akbari asbagh f

Premature ovarian failure (POF) is a heterogeneous syndrome with several causative factors. Autoimmune mechanisms are involved in pathogenesis of 4-30 % of POF cases. The present review focuses on the role of autoimmunity in the pathophysiology of POF. The evidences for an autoimmune etiology are: demonstration of ovarian autoantibodies, the presence of lymphocytic oophoritis, and association with other autoimmune disorders. Several ovarian antigenic targets have been identified in POF patients. The oocyte seems to be the most often targeted cell. Lymphocytic oophoritis is widely present in POF associated adrenal insufficiency. Addisonۥs disease is one of the most common autoimmune disorders associated with POF. Early detection of this potentially life threatening disease was recommended in several studies. The gold standard for detecting autoimmune POF is ovarian biopsy. This procedure is not recommended due to unknown clinical value, expense, and risks. Several immunoassays have been proposed as substitute diagnostic tools. Nevertheless, there is no clinically proven sensitive and specific serum test to confirm the diagnosis of autoimmune POF or to anticipate the patient’s chance of developing POF or associated diseases. Some authors suggested the possible effects of immuno-modulating therapy on the resumption of ovarian function and fertility in a selected group of autoimmune POF patients. However, in most instances, this treatment fails to reverse the course of the disease. Numerous studies illustrated that standard treatment outcome for infertility is less effective in the presence of ovarian autoimmunity. The antibody-induced damage could be a pathogenic factor. Nevertheless, the precise cause remains obscure.

Abstract: Hydrosalpins (dilatation of Fallpian tube that can be seen by hysterosalpingogeraphy. Laparoscocpy, and in severe cases by sonography) is one of the probable confounding factors of assited – reproduction therapy (ART) outcomes. This cohort study is conducted to determine the effects of hydrosalpins on IVF-ET outcomes. For this, of the total number of patients who had approached the infertility Department Mirza Koochak Khan Hospital in the period between ordibehcesht 1377 to Aban 1378 (April 1998 to November 1999), 392 patients had come for the IVF0 ET cysles and were selected for our study. In these patients the numbers of oocytes retrieved and fertilized, the number of embryos transferred to the uterine cavity and resulting clinical pregnancy rates were measured.51 patients who had hydrosalpins were studied in two separate comparisons. Initially with 50 patients who had tubal involvement other hydrosalpinx, but had other indications of IVF-ET. These groups had similar age distribution. The numbers of oocytes retrieved (in first comparison = 1.6 & 3.92 and in second comparison = 4.6 & 4.65) and the number of embryo comparison = 2.6& 2.47) didn’t have significant statistical differences, but despite the fact that the same number of embryos were transferred to the uterine cavity (in the first comparison = 2.53 & 2.14 and in the second comparison= 2.53 & 2.27), the clinical pregnancy rates in both comparisons were reduced by more than 50% in patients with hydrosaplins as comparison = 7.8% & 20% and in second comparison = 7.8% & 16.1%). we conclude that hydrosalpins didn’t result in impaired ovarian stimulation or decreased oocyte fertilization. It did however interfere with implantation and reduced to some degree the success of IVF in achieving a clinical pregnancy.