was used for the assessment of sperm parameters. Results: THT increased volume of testis (6.5%), seminiferous tubule and interstitial tissue volume (6.5%, 6.9% and 11.7% respectively), germinal epithelium height (13%), sperm count (7.5%), and decreased sperm with abnormal morphology (1%) in comparison with the L-carnitine in busulfan treated group. Conclusion: It seems the use of L-carnitine and THT decreases side effects of busulfan on the male reproductive system. However, in our study, THT is more effective than L-carnitine and leads to the recovery testis structure and sperm parameters after treatment with busulfan.

Journal Article
TL;DR: Omega-3 supplementation could reduce serum concentrations of testosterone and regulate menstrual cycle without significant effect on SHBG and FAI.
Abstract: Background: There is some evidence regarding the effect of poly unsaturated fatty acid intake on androgen levels and gonadal function in polycystic ovary syndrome (PCOS). Objective: This study was conducted to determine the effect of omega-3 supplementation on sex hormone-binding protein (SHBG), testosterone, free androgen index (FAI) and menstrual status in women with PCOS. Materials and Methods: This double-blind randomized clinical trial was conducted on 78 overweight/obese women with PCOS. Participants were randomized to receive omega-3 (3gr/day) or placebo for 8 weeks. Data about weight, height and nutrient intake as well as blood samples were collected before and after intervention. Serum concentrations of testosterone (nmol/L) and SHBG (nmol/L) were measured. FAI was also calculated as the ratio of testosterone to SHBG. Results: Seventy eight patients (age: 26.92±5.46 yrs, Body Mass Index: 31.69±4.84 Kg/m 2 ) completed the study. There was no significant difference in mean age, weight, height, Body Mass Index and intake of energy, and macronutrients between 2 study groups before and after treatment. All the participants had irregular periods. After the trial the percentage of regular menstruation in the omega-3 group was more than the placebo group (47.2% vs. 22.9%, p=0.049). Furthermore, testosterone concentration was significantly lower in the omega-3 group compared with placebo, after supplementation (p=0.04). SHBG and FAI did not change in either group. Conclusion: Omega-3 supplementation could reduce serum concentrations of testosterone and regulate menstrual cycle without significant effect on SHBG and FAI. Future studies with longer period of supplementation are warranted.

Journal Article
TL;DR: The data indicated that co-administration of Metformin and honey could inhibit the diabetes-induced damages in testicular tissue and up-regulated the Diabetes-reduced insulin, LH, FSH and testosterone levels.
Abstract: Background: The global prevalence of diabetes mellitus is on rise Diabetesinduced oxidative stress has been known to affect liver, pancreas, kidney and reproductive organs pathologically Honey is a natural product of bee with antioxidant properties Objective: Current study aimed to analyze the protective effects of Metformin (MF) alone and MF+ natural honey co-administration on diabetes-induced histological derangements in testis of rats Materials and Methods: Thirty six, mature male Wistar rats were randomly divided into six groups including; control, honey-dosed non-diabetic, diabetesinduced (65 mg/kg, single dose), honey-administrated diabetic (10 g/kg/day), Metformin-received diabetic (100 mg/kg/day), Metformin and honey-co-treated diabetic which were followed 40 days The animals were anesthetized by diethyl ether and the blood samples were collected The serum levels of testosterone, Insulin, LH and FSH analyzed using antibody enzyme immunoassay method The testicular tissues were dissected out and underwent to histological analyses Results: The biochemical analyses revealed that the diabetes resulted in significantly reduced testosterone (p<001), LH and FSH (P<001, 0001) levels in serum Light microscopic analyses showed remarkable (p<001) reduction in seminiferous tubules diameter (STD), spermiogenesis index (SPI) and thickness of the epithelium in the diabetic group versus control and co-treated groups Simultaneous administration of the honey with MF could fairly up-regulate testosterone, LH and FSH levels The animals in metformin and honey-treated group exhibited with improved tubules atrophy, elevated spermiogenesis index and germinal epithelium thickness Conclusion: Our data indicated that co-administration of Metformin and honey could inhibit the diabetes-induced damages in testicular tissue Moreover, the simultaneous administration of metformin and honey up-regulated the diabetesreduced insulin, LH, FSH and testosterone levels

Journal Article
TL;DR: The results showed that oral dydrogesterone is as effective as vaginal progesterone for luteal-phase support in women undergoing IVF.
Abstract: Background: Luteal phase support is mandatory in assisted reproductive technologies (ART) for optimizing outcome, so the luteal phase is supported with either progesterone, addition of estradiol to progesterone, hCG or gonadotropin releasing hormone (GnRH) agonists. Supplementation of luteal phase with progesterone is prescribed for women undergoing routine IVF treatment. Objective: To compare oral dydrogestrone with vaginal progesterone for lutealphase support in IVF. Materials and Methods: We performed this prospective, randomized trial in a tertiary infertility care unit in Taleghani Hospital, Tehran, Iran. In total 80 Women with a history of male factor infertility undergoing controlled ovarian stimulation for IVF treatment (fresh cycle) randomly were divided in two groups (group A or oral dydrogesterone group and group B or vaginal progesterone group). The inclusion criteria were the use of GnRH analogue down-regulation and age less than 40 years old with regular menstrual cycles. All women were euthyroid and normoprolactinemic. Group A (n=40) received 10 mg dydrogesterone QID (40mg daily) and group B (n=40) received 400 mg suppository vaginal progesterone (cyclogest) twice per day (800 mg daily). Results: Clinical pregnancy rate in cyclogest group was higher than dydrogesterone group but the difference was not significant (p=0.52), furthermore the miscarriage rate in two group was the same .The difference between two groups regarding antral follicle, embryo number, luteal-phase duration, endometrial thickness, oocyte number and metaphase-II was not significant (p>0.05). Conclusion: The results showed that oral dydrogesterone is as effective as vaginal progesterone for luteal-phase support in women undergoing IVF.

Journal Article
TL;DR: Local mechanical injury of the endometrium can enhance the uterine receptivity and facilitates the embryo implantation and is worth considering in selective unexplained infertility patients who implantation failure is the likely causes of infertility before complex treatments.
Abstract: Background: Unexplained infertility is still a challenging issue as to its causes, appropriate management and treatment. Evidence implicates early embryopathy or implantation failure as likely causes. Objective: This study aims to investigate the effect of local endometrial injury on pregnancy rate in selected unexplained infertile patients. Materials and Methods: This was a randomized clinical trial conducted in Shiraz University Infertility Clinic of Ghadir Hospital. A total of 217 women with unexplained infertility aged 23-35 years old were randomly divided into two study groups through block randomization. After superovulation by clomiphene-citrate and gonadotropins and when the dominant follicles reached 18-20 mm, patients were randomly assigned to undergo endometrial local injury at posterior uterine wall by piplle endometrial sampling (n=114) or mock pipette biopsy (n=103) during pre-ovulatory days (when spontaneous urinary LH surge was detected). Then all the patients were instructed to follow a regularly timed intercourse. Results: The pregnancy rate was significantly higher in the endometrial injury group compared to the control group [17/114 (14.9%) vs. 6/103 (5.8%) (OR: 2.83 95% CI: 1.07-7.49, p=0.03]. The abortion rate was comparable between two groups (17.64% vs. 14.28%; p=0.701). Conclusion: Local mechanical injury of the endometrium can enhance the uterine receptivity and facilitates the embryo implantation. This simple, easy, and cost effective procedure is worth considering in selective unexplained infertility patients who implantation failure is the likely causes of infertility before complex treatments. This procedure may help reduce psychological tensions and high expenses imposed through such interventions. Registration ID in IRCT: IRCT2012082510657N1

Journal Article
TL;DR: The maternal periodontal disease can be a potential independent risk factor for LBW, and history of previous LBW infant among case mothers reached statistical significance.
Abstract: Background: Periodontal infections, which serve as a reservoir of inflammatory mediators, may pose a threat to the fetal-placental unit and cause adverse pregnancy outcomes. Objective: The aim of this study was assessing the periodontal status of women during puerperium and determining the possible relationship between their periodontal disease and low birth weight delivery. Materials and Methods: This was a case-control study. The sample included 88 ex-pregnant women were seen at maternity hospitals of Yazd, Iran. Half of the mothers had low birth babies (LBW) (birth weight below 2500g- case group) and the others had normal weight babies (>2500g- control group). The mothers’ data were obtained from medical files, interview and periodontal clinical examination carried out up to 3 days after delivery. Bleeding on probing, presence of supra-gingival calculus and CPITN (Community Periodontal Index for Treatment Needs) were used for periodontal assessment Results: Among the known risk factors of LBW babies, history of previous LBW infant among case mothers reached statistical significance (p=0.0081, Student t-test). Mothers of LBW infants had less healthy areas of gingiva (p=0.042), and more deep pockets (p=0.0006, Mann-Whitney test). Conclusion: The maternal periodontal disease can be a potential independent risk factor for LBW.

Journal Article
TL;DR: Managing the fertility behaviors need to include the consideration of personal social networks surrounding the couples by applying the study findings in providing family planning services and dissemination of appropriate fertility behaviors through community-based reproductive health care delivery system.
Abstract: Background: Recently, the relevance of social interactions as determinants of behavioral intentions has been increasingly perceived, but there is a lack of knowledge on how and why it interacts with couples’ fertility intentions. Objective: This qualitative study was conducted to explore the influence of social network on couples’ intention to have their first child in urban society of Mashhad, Iran in 2011. Materials and Methods: In this exploratory qualitative study in-depth interviews were conducted with 24 participants including 14 fertile women, two parents, three husbands and five midwives and health care providers. The sample was selected purposively in urban health centers, homes and workplaces until data saturation was achieved. Data analysis was carried out adopting conventional content analysis approach through giving analytical codes and identification of categories using MAXqda software. Study rigor verified via prolonged engagement, validation of codes through member check and peer debriefing. Results: Findings from data analysis demonstrated four major categories about social network’s influence on couples’ intention to have their first child including 1) perception of fertility relevant social network, 2) occurrence of various types of social influence 3) subjective judgment to the benefits of social network and its fitness to personal life, and 4) couples’ interaction with social network. Conclusion: Managing the fertility behaviors need to include the consideration of personal social networks surrounding the couples. It is important to apply the study findings in providing family planning services and dissemination of appropriate fertility behaviors through community-based reproductive health care delivery system.

Journal Article
TL;DR: It seems that zingiber officinale stimulate male reproductive system in induce busulfan infertility.
Abstract: Background: In traditional medicine zingiber officinale used to regulate female menstural cycle and treat male infertility. Recent studies have suggested the possible role of ginger extract in improving the testicular damage of busulfan. Objective: The aim of this study was to evaluate the effects of zingiber officinale on the sperm parameters, testosterone level and the volume of the testes and seminiferous tubules by stereological methods. Materials and Methods: Fifty rats were divided into four groups. All the rats were given a single intraperitoneally injection of 5mg/kg busulfan solution. The first group was kept as busulfan control, while the other groups were orally administrated ginger extract in graded doses of 50, 100 and 150mg/kg b.wt, for 48 consecutive days. At the end, all animals were anesthetized and their testes and vas deference were removed, fixed, embedded, and stained. The volume of testes and seminiferous tubules were estimated by cavalieri methods. Results: The result showed, that zingiber officinale increased the volumes of seminiferous tubule in 100mg/kg treated group compared to control group. Sperm count (706×105 and 682×105) and the level of testosterone (50.90 ng/mL and 54.10 ng/mL) enhanced in 100 mg/kg and 150 mg/kg treated groups compared to control group (p=0.00). Conclusion: It seems that zingiber officinale stimulate male reproductive system in induce busulfan infertility.

Journal Article
TL;DR: Worsened HRQOL in women with PCOS was related to more menstrual irregularities and infertility than to obesity, suggesting a potential for poorer compliance with weight management protocols among affected PCOS patients.
Abstract: Background: Polycystic ovarian syndrome (PCOS) has been shown to cause a reduction in Health-related quality of life (HRQOL). Objective: This study examines the extent of different clinical symptoms in PCOS patients on HRQOL. Materials and Methods: A cross-sectional study was undertaken to ascertain the factors related to HRQOL in 200 PCOS patients in Kashan, Iran. Main outcome measures were modified polycystic ovarian syndrome questionnaire (MPCOSQ) and clinical information of PCOS. Major clinical PCOS features including obesity (BMI), excessive body hair (hirsutism score), acne, menstrual cycle disturbances and infertility. Results: Findings showed that the most common HRQOL concern was menstrual irregularities and infertility, followed in descending order by hirsutism, weight, emotion, and acne. Multivariate analysis revealed the menstrual irregularities as a significant predictor of menstruation (p=0.005), emotion (p=0.02) and infertility (p=0.02) subscales of the MPCOSQ. Having of infertility, predicted scores on the infertility subscale (p<0.0001). Hirsutism score was a significant predictor of hirsutism (p<0.0001) and emotion (p<0.0001) subscales. Weight subscale concerns was predicted by BMI (p<0.0001), also, acne was found to be predicted score of acne subscale (p<0.0001). Conclusion: Worsened HRQOL in women with PCOS was related to more menstrual irregularities and infertility than to obesity. The finding suggests a potential for poorer compliance with weight management protocols among affected PCOS patients.

Journal Article
TL;DR: To increase the surgical success rate and lower the number of ICU admissions, the decision to treat primary postpartum hemorrhage using UAE should be based on individual patient clinical findings under the direction of obstetrics staff and an interventional radiologist.
Abstract: Background: Postpartum hemorrhage is the leading cause of severe maternal morbidity and death. A prompt management of uterine artery embolization (UAE) is important for a good outcome. UAE is generally accepted to be a safe and reliable procedure. Objective: To estimate critical patient characteristics influencing the success of UAE for the treatment of emergent primary postpartum hemorrhage. Materials and Methods: This was a cross sectional study that reviewed 121 patients who were diagnosed primary postpartum hemorrhage between February 2002 and December 2009 at a tertiary treatment center among 4,022 deliveries. We evaluated patient clinical characteristics associated with a successful surgical outcome of UAE. Results: The success rate for UAE was 96%. For two cases, UAE complication was associated with fever (>38.5 o C). Five patients had problems that required admission to the intensive care unit (ICU). Conclusion: To increase the surgical success rate and lower the number of ICU admissions, the decision to treat primary postpartum hemorrhage using UAE should be based on individual patient clinical findings under the direction of obstetrics staff and an interventional radiologist.

Journal Article
TL;DR: Level of BMI, FSH, estradiol, number of preovulatory follicles and the ratio of progressive motile sperm may determine IUI procedure as optimum treatment model.
Abstract: Background: So far, many studies investigated factors that affect pregnancy rates after intrauterine insemination (IUI). Various investigators have not agreed on the nature and ranking of these criteria. Objective: The aim of this study was to assess the predictive factors for pregnancy rate after controlled ovarian hyperstimulation (COH)/ IUI. Materials and Methods: Retrospective study of all patients undergoing IUI at Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital from January 2006 to December 2009. In total 980 IUI cycles in 569 couples were analyzed. All women in the study underwent ovarian stimulation using gonadotropin and IUI was performed 36 h after triggering ovulation. The primary outcome measure was clinical pregnancy rates. Predictive factors evaluated were female age, body mass index (BMI), duration of infertility, type of infertility, follicle stimulating hormone (FSH) level and estradiol (E2) on third day of the cycle, number of preovulatory follicles, endometrial thichness, total motil sperm (TMS) count, and ratio of progressive motile sperm. Results: The overall clinical pregnancy rate was 4.7%. Among the predictive factors after multivariate logistic regression analysis level of BMI ( 50%) significantly influenced the clinical pregnancy rate. Conclusion: Level of BMI, FSH, estradiol, number of preovulatory follicles and the ratio of progressive motile sperm may determine IUI procedure as optimum treatment model.

Journal Article
TL;DR: Vaginal fluid concentrations of urea and creatinine were significantly different between the three groups (p<0.001), demonstrating that of two markers investigated creat inine has the higher diagnostic power.
Abstract: Background: Rupture of fetal membranes can occur at any gestational age. Premature rupture of membranes (PROM) means rupture of fetal membranes before the onset of labor. Objective: The purpose of this study was to evaluate and compare the reliability of the vaginal washing fluid urea and creatinine for the diagnosis of PROM and to determine cut-off values. Materials and Methods: A total of 179 pregnant women were recruited. All patients underwent different examinations. These included nitrazine paper test, fern test, amniotic fluid pooling, vaginal washing fluid urea and creatinine sampling. The one group consisted of 126 pregnant women between 14 and 41 weeks of gestation with the complaint of vaginal fluid leakage. Patients who had positive pooling, nitrazine paper test and fern test were considered as confirmed PROM group (group 1). On the other side, patients with pooling (-) and/or nitrazine paper test (-) and/or fern test (-) were taken as suspected unconfirmed PROM cases (group 2). The control group consisted of 53 pregnant women between 14 and 41 weeks of gestation without any complaint or complication. Weconducted one-way ANOVA test on the urea and creatinine measures and post-hoc comparison test. Cut-off value was determined by receiver operating characteristic (ROC) curve. Results: Vaginal fluid concentrations of urea and creatinine were significantly different between the three groups (p<0.001). The sensitivity, specificity, positive and negative predictive values and accuracy were all 100% in detecting premature rupture of membranes by evaluation of vaginal fluid creatinine concentration with a cut-off value of 0.45 mg/dl, respectively. Conclusion: This study demonstrates that of two markers investigated creatinine has the higher diagnostic power.

Journal Article
TL;DR: Attitude regarding sexual function has a great impact on sexual activity of postmenopausal women that need to be considered in their health care programming.
Abstract: Background: Menopause and its physical, hormonal and psychosocial changes could affect women’s sexual function. There are controversial results regarding relationship between sexual attitudes and function. Objective: We aimed to evaluate sexual attitudes and sexual function among Iranian menopausal age women. Materials and Methods: This population based cross-sectional study was carried out on 225 menopausal women, aged 45-65 years. Based on a self-made questionnaire data were collected about women’s socio-demographic characteristics, attitudes regarding sexuality and sexual function. Data were analyzed using SPSS and sexual function was compared between three groups of women who had positive, medium and negative attitudes regarding sexuality. Results: The mean age of women was 53.11±4.56 years. Seventy percent of them had at least one sexual problem. Feeling of dyspareunia was significantly different between three categories of attitudes regarding sexuality (p=0.03). Comparing data obtained on their attitudes, sexual desire, orgasm and dyspareunia demonstrated significant differences (p=0.03, 0.04, and 0.04 respectively). Conclusion: Attitude regarding sexual function has a great impact on sexual activity of postmenopausal women that need to be considered in their health care programming.

Journal Article
TL;DR: It is possible to assume that elevated TGs levels in GDM cases is a reflection of variation in maternal insulin levels, due to positive correlation of hypertriglyceridemia and hyperinsulinemia with newborn weight.
Abstract: Background: Fetal growth in diabetic pregnancies is a complex process and probably abnormalities in other metabolic pathways such as protein and lipid, as well as carbohydrate are responsible for delivering of macrosomic newborn. Objective: The purpose of this study was to investigate the association between fetal growth and different maternal metabolic parameters in women with gestational diabetes mellitus (GDM) in comparison to control group. Materials and Methods: This was a prospective cohort study conducted between March 2011 and May 2012, on 112 pregnant women with GDM and 159 healthy pregnant women. In order to determine of lipids or lipoproteins changes during pregnancy and to investigate any possible effects on fetal growth, lipid components, glucose and insulin levels were obtained in maternal serum three times in third trimester. Results: Maternal serum glucose, total cholesterol (TC), low and high density lipoprotein (LDL-c, HDL-c) levels did not show any significant difference between two groups. While insulin, homeostasis model assessment-insulin resistance (HOMA-IR) and triglyceride (TG) values were detected to be significantly higher in the GDM cases especially after 32 weeks of gestation (p<0.001). After adjustment for confounding variables, maternal hypertriglyceridemia remained as a significant risk factor for delivering large for gestational age (LGA) newborns (p=0.04); and according to spearman test the increase of TG level was correlated with increase of insulin resistance and HOMA-IR (p<0.001, CI: 0.312). Conclusion: Due to positive correlation of hypertriglyceridemia and hyperinsulinemia with newborn weight, it is possible to assume that elevated TGs levels in GDM cases is a reflection of variation in maternal insulin levels.

Journal Article
TL;DR: Ch chromium picolinate decreased FBS and insulin levels and, thus, increased insulin sensitivity in clomiphene citrate-resistance PCOS women and these effects were comparable with metformin; however, met formin treatment was associated with decreased hyperandrogenism.
Abstract: Background: Chromium picolinate could be effective in clomiphen citrate resistant PCOS patients. Objective: To compare the effects of chromium picolinate vs. metformin in clomiphen citrate resistant PCOS patients. Materials and Methods: The present randomized clinical trial was performed on 92 women with clomiphen citrate-resistant PCOS at the clinics which were affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. The subjects were randomly assigned to two groups receiving either chromium picolinate (200µg daily) or metformin (1500mg daily) for 3 months. Anthropometric and hormonal profile were measured and compared both before and after the treatment. Ovulation and pregnancy rate was measured in the two study groups, as well. Results: Chromium picolinate significantly decreased fasting blood sugar (FBS) after 3 months of treatment (p=0.042). In the same way, the serum levels of fasting insulin had significantly decreased leading to an increase in insulin sensitivity as measured by QUICKI index (p=0.014). In comparison to the patients who received chromium picolinate, those who received metformin had significantly lower levels of testosterone (p=0.001) and free testosterone (p=0.001) after 3 months of treatment. Nevertheless, no significant difference was found between the two study groups regarding ovulation (p=0.417) and pregnancy rates (p=0.500). Conclusion: Chromium picolinate decreased FBS and insulin levels and, thus, increased insulin sensitivity in clomiphene citrate-resistance PCOS women. These effects were comparable with metformin; however, metformin treatment was associated with decreased hyperandrogenism. Overall, chromium picolinate was better tolerated compared to metformin; nonetheless, the two study groups were not significantly different regarding ovulation and pregnancy rates. Registration ID in IRCT: IRCT201203139281N1

Journal Article
TL;DR: Body massage might be used as an effective and safe non-medical intervention for increasing of weight gain velocity in LBW preterm neonates in Yazd, Iran.
Abstract: Background: Admission of low birth-weight (LBW) neonates in neonatal intensive care unit (NICU) causes their deprivation of tactile and sensory stimulation. Objective: The purpose of this study was to evaluate efficacy of body massage on growth parameters (weight, height and head circumference) gain velocity of LBW in Yazd, Iran. Materials and Methods: A randomized clinical trial study was conducted on LBW neonates whom were admitted to NICU of Shahid Sadoughi Hospital, Yazd, Iran from March to December 2011. Neonates were randomly assigned to two groups. In group one, 20 neonates were received massage three times in a day for consecutive 14 days by their mothers. In group two, intervention consisted of standard and routine care as control group. The primary endpoints were efficacy in increase of mean of weight, height and head circumference that were evaluated 14 days after intervention, at ages one and two months. Secondary outcome was clinical side effects. Results: 17 girls and 23 boys with mean gestational age of 34.4±1.22 weeks were evaluated. In the body massage group, only weight at the age of two months was significantly higher than the control group (mean±SD: 3250±305 vs. 2948±121 gr, p=0.005). No adverse events were seen in the two groups. Conclusion: Body massage might be used as an effective and safe non-medical intervention for increasing of weight gain velocity in LBW preterm neonates.

Journal Article
TL;DR: CBT can serve as an effective psychosocial intervention for promoting self-efficacy of infertile women and there was evidence of high infertility self- efficacy for women exposed to the intervention compared with those in the control group.
Abstract: Background: The infertility is associated with psychological consequence including depression, and lack of self-efficacy. Objective: The aim of this study was to compare the pharmacological and no pharmacological strategies in promotion of self-efficacy of infertile women. Materials and Methods: A randomized controlled clinical trial was conducted on 89 infertile women who were recruited from Fatemeh Zahra Infertility and Reproductive Health Research Center and were randomized into three groups; cognitive behavioral therapy (CBT), antidepressant therapy with flouxetine 20 mg daily for 3 month, and a control group. All participants completed Infertility Self-efficacy Inventory (ISE) and the Beck Depression Inventory (BDI) at the beginning and end of the study. Results: The means ISE scores among the CBT, fluoxetine, and control groups at the beginning and end of the study were 6.1±1.6 vs. 7.2±0.9, 6.4±1.4 vs. 6.9±1.3 and 6.1±1.1 vs. 5.9±1.4 respectively. Both CBT and fluoxetine increased the mean of ISE scores more than control group after intervention (p<0.0001, p=0.033; respectively), but increase in the CBT group was significantly greater than flouxetine group. Finally, there was evidence of high infertility self-efficacy for women exposed to the intervention compared with those in the control group. Also, there was an improvement in depression. Both fluoxetine and CBT decreased significantly the mean of BDI scores more than the control group; decrease in the CBT group was significantly more than that in the fluoxetine group. Conclusion: CBT can serve as an effective psychosocial intervention for promoting self-efficacy of infertile women.