International Journal Of Fertility and Sterility
Volume:12 Issue: 3, Oct-Dec 2018

The 100,000th scientific article on the subject of spermatozoa was recently published. Numerous studies evaluated the characteristics of this important cell that led to tremendous discoveries. Since its first observation and description in 1677, many important characteristics have been described regarding this highly fascinating gamete. In this review, we intend to provide a historical account of the numerous milestones and breakthroughs achieved related to sperma- tozoa. We conducted a review of the literature by selecting the most important subjects with regards to spermatozoa. Since their discovery by van Leeuwenhoek, spermatozoa have been studied by scientists to better understand their physiology and process of interaction with their female counterpart, the oocyte, in order to treat and resolve infertility problems. Three centuries after van Leeuwenhoek’s discovery, the 100,000th article about these cells was published. It is encouraging that sperm research reached this landmark, but at the same time it is clear that further research on male reproductive physiology and spermatozoa is required to shed more light on their function and pathology in order to reduce the number of unexplained infertility cases.

Several studies have been conducted regarding the prevalence of Chlamydia trachomatis, Mycoplasma hominis, and Ureaplasma urealyticum in pregnant Iranian women. However, it is necessary to combine the previous results to present a general assessment. We conducted the present study based on systematic review and meta-analysis studies according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We searched the national and international online databases of MagIran, IranMedex, SID, MedLib, IranDoc, Scopus, PubMed, ISI Web of Knowledge, and Google Scholar search engine for certain MeSH keywords until June 16, 2017. In addition, heterogeneity, sensitivity analysis, subgroup analysis, and publication bias were performed. The data were analyzed using random-effects model and Comprehensive Meta-Analysis version 2 and P value was considered lower than 0.05. The prevalence of Chlamydia trachomatis in 11 surveyed articles that assessed 2864 pregnant Iranian women was 8.74% [95% confidence interval (CI): 5.40-13.84]. The prevalence of Chlamydia trachomatis was estimated 5.73% (95% CI: 2.09-14.73) and 13.55% (95% CI: 11.23-16.25) by enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR), respectively which the difference was not significant (P=0.082). The lowest and highest prevalence of Chlamydia trachomatis was estimated in Tehran province [4.96% (95% CI: 2.45-9.810)] and Ardabil province [28.60% (95% CI: 20.61-38.20)], respectively. This difference was statistically significant (P

The aim of this study is to evaluate the menstrual pattern, sexual function, and anxiety, and depression in women with poststerilization regret, and potential influencing factors for regret following tubal ligation (TL) in Iranian women.
In this cross-sectional study, 166 women with TL were subdivided into two groups including women with poststerilization regret (n=41) and women without poststerilization regret (n=125). They were selected from a health care center in Guilan province (Iran) during 2015-2016. Menstrual blood loss was measured using the Pictorial Blood Loss Assessment Chart (PBLAC) and through a self-administered questionnaire. In addition, sexual function was assessed by the Female Sexual Function Index (FSFI), and psychological distress was measured by employing the Hospital Anxiety and Depression Scale (HADS). Student’s t test and Chi-square test were used to reveal the statistical differences between the two groups. We used logistic regression to determine the influencing factors associated with regretting sterilization.
Women with poststerilization regret had more menorrhagia (78 vs. 57.6%, P=0.03) than those who did not regret sterilization. A significant difference was found in sexual dysfunction in orgasm (P=0.02), satisfaction (P=0.004), pain (P=0.02), and total FSFI scores (P=0.007) between the two groups. Also, there was a significant difference between the two groups in anxiety, depression and total scores HADS (P=0.01). In the logistic regression model, age of sterilization [odds ratio (OR=2.67), confidence interval (CI): 1.03-7.81, P=0.04)], pre-sterilization counseling (OR=19.92, CI: 6.61-59.99, P Complications due to sterilization are the main causes of regret; therefore, it is necessary to pay due attention to mentioning the probable complications of the procedures such as menstruation disorders, sexual dysfunction, and anxiety and depression in women during pre-sterilization counseling.

Women’s sexual well-being has been the center of attention in the field of sexology. Study of sexual behavior and investigating its predictors are important for women’s health promotion. This study aimed to explore the components of women’s sexual behaviors and their possible associations with demographic variables.
This study was a cross-sectional study (descriptive and analytic) that was conducted in Kashan city, Iran. A National Sexual Behavior Assessment Questionnaire was completed by 500 women of 15 to 49 who referred to the public health centers. To analyze the data, R software was used, ANOVA or Kruskal-Wallis (for parametric or nonparametric data, respectively) were used to compare outcomes among different groups. In order to evaluate the correlation between the subscales, the Pearson correlation coefficient was used.
From all participants, 31.8% obtained high scores in the sexual capacity, 21.2% had high scores in sexual motivation and 0.2% had high scores in sexual function. In sexual script component, 86.2% of women who held traditional beliefs toward sexual behaviors; the majority (91.5%) of women believed in mutual and relational sexuality, 83.4% believed in androcentricity (male-dominated sexuality). Pearson correlation test showed a significant positive correlation between sexual capacity, motivation, function and sexual script. Linear Regression model showed that sexual capacity is associated with women’s education and age of her spouse. Sexual function and sexual motivation were significantly associated with the age of subject's spouses.
In this study, subjects had low scores in sexual performance while higher scores were achieved in sexual capacity and motivation. This discrepancy can be attributed to the role of sexual scripts dominating the participants’ sexual interactions in this study. We suggest gender-specific and culturally-sensitive education should become a part of women’s health programs in Iran.

Endometriosis is a common gynaecological disease that affects quality of life for women. Several studies have revealed that both environmental and genetic factors contribute to the development of endometriosis. The aim of this study was to investigate the distribution of ABO and Rh blood groups in Iranian women with endometriosis who presented to two referral infertility centers in Tehran, Iran.
In this case-control study, women who referred to Royan Institute and Arash Women’s Hospital for diagnostic laparoscopy between 2013 and 2014 were assessed. Based on the laparoscopy findings, we categorized the women into two groups: endometriosis and control (women without endometriosis and normal pelvis). Chi-square and logistic regression tests were used for data analysis.
In this study, we assessed 433 women, of which 213 patients were assigned to the endometriosis group while the remaining 220 subjects comprised the control group. The most frequent ABO blood group was O (40.6%). The least frequent blood group was AB (4.8%). In terms of Rh blood group, Rh (90.1%) was more frequent than Rh- (9.9%). There was no significant correlation between ABO (P=0.091) and Rh (P=0.55) blood groups and risk of endometriosis. Also, there was no significant difference between the two groups with regards to the stage of endometriosis and distribution of ABO and Rh blood groups (P>0.05).
Although the O blood group was less dominant in Iranian women with endometriosis, we observed no significant correlation between the risk of endometriosis and the ABO and Rh blood groups. Endometriosis severity was not correlated to any of these blood groups.

The subtelomeric rearrangements are increasingly being investigated in cases of idiopathic intellectual disabilities (ID) and congenital abnormalities (CA) but are also thought to be responsible for unexplained recurrent miscarriage (RM). Such rearrangements can go unnoticed through conventional cytogenetic techniques and are undetectable even with high-resolution molecular cytogenetic techniques such as array comparative genomic hybridization (aCGH), especially when DNA of the stillbirth or families are not available. The aim of the study is to evaluate the rate of subtelomeric rearrangements in patients with RM.
In this cross-sectional study, fluorescent in situ hybridization (FISH), based on ToTelVysion telomeric probes, was undertaken for 21 clinically normal couples exhibiting a “normal” karyotype with at least two abortions. Approximately 62% had RM with a history of stillbirth or CA/ID while the other 38% had only RM.
FISH detected one cryptic rearrangement between chromosomes 3q and 4p in the female partner of a couple (III:4) [46,XX,ish t(3;4)(q28-,p16;p16-,q28)(D3S4559,D3S4560-,D4S3359; D3S4560, D4S3359- ,D4S2930)] who presented a history of RM and family history of ID and CA. Analysis of the other family members of the woman showed that her sisters (III:6 and III:11) and brother (III:8) were also carriers of the same subtelomeric translocation t(3;4)(q28;p16).
We conclude that subtelomeric FISH should be undertaken in couples with RM especially those who not only have abortions but also have had at least one child with ID and/or CA, or other clinically recognizable syndromes. For balanced and cryptic anomalies, subtelomeric FISH still remains the most suitable and effective tool in characterising such chromosomal rearrangements in RM couples.

The inhibitory effects of morphine and the stimulatory influence of kisspeptin signaling have been demonstrated on gonadotropin releasing hormone (GnRH)/luteinizing hormone (LH) release. Hypothalamic kisspeptin is involved in relaying the environmental and metabolic information to reproductive axis. In the present study, the role of kisspeptin/ GPR54 signaling system was investigated on relaying the inhibitory influences of morphine on LH hormone secretion.
In this experimental study, 55 wistar male rats weighing 230-250 g were sub-grouped in 11 groups (in each group n=5) receiving saline, kisspeptin (1 nmol), peptide234 (P234, 1 nmol), morphine (5 mg/kg), naloxone (2 mg/kg), kisspeptin/P234, morphine/naloxone, kisspeptin/morphine, kisspeptin/naloxone, P234/morphine or P234/naloxone respectively. Blood samples were collected via tail vein. Mean plasma (LH) concentrations and mean relative KiSS1 or GPR54 mRNA levels were determined by radioimmunoassay (RIA) and real time reverse transcriptase-polymerase chain reaction (RT-PCR), respectivwely.
Morphine significantly decreased mean plasma LH concentration and mean relative KiSS1 gene expression compared to saline; while it did not significantly decrease mean relative GPR54 gene expression compared to saline. Naloxone significant increased mean LH level and mean relative KiSS1 gene expression compared to saline; while it did not significantly increase mean relative GPR54 gene expression compared to saline. Injections of kisspeptin plus morphine significantly increased mean LH concentration compared to saline or morphine, while simultaneous infusions of them significantly declined mean plasma LH level compared to kisspeptin. In kisspeptin/naloxone group mean plasma LH level was significantly increased compared to saline or naloxone. Co-administration of P234/morphine significantly decreased mean LH concentration compared to saline.
Down regulation of KiSS1 gene expression may be partly involved in the mediating the inhibitory effects of morphine on reproductive axis.

IL-1α produced by Sertoli cells is considered to act as a growth factor for spermatogonia. In this study, we investigated the association of the C376A polymorphism in IL-1α with male infertility in men referring to the Kashan IVF Center.
In this case-control study, 2 ml of blood was collected from 230 fertile and 230 infertile men. After DNA extraction, the C376A variant was genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). In addition, the molecular effects of the C376A transversion were analysed using bioinformatics tools.
A significant association was observed between the homozygous genotype CC with male infertility [odds ratio (OR)=1.97, 95% confidence interval (CI)=1.14-3.41, P=0.016)]. Carriers of C (AC) showed a similar risk for male infertility (OR=1.78, 95% CI=1.06-2.99, P=0.030). Also, allelic analysis showed that the C allele is associated with male infertility (OR=1.43, 95% CI=1.09-1.88, P=0.011). In sub-group analysis, we found that the AC genotype is associated with asthenozoospermia (OR=2.38, 95% CI=1.03-5.53, P=0.043). In addition, carriers of C were at high risk for asthenozoospermia (OR=2.25, 95% CI=1.01-4.10, P=0.047). Also, C allele was significantly associated with oligozoospermia (OR=1.44, 95% CI=1.01-2.06, P=0.049) and non-obstructive azoospermia (OR=1.67, 95% CI =1.04-2.68, P=0.034). Finally, in silico analysis showed that the C376A polymorphism could alter splicing especially in the acceptor site.
This is the preliminary report on the association of IL-1α C376A polymorphism with male infertility in the Kashan population. This association shows that the IL-1α gene may be a biomarker for male infertility, and therefore needs additional investigations in future studies to validate this.

Hypoxia causes detrimental effects on the structure and function of tissues through increased production of reactive oxygen species that are generated during the re-oxygenation phase of intermittent and continuous hypobaric hypoxia. This study was carried out to evaluate the effects of flaxseed (Fx) in reducing the incidence of hypoxia in rat testes.
In this experimental study, 24 adult Wistar rats were randomly divided into four groups: i. Control group (Co) that received normal levels of oxygen and food, ii. Sham group (Sh) that were placed in hypoxia chamber but received normal oxygen and food, iii. Hypoxia induction group (Hx) that were placed in hypoxia chamber and treated with normal food, iv. Hypoxia induction group (Hx) that were placed in hypoxia chamber and treated with 10% flaxseed food. Both the Hx and Hx groups were kept in a hypoxic chamber for 30 days; during this period rats were exposed to reduced pressure (oxygen 8% and nitrogen 92%) for 4 hours/day. Then, all animal were sacrificed and their testes were removed. Malondialdehyde (MDA) and total antioxidant capacity (TAC) levels were evaluated in the testis tissue. Tubular damages were examined using histological studies. Blood samples and sperm were collected to assess IL-18 level and measure sperms parameters, respectively. All data were analyzed using SPPSS-22 software. One way-ANOVA or Kruskal-Wallis tests were performed for statistical analysis.
A significant difference was recorded in the testicular mass/body weight ratio in Hx and Hx groups in comparison to the control (P=0.003 and 0.027, respectively) and Sh (P=0.001 and 0.009, respectively) groups. The sperm count and motility in Hx group were significantly different from those of the Hx group (P=0.0001 and 0.028, respectively) .Also sperm viability (P=0.0001) and abnormality (P=0.0001) in Hx group were significantly different from Hx group.
This study therefore suggests that the oral administration of flaxseed can be useful for prevention from the detrimental effects of hypoxia on rat testes structure and sperm parameters.

There is some evidence indicating that Matricaria chamomile (MC) had protective effects on ischemia- reperfusion. In the present study, a rat model was used to investigate the effect of hydroalcoholic extract of MC on torsion/detorsion-induced testis tissue damage.
In this experimental study, 28 male Wistar rats were randomly divided into 4 groups as follows: G1, Sham operated; G2, testicular torsion/detorsion (T/D); G3, rats with testicular torsion/detorsion that received 300 mg/kg of MC extracts 30 minutes before detorsion (T/DMC); and G4, healthy rats that received 300 mg/kg of MC extracts (MC). Also, the reperfusion period was 24 hours. After blood sampling, the oxidative stress marker [e.g. superoxide dismutase (SOD) levels], blood levels of testosterone, and anti-oxidant enzyme levels [e.g. glutathione peroxidase (GPx)] were assessed by ELISA methods. Serum activity of malondialdehyde (MDA) was evaluated by spectrophotometry. Another assessment was carried out by histomorphometry, 24-hour post-procedure. The histological parameters investigated by Johnson’s scores (JS), also the seminiferous tubule diameter (STD) and the height of the germinal epithelium (HE) measured using the linear eyepiece grids using light microscopy.
Histological features significantly differed between sham and the other groups. The levels of SOD, GPx, and testosterone hormone were significantly decreased in T/D group as compared to sham group, while these parameters increased in T/DMC group as compared to T/D group. During ischemia, the MDA levels increased; however, treatment with MC extract decreased the MDA levels in G3 and G4 groups.
Results of the present study demonstrated that MC can protect the testis tissue against torsion/detorsion- induced damages by suppressing superoxide production.

Titanium dioxide (TiO2) is a white pigment which is used in paints, plastics, etc. It is reported that TiO2 induces oxidative stress and DNA damage. N-acetylcysteine (NAC) has been used to fight oxidative stress-induced damage in different tissues. The objective of this study was to evaluate the toxic effects of orally administered TiO2 nanoparticles and the possible protective effect of NAC on the testes of adult male albino rats.
In this experimental study, 50 adult male albino rats were classified into five groups. Group I was the negative control, group II was treated with gum acacia solution , group III was treated with NAC, group IV was treated with TiO2nanoparticles, and group V was treated with 100 mg/kg of NAC and 1200 mg/kg TiO2nanoparticles. Total testosterone, glutathione (GSH), and serum malondialdehyde (MDA) levels were estimated. The testes were subjected to histopathological, electron microscopic examinations, and immunohistochemical detection for tumor necrosis factor (TNF)-α. Cells from the left testis were examined to detect the degree of DNA impairment by using the comet assay.
TiO2nanoparticles induced histopathological and ultrastructure changes in the testes as well as positive TNF-α immunoreaction in the testicular tissue. Moreover, there was an increase in serum MDA while a decrease in testosterone and GSH levels in TiO2nanoparticles-treated group. TiO2resulted in DNA damage. Administration of NAC to TiO2- treated rats led to improvement of the previous parameters with modest protective effects against DNA damage.
TiO2-induced damage to the testes was mediated by oxidative stress. Notably, administration of NAC protected against TiO2’s damaging effects.

Apigenin is a plant-derived compound belonging to the flavonoids category and bears protective effects on different cells. The aim of this study was to evaluate the effect of apigenin on the number of viable and apoptotic blastomeres, the zona pellucida (ZP) thickness and hatching rate of pre-implantation mouse embryos exposed to H2O2 and actinomycin D.
In this experimental study, 420 two-cell embryos were randomly divided into six groups: i. Control, ii. Apigenin, iii. H2O2 , iv. Apigeninὣ , v. Actinomycin D, and vi. ApigeninNj択覲爩 D. The percentage of blastocysts and hatched blastocysts was calculated. Blastocyst ZP thickness was also measured. In addition, viable blastomeres quantity was counted by Hoechst and propidium iodide staining and the number of apoptotic blastomeres was counted by TUNEL assay.
The results of viable and apoptotic blastomeres quantity, the ZP thickness, and the percentage of blastocysts and hatched blastocysts were significantly more favorable in the apigenin group, rather than the control group (P The results suggest that apigenin may protect mouse embryos against H2O2 and actinomycin D. So that it increases the number of viable blastomeres and decreases the number of apoptotic blastomeres, which may cause expanding the blastocysts, thinning of the ZP thickness and increasing the rate of hatching in mouse embryos.

Endometriosis affects about 10% of women of reproductive age. Its main feature is the presence of stroma and endometrial glands in sites other than the uterus, mainly in pelvis. Pelvic peritoneum, ovaries, uterine ligaments, bladder, intestines, andcul-de-sac are among the affected areas. Sometimes endometriosis can be found outside of the pelvis and even above abdominal cavity, like indiaphragm.Herein, we present a case of an asymptomatic diaphragmatic endometriosis that was discovered incidentally during laparoscopy of pelvic endometriosis, as well as our appropriately proposed treatment protocol.