Showing papers in "Iranian Journal of Reproductive Medicine in 2016"
TL;DR: Spermatozoa need small amounts of ROS to acquire the ability of nuclear maturation regulation and condensation to fertilize the oocyte, indicating that oxidative stress is one of the main cause of DNA damage in the germ cells, then there should be good reason for antioxidant therapy in these conditions.
Abstract: Sperm is particularly susceptible to reactive oxygen species (ROS) during critical phases of spermiogenesis. However, the level of seminal ROS is restricted by seminal antioxidants which have beneficial effects on sperm parameters and developmental potentials. Mitochondria and sperm plasma membrane are two major sites of ROS generation in sperm cells. Besides, leukocytes including polymer phonuclear (PMN) leukocytes and macrophages produce broad category of molecules including oxygen free radicals, non-radical species and reactive nitrogen species. Physiological role of ROS increase the intracellular cAMP which then activate protein kinase in male reproductive system. This indicates that spermatozoa need small amounts of ROS to acquire the ability of nuclear maturation regulation and condensation to fertilize the oocyte. There is a long list of intrinsic and extrinsic factors which can induce oxidative stress to interact with lipids, proteins and DNA molecules. As a result, we have lipid peroxidation, DNA fragmentation, axonemal damage, denaturation of the enzymes, over generation of superoxide in the mitochondria, lower antioxidant activity and finally abnormal spermatogenesis. If oxidative stress is considered as one of the main cause of DNA damage in the germ cells, then there should be good reason for antioxidant therapy in these conditions.
196 citations
TL;DR: It was showed that antioxidant supplements, especially a combination of antioxidants such as vitamin C, vitamin E, and CoQ10 intake can effectively improve semen parameters in infertile men.
Abstract: Many studies have focused on male infertility. There is limited evidence about the influence of nutrition on quality of semen. Approximately, 30-80% of infertility cases are caused by oxidative stress and decreased level of seminal total antioxidant capacity. This study was aimed to review the effects of oral antioxidant supplements on improving major semen parameters such as sperm concentration, motility, morphology, DNA damage, and fertility rate. Data were extracted from PubMed and Google scholar database by using the terms "antioxidant", "multivitamin", "carnitine", "CoQ10", "vitamin C", "vitamin E", "zinc", "folic acid", "N-acetyl cysteine" and "selenium" combined with "male infertility", "semen", and "sperm" to generate a set of relevant citations. Supplements such as CoQ10 and alpha-tocopherol significantly improve sperm count. Also, carnitine has positive effects on sperm motility and morphology. Simultaneous administration of vitamin E and vitamin C reduces the sperm DNA damage. However, in some studies, one or more factors have not changed substantially. In most of the studies, antioxidant supplementation improved the number, motility, morphology and sometimes DNA integrity of sperm. The present study showed that antioxidant supplements, especially a combination of antioxidants such as vitamin C, vitamin E, and CoQ10 intake can effectively improve semen parameters in infertile men.
149 citations
TL;DR: RJ improved diabetes-induced impairment in testis, probably through its antioxidant property, according to Histological results of the testis from diabetic rats.
Abstract: Background: Diabetes is the most common endocrine disease. It has adverse effects on male reproductive function. Royal Jelly (RJ) has antioxidant and anti-diabetic effects and show protective effects against diabetes. Objective: This study was conducted to evaluate the effect of RJ on histopathological alterations of the testicular tissue in streptozotocin (STZ)-induced diabetic rats. Materials and Methods: In this experimental study, 28 adult Wistar rats were randomly divided into control (C), royal jelly (R), diabetic (D) and RJ-treated diabetic (D+R) groups. Diabetes was induced by a single intraperitoneal injection of STZ at 50 mg/kg body weight (BW). The rats from the R and D+R groups received daily RJ (100 mg/kg BW) for 6 wks orally. Hematoxylin-Eosin staining was used to analyze histopathological changes including: tunica albuginea thickness (TAT), seminiferous tubules diameter (STsD), Johnsen’s score, tubular differentiation index (TDI), spermiogenesis index (SPI), Sertoli cell index (SCI), meiotic index (MI), and mononuclear immune cells (MICs) in testes. The antioxidant status was examined by evaluating testicular levels of ferric reducing antioxidant power (FRAP) and catalase (CAT) activity. Results: Histological results of the testis from diabetic rats showed significant decrease in STsD, Johnsen’s score, TDI, SPI, SCI and MI, and significant increase in TAT and MICs, while administration of RJ significantly reverted these changes (p<0.05). RJ treatment markedly increased activity of CAT and FRAP. There were significant differences in FRAP levels among C (13.0±0.5), RJ (13.4±0.3), D (7.8±0.6) and D+R (12.4±0.7) groups (p<0.05). Conclusion: RJ improved diabetes-induced impairment in testis, probably through its antioxidant property.
74 citations
TL;DR: It seems that platelet-rich plasma is effective in improvement of pregnancy outcome in RIF patients, according to this study.
Abstract: Background: Repeated implantation failure (RIF) is a major challenge in reproductive medicine and despite several methods that have been described for management, there is little consensus on the most effective one Objective: This study was conducted to evaluate the effectiveness of platelet-rich plasma in improvement of pregnancy rate in RIF patients Materials and Methods: Twenty women with a history of RIF who were candidates for frozen-thawed embryo transfer were recruited in this study Intrauterine infusion of 05 ml of platelet-rich plasma that contained platelet 4-5 times more than peripheral blood sample was performed 48 hrs before blastocyst transfer Results: Eighteen participants were pregnant with one early miscarriage and one molar pregnancy Sixteen clinical pregnancies were recorded and their pregnancies are ongoing Conclusion: According to this study, it seems that platelet-rich plasma is effective in improvement of pregnancy outcome in RIF patients
67 citations
TL;DR: The thyroid function changes occurring during pregnancy, the different disorders with their maternal and fetal implications, the laboratory diagnosis and the best ways of management of these conditions are assessed.
Abstract: Thyroid dysfunctions such as hypothyroidism, thyrotoxicosis and thyroid nodules may develop during pregnancy leading to abortion, placental abruptions, preeclampsia, preterm delivery and reduced intellectual function in the offspring. Epidemiological data have shown the significant role of maternal thyroid hormone in fetal neurologic development and maternal health. It has been suggested that the deleterious effects of thyroid dysfunction can also extend beyond pregnancy and delivery to affect neuro-intellectual development in the early life of the child. Pregnancy poses an important challenge to the maternal thyroid gland as hormone requirements are increased during gestation as a result of an increase in thyroid- binding globulin, the stimulatory effect of HCG on TSH receptors, and increased peripheral thyroid hormone requirements. Maternal thyroid dysfunction is associated with increased risk for early abortion, preterm delivery, neonatal morbidity and other obstetrical complications. Early diagnosis for thyroid dysfunction of pregnant women and treatment of thyroid dysfunction during pregnancy is important and cost effective to avoid both fetal and maternal complications secondary to thyroid dysfunction. Therefore the aim of this review was to assess the thyroid function changes occurring during pregnancy, the different disorders with their maternal and fetal implications, the laboratory diagnosis and the best ways of management of these conditions.
59 citations
TL;DR: The SWLS has adequate psychometric properties for assessing life satisfaction in Iranian infertile women, and a single-factor model provides a good fit to the data.
Abstract: Background: Infertility is a global public health issue and may adversely affect life satisfaction. One of the most widely instruments used to assess life satisfaction is the Satisfaction with Life Scale (SWLS). Objective: The objective of this study was to examine the psychometric properties of the SWLS in Iranian infertile women. Materials and Methods: In this descriptive cross-sectional study, a total of 125 infertile women referring to Royan Institute in Tehran were selected by convenience sampling method. The participants were administered the SWLS, the Hospital Anxiety and Depression Scale (HADS), and a demographic questionnaire. The psychometric properties of the SWLS were examined: construct validity using confirmatory factor analysis (CFA), reliability using Cronbach’s alpha and convergent validity by examining the relationship with HADS. Result: Results of the CFA indicated that a single-factor model provides a good fit to the data (χ2/df= 1.58; GFI= 0.975; CFI= 0.995; NFI= 0.985; RMSEA= 0.069 and SRMR= 0.027). The Cronbach’s alpha coefficient for SWLS was 0.887. Significant negative correlations were found between SWLS and HADS scores for anxiety (r= -0.410) and depression (r= -0.434), indicating an acceptable convergent validity. Conclusion: The SWLS has adequate psychometric properties for assessing life satisfaction in Iranian infertile women.
47 citations
TL;DR: CS decreased the expression of CYP11A, resulting in decreased testosterone, and increased acrosome-reacted sperm, assumed to be the result of an increase of 55 kDa phosphorylated protein.
Abstract: Background: Stress is a cause of male infertility. Although sex hormones and sperm quality have been shown to be low in stress, sperm physiology and testicular functional proteins, such as phosphotyrosine proteins, have not been documented. Objective: To investigate the acrosome status and alterations of testicular proteins involved in spermatogenesis and testosterone synthesis in chronic stress in rats. Materials and Methods: In this experimental study, male rats were divided into 2 groups (control and chronic stress (CS), n=7). CS rats were immobilized (4 hr/day) for 42 consecutive days. The blood glucose level (BGL), corticosterone, testosterone, acrosome status, and histopathology were examined. The expressions of testicular steroidogenic acute regulatory (StAR), cytochrome P450 side chain cleavage (CYP11A1), and phosphorylated proteins were analyzed. Results: Results showed that BGL (71.25±2.22 vs. 95.60±3.36 mg/dl), corticosterone level (24.33±4.23 vs. 36.9±2.01 ng/ml), acrosome reacted sperm (3.25±1.55 vs. 17.71±5.03%), and sperm head abnormality (3.29±0.71 vs. 6.21±1.18%) were significantly higher in CS group in comparison with control. In contrast, seminal vesicle (0.41±0.05 vs. 0.24±0.07 g/100g), testosterone level (3.37±0.79 vs. 0.61±0.29 ng/ml), and sperm concentration (115.33±7.70 vs. 79.13±3.65×106 cells/ml) of CS were significantly lower (p<0.05) than controls. Some atrophic seminiferous tubules and low sperm mass were apparent in CS rats. The expression of CYP11A1 except StAR protein was markedly decreased in CS rats. In contrast, a 55 kDa phosphorylated protein was higher in CS testes. Conclusion: CS decreased the expression of CYP11A, resulting in decreased testosterone, and increased acrosome-reacted sperm, assumed to be the result of an increase of 55 kDa phosphorylated protein
45 citations
TL;DR: G-CSF may increase chemical pregnancy and implantation rate in patients with recurrent implantation failure but clinical pregnancy rate and abortion rate was unaffected.
Abstract: Background: Recurrent implantation failure (RIF) is the absence of implantationafter three consecutive In Vitro Fertilization (IVF) cycles with transferring at leastfour good quality embryos in a minimum of three fresh or frozen cycles in a womanunder 40 years. The definition and management of RIF is under constant scrutiny.Objective: To investigate the effects of Granulocyte colony stimulating factor (GCSF)on RIF, pregnancy rate, abortion rate and implantation rates.Materials and Methods: A double blind placebo controlled randomized trial wasconducted at two tertiary university based hospitals. One hundred patients with thehistory of RIF from December 2011 until January 2014 were recruited in the study.G-CSF 300μg/1ml was administered at the day of oocyte puncture or day ofprogesterone administration of FET cycle. Forty patients were recruited at G-CSFgroup, 40 in saline and 20 in placebo group.Results: The mean age for whole study group was 35.3±4.2 yrs (G-CSF 35.5±4.32,saline 35.3±3.98, placebo 35.4±4.01, respectively). Seventeen patients had a positivepregnancy test after embryo transfer [10 (25%) in G-CSF; 5 (12.5%) in saline; and 2(10%) in placebo group]. The mean of abortion rates was 17.6% (3), two of them inG-CSF, one in saline group. The implantation rate was 12.3% in G-CSF, 6.1% insaline and 4.7% in placebo group.Conclusion: G-CSF may increase chemical pregnancy and implantation rate inpatients with recurrent implantation failure but clinical pregnancy rate and abortionrate was unaffected.
43 citations
TL;DR: Investigating whether the Genistein could protect morphine adverse effects on sperm cells viability, count, motility, and testis histology and testosterone hormone and nitric oxide in blood serum found it seems thatGenistein administration could increase the quality of spermatozoa and prevent morphine- induced adverseeffects on sperm parameters.
Abstract: Background: The predominant phytoestrogen in soy and derived products is the isoflavone Genistein. Genistein has antioxidant properties. Morphine is a main psychoactive chemical in opium that can increase the generation of free radicals and therefore it could adversely affects the spermatogenesis. Objective: The main goal was to investigate whether the Genistein could protect morphine adverse effects on sperm cells viability, count, motility, and testis histology and testosterone hormone and nitric oxide in blood serum. Materials and Methods: In this study, various doses of Genistein (0, 1, 2, and 3 mg/kg) and Genistein plus morphine (0, 1, 2, and 3 mg/kg) were administered interaperitoneally to 48 male mice for 30 consequent days. These mice were randomly assigned to 8 groups (n=6) and sperm parameters (sperm cells viability, count, motility and morphology), testis weight and histology, testosterone hormone (ELISA method), FSH and LH hormones (immunoradiometry) and serum nitric oxide (griess assay) were analyzed and compared. Results: The results indicated that morphine administration significantly decreased testosterone (0.03 ng/mg) LH and FSH level, histological parameters, count, viability (55.3%), morphology and motility of sperm cells (1%), testis weight (0.08 gr) and increase nitric oxide compared to saline group (p=0.00). However, administration of Genistein and Genistein plus morphine significantly boosted motility, morphology, count, viability of sperm cells, seminiferous tubules diameter, germinal thickness, testosterone, LH and FSH while decrease nitric oxide level in all groups compared to morphine group (p<0.025). Conclusion: It seems that Genistein administration could increase the quality of spermatozoa and prevent morphine- induced adverse effects on sperm parameters
43 citations
TL;DR: Findings indicate that Purslane can attenuate aging alternations induced by D-gal and aging in female reproductive system and could also improve histological changes such as atrophy of endometrium.
Abstract: Background: Aging contains morphological and functional deterioration in biological systems. D-galactose (D-gal) generates free radicals and accelerates aging. Portulaca oleracea (Purslane) may have protective effect against oxidative stress. Objective: Purslane ethanolic extract effects were evaluated on antioxidant indices and sex hormone in D-gal aging female mice. Materials and Methods: 48 female NMRI mice (25-35 gr) were randomly divided into, 6 groups: 1- control (normal saline for 45 days), 2- Purslane (200 mg/kg for last 3 weeks), 3-D-gal (500 mg/kg for 45 days), 4-D-gal+Purslane, 5- Aging, 6-Aging+Purslane. Sex hormones, antioxidants and malondialdehyde (MDA) level of ovary and uterus were measured. Histological assessment was also done. Results: In D-gal treated and aging animals, LH and FSH levels were significantly increased (p<0.001) while estrogen and progesterone levels were significantly reduced (p<0.001) in comparison with control group. MDA contents were significantly increased in ovaries and uterus of D-gal and aging groups (p<0.01). Superoxide dismutase (SOD) (p<0.001) and catalase (p<0.01) activities were significantly decreased in both aging and D-gal treated animals. Ovarian follicles were degenerated and atrophy on uterine wall and endometrial glands was observed in D-gal and aging groups. Alteration in hormone levels, MDA contents and antioxidant activity were significantly reversed by Purslane (p<0.05). Purslane could also improve histological changes such as atrophy of endometrium. Conclusion: These findings indicate that Purslane can attenuate aging alternations induced by D-gal and aging in female reproductive system.
33 citations
TL;DR: Gold nano-particles can reduce the sperm parameters such as motility and normal morphology and secondly affect sperm chromatin remodeling and cause the increase instability of chromatin and also increase the rate of sperm DNA damage.
Abstract: Background: The particles in the range of 1-100 nm are called nanoparticles56T. Gold nanoparticle is one of the most important metal nanoparticles with wide usage56T.Objective: 56TThis study investigated the effects of gold nanoparticles on sperm parameters and chromatin structure in mice56T.Materials and Methods: 56TIn this experimental study, 72 male bulb-c mice were divided into 9 groups including: 4 Sham groups (Sc 1-4), 4 experimental groups (Au 1-4), and 1 control group (C). Experimental groups received 40 and 200 μg/kg/day soluble gold (Au) nano-particles for 7 and 35 days, by intra peritoneal injection, respectively. Sham groups were treated with 1.2 mM sodium citrate solution with 40 and 200 μg/kg/day doses for same days and control group did not receive any materials. Motility and Morphology of spermatozoa were analyzed. Chromatin quality was also evaluated using AB (Aniline blue), TB (Toluidine blue) and CMA3 (Chromomycin A3) staining methods.Results: 56TThe sperm analysis results showed that motility and morphology of sperm in experimental groups (especially in groups that have been treated for 35 days with nano-particles) had significant decrease in comparison with control group. TB, AB and CMA3 results showed a significant increase in abnormal spermatozoa from all Au-treated groups56T.Conclusion: 56TGold nano-particles56T 56Tfirstly can reduce the sperm parameters such as motility and normal morphology and secondly affect sperm chromatin remodeling and cause the increase instability of chromatin and also increase the rate of sperm DNA damage. These deleterious effects were more obvious in maximum dose and chronic phase56T.
TL;DR: Overall, studies showed that Anise (Pimpinella anisum), licorice (Glycyrrhizaglabra), Soy, Black cohosh, Red clover, Evening primrose, Flaxseed, Salvia officinalis, Passiflora, and valerian can alleviate the side effects of hot flashes.
Abstract: Background: Hot flashes are the most common symptoms experienced by women around the time of menopause. Many women are interested in herbal medicines because of fear of side effects of hormone therapy. Objective: The aim of this systematic review was to assess the effectiveness of Iranian herbal medicines in alleviating hot flashes. Materials and Methods: MEDLINE (1966 to January 2015), Scopus (1996 to January 2015), and Cochrane Central Register of Controlled Trials (The Cochrane Library, issue 1, 2015) were searched along with, SID, Iran Medex, Magiran, Medlib and Irandoc. Nineteen randomized controlled trials met the inclusion criteria. Results: Overall, studies showed that Anise (Pimpinella anisum), licorice (Glycyrrhizaglabra), Soy, Black cohosh, Red clover, Evening primrose, Flaxseed, Salvia officinalis, Passiflora، itex Agnus Castus, Piascledine (Avacado plus soybean oil), St. John's wort (Hypericum perforatum), and valerian can alleviate the side effects of hot flashes. Conclusion: This research demonstrated the efficacy of herbal medicines in alleviating hot flashes, which are embraced both with people and health providers of Iran Therefore, herbal medicine can be seen as an alternative treatment for women experiencing hot flashes.
TL;DR: Endometrial injury in preceding cycle improves the implantation rate and live birth rate and reduces the miscarriage rate per clinical pregnancy in patients undergoing their first IVF/ICSI cycle.
Abstract: Background: Implantation remains a limiting step in IVF/ICSI. Endometrial injury isa promising procedure aiming at improving the implantation and pregnancy rates after IVF/ICSI. Objective: The aim of this study was to evaluate the effect of endometrial injury induced in precedingcycle on IVF/ICSI outcome. Materials and Methods: Four hundred patients undergoing their first IVF/ICSI cycle in two IVF units in Minia, Egypt were randomly selected to undergo either endometrial injury in luteal phase of preceding cycle (intervention group) or no treatment (control group). Primary outcome wasthe implantation and live birth ratesWhile the secondary outcome was clinical pregnancy, miscarriage, multiple pregnancy rates, pain and bleeding during and after procedure. Results: Implantation and live birth rates were significantly higher in intervention compared with control group (22.4% vs. 18.7%, p=0.02 and 67% vs. 28%, p=0.03), respectively. There was also a significant reduction in miscarriage rate in intervention group (4.8% vs. 19.7%, respectively, p<0.001). Conclusion: Endometrial injury in preceding cycle improves the implantation rate and live birth rate and reduces the miscarriage rate per clinical pregnancy in patients undergoing their first IVF/ICSI cycle.
TL;DR: It is concluded that the age is the superior predictor of IVF outcome and AMH and AFC are variable predicting markers of ovarian reserve in different age groups.
Abstract: Background: The predictive roles of follicle stimulating hormone (FSH), anti-mullerian hormone (AMH) and antral follicle count (AFC) as ovarian reserve markers in women with different age groups are not established well. Objective: This study compares the value of FSH, AMH and AFC at the time of in vitro fertilization (IVF) treatment in different age groups. Materials and Methods: In this cross-sectional study, 103 women aged 20-43 years candidates for IVF/ICSI cycle were recruited. FSH, AMH and AFC on day 3 of menstrual cycle were measured. The relationship of these measured markers with outcome variables (oocytes number, number of frozen/fresh embryo and chemical and clinical pregnancy) was assessed in different age groups (i.e. 20-32, 33-37 and 38-43 years). Results: our results show that age was correlated with clinical pregnancy, oocyte count and fresh and frozen embryo (p<0.001). AMH, AFC and FSH were not correlated with clinical or chemical pregnancy at total population or age subgroups except the significant correlation of AFC with clinical pregnancy at 33-37 years old group. AFC was correlated with oocyte count and the number of fresh and frozen embryos in the ages group 20-32 years. In this age group, AMH was correlated with fresh and frozen embryos. AMH, AFC and FSH were correlated with oocyte count and the number of fresh embryos in age group 33-37 years. AMH was correlated with oocyte count and the number of fresh embryos in 38-43 years old group. Conclusion: We concluded that the age is the superior predictor of IVF outcome and AMH and AFC are variable predicting markers of ovarian reserve in different age groups.
TL;DR: In normal IVF patients with normal endometrial thickness, the intrauterine infusion of G-CSF did not improve pregnancy outcomes and there were no significant differences between groups.
Abstract: Background: Despite major advances in assisted reproductive techniques, the implantation rates remain relatively low. Some studies have demonstrated that intrauterine infusion of granulocyte colony stimulating factor (G-CSF) improves implantation in infertile women. Objective: To assess the G-CSF effects on IVF outcomes in women with normal endometrial thickness. Materials and methods : In this randomized controlled clinical trial, 100 infertile women with normal endometrial thickness who were candidate for IVF were evaluated in two groups. Exclusion criteria were positive history of repeated implantation failure (RIF), endocrine disorders, severe endometriosis, congenital or acquired uterine anomaly and contraindication for G-CSF (renal disease, sickle cell disease, or malignancy). In G-CSF group (n=50), 300 µg trans cervical intrauterine of G-CSF was administered at the oocyte retrieval day. Controls (n=50) were treated with standard protocol. Chemical, clinical and ongoing pregnancy rates, implantation rate, and miscarriage rate were compared between groups. Results: Number of total and mature oocytes (MII), two pronuclei (2PN), total embryos, transferred embryos, quality of transferred embryos, and fertilization rate did not differ significantly between two groups. So there were no significant differences between groups in chemical, clinical and ongoing pregnancy rate, implantation rate, and miscarriage rate Conclusion: our result showed in normal IVF patients with normal endometrial thickness, the intrauterine infusion of G-CSF did not improve pregnancy outcomes.
TL;DR: According to the results, preoperative serum CA-125 is an important predictor for patients with endometriosis and it should be taken into consideration when surgical management is suspected, especially if stage of disease, lesion size and adhesion score are undertaken.
Abstract: Background: Cancer antigen 125 (CA-125) is a glycoprotein biomarker that is used in women with pelvic masses such as endometriosis and maybe is useful in practice of patients suspicious to endometriosis.Objective: The aim of this study was to evaluate the association between preoperative serum CA-125 levels and clinic pathological characteristic in women with endometriosis, and find out the best serum CA-125 levels cut-off in pre and post menopause women.Materials and Methods: Serum CA-125 levels in 87 women aged 21-54 years suspected to endometriosis with pelvic pain, dysmenorrhea, or dyspareunia were measured preoperatively. Also the association between clinic pathological characteristic and serum CA-125 level were analyzed.Results: The mean age of women was 32.22±6.91. The mean serum CA-125 level was 49.93±4.30 U/mL. There was a significant correlation between the endometriosis stage, lesion size, adhesion score and preoperative CA-125 plasma concentration. However, we did not found significant differences in age, marital status, patient’s complaints, and pelvic pain associated to Ca125 serum level. The suggested preoperative serum cut-off levels in premenopausal and postmenopausal patients were 37 U/ml and 35 U/ml, respectively.Conclusion: According to the results, preoperative serum CA-125 is an important predictor for patients with endometriosis and it should be taken into consideration when surgical management is suspected, especially if stage of disease, lesion size and adhesion score are undertaken.
TL;DR: Although, the result showed no significantly difference between the fresh ET and the FET cycles, however, the embryos are able to be stored for subsequent ART, therefore, it is recommended to recommend fET cycles as an option alongside the freshET.
Abstract: Background: The use of assisted reproductive technology (ART) is increasing in the world. The rate, efficacy and safety of ART are very different among countries. There is an increase in the use of intra cytoplasmic sperm injection (ICSI), single fresh embryo transfer (ET) and frozen-thawed embryo transfer (FET). Objective: The objective of this study was to compare pregnancy rate in fresh ET and FET. Materials and Methods: In this retrospective cross-sectional study 1014 ICSI-ET cycles (426 fresh ET and 588 FET) from 753 women undergoing ICSI treatment referred to Fatemezahra Infertility and Reproductive Health Research Center in Babol, Iran from 2008 to 2013 were reviewed. Results: There were no significant differences between biochemical pregnancy rate (23% versus 18.8%, OR 1.301; 95% CI .95-1.774), gestational sac (95.6% versus 100% in FET, OR 0.60; 95% CI 0.54-0.67), and fetal heart activity (87.2% versus 93.6% OR .46; 95% CI .16-1.32) in fresh ET and FET cycles, respectively. P< 0.05 was considered statistically significant for all measures. Conclusion: Although, the result showed no significantly difference between the fresh ET and the FET cycles, however the embryos are able to be stored for subsequent ART. Therefore, we recommend FET cycles as an option alongside the fresh ET.
TL;DR: The findings suggest that infertility impacts on women’s sexual function in desire, arousal, satisfaction and total sexual dysfunction, and health care professional should be sensitive to impact that diagnosis of infertility can have on women's sexuality.
Abstract: Background: One of the affected aspects in infertile women that have not been given sufficient attention is sexual function. Sexual function is a key factor in physical and marital health, and sexual dysfunction could significantly lower the quality of life. Aim of this study was to assess the comparison sexual dysfunction in women with infertility and without infertility, admitted to Al- Zahra Hospital. Objective: We decided to assess the prevalence of women sexual disorders in fertile and infertile subjects, admitted to Al-Zahra Hospital. Materials and Methods: 149 fertile and 147 infertile women who referred to infertility clinic of Al-Zahra Hospital during 2013-2014 were entered this cross-sectional study and Female Sexual Function Index questionnaire (FSFI) had been filled by all the cases. Most of women were married for 6-10 years (35.5%) and mean marriage time in participants was 9.55±6.07 years. Data were analyzed using SPSS software Ver. 18 and 2 test and logistic regression model has been used for analysis. Results: Results showed significant differences between desire (p=0.004), arousal (p=0.001), satisfaction (p=0.022) and total sexual dysfunction (p=0.011) in both groups but in lubrication (p=0.266), orgasm (p=0.61) and pain (p=0.793) difference were not significant. Conclusion: Some of sexual dysfunction indices are high in all infertile women. Our findings suggest that infertility impacts on women’s sexual function in desire, arousal, satisfaction and total sexual dysfunction. Health care professional should be sensitive to impact that diagnosis of infertility can have on women’s sexuality.
TL;DR: It seems that there is no major difference regarding perinatal outcome between fresh and frozen embryo transfer, although, live birth is slightly increased in fresh cycles and prematurity was significantly increased among singleton infants in FET group.
Abstract: Background: Despite of higher pregnancy rate after frozen embryo transfer (FET) which is accepted by the majority of researches, the safety of this method and its effect on neonatal outcome is still under debate. Objective: The aim of this study was to evaluate pregnancy and neonatal outcome of FET compare to fresh cycles. Materials and Methods: In this study,1134 patients using fresh ET and 285 women underwent FET were investigated regarding live birth as primary outcome and gestational age, birth weight, gender, multiple status, ectopic pregnancy, still birth and pregnancy loss as secondary outcomes. Results: Our results showed that there is no difference between FET and fresh cycles regarding live birth (65.6% vs. 70.4% respectively). Ectopic pregnancy, still birth and abortion were similar in both groups. The mean gestational age was significantly lower among singletons in FET group compared to fresh cycles (p=0.047). Prematurity was significantly elevated among singleton infants in FET group (19.6%) in comparison to neonates born after fresh ET (12.8%) (p=0.037). Conclusion: It seems that there is no major difference regarding perinatal outcome between fresh and frozen embryo transfer. Although, live birth is slightly increased in fresh cycles and prematurity was significantly increased among singleton infants in FET group.
TL;DR: Screening of sexual dysfunction for finding the causes in women should be the main sexual health program, and the role of physicians and experts on education and counseling in this subject would be important.
Abstract: Background: Sexual function and its subsequent satisfaction are among the most important aspects of women’s life. However, this instinct could be influenced by some factors such as diseases, drug using, aging, and hormonal and physiologic changes associated with menopause, and sexual behavior. Objective: The aim of this study was to describe the prevalence rates of sexual dysfunction, and related attitudes among aged women in Jahrom, Iran. Materials and Methods: This cross-sectional study was conducted on 746 postmenopausal women aged between 50 and 89 years old who had referred to obstetric and gynecologic clinic in Jahrom, from April to October 2014. Female Sexual Function Index questionnaire was used order to assess the sexual function. The cases were classified into three categories according to the attitude scores: negative (17-32), medium (33-38), and positive (39-48). One-way ANOVA test was used to determine the relationship between FSFI and attitude scores. Results: The participants’ mean±SD age was 60.10±6.89 years and the total mean score of FSFI was 19.31±8.5. In addition, 81.5% of the women had sexual dysfunction (FSFI 26.55). Almost 62.1% the women displayed a negative attitude towards sexuality and only 18.8% women had positive attitude. Feeling of dyspareunia (p= 0.02), lubrication (p< 0.0001), orgasm (p= 0.002) and satisfaction (p= 0.002) were significantly different between three categories of attitudes regarding sexuality, respectively Conclusion: Our data showed that sexual disorders were highly prevalent among postmenopausal women. The most affected problems were arousal, dyspareunia, and lubrication. More than half of the women had negative attitude towards sexual function consequently this could affect their sexual function. So, it seems screening of sexual dysfunction for finding the causes in women should be the main sexual health program. Also, it would be important to emphasis the role of physicians and experts on education and counseling in this subject.
TL;DR: Morphine could affect all spermatogenesis stages and changes in different groups of opioid application might affect sperm formation, according to Histological studies revealed.
Abstract: Background: There are numerous investigations on wide range of issues that disrupt regulatory spermatogenesis, individuals who are exposed to drug abuse faced infertility and immature spermatogenesis. Objective: The aim of this study was to evaluate the addiction effects of morphine and its derivatives on rats spermatogenesis. Materials and Methods: 40 male Wistar rats were randomly divided into 5 equal groups, which were exposed either with intravenous morphine, naloxone, naloxone and morphine, sham (with normal saline injection) and a control group without infusion. Spermatogenesis was assessed after three months via histological sections with hematoxylin and eosin staining, using a light microscope based on measurement of spermatogonia, spermatocyte, spermatid, and spermatozoa. Results: Those rats that received opioids had changes in spermatogenesis function. The population of spermatogenesis cycle cells at spermatogonia, spermatocyte, spermatid, and spermatozoa stages was significantly decreased in those rats that received opioid in comparison to the control group (p<0.05). Histological studies revealed that changes in different groups of opioid application might affect sperm formation. Sperm count in morphine group was (0±0) and in naloxone group, naloxone+morphine, sham and control were 235±3.77, 220±3.81, 247.12±6.10 and 250±6.54, respectively (p<0.001). Conclusion: Morphine could affect all spermatogenesis stages.
TL;DR: GCSF can improve pregnancy outcome in patients with history of implantation failure, and there were no significant differences between demographic characteristics in two groups.
Abstract: Background: Although pregnancy rate in in vitro fertilization-embryo transfer (IVF-ET) cycles has been increased over the preceding years, but the majority of IVF-ET cycles still fail. Granulocyte colony stimulating factor (GCSF) is a glycoprotein that stimulates cytokine growth factor and induces immune system which may improve pregnancy rate in women with history of implantation failure.Objective: The aim of this study was to evaluate GCSF ability to improve pregnancy rate in women with history of implantation failureMaterials and Methods: 0.5 ml (300 μg/ml) GCSF was infused intrauterine in intervention group. Pregnancy outcomes were assessed based on clinical pregnancy.Results: The mean age of participants was 31.95±4.71 years old. There were no significant differences between demographic characteristics in two groups (p>0.05). The pregnancy outcome in GCSF group was improved significantly (p=0.043).Conclusion: GCSF can improve pregnancy outcome in patients with history of implantation failure.
TL;DR: Silymarin could compensate the adverse effect of sodium arsenite on viability, nonprogressive motility and mitochondrial membrane potential of ram sperm.
Abstract: Background: Sodium arsenite can impair male reproductive function by inducing oxidative stress. Silymarin is known as a potent antioxidant.Objective: This study was performed to investigate if silymarin can prevent the adverse effect of sodium arsenite on ram sperm viability, motility and mitochondrial membrane potential.Materials and Methods: Epidydimal spermatozoa obtained from ram were divided into five groups: 1) Spermatozoa at 0 hr, 2) spermatozoa at 180 min (control), 3) spermatozoa treated with sodium arsenite (10 μM) for 180 min, 4) spermatozoa treated with silymarin (20 μM) + sodium arsenite (10 μM) for 180 min and 5) spermatozoa treated with silymarin (20 μM) for 180 min. MTT assay and Rhodamine 123 staining were used to assess sperm viability and mitochondrial membrane potential respectively. Sperm motility was performed according to World Health Organization (WHO) guidelines.Results: Viability (p<0.01), nonprogressive motility (p<0.001) and intact mitochondrial membrane potential (p<0.001) of the spermatozoa were significantly decreased in sodium arsenite treated group compared to control group. In silymarin + sodium arsenite group, silymarin could significantly reverse the adverse effect of sodium arsenite on these sperm parameters compared to sodium arsenite group (p<0.001). In addition, the application of silymarin alone for 180 minutes could significantly increase progressively motile sperm (p<0.001) and decrease non motile sperm (p<0.01) compared to the control.Conclusion: Silymarin could compensate the adverse effect of sodium arsenite on viability, nonprogressive motility and mitochondrial membrane potential of ram sperm.
TL;DR: In this article, the authors compared the insulin resistance and various endocrine and metabolic abnormalities in obese and non-obese PCOS women, and found that metabolic abnormalities are more prevalent in obese PCOS patients, but adrenal axis activity that is reflected in higher levels of DHEAS was more commonly pronounced in nonobese patients.
Abstract: Background: Insulin resistance has an important role in pathophysiology of polycystic ovarian syndrome (PCOS). Yet there are certain controversies regarding the presence of insulin resistance in non-obese patients. Objective: The aim was to compare the insulin resistance and various endocrine and metabolic abnormalities in obese and non-obese PCOS women.Materials and Methods: In this cross-sectional study which was performed from 2007-2010, 115 PCOS patients, aged 16-45 years were enrolled. Seventy patients were obese (BMI ≥25) and 45 patients were non-obese (BMI 2.3) between two groups (p=0.357). Waist circumference (p<0.001), waist/hip ratio (p<0.001), systolic (p<0.001) and diastolic (p<0.001) blood pressures, fasting blood sugar (p=0.003) and insulin (p=0.011), HOMA-IR (p=0.004), total cholesterol (p=0.001) and triglyceride (p<0.001) were all significantly higher in obese PCOS patients. There was no significant difference in total testosterone (p=0.634) and androstenedione (p=0.736) between groups whereas Dehydroepiandrotendione sulfate (DHEAS) was significantly higher in non-obese PCOS women (p=0.018). There was no case of fatty liver and metabolic syndrome in non-obese patients, whereas they were seen in 31.3% and 39.4% of obese PCOS women, respectively.Conclusion: Our study showed that metabolic abnormalities are more prevalent in obese PCOS women, but adrenal axis activity that is reflected in higher levels of DHEAS was more commonly pronounced in our non-obese PCOS patients.
TL;DR: It is suggested that adding HCG to the conventional preparation method was an effective protocol and significantly improved endometrial thickness and pregnancy outcomes in women with previous embryo transfer failure because of thin endometrium.
Abstract: Background: Embryo implantation process is a complex phenomenon and depends on fetal and maternal factors interaction. Endometrial thickness is needed for successful implantation. Objective: We designed this study in order to assess adding human chorionic gonadotropin (HCG) to the conventional protocol in endometrial preparation in women with thin endometrium and a history of in vitro fertilization–embryo transfer (IVF-ET) failure. Materials and Methods: The non-randomized clinical trial study (quasi experimental design) was performed on 28 patients. Participants were women who were candidate for frozen-thawed (ET) and had two previous failed ET cycles because of thin endometrial. HCG was administrated (150 IU, intramuscular) from the 8th day of cycle and when endometrial thickness reached at least 7mm HCG was discontinued and frozen thawed ET was done. Results: Totally 28 patients were included. The mean ± SD age of participants was 30.39±4.7. The mean of endometrium thickness before and after HCG were 5.07±0.43 and 7.85±0.52, respectively p<0.001. Also, there were five clinically and chemically pregnant women. Conclusion: The findings of the study suggested that adding HCG to the conventional preparation method was an effective protocol and significantly improved endometrial thickness and pregnancy outcomes in women with previous embryo transfer failure because of thin endometrium.
TL;DR: It is demonstrated that ginger in a controlled study of efficacy was effective in decreasing SDF in infertile men.
Abstract: Background: Although the effectiveness of ginger as an antioxidant agent has been exploited, little human research has been conducted on its activity on male reproductive functions. Objective: This study was designed to investigate the effects of ginger (Zingiber officinale) on sperm DNA fragmentation (SDF) in infertile men. Materials and Methods: This randomized double-blind, placebo-controlled trial with a 1:1 allocation was performed on 100 infertility treatment candidates who were admitted to Royan Institute for Reproductive Biomedicine, Tehran, Iran. Patients were randomly assigned to receive one of two treatments: ginger and placebo. Patients were given a 3-month oral treatment (members received capsules containing 250 mg of ginger powder twice a day in ginger and a placebo in other group). Before and after treatment, standardized semen samples were obtained to determine sperm concentration, motility, and SDF according to World Health Organization. Results: There was no significant difference between two groups regarding SDF at baseline (53.48. 95%CI: 37.95-69.02) in cases and (56.75, 95%CI: 40.01-73.5) in controls. The average positive percentage of SDF in patients receiving ginger (17.77, 95%CI: 6.16-29.39) was lower compared with placebo (40.54, 95%CI: 23.94-57.13) after three month of treatment (p=0.02). In multivariate analysis, SDF was significantly lower in patients receiving ginger compared with placebo (mean difference: 3.21, 95%CI: 0.78-5.63, p=0.009). There were no significant differences between two groups regarding to semen parameters. Conclusion: The present study has demonstrated that ginger in a controlled study of efficacy was effective in decreasing SDF in infertile men.
TL;DR: The QDA and ANNs modeling can be used as computational tools in noninvasive diagnose of endometriosis, however, the model designed by QDA methods is more efficient compared to ANNs in diagnosis of endometricriosis patients.
Abstract: Background: So far, non-invasive diagnostic approaches such as ultrasound, magnetic resonance imaging, or blood tests do not have sufficient diagnostic power for endometriosis disease. Lack of a non-invasive diagnostic test contributes to the long delay between onset of symptoms and diagnosis of endometriosis. Objective: The present study focuses on the identification of predictive biomarkers in serum by pattern recognition techniques and uses partial least square discriminant analysis, multi-layer feed forward artificial neural networks (ANNs) and quadratic discriminant analysis (QDA) modeling tools for the early diagnosis of endometriosis in a minimally invasive manner by 1H- NMR based metabolomics. Materials and Methods: This prospective cohort study was done in Pasteur Institute, Iran in June 2013. Serum samples of 31 infertile women with endometriosis (stage II and III) who confirmed by diagnostic laparoscopy and 15 normal women were collected and analyzed by nuclear magnetic resonance spectroscopy. The model was built by using partial least square discriminant analysis, QDA, and ANNs to determine classifier metabolites for early prediction risk of disease. Results: The levels of 2- methoxyestron, 2-methoxy estradiol, dehydroepiandrostion androstendione, aldosterone, and deoxy corticosterone were enhanced significantly in infertile group. While cholesterol and primary bile acids levels were decreased. QDA model showed significant difference between two study groups. Positive and negative predict value levels obtained about 71% and 78%, respectively. ANNs provided also criteria for detection of endometriosis. Conclusion: The QDA and ANNs modeling can be used as computational tools in noninvasive diagnose of endometriosis. However, the model designed by QDA methods is more efficient compared to ANNs in diagnosis of endometriosis patients.
TL;DR: No significant association between serum level of lipids and BMD of femur and lumbar was found in postmenopausal women in Yazd, Iran, after controlling for body mass index.
Abstract: Background: Low bone mass is a major health problem in postmenopausal women.There is no general agreement regarding relationship between serum level of lipidsand bone mineral density.Objective: This study was carried out to investigate the association between lipidprofile and bone mineral density (BMD) in postmenopausal women in Yazd, Iran.Materials and Methods: This cross-sectional study was performed on 170 womenaged between 50 and 70 years old with menopause for at least one year from Yazd,Iran, between March 2013 to September 2013. Association of lipid profile and BMDwere measured in all study participants.Results: Among our participants 73 cases had lumbar osteoporosis, 17 cases hadfemoral osteoporosis and 80 cases did n’t have osteoporosis. After controlling forbody mass index, there were no correlations between serum level of lipids and bonemineral density of femur and lumbar bones.Conclusion: No significant association between serum level of lipids and BMD offemur and lumbar was found in postmenopausal women
TL;DR: Based on results of this study, local injury to endometrium in luteal phase prior to FET cycle had a negative impact on implantation and clinical pregnancy rates.
Abstract: Background: Implantation failure is one of the most important factors limiting success in IVF treatment. The majority of trials have demonstrated favorable effect of endometrial injury on implantation success rate especially in women with recurrent implantation failure, while some studies failed to detect any benefit. Objective: The purpose of our trial was to explore whether endometrial injury in luteal phase prior to frozen-thawed embryo transfer cycles would improve pregnancy outcomes? Materials and Methods: We conducted a prospective controlled trial of 93 consecutive subjects at a research and clinical center for infertility. All women were undergone frozen-thawed embryo transfer (FTE) cycles. Women in the experimental group underwent endometrial biopsy with a Pipelle catheter in luteal phase proceeding FET cycle. Primary outcomes were implantation and clinical pregnancy rates and secondary outcomes were chemical, ongoing and multiple pregnancy and miscarriage rates. Results: 45 subjects who underwent endometrial injury (EI) were compared with 48 control group which did not include any uterine manipulation. There were no significant differences in baseline and cycle characteristics between two groups. The difference in implantation rate was trend to statistically significance, 11.8% in EI group vs. 20.5% in control group (p=0.091). The chemical, clinical and ongoing pregnancy rates were lower in EI group compared with control group but not statistically significant. The multiple pregnancy rate and miscarriage rate also were lower in EI group compared with control group. Conclusion: Based on results of this study, local injury to endometrium in luteal phase prior to FET cycle had a negative impact on implantation and clinical pregnancy rates.
TL;DR: Prophylactic vaginal progesterone reduced the rate of preterm delivery, the risk of a birth weight ≤2500 gr, the rates of respiratory distress syndrome (RDS) and admission to NICU in women who were at risk of pre term delivery.
Abstract: Background: Preterm birth is the major cause of neonatal mortality and morbidity. Objective: The aim of this study was to evaluate the effect of prophylactic vaginal progesterone on decreasing preterm birth rate and neonatal complications in a high-risk population. Materials and Methods: A randomized, double-blind, placebo-controlled study was performed on 100 high-risk singleton pregnancies. Vaginal suppository progesterone (400 mg) or placebo was administered daily between 16-22 wks to 36 wks of gestation. Progesterone (n=50) and placebo (n=50) groups were compared for incidence of preterm delivery and neonatal complications. Results: The preterm birth rate was 52%. Preterm birth rate before the 37 wks of gestation (68% vs. 36%: RR=1.89, 95% CI: 1.25-2.86) and also before the 34 wks of gestation (42% vs. 18%: RR=2.33, 95% CI: 1.19-4.58) in placebo group was significantly higher than progesterone group. Our study also showed that the administration of vaginal progesterone was associated with a significant reduction in the risk of birth weight ≤2500 gr, the rates of respiratory distress syndrome (RDS) and admission to the Neonatal Intensive Care Unit (NICU) in the progesterone group when compared with the placebo group. However, there was no significant difference between the two groups in terms of neonatal death, days of admission in NICU, intraventricular hemorrhage and necrotizing enterocolitis. Conclusion: Prophylactic vaginal progesterone reduced the rate of preterm delivery, the risk of a birth weight ≤2500 gr, the rates of RDS and admission to NICU in women who were at risk of preterm delivery.