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Fertility and Sterility - Volume:10 Issue: 4, Jan-Mar 2017

International Journal Of Fertility and Sterility
Volume:10 Issue: 4, Jan-Mar 2017

  • تاریخ انتشار: 1395/10/04
  • تعداد عناوین: 10
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  • Serkan Kahyaoglu, Omer Yumusak, Sebnem Ozyer, Meryem Kuru Pekcan, Merve Erel, Nedim Cicek, Salim Erkaya, Yasemin Tasci Page 320
    Background
    Polycystic ovary syndrome (PCOS) is highly associated with an ovulatory infertility, features of the metabolic syndrome, including obesity, insulin resistance and dyslipidemia. Serum concentrations of high sensitive C-reactive protein (hs-CRP) were significantly higher in obese than in non-obese PCOS patients at baseline, suggesting a relationship between elevated hs-CRP levels and obesity. The aim of this study was to evaluate whether cycle day 3 hs-CRP levels before clomiphene citrate (CC) treatment would predict cycle outcomes in women with PCOS.
    Materials And Methods
    This cross-sectional study was conducted among 84 infertile women with PCOS who were treated with CC at Zekai Tahir Burak Women’s Health Education and Research Hospital, Ankara, Turkey, between January 2014 and January 2015. Based on the exclusion criteria, cycle outcomes of remaining 66 infertile women with PCOS treated with CC were analyzed. The hs-CRP levels and insulin resistance indexes were evaluated on day 3 of the CC treatment cycle. The primary outcome measures were number of preovulatory follicles measuring≥17 mm and pregnancy rates.
    Results
    The mean ± SD age of the patients was 24.0 ± 3.8 years (range 18-36). The mean ± SD body mass index (BMI) of the patients was 25.7 ± 4.9 (range 17-43). Fifty patients developed dominant follicle (75%) and 5 patients established clinical pregnancy during the study (clinical pregnancy rate: 7%). The mean ± SD baseline hs-CRP, fasting insulin and Homeostasis Model Assessment-Insulin Resistance (HOMA-IR) values of the patients with and without dominant follicle generation during treatment cycle were 6.42 ± 7.05 and 4.41 ± 2.95 (P=0.27), 11.61 ± 6.94 and 10.95 ± 5.65 (P=0.73), 2.68 ± 1.79 and 2.41 ± 1.30 (P=0.58), respectively. The mean ± SD baseline hs-CRP, fasting insulin and HOMA-IR values of the patients with and without clinical pregnancy establishment following treatment cycle were 6.30 ± 2.56 and 5.90 ± 6.57 (P=0.89), 11.60 ± 7.54 and 11.44 ± 6.61 (P=0.95), 2.42 ± 1.51 and 2.63 ± 1.70 (P=0.79), respectively.
    Conclusion
    In this study, we did not observe a predictive value of cycle day 3 hs-CRP levels on preovulatory follicle development and pregnancy rates among infertile PCOS patients treated with CC. Also, no relationship between HOMA-IR values and dominant follicle generation or clinical pregnancy establishment was demonstrated in our study, confirming the previous studies emphasizing the neutral effect of metformin utilization before and/or during ovulation induction to pregnancy rates.
    Keywords: Polycystic Ovary Syndrome, Ovulation Induction, Clomiphene, CReactive Protein
  • Amir Abdoli, Abdolhossein Dalimi, Haleh Soltanghoraee, Fatemeh Ghaffarifar Page 327
    Background
    Congenital toxoplasmosis is an important cause of spontaneous abortion worldwide. However, there is limited information on detection and genotypic characterization of Toxoplasma gondii (T. gondii) in women with recurrent spontaneous abortion (RSA). The aim of this study is the molecular detection and genotypic characterization of T. gondii in formalin-fixed, paraffin-embedded fetoplacental tissues (FFPTs) of women with RSA that have referred to the Avicenna Research Institute in Tehran, Iran.
    Materials And Methods
    This experimental research was undertaken on 210 FFPTs of women with RSA. The information of the patients was collected from the archives of Avicenna Research Institute in Tehran, Iran. After DNA extraction, the presence of T. gondii was examined by nested polymerase chain reaction targeting the GRA6 gene. Genotyping was performed on positive samples using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) that targeted the GRA6 and SAG3 genes. Sequencing was conducted on two GRA6 positive samples.
    Results
    T. gondii DNA was detected in 3.8% (8/210) of the samples. Genotyping showed that all positive samples belonged to type III of the T. gondii genotype. Sequencing two genomic DNAs of the GRA6 gene revealed 99% similarity with each other and 99-100% similarity with T. gondii sequences deposited in GenBank. There were six patients with histories of more than three abortions; one patient had a healthy girl and another patient had two previous abortions. Abortions occurred in the first trimester of pregnancy in seven patients and in the second trimester of pregnancy in one patient.
    Conclusion
    The results of this study have indicated that genotype III is the predominant type of T. gondii in women with RSA in Tehran, Iran. Also, our findings suggest that toxoplasmosis may play a role in the pathogenesis of RSA. However, further studies are needed to elucidate a clear relationship between T. gondii infection and RSA.
    Keywords: Toxoplasma gondii, Abortion, Molecular Detection, Genotype, Iran
  • Saeideh Ziaei, Rahimeh Ahmadi, Sousan Parsay Page 337
    Background
    Spontaneous abortion is the most common adverse pregnancy outcome. We aimed to investigate a possible link between nutrient deficiencies and the risk of spontaneous abortion.
    Materials And Methods
    This case-control study included the case group (n=331) experiencing a spontaneous abortion before 14 weeks of pregnancy and the control group (n=331) who were healthy pregnant women over 14 weeks of pregnancy. The participants filled out Food Frequency Questionnaire (FFQ), in which they reported their frequency of consumption for a given serving of each food item during the past three months, on a daily, weekly or monthly basis. The reported frequency for each food item was converted to a daily intake. Then, consumption of nutrients was compared between the two groups.
    Results
    There are significant differences between the two groups regarding consumed servings/day of vegetables, bread and cereal, meat, poultry, fish, eggs, beans, fats, oils and dairy products (P=0.012, P
    Conclusion
    Poor nutrientions may be correlated with increased risk of spontaneous abortion.
    Keywords: Abortion, Nutrition, Pregnancy
  • Mahnaz Abdinasab, Razieh Dehghani Firouzabadi, Tahmineh Farajkhoda, Ali Mohammad Abdoli Page 343
    Background
    The appropriate choice of a contraceptive method has been a major issue in reproductive health research. Cu T intrauterine device (Cu T IUD) has been introduced as one of the most effective contraceptive methods in the world, however, the relationship between prior use of Cu T IUD and secondary infertility has not been evaluated in Iran. To examine the association of Cu T-380A IUD and secondary infertility in Iran.
    Materials And Methods
    A retrospective cohort study was conducted from December 2010 to September 2011 in the Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. A total of 750 married women (15-49 years old) with at least one parity, whom were referred to four educational healthcare centers of Shahid Sadoughi University of Medical Sciences, were selected as participants. They were divided into two groups (case and control) based on previous history of using Cu T-380A IUD. Data were gathered using a standard reliable questionnaire along with a face-to-face interview and were analyzed with descriptive and analytical (χ²) tests.
    Results
    Mean period of Cu T-380A IUD usage in the case group was 57.46 ± 47.74 months and mean time length from Cu T-380A IUD removal to pregnancy was 14.87 ± 5.18 months in this group. We observed no relationship between the use of Cu T-380A IUD and frequency of secondary infertility (3.5% in the case group versus 2.7% in the control group, P=0.52).
    Conclusion
    Given the relatively large sample size studied here, it is unlikely that Cu T-380A IUD results in secondary infertility and may be used by Iranian women as a safe contraceptive method.
    Keywords: Copper Intrauterine Devices, Infertility, Complication, Cohort Study, Iran
  • Soryya Panahi, Fariba Fahami, Mohammad Reza Deemeh, Marziyeh Tavalaee, Hamid Gourabi, Mohammad Hossain Nasr, Esfahani Page 350
    Background
    Gender selection and family planning have their roots in human history. Despite great interest in these fields, very few scientific propositions exist which could explain why some family do not attain the desired sex. Therefore, the aim of this study was to evaluate whether sex of previous child or children could affect the outcomes of pre-implantation genetic screening (PGS).
    Materials And Methods
    This historical cohort study including 218 PGS cases referring to Isfahan Fertility and Infertility Center (IFIC). Couples were grouped as those who their male child passed away or her husbands’ has a son(s) from their previous marriage (n=70) and couples who just have daughter (n=148). Male normal blastocysts were transferred for both groups. The outcomes of PGS including pregnancy, implantation and abortion rates, along with possible confounding factors were compared between the two groups.
    Results
    Significant differences in pregnancy, implantation and abortion rates were observed between couples whose their male partner had/has one boy (n=70) compared to those who have just girl(s) (n=148) despite similar number and quality of male normal blastocyst transferred in the two groups. Confounding factors were also considered.
    Conclusion
    The Ybearing spermatozoa in male partners with no history of previous boy have lower ability to support a normal development to term, compared to male partners with previous history of boy requesting family balancing.
    Keywords: Pre, Implantation Genetic Screening, Pregnancy, Implantation, Abortion
  • Nasibeh Ghandy, Abbas Ali Karimpur Malekshah Page 357
    Background
    Vitrification has been shown as one of the most effective methods of cryopreservation for mammalian embryos. However, there is no consensus which stage of embryonic development is the most appropriate for vitrification with subsequent maximal development after thawing. This study was carried out to explore and compare the effect(s) of vitrification on mouse 2-cell, 4-cell, 8-cell, morula and blastocyst stage embryos and subsequent blast formation and hatching after thawing.
    Materials And Methods
    In this experimental study, 2-cell embryos were obtained from the oviducts of super ovulated female NMRI mice. Some embryos were randomly selected and vitrified through a two-step media protocol and cryotop. Other embryos were cultured to assess their development. During the ensuing days, some of these cultured embryos were vitrified at 4-cell, 8-cell, morula and blastocyst stages. After 10 to 14 days, the embryos were thawed to assess their survival and also cultured to determine the rate of blastocyst formation and hatching. The results were analyzed using one-way ANOVA and Tukey’s post-hoc tests.
    Results
    There was no significant difference in the survival rates of vitrified embryos at 2-cell, 4-cell, 8-cell, morula and blastocyst stages after thawing (P>0.05). The blastocyst formation rate of vitrified 8-cell embryos was significantly higher than that of 2-cell embryos (P
    Conclusion
    Vitrification is suitable for cryopreservation of all stages of mouse embryonic development. However, the best tolerance for vitrification was observed at 4and 8-cell stages of development. Accordingly, the development of vitrified embryos to blastocysts, following thawing, was most efficacious for 4 and 8-cell embryos. Compared to mouse 2-cell embryos, embryos vitrified as blastocysts had the highest rate of hatching.
    Keywords: Vitrification, Embryo, Preimplantation
  • Majid Moeenizadeh, Haniyeh Zarif Page 363
    Background
    Infertility is a major public health problem with physical, psychological and social dimensions. High prevalence of psychological problems has been reported in infertile women. The objective of this study was to examine the effectiveness of well- being therapy (WBT) for depression in infertile women who were referred to an infertility center in Mashhad, Iran.
    Materials And Methods
    This preliminary trial was conducted at the Montasariya Infertility Center, Mashhad, Iran, between July and October 2011. A group of 22 infertile women were randomly assigned into experimental (n=11) and control groups (n=11). Patients were assessed with two self-rating inventories including the Psychological Well- being (PWB) and the Depression, Anxiety and Stress Scale-21 (DASS-21) before and after the interventions and the waiting-list period. WBT was performed in 8 to 10 sessions according to the published protocol.
    Results
    Analysis of covariance (ANCOVA) showed a significant difference regarding the depression scores of experimental group between preand post-treatment as compared to control subjects.
    Conclusion
    The results suggested the feasibility and clinical advantages of adding WBT to repertoire of the treatment techniques for depression in infertile women.
    Keywords: Infertility, Depression, Psychological Well, Being, Well, Being Therapy
  • Saman Maroufizadeh, Azadeh Ghaheri, Payam Amini, Reza Omani Samani Page 371
    Background
    Infertility and its treatment can have a considerable effect on a person’s quality of life (QoL). The Fertility QoL (FertiQoL) questionnaire is currently the most frequently used instrument to measure QoL in people with fertility problems. This study aims to examine the reliability and validity of the FertiQoL in infertile Iranian women.
    Materials And Methods
    This cross-sectional study included 155 women with fertility problems in a referral fertility clinic in Tehran, Iran from January to March 2014. A battery of instruments was used: FertiQoL, Satisfaction with Life Scale (SWLS), Hospital Anxiety and Depression Scale (HADS), and a demographic questionnaire. Construct validity of the scale was evaluated using confirmatory factor analysis (CFA). We assessed internal consistency with Cronbach’s alpha and convergent validity was examined by correlating the FertiQoL with SWLS and HADS.
    Results
    The results of the CFA generally supported the four-factor model of Core FertiQoL and two-factor model of Treatment FertiQoL. Both FertiQoL modules and their subscales revealed acceptable internal consistency that ranged from 0.643 to 0.911. However, the FertiQoL might be improved if Q15 and T2 items were removed from the scale. These items had low loadings on the Relational and Environment factors which decreased their internal consistency. The FertiQoL and their subscales significantly correlated with both SWLS and HADS, which confirmed convergent validity.
    Conclusion
    The Persian version of the FertiQoL is a valid, reliable instrument to measure QoL in infertile women and seems to perform as well as the original English Version.
    Keywords: Infertility, Quality of Life, Validity, Reliability
  • Atefeh Zabihi Bidgoli, Faezeh Azimzadeh Ardbili Page 380
    Background
    Advancements in medical technology have significantly increased the possibility of successful infertility treatment. Medical interventions in the initial process of pregnancy that intend to increase the chances of pregnancy create the risk of multifetal pregnancies for both mothers and fetuses. Physicians attempt to reduce the numbers of fetuses in order to decrease this risk and guarantee the continuation of pregnancy. The aim of this paper is to understand the Shiite instruction in terms of the risks multifetal pregnancies have for fetuses and if it is permissible to reduce the numbers of fetuses. An affirmative answer will lead to the development of Islamic criteria for reduction of the number of embryos.
    Materials And Methods
    This analytical-descriptive research gathered relevant data as a literature search. We reviewed a number of Islamic resources that pertained to the fetus; after a description of the fundamentals and definitions, we subsequently analyzed juridical texts. The order of reduction was inevitably determined by taking into consideration the rules that governed the abortion provisions or general juridical rules. We also investigated the UK law as a comparison to the Shiite perspective.
    Results
    The primary ordinance states that termination of an embryo is not permitted and is considered taboo. However, fetal reductions that occur in emergency situations where there is no option or ordinary indication are permitted before the time of ensoulment. The goal of reduction can be chosen from different ways.
    Conclusion
    According to Shiite sources, fetal reduction is permitted. Defective fetuses are the criteria for selective reduction. If none are defective, the criteria are possibility and facility. But if the possibility of selection is equally for more than one fetus, the criterion is importance (for example one fetus is healthier).
    Keywords: Fetal Reduction, Multifetal Pregnancy, Embryo
  • Somayeh Heidari, Zohreh Hojati, Majid Motovali, Bashi Page 390
    The genetic association between cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations and male infertility due to congenital bilateral absence of vas deferens (CBAVD) is well established. Mutant CFTR, however may also be involved in the etiology of male infertility in non-CBAVD cases. The present study was conducted to estimate the frequency of ∆I507 and ∆F508 CFTR gene mutations in Iranian infertile males. We undertook the first study of association between these CFTR mutations and non-obstructive azoospermia in Iran. In this case-control study, 100 fertile healthy fathers and 100 non-obstructive azoospermia’s men were recruited from Isfahan Infertility Center (IIC) and Sari Saint Mary’s Infertility Center, between 2008 and 2009. Screening of F508del and I507del mutations was carried out by the multiplex-ARMS-PCR. Significance of differences in mutation frequencies between the patient and control groups was assessed by Fisher’s exact test. The ΔF508 was detected in three patients. However there are no significant association was found between the presence of this mutated allele and infertility [OR=9.2 (allele-based) and 7.2 (individual-based), P=0.179]. None of the samples carried the ΔI507 mutation. Altogether, we show that neither ΔI507 nor ΔF508 is involved in this population of Iranian infertile males with non-obstructive azoospermia.
    Keywords: CFTR, Mutation, Azoospermia, Male Infertility