فهرست مطالب
International Journal Of Fertility and Sterility
Volume:11 Issue: 3, Oct-Dec 2017
- تاریخ انتشار: 1396/06/16
- تعداد عناوین: 14
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Pages 134-141BackgroundRecurrent vulvovaginal candidiasis (RVVC) is a common cause of morbidity affecting millions of women worldwide. Patients with RVVC are thought to have an underlying immunologic defect. This study has been established to evaluate cell-mediated immunity defect in response to candida antigen in RVVC cases.Materials And MethodsOur cross-sectional study was performed in 3 groups of RVVC patients (cases), healthy individuals (control I) and known cases of chronic mucocutaneous candidiasis (CMC) (control II). Patients who met the inclusion criteria of RVVC were selected consecutively and were allocated in the case group. Peripheral blood mononuclear cells were isolated and labeled with CFSE and proliferation rate was measured in exposure to candida antigen via flow cytometry.ResultsT lymphocyte proliferation in response to candida was significantly lower in RVVC cases (n=24) and CMC patients (n=7) compared to healthy individuals (n=20, P0.05). Family history of primary immunodeficiency diseases (PID) differed significantly among groups (P=0.01), RVVC patients has family history of PID more than control I (29.2 vs. 0%, P=0.008) but not statistically different from CMC patients (29.2 vs. 42.9%, P>0.05). Prevalence of atopy was greater in RVVC cases compared to healthy individuals (41.3 vs. 15%, P=0.054). Lymphoproliferative activity and vaginal symptoms were significantly different among RVVC cases with and without allergy (P=0.01, P=0.02).ConclusionOur findings revealed that T cells do not actively proliferate in response to Candida antigen in some RVVC cases. So it is concluded that patients with cell-mediated immunity defect are more susceptible to recurrent fungal infections of vulva and vagina. Nonetheless, some other cases of RVVC showed normal function of T cells. Further evaluations showed that these patients suffer from atopy. It is hypothesized that higher frequency of VVC in patients with history of atopy might be due to allergic response in mucocutaneous membranes rather than a functional impairment in immune system components.Keywords: Allergy, candida albicans, Cell Mediated Immunity, Vulvovaginal Candidiasis, Atopy
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Pages 142-147BackgroundInfertility is the inability of a couple to conceive after one and a half years of unprotected sex. Male infertility, which accounts for almost half of infertility cases, is considered as a major problem all over the world. The aim of this study was to investigate the association of CYP1A1 polymorphisms with idiopathic non-obstructive azoospermia in a South Indian cohort.Materials And MethodsAn experimental study was conducted with idiopathic nonobstructive azoospermia. A total of 120 infertile and 80 fertile samples were collected, and DNA was then extracted from all samples. The CYP1A1*2A polymorphism genotyping was carried out by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP).ResultsThe genotype distribution of CYP1A1*2A polymorphism showed significant difference between patients and controls. Moreover, the CC genotype was associated with decreased risk of idiopathic non-obstructive azoospermia in comparison with the TT and TC genotypes.ConclusionThe current experimental study identified that the CT genotype of CYP1A1*2A polymorphism may contribute to the pathogenesis of male infertility in the South Indian population.Keywords: CYP1A1, Restriction Fragment Length Polymorphism, Infertility, Cohort
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Pages 148-155BackgroundThis study was designed to create an experimental varicocele model by a simple surgical procedure in dog with minimum invasion and to investigate the effect of varicocele-induced infertility on the expression of six related genes (HSP90, HSP70, IL-4, TNF, KITLG and KIT receptor).Materials And MethodsIn this experimental study, the proximal part of the pampini-form plexus of dog testes was partially occluded without abdominal incision which was confirmed by venographic examination. To evaluate varicocele in its acute form, dogs were castrated after 15 days and testes were dissected. Histopathologic evaluation was undertaken and the relative expression of the six genes was assessed by quantitative realtime polymerase chain reaction (PCR).ResultsMicroscopic changes showed tubule degeneration. The Johnson score was significantly decreased in the varicocele testes when compared with non-varicocele testes. Expressions of HSP90, TNF, KITLG and the KIT-receptor gene were significantly downregulated (P=0.029, 0.047, 0.004 and 0.035 respectively) in varicocele-induced testes while HSP70 was upregulated (P=0.018). IL-4 did not show differential expression (P=0.377).ConclusionWe conclude that partial occlusion of the proximal part of the pampiniform plexus induces varicocele in the testis of dog. Differential expression of the mentioned genes may be responsible for the pathophysiology of varicocele and related subfertility.Keywords: Varicocele, Dog, Gene Expression
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Pages 156-165BackgroundThe quality of semen depends upon several factors such as environment, life style, physical activity, age, and occupation. The aim of this study was to analyze and compare the conventional and functional semen parameters in men practicing vigorous physical activity to those of sedentary men.Materials And MethodsIn this descriptive cross-sectional study, semen samples of 17 physically active men and 15 sedentary men were collected for analysis. Semen analysis was performed according to the World Health Organization (WHO) guidelines, while functional parameters were evaluated by flow cytometry.ResultsResults showed that several semen parameters (semen volume, viability, progressive motility, total motility, normal morphology, and moribund cells) were superior in the physically active group in comparison with the sedentary group. Semen parameters such as viability, progressive motility and total motility, as well as the percentage of moribund spermatozoa were significantly different between both groups. However, sperm DNA damage, lipid peroxidation and mitochondrial potential were not significantly different among the groups.ConclusionNevertheless, the physical activity shows better semen parameters than sedentary group. Taken together, our results demonstrate that regular physical activity has beneficial impact in sperm fertility parameters and such a life style can enhance the fertility status of men.Keywords: Sperm, Fertility, Physical Activity, Sedentary, Lifestyle
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Pages 166-175BackgroundReproductive toxicity is a major challenge associated with aluminum (Al) exposure. No studies have evaluated the possible effects of curcumin (CUR) on Al-induced reproductive dysfunction. Therefore, this study investigated the effects of CUR treatment on Al-induced reproductive damage.Materials And MethodsIn this experimental study, 40 male Wistar rats were allocated to the five groups (n=8) based on the treatment they received: no treatment (control), solvent [dimethyl sulfoxide (DMSO) or distilled water], CUR 10 mg/kg body weight (BW), Al chloride 10 mg/kg BW, and CUR chloride (10 mg/kg BW/each alone). Treatments were performed by intraperitoneal (IP) injections for 28 days. The left testis was assessed for histopathological analysis as well as the incidence of germ cell apoptosis. One-way analysis of variance (ANOVA) followed by the Tukeys test was used. PResultsSignificant reductions in body and testis weight; plasma testosterone and luteinizing hormone levels; sperm count, motility, morphology, and viability; germinal epithelium thickness; seminiferous tubules diameter; as well as, superoxide dismutase activity were observed in rats treated with Al. Moreover, Al exposure caused significant increments in the lumen diameter of tubules, terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL)-positive cells and malondialdehyde (MDA) levels compared to the control group. However, in rats receiving CUR, CUR significantly reversed the adverse effects of Al on testis and sperm quality. No significant differences in follicle-stimulating hormone (FSH) levels and nuclear diameter of spermatogonia were detected among all groups.ConclusionIt can be concluded that Al causes reproductive dysfunction by creating oxidative damage. CUR, on the other hand, reduces the toxic effects of Al and improves the antioxidant status and sperm quality in male rats.Keywords: Aluminum, Toxicity, Curcumin, Male Reproductive System, Oxidative Stress
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Pages 176-183BackgroundPolycystic ovary syndrome (PCOS) is a common but complex endocrine disorder and is the major cause of anovulation and consequent subfertility. In this study the effect of grape seed extract (GSE) on triglyceride (TG), total cholesterol (TC), highdensity lipoprotein-cholestrol (HDL-C), low-density lipoprotein-cholestrol (LDL-C) and interleukin-6 (IL-6) in PCOS Wistar rats were assessed.Materials And MethodsIn this experimental study, 84 adult female Wistar rats were divided into 7 groups (n=12) including control (intact), Sham (estradiol valerate solvent injection), control PCOS and 4 experimental PCOS groups. To induce the syndrome, a single subcutaneous injection of 2 mg estradiol valerate was applied. In experimental groups, PCOS rats were treated with different doses of 50, 75, 100 and 200 mg/kg body weight (BW) GSE by intraperitoneal injection for 10 consecutive days. After harvesting blood serum, TG was measured by Glycerol-3-phosphate Oxidase-Peoxidase (GPO- PAP), TC by Cholesterol Oxidase-Peroxidase (CHOD-PAP), and HDL-C by sedimentation method, LDL-C by Friedwald calculation and IL-6 by ELISA method. The serum values of each parameter were analyzed using one-way ANOVA at P≤0.05.ResultsIn all experimental groups significant decrease of visceral fat was obvious as compared with control PCOS group. LDL-C, TC and IL-6 levels in experimental groups, particularly at dose of 50 mg/kg of GSE, were significantly decreased as compared with PCOS group. However, HDL-C levels were not significantly changed.ConclusionAccording to the findings of this study, it can be concluded that GSE with its effects on serum TC, LDL-C and IL-6 could reduce the effects of dyslipidemia and inflammation in PCOS rats and improve systemic symptoms of PCOS.Keywords: Dyslipidemia, Grape Seed Extract, IL-6, Polycystic Ovarian Syndrome, Wistar Rat
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Pages 184-190BackgroundIn vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) are two important subsets of the assisted reproductive techniques, used for the treatment of infertility. Predicting implantation outcome of IVF/ICSI or the chance of pregnancy is essential for infertile couples, since these treatments are complex and expensive with a low probability of conception.Materials And MethodsIn this cross-sectional study, the data of 486 patients were collected using census method. The IVF/ICSI dataset contains 29 variables along with an identifier for each patient that is either negative or positive. Mean accuracy and mean area under the receiver operating characteristic (ROC) curve are calculated for the classifiers. Sensitivity, specificity, positive and negative predictive values, and likelihood ratios of classifiers are employed as indicators of performance. The state-of-art classifiers which are candidates for this study include support vector machines, recursive partitioning (RPART), random forest (RF), adaptive boosting, and one-nearest neighbor.ResultsRF and RPART outperform the other comparable methods. The results revealed the areas under the ROC curve (AUC) as 84.23 and 82.05%, respectively. The importance of IVF/ICSI features was extracted from the output of RPART. Our findings demonstrate that the probability of pregnancy is low for women aged above 38.ConclusionClassifiers RF and RPART are better at predicting IVF/ICSI cases compared to other decision makers that were tested in our study. Elicited decision rules of RPART determine useful predictive features of IVF/ICSI. Out of 20 factors, the age of woman, number of developed embryos, and serum estradiol level on the day of human chorionic gonadotropin administration are the three best features for such prediction.Keywords: In Vitro Fertilization, Intracytoplasmic Sperm Injection, Clinical Decision Support, Data Mining
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Pages 191-196BackgroundMultiple pregnancies are an important complication of assisted reproductive technology (ART). The present study aims to indentify the risk factors for multiple pregnancies independent of the number of transferred embryos.Materials And MethodsThis retrospective study reviewed the medical records of patients who underwent intracytoplasmic sperm injection (ICSI) cycles in Royan Institute between October 2011 and January 2012. We entered 12 factors that affected the number of gestational sacs into the poisson regression (PR) model. Factors were obtained from two study populations-cycles with double embryo transfer (DET) and cycles that transferred three embryos (TET). We sought to determine the factors that influenced the number of gestational sacs. These factors were entered into multivariable logistic regression (MLR) to identify risk factors for multiple pregnancies.ResultsA total of 1000 patients referred to Royan Institute for ART during the study period. We included 606 eligible patients in this study. PR analysis demonstrated that the quality of transferred embryos and womans age had a significant effect on the number of observed sacs in patients who underwent ICSI with DET. There was no significant predictive variable for multiple pregnancies according to MLR analysis. Our findings demonstrated that both regression models (PR and MLR) had the same outputs. A significant relation existed between age and fertilization rate with multiple pregnancies in patients who underwent ICSI with TET.ConclusionSingle embryo transfer (SET) should be considered with the remaining embryos cryopreserved to prevent multiple pregnancies in women younger than 35 years of age who undergo ICSI cycles with high fertilization rates and good or excellent quality embryos. However, further prospective studies are necessary to evaluate whether SET in women with these risk factors can significantly decrease multiple pregnancies and improve cycle outcomes.Keywords: Multiple Pregnancy, Intracytoplasmic Injection Cycles, Risk Factors, Logistic Regression
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Pages 197-204BackgroundInfertile couples only think of having children during their sexual intercourse, and their constant concern about this issue increases their stress level. Psychosocial and social stress leads to decreased life satisfaction, increased marital problems, and reduced sexual confidence. This study aims to determine the effect of enrichment program on marital and sexual satisfaction as well as marital intimacy among infertile couples.Materials And MethodsThis randomized controlled clinical trial was conducted on 50 infertile couples in 2013 in Hamedan. The marital relationship enrichment program was taught to the experimental group during seven 90 minutes sessions. Enrich marital satisfaction, Linda Berg sexual satisfaction, and marital intimacy questionnaires were completed by both groups in 3 pretest steps immediately after the end of training sessions, and 8 weeks later. The results were analyzed in STATA11 software using t test, Chi-square, ANCOVA, RM-ANOVA, and Bonferroni post-hoc test. To check the data normality, Kolmogorov-Smirnov test was used. PResultsComparison of mean scores related to pretest on the one hand and immediately after the test in 8 week later on the other hand showed marital relationship enrichment program significantly increased marital and sexual satisfaction (PConclusionEnrichment training can increase marital intimacy and also marital and sexual satisfaction in infertile couples (Registration Number: IRCT201604299014N97).Keywords: Infertility, Training, Marital Therapy, Sexual Satisfaction
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Pages 205-210BackgroundThis study compared common psychological symptoms and life satisfaction in husbands and wives according to infertility diagnosis.Materials And MethodsWe conducted this cross-sectional study on 248 infertile couples between November 1, 2014 and February 28, 2015 at Royan Institute, Tehran, Iran. Participants answered three questionnaires. First, they completed a demographic questionnaire followed by the Hospital Anxiety and Depression Scale (HADS, 14-item self-report instrument) composed of two sub-scales: anxiety (HADS-A) and depression (HADS-D). Participants also completed the Satisfaction with Life Scale (SLWS) comprised of 5 items. Both our questionnaires were validated for the Iranian population.ResultsIn couples with male factor infertility, wives had a significantly higher mean score for anxiety compared to their husbands (PConclusionOur findings showed that when the infertility etiology was male factor, female factors or unexplained, wives showed significantly higher anxiety than their husbands. In couples diagnosed with female factor infertility, wives showed significantly more depression than their husbands.Keywords: Anxiety, Depression, Reproduction, Infertility
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Pages 211-219BackgroundThe Islamic Republic of Iran has experienced a dramatic decrease in fertility rates in the past three decades. One of the main issues in the field of fertility is the couples preferences and the desire to bear children. This study aimed to determine desired number of children, fertility preference, and related factors among people referring pre-marriage counseling to clarify their presumed behavior in case of fertility.Materials And MethodsThis study was a descriptive analytic cross-sectional survey, conducted during 8 months. The participants were 300 couples came to pre-marriage counseling centers of two health centers of Karaj and asked to complete a 22 items questionnaire about of demographic characteristics, participants interest, preference about fertility, and economic situation.ResultsMajority of the males were between the ages of 20-30 years (66.6%) while majority of the females were below 25 years of age (57%). About 17 percent of men and 22.3 percent of women stated that they want to have 1 child and equally 52.7 percent of men and 52.7 percent of women wanted to have 2 children. The only factor that contributed to the female participants decision for a desirable number of children was the number of siblings that they have. In male participants with an increasing age at marriage and aspiration for higher educational level, the time interval between marriage and the birth of the first child has increased. There was a convergence in desired number of children in male and female participants.ConclusionMajority of the participants express their desire to have only one or two children in future but in considering the fact that what one desires does not always come into reality, the risk of reduced fertility is generally present in the community. Appropriate policies should be implemented in order to create a favorable environment for children.Keywords: Fertility, Fertility Preferences, Time to Pregnancy, Family Size
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Pages 220-225BackgroundThe multiple pregnancy incidence is increasing worldwide. This increased incidence is concerning to the health care system. This study aims to determine the frequency of multiple pregnancy and identify factors that affect this frequency in Tehran, Iran.Materials And MethodsThis cross-sectional study included 5170 mothers in labor between July 6-21, 2015 from 103 hospitals with Obstetrics and Gynecology Wards. The questionnaire used in this study consisted of five parts: demographic characteristics; information related to pregnancy; information related to the infant; information regarding the multiple pregnancy; and information associated with infertility. We recruited 103 trained midwives to collect data related to the questionnaire from eligible participants through an interview and medical records review. Frequencies and odds ratios (OR) for the association between multiple pregnancy and the selected characteristics (maternal age, economic status, history of multiple pregnancy in first-degree relatives, and reproductive history) were computed by multiple logistic regression. Stata software, version 13 (Stata Corp, College Station, TX, USA) was used for all statistical analyses.ResultsMultiple pregnancy had a prevalence of 1.48% [95% confidence interval (CI): 1.19-1.85]. After controlling for confounding variables, we observed a significant association between frequency of multiple pregnancy and mothers age (OR=1.04, 95% CI: 1.001-1.09, P=0.044), assisted reproductive technique (ART, OR=6.11, 95% CI: 1.7- 21.97, P=0.006), and history of multiple pregnancy in the mothers family (OR=5.49, 95% CI: 3.55-9.93, P=0.001).ConclusionThe frequency of multiple pregnancy approximated results reported in previous studies in Iran. Based on the results, we observed significantly greater frequency of multiple pregnancy in older women, those with a history of ART, and a history of multiple pregnancy in the mothers family compared to the other variables.Keywords: Multiple Pregnancy, Pregnancy, Labor, Cross-Sectional Study, Prevalence Rate
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Pages 226-233BackgroundOne of the most controversial issues related to the human embryo is the determination of the moment when an embryo is considered a human being and acquires a moral status. Although personhood and moral status are frequently mentioned in medical ethics, they are considered interdisciplinary as concepts that shape the debate in medical law (fiqh) since their consequences are influential in the way which the parents and other individuals behave towards the embryo.Materials And MethodsThis analytical-descriptive research gathered relevant data in a literature search. After a description of the fundamentals and definitions, we subsequently analyzed juridical texts and selected one of the viewpoints that regarded the surrogacy contract revocation.ResultsThe surrogacy contract is a contract based upon which two sides (infertile couple and surrogate mother) involved in making the contract are obligated to fulfill its terms. Therefore, contract revocation can be surveyed from three perspectives: mutual revocation (iqala), legal unilateral wills (khiar al-majlis, khiar al-ayb), and contractual wills (khiar al-shart).ConclusionRevocation of a surrogacy contract either by the genetic parents, surrogate or the fertility clinic is allowed by Muslim jurists only when the embryo lacks personhood. Based on Islamic teachings, the termination of a surrogacy contract in and after the sixteenth week of pregnancy, when the embryo acquires a human soul (ensoulment), is not allowed. However religious thought emphasizes the moral status of the fetus before the sixteenth week and states that optional termination of the surrogacy contract is not permitted while the fetus becomes a human being.Keywords: Personhood, Moral Status, Embryo