فهرست مطالب bahia namavar jahromi
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مقدمه
COVID-19 که توسط ویروس SARS-CoV-2ایجاد می شود، با آسیب به چندین سیستم ارگان مرتبط است. یکی از جنبه های قابل توجه این ویروس تاثیر آن بر باروری مردان و دستگاه تناسلی است. هدف ما جهت بررسی اجمالی مسیرهای مولکولی درگیر به منظور پیش بینی اثرات ویروس بر سیستم تناسلی مردان، اسپرم زایی و پارامترهای مایع منی می باشد.
روش هاپایگاه های اطلاعاتی PubMed و Scopus (مقالات منتشر شده از سال 2020 تا 2023) برای مطالعاتی که تاثیر کووید-19 را بر مسیرهای مرتبط با سیستم تناسلی مردان در سطح سلولی گزارش می کنند، جستجو گردید و 98 مقاله بررسی شد.
یافته هااثرات کووید-19 ممکن است مستقیما به دلیل حملات ویروس به دستگاه تناسلی مردان ایجاد شود و یا ممکن است به دلیل واکنش بیش از حد نامطلوب پاسخ ایمنی، مانند طوفان سیتوکین ها یا کاهش آن ها باشد. سیستم رنین-آنژیوتانسین و مسیر سیگنالینگ PI3K/AKT نیز درگیر هستند. تعداد و تحرک اسپرم کاهش می یابد، اگرچه تقریبا بهبودی در عرض چند ماه مشاهده شد. برخلاف داروهای مورد استفاده برای درمان کووید-19 که اثرات متناقضی نشان دادند به نظر می رسد واکسن ها هیچ اثر نامطلوب ملموسی بر باروری مردان ندارند.
نتیجه گیریتاثیر SARS-CoV-2 بر باروری و سیستم تولید مثل مردان به دلیل وجود دو عامل میزبان اصلی شامل ACE2 و TMPRSS2 و درگیر شدن مسیرهای مرتبط قابل توجه است. می توان به درگیری بالقوه این اندام ها و اثرات بعدی آن بر نسل های آینده اشاره کرد. درک این فرایند ممکن است سرنخی برای مدیریت اثربخش ارائه دهد.
کلید واژگان: SARS-Cov-2, COVID-19, ناباروری مردها, اسپرماتوژنز, پارامترهای اسپرم}BackgroundCOVID-19, caused by the SARS-CoV-2 virus, has been associated with damage to multiple organ systems. One of the noteworthy aspects of the virus is its effect on male fertility and the reproductive system. We aimed to overview the involved molecular pathways to prospect the virus's effects on male reproductive tissue, spermatogenesis, and semen parameters.
MethodsPubMed and Scopus databases (papers published from 2020 to 2023) were searched for studies reporting the impact of COVID-19 on the related pathways associated with the male reproductive system at the level of cells, and 98 articles were reviewed.
FindingsThe effects of COVID-19 may arise directly due to the virus's attacks on the male reproductive system or may be due to an undesirable overreaction of the immune response, such as cytokines storm or fewer. Renin-Angiotensin System and PI3K/AKT signaling pathway are also involved; counts and sperm motility were decreased, although approximately recovery was observed in survivals within months. Contrasting the drugs used for treating COVID-19 that had contradictory effects regarding vaccines, it seems there is no tangible adverse effect on male fertility.
ConclusionThe impact of SARS-CoV-2 on male fertility and the reproductive system is notable due to the presence of two major host factors, ACE2 and TMPRSS2, and involving the related pathways. It is possible that these organs could be involved, leading to effects on future generations. Understanding the process may provide a clue for managing the efficacies.
Keywords: SARS-Cov-2, COVID-19, Male Infertility, Spermatogenesis, Sperm Parameters} -
علت حدودا نیمی از ناباروری ها در زوجین مربوط به فاکتورهای مردانه است که می تواند به دلایل گوناگونی رخ دهد. بررسی متغیرهای پلاسمای منی اولین و ساده ترین روش بررسی ناباروری در مردان است و اطلاعات ارزنده ای از وضعیت باروری فرد در اختیار قرار می دهد. در این مطالعه، حضور و ارتباط میان میزان غلظت اینترلوکین 35 (IL-35) مایع منی با متغیرهای استاندارد اسپرم در مردان نابارور بررسی گردید. تجزیه و تحلیل مایع منی روی نمونه های منی مردان مراجعه کننده به مرکز درمان ناباروری حضرت زینب(س) دانشگاه علوم پزشکی شیراز انجام گردید. نمونه های منی بر اساس دستورالعمل آزمایشگاهی سازمان بهداشت جهانی بررسی و به سه گروه تقسیم بندی شدند که شامل 21 نمونه نرمال، 21 نمونه آستنوتراتوزواسپرمی و 15 نمونه آزواسپرمی بودند. حضور و سطح غلظت IL-35 پلاسمای منی در گروه های مورد مطالعه با استفاده از روش الایزا اندازه گیری شد. بررسی IL-35 بیانگر حضور این اینترلوکین در مایع منی هر سه گروه مورد مطالعه است، اما غلظت آن از نظر آماری تفاوت معنی دار نشان نداد (p>0.05). تجزیه و تحلیل همبستگی و ارتباط میان غلظت IL-35 با متغیرهای استاندارد اسپرم نشان داد که بین غلظت IL-35 با درصد مورفولوژی نرمال اسپرم همبستگی منفی معناداری وجود دارد (317/0-r=، 04/0p=)، درحالیکه همبستگی معنادار با تعداد اسپرم (27/0-r=، 08/0p=) و حرکت اسپرم (27/0-r=، 08/0p=) مشاهده نشد. با وجود اثبات حضور IL-35 در مایع منی حتی در مردان با متغیرهای نرمال، نقش و اهمیت عملکردی آن هنوز مشخص نشده است. وجود رابطه منفی بین غلظت IL-35 با درصد مورفولوژی نرمال اسپرم می تواند نشان دهنده اهمیت آن در توانایی باروری مردان باشد.کلید واژگان: اینترلوکین 35, پلاسمای منی, کیفیت اسپرم}The presence of Interleukin 35 in seminal plasma: is it a significant issue in male infertility? Approximately half of infertility in couples can be attributed to male factors, which may occur in a wide range of causes. Examining seminal plasma parameters is the initial and simplest approach in male infertility evaluation and provides valuable information about fertility status. In this study, the presence and relationship between the concentration of interleukin 35 (IL-35) in seminal plasma and standard parameters of sperm in infertile men were investigated. Semen analysis was performed on semen samples of men referred to the Infertility Center of Shiraz University of Medical Sciences. Semen samples were analyzed in accordance with the laboratory guidelines of the World Health Organization and were divided into three groups including 21 normozoospermic, 21 asthenoteratozoospermic, and 15 azoospermic samples. The seminal concentration level of IL-35 was analyzed using the enzyme-linked immunosorbent assay (ELISA) method. Results showed that IL-35 was detectable with different levels in the seminal plasma of studied groups, however, its concentration did not show a statistically significant difference (p>0.05). The correlation analysis between IL-35 concentration and sperm standard parameters showed that there is a significant negative correlation between IL-35 concentration and the normal sperm morphology percentage (r=0.317, p=0.04), while no significant correlation was observed with sperm count (r=-0.27, p=0.08) and sperm motility (r=-0.27, p=0.08). Despite the presence of IL-35 in semen, even in normozoospermic male patients, its role and functional significance have not been determined. The existence of a negative relationship between the IL-35 concentration and the normal sperm morphology percentage can indicate its importance in male infertility status.Keywords: Interleukin 35, Seminal plasma, Sperm quality}
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Introduction
Changes of physical activity before and during three trimesters of pregnancy known as pattern of physical activity and anxiety during pregnancy can be two concerns of pregnant women about preterm birth which require clarification. So, this retrospective study aimed to assess the effect of pattern of physical activity, and anxiety on preterm birth in Iranian pregnant women.
MethodsThis study was a kind of descriptive correlation which was performed retrospectively. Participants of this study (2019-2020) included 118 pregnant women with preterm (n=62) and term (n=56) birth who participated in the study voluntarily and were selected according to the study inclusion criteria. The energy cost of physical activity before and during three trimesters of pregnancy, and anxiety level were recorded through interview using pregnancy physical activity (PPAQ) and Hospital Anxiety and Depression Rating Scale Anxiety (HADS) questionnaires respectively.
ResultsThere was no significant difference between preterm and term birth groups regarding total physical activity, and sedentary behavior energy expenditure before and during pregnancy as well as anxiety during pregnancy(P>0.05). Physical activity pattern was not significantly different between the two groups (P>0.05). However, physical activity before pregnancy was significantly higher than all trimesters of pregnancy in both groups of the study (P<0.001). In two groups of preterm and term deliver, physical activity reduced in the third compared to the second trimester of pregnancy similarly.
ConclusionsPhysical activity reduced during pregnancy in preterm and term birth women similarly. In this study, physical activity, sedentary behavior and anxiety during pregnancy and before it were not effective on the pre-term birth.
Keywords: Anxiety, Exercise, Physical Activity, Pregnancy trimesters, Preterm Birth} -
Background
The Coronavirus disease 2019 (COVID-19) pandemic has raised concerns regarding the application of assisted reproductive technology (ART) in the world. Many ART programs have been delayed or continued with new precautions due to the ambiguity about vertical transmission and pregnancy safety. Regarding the possible risks of SARS-CoV-2 infection on ART and the resultant embryos, this study aimed to investigate the presence of SARS-CoV-2 in follicular fluid, granulosa cells, and oocytes of COVID-19-infected women undergoing ART.
Materials and MethodsCOVID-19-positive polymerase chain reaction tests were reported for five women undergoing ART cycles on the day of oocyte retrieval. SARS-CoV-2 tests were performed on oocytes, granulosa cells, and follicular fluid obtained from these COVID-19-infected women.
ResultsSARS-CoV-2 RNA was detected only in one follicular fluid sample; however, other follicular fluid samples, granulosa cells, and oocytes were negative regarding viral RNA.
ConclusionGiven the unknown effects of COVID-19 on human reproduction and ART, strict precautions should be taken during the COVID-19 pandemic.
Keywords: SARS-Cov-2, Follicular Fluid, Oocyte, Granulosa Cell, Reproduction} -
Objectives
Polycystic ovary syndrome (PCOS) is a common endocrine disorder among women. Hyperinsulinemia and insulin resistance are normally observed in PCOS patients and metformin is used to treat this disease. The evidence indicates that the opioid system plays a role in the pathogenesis of the PCOS. Based on the above-mentioned explanation, the present study evaluated the role of opioid antagonist (naltrexone) in PCOS-induced infertility compared to metformin.
Materials and MethodsTotally, 120 patients afflicted with PCOS were assigned to three groups based on Rotterdam diagnostic criteria, with a body mass index (BMI) of 25-30 kg/m2. The first group received naltrexone (50 mg/d) for 8 weeks. In addition, the second group were injected with metformin 1000 and then 1500 mg/d for the first and seventh weeks, respectively. Finally, the third group entered the intrauterine insemination (IUI) without prior therapeutic treatment. Then, the groups were compared in terms of the amount of estradiol produced per day of human chorionic gonadotropin injection and the total amount of gonadotropin needed, the number and size of the adult follicles, the number of days of taking the drug, and incidence of pregnancy-induced abo
ResultsBased on the results, the mean of infertility duration was not significant among the three groups (P = 0.782). Further, the mean fasting insulin level between the metformin and control groups represented a significant difference (P = 0.045). The average number of days to trigger patients in the 3 groups was not significant (P = 0.346). Although the average number of follicles between metformin and naltrexone groups was not significant, it was higher in the naltrexone group. Finally, the average BMI of the naltrexone group after the treatment was lower compared to before treatment (P ≤ 0.001).
ConclusionsIn general, the number of receiving days and the dose of the drug in the naltrexone group was lower compared to the metformin group. Furthermore, the number of mature follicles in both ovaries and the serum estradiol level in the naltrexone group was higher compared to the metformin group.
Keywords: Naltrexone, Polycystic ovary syndrome, Metformin} -
International Journal of Reproductive BioMedicine، سال بیستم شماره 3 (پیاپی 146، Mar 2022)، صص 177 -184مقدمه
حاملگی خارج از رحم یکی از دلایل مهم در مرگ و میر مادران در سه ماهه اول بارداری می باشد.
هدفدر این مطالعه به بررسی چهار روش درمان حاملگی خارج از رحم که شامل درمان تک دوز و دو دوز متوتروکسات، جراحی و درمان انتظاری است می پردازیم.
مواد و روش هادر این مطالعه مقطعی، مشخصات بالینی مربوط به 365 بیمار مراجعه کننده به بیمارستان های وابسته به دانشگاه علوم پزشکی شیراز با محدوده سنی 44-15 سال و در بازه زمانی اسفند 1395 تا 1397، که حاملگی خارج از رحم برای آنها تشخیص داده شده بود مورد مطالعه قرار گرفت. نمودار راک به منظور پیش بینی نقطه برش برای سایز توده و میزان هورمون β-hCG به منظور مقایسه روش جراحی و درمان دارویی دو دوز رسم گردید.
نتایجبیشترین توده ها در قسمت آدنکس قرار گرفته بودند. طبق نتایج به دست آمده از نمودار راک، روش جراحی برای افرادی که دارای سایز توده mm 50/34> و mIU/ml6419 < β-hCG باشند، به عنوان بهترین روش محسوب می شود. میزان β-hCG در گروه متوتروکسات تک دوز با درمان موفق به صورت معنی دار کمتر از درمان تک دوز ناموفق بود (02/0 = p). در مقایسه درمان متوتروکسات تک دوز و دو دوز، درمان تک دوز با داشتن میزان موفقیت بالاتر و طول بستری کوتاه تر بیماران، به عنوان درمان موثرتری نسبت به درمان دو دوز مورد توجه قرار گرفت.
نتیجه گیریجراحی به عنوان خط اول درمان برای بیماران با میزان β-hCG بالا و سایز توده بزرگ پیشنهاد می گردد. در این مطالعه، درمان متوتروکسات تک دوز به دلیل میزان موفقیت بالاتر و زمان بستری کوتاه تر، درمان مناسب تری نسبت به درمان دو دوز معرفی می گردد. کارآزمایی های بالینی تصادفی سازی شده بیشتر با حجم نمونه بزرگ تر برای تایید نتایج فعلی توصیه می شود.
کلید واژگان: حاملگی خارج از رحم, متوتروکسات, β-hCG, درمان}BackgroundEctopic pregnancy (EP) is one of the major causes of maternal mortality during the first trimester of pregnancy.
ObjectiveFour treatment methods for EP including single-dose methotrexate (SD-MTX), double-dose methotrexate, expectant and surgical management were considered.
Materials and MethodsIn this cross-sectional study, the clinical characteristics of 365 women aged 15-44 yr who had been diagnosed with EP were reviewed from March 2017 to March 2019 in hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. Receiver operating characteristics curves were plotted to determine the cut-off points for size of ectopic mass and beta-human chorionic gonadotropin (β-hCG) that suitably discriminated between double-dose methotrexate and surgery management.
ResultsThe most common site of EP was adnexa. According to the receiver operating characteristics analysis, surgery was the best plan for the women with an ectopic mass > 34.50 mm in diameter or with an initial β-hCG level > 6419 mIU/ml. The β-hCG levels in the women successfully treated with SD-MTX were significantly lower than in those with failed treatment (p = 0.02). The SD-MTX group had a higher success rate and significantly shorter duration of hospitalization, and so this was a more effective medical treatment in comparison with the DD protocol.
ConclusionSurgery is proposed as the best option for the cases with large ectopic mass or high β-hCG level. SD-MTX had a higher success rate and shorter hospital stay than the DD protocol, and so was found to be an efficient and safe alternative. Further randomized clinical trials with larger sample sizes are recommended to validate the current results.
Keywords: Ectopic pregnancy, Methotrexate, β-hCG, Treatment} -
Background
The coronavirus disease-2019 (COVID-19), caused by a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is now spread worldwide. Therefore, informative and reliable data related to the exact effects of COVID-19 on fertility and pregnancy is still of great interest until the pandemic is declared over. General guidelines regarding the protection and management of COVID-19 have been published and new information will continue to be updated daily.
MethodsIn this review, we summarized clinical health guidelines for reproductive and infertility centers to improve quality management in assisted reproductive technology and minimize the potentially harmful consequences of COVID-19 on pregnancy and fertility.
ResultsAs specified in the literature, protocols consist of five categories, including protocols for couples, protocols for women, protocols for men, labor and delivery, and postpartum and breastfeeding.
ConclusionGeneral protocols for patients and staff may vary depending on specific conditions. However, this review provides some rules to ensure their safety against the disease during the pandemic.
Keywords: Assisted, Assisted Reproductive Technology, COVID-19, infertility, Pandemic, Reproductive Techniques} -
International Journal of Reproductive BioMedicine، سال نوزدهم شماره 7 (پیاپی 138، Jul 2021)، صص 653 -662مقدمه
مقاومت به انسولین در 50-70% زنان مبتلا به سندرم تخمدان پلی کیستیک (PCOS) دیده شد، و می تواند به عنوان راهکاری در جهت تشخیص به موقع پیش دیابت در نظر گرفته شود.
هدفاین مطالعه با هدف مقایسه روش های غیر مستقیم اندازه گیری مقاومت به انسولین و معرفی روش ایده آل طراحی شد. ارتباط مقاومت به انسولین با سطح سرمی تری گلیسیرید، گلوبولین متصل شونده به هورمون جنسی (SHBG) و هورمون های مختلف از جمله آندروژن ها مورد ارزیابی قرار گرفت.
مواد و روش هااین مطالعه مقطعی بر روی 74 زن مبتلا به PCOS انجام گرفت. سطح سرمی انسولین (FI)، گلوکز (FBS)، تری گلیسیرید ((TG، گلوبولین متصل شونده به هورمون جنسی (SHBG) و هورمون های مختلف از جمله آندروژن ها به صورت ناشتا اندازه گیری شد. حساسیت و ویژگی روش های غیر مستقیم شامل FI، FBS، FBS/FI و روش QUICKI با در نظر گرفتن HOMA-IR به عنوان روش استاندارد مورد مقایسه قرار گرفت. ارتباط مقاومت به انسولین با TG، SHBG و هورمون های مختلف از جمله آندروژن ها بین دو گروه با سطح مقاومت به انسولین نرمال و غیر نرمال با انجام آزمون تی مستقل بررسی شد.
نتایجTG ارتباط مثبت معناداری با میزان FBS (002/0 = p) و HOMA-IR (01/0 = p) و ارتباط منفی معنادار با QUICKI (02/0 = p) و SHBG (02/0 p =) نشان داد. SHBG در این بیماران با افزایش FBS به صورت معنا داری کاهش یافت (001/0 = p). هورمون دهیدرو اپی آندوسترون سولفات (DHEAS) با افزایش انسولین به صورت معناداری افزایش یافت (002/0 = p). هفت نفر از زنان PCOS در این مطالعه با وجود داشتن رنج نرمال در متغیرهای مقاومت به انسولین، هورمون ها، و تری گلیسیرید، سطح غیر نرمال SHBG (< 36 nmol/L) را بروز دادند. در صورتیکه آزمون HOMA-IR به عنوان آزمون استاندارد در نظر گرفته شود، QUICKI و FI از بالاترین حساسیت و FBS/FI و QUICKI از بالاترین ویژگی برخوردار بودند.
نتیجه گیریSHBG و TG به ترتیب ارتباط منفی و مثبت معناداری را با مقاومت به انسولین نشان دادند. بعد از HOMA-IR، QUICKI و FI به عنوان حساس ترین روش غیر مستقیم جهت اندازه گیری مقاومت به انسولین شناخته شدند. بررسی سطح سرمی SHBG می تواند به عنوان مارکر قابل توجه در شناسایی افراد PCOS در نظر گرفته شود.
کلید واژگان: سندرم تخمدان پلی کیستیک, مقاومت به انسولین, گلوبولین متصل شونده به هورمون جنسی}BackgroundInsulin resistance (IR) occurs in 50-70% of women with polycystic ovary syndrome (PCOS) and can be applied as a pre-diabetic feature in PCOS.
ObjectiveIn this study, indirect methods including fasting blood sugar (FBS), fasting insulin (FI), FBS/FI ratio, and quantitative insulin sensitivity check index (QUICKI) were compared with the homeostasis model assessment of insulin resistance (HOMA-IR) as a standard technique. The association of IR to sex hormone-binding globulin (SHBG) and several hormones was also analyzed.
Materials and MethodsThis cross-sectional study was performed on 74 PCOS women. Sensitivity and specificity of each IR method was calculated based on HOMA-IR. Hormonal profiles of the patients were compared between the groups with defined normal and abnormal values of IR.
ResultsTriglyceride levels had a positive association with FBS and HOMA-IR (p = 0.002 and p = 0.01, respectively) with a negative association to QUICKI and SHBG (p = 0.02 and p = 0.02, respectively). SHBG showed a significant negative association with FBS (p = 0.001). Dehydroepiandrosterone sulfate showed a positive association with FI (p = 0.002). Seven PCOS women showed abnormal SHBG levels (< 36 nmol/L) while expressed normal values of the rest of the studied variables. FI and QUICKI had the highest sensitivity while FBS/FI and QUICKI had the highest specificity when HOMA-IR was applied as a standard test.
ConclusionSHBG and Triglyceride had a significant negative and positive association with IR, respectively. HOMA-IR followed by FI and QUICKI is the most sensitive test for the detection of IR. SHBG levels can be a helpful biomarker for the diagnosis of PCOS.
Keywords: Polycystic ovary syndrome, Insulin resistance, Sex hormone-binding globulin} -
International Journal of Reproductive BioMedicine، سال هجدهم شماره 6 (پیاپی 125، Jun 2020)، صص 415 -424مقدمه
استرس اکسیداتیو شرایطی است که در آن عدم تعادل بین مولکول های پروکسیدانت و آنتی اکسیدانت ها وجود دارد. ثابت شده که این شرایط در سندرم تخمدان پلی کیستیک (PCOS) نقش دارد.
هدفهدف ما در این مطالعه مقایسه فعالیت گلوتاتیون پراکسیداز (GPX) و گلوتاتیون ردوکتاز (GR) و سطوح گلوتاتیون (GSH) در سرم و مایع فولیکولی مربوط به نخستین فولیکول استخراج شده و تاثیر آن بر کیفیت همان تخمک و جنین حاصل از آن، در خانم های مبتلا به PCOS کاندید لقاح مصنوعی بوده است.
مواد و روش هااین مطالعه بصورت مقطعی روی 80 جفت نمونه خون و مایع فولیکولی مربوط به نخستین فولیکول از خانم های مبتلا به PCOS در مرکز ناباروری بیمارستان مادر و کودک غدیر انجام شد. اولین تخمک و جنین حاصل از آن در آزمایشگاه بر اساس کیفیت طبقه بندی شدند. ارتباط بین میانگین میزان فعالیت GPX و GR و سطوح GSH در سرم و مایع فولیکولی و کیفیت سلول ها به وسیله روش Paired-t-Test مقایسه شدند.
نتایج53 (25/66%) فولیکول استخراج شده حاوی تخمک با کیفیت MII، 17 (25/21%) عدد حاوی تخمک MI و 10 (5/12%) فولیکل حاوی جرمینال وزیکل بودند. بدنبال انجام لقاح مصنوعی 42 (5/52%) جنین درجه I و 11 (75/13%) جنین درجه II تولید شد. میانگین سطوح تمام آنتی اکسیدان های اندازه گیری شده در مایع فولیکولی بطور معنی داری بیشتر از سرم بود. همچنین میانگین سطوح تمام آنتی اکسیدان های اندازه گیری شده در مایع فولیکولی مربوط به فولیکول های حاوی تخمک با کیفیت MIΙ بطور معنی داری بیشتر از فولیکول های حاوی تخمک هایی با کیفیت ضعیفتر بود. میانگین میزان فعالیت GPX و سطوح GSH در سرم و مایع فولیکولی مربوط به جنین های درجه I بطور معنی داری بیشتر از جنین های ضعیفتر بود. ارتباط مستقیمی بین مایع فولیکولی و سرم از این نظر وجود داشت.
نتیجه گیریفعالیت سیستم آنتی اکسیدان های وابسته به گلوتاتیون در مایع فولیکولی مربوط به تخمک ها و جنین های با کیفیت بالاتر، بیشتر است.
کلید واژگان: لقاح مصنوعی, گلوتاتیون, آنتی اکسیدان, تخمک, جنین}BackgroundOxidative stress and GSH-dependent antioxidant system plays a key role in the pathogenesis of polycystic ovary syndrome (PCOS).
ObjectiveWe compared glutathione peroxidase (GPx) and glutathione reductase activities and reduced glutathione (GSH) levels in serum and follicular fluid (FF) of the first-retrieved follicle and their impact on quality of oocyte and embryo in PCOS women undergoing IVF.
Materials and MethodsThis cross sectional study was conducted on 80 pairs of blood samples and FF of the first-retrieved follicle from PCOS women, at the Infertility center of Ghadir Mother and Child Hospital. The mean activity of GPx and GR, also GSH levels in the serum and FF were compared to the quality of the first follicle and resultant embryo.
ResultsRetrieved oocytes included 53 (66.25%) MII, 17 (21.25%) MI, and 10 (12.5%) germinal vesicles; after IVF 42 (52.50%) embryos with grade I and 11 (13.75%) with grade II were produced. The mean values for all three antioxidants were higher in the FF compared to serum (p < 0.001). Also all of the mean measured levels were significantly higher in the FF of the MII oocytes compared to that of oocytes with lower grades (p = 0.012, 0.006 and 0.012, respectively). The mean GPX activity and GSH levels were significantly higher in the serum (p = 0.016 and 0.012, respectively) and FF (p = 0.001 for both) of the high-quality grade I embryos.
ConclusionGSH-dependent antioxidant system functions more efficiently in the FF of oocytes and embryos with higher quality.
Keywords: In vitro fertilization, Glutathione, Antioxidant, Oocyte, Embryo} -
Due to an interaction between gall wasp Andricus sternlichti Bellido and Quercus infectoria G.Olivier from Fagaceae, the oak galls with a wide range of industrial and pharmaceutical applications are produced. Quercus infectoria galls have been well-known by both ethnopharmacology and traditional medicine of Iran. The aim of current study was a comprehensive collection of Persian scholars' notions and recent findings about medicinal effects of this gall. Sixteen traditional manuscripts of one millennium were sought by two keywords (“Afs” and “Mazu”. Arabic and Persian names of Quercus gall, respectively), and relevant articles till October 2018 were reviewed. In traditional manuscripts, three main dosage forms from gall including decoction, powder, and poultice were found. They had been prescribed for about of thirty disorders. Except for one clinical trial, other articles described related to animal studies and antimicrobial effect evaluation. Since Quercus infectoria gall as an endemic natural product of Iran is a valuable source for export, ethnic usages and pharmaceutical applications, the outcomes of this study can be beneficial for researchers involved in development of natural medications.
Keywords: Ethnopharmacology, plant tumors, Quercus infectoria G.Olivier, Traditional Iranian Medicine} -
Background
Abnormal female immune response is one of the potential causes of unexplained infertility (UI). Seminal plasma (SP) is an important regulator of female immune responses during pregnancy. This study investigated a SP effect on the expression of CD4+ T‑cell‑related cytokines in a group of UI woman candidates for in vitro fertilization (IVF) and healthy fertile women.
Materials and MethodsThis was a semi‑experimental study that performed on 20 UI couples (ten unsuccessful and ten successful IVF outcomes) and 10 fertile couples as the healthy group. CD4+ T‑cells were separated from peripheral blood mononuclear cells of women by magnetic‑activated cell sorting technique and incubated with (stimulated condition) or without (unstimulated condition) SP of their husbands. After incubation, real‑time polymerase chain reaction method was used to investigate interleukin (IL)‑23, IL‑17, IL‑4, IL‑10, transforming growth factor (TGF)‑β, and interferon (IFN)‑γ gene expression. Mann–Whitney U‑test, Kruskal–Wallis test, and Wilcoxon signed‑rank test were used for statistical analysis.
ResultsBaseline TCD4+ mRNA levels of IL‑23 (P = 0.03) and TGF‑β (P = 0.01) were different between healthy and infertile groups. However, IL‑17, IL‑4, IFN‑γ, and IL‑10 were expressed similarly regardless of fertility status. Comparing mRNA expression before and after SP exposure, our results have shown that relative expression of IL‑23 significantly increased in successful (P = 0.04) and unsuccessful IVF groups (P = 0.01), whereas IL‑10 expression increased only in the IVF failure group (P = 0.01).
ConclusionSP can make a positive effect on IVF outcome through alteration in CD4+ T‑cell‑related cytokines expression, especially IL‑10 and IL‑23.
Keywords: CD4‑positive T‑lymphocytes, fertilization in vitro, infertility, real‑time polymerase chain reaction, seminal plasma} -
Background
Genital tract infection is one of the causes of male infertility. Several studies have shown a role for human cytomegalovirus (CMV) in this context. In the present study, the prevalence of CMV in a population of male partners of infertile couples was estimated and the impact of CMV on sperm parameters was determined.
MethodsIn this cross sectional study, CMV DNA and virus copy number were examined in the semen of 150 participants including 80 with normal semen analysis (SA) and 70 with abnormal SA, by quantitative Real-Time PCR. Sperm parameters were compared between CMV positive and negative groups. Comparisons with pvalues under 0.05 were considered significant. Logistic regression was performed to control the effect of some variables with p<0.25 on sperm parameters.
ResultsCMV DNA was detected in the semen of 28 (18.6%) individuals. 21 men (30%) with abnormal SA and 7 (8.8%) with normal SA were positive for CMV DNA (p=0.001). The mean virus copy number was 883.1±4662.01 for the men with abnormal SA and 2525.7±12680.9 for those with normal SA (p=0.001). Sperm count was (32.1±23.5) x106 in CMV positive and (44.2±24.1) x106 in CMV negative groups (p=0.022). Normal sperm morphology was 2.73±2.83% and 5.99±5.44% in CMV positive and negative groups, respectively (p<0.001). After controlling some variables, the sperm morphology remains the only statistically significant sperm parameter that was reduced by CMV.
ConclusionThe higher CMV prevalence in the semen of males with abnormal SA compared to normal SA and significant reduction of sperm morphology in the presence of CMV, are in favor of the negative impact of CMV on male fertility.
Keywords: Cytomegalovirus, Male infertility, Polymerase chain reaction, Semen analysis} -
Background
Recurrent hydatidiform moles (RHMs) are an unusual pregnancy with at least two molar gestations that are associated with abnormal proliferation of trophoblastic tissue and a failure in the embryonic tissues development. Three maternal-effect genes, including NLRP7, KHDC3L, and PADI6 have been identified as the cause of RHMs. The present study aimed to understand the association of a founder mutation with the incidence and prevalence of a disease in different individuals of a population.
Methods14 unrelated Iranian patients with recurrent reproductive wastage, including at least two HMs, entered this study. In order to find a possible mutation in KHDC3L, all the 14 samples were Sanger sequenced. For haplotype analysis, three single nucleotide polymorphisms (SNPs) were selected with highest Minor Allele Frequency along KHDC3L.
ResultsA common KHDC3L mutation with the same haplotype was identified in four out of 14 patients with RHM. Regarding the present study, c.1A>G is the highest reported mutation in KHDC3L so far and is also the first report of the homozygous state that has led to RHM.
Conclusionc.1A>G mutation in KHDC3L is the highest reported mutation around the world. Our data also demonstrated the presence of founder effects for this particular mutation in Iranian populations. These data suggest that the high frequency of this mutation is potentially responsible for a higher rate of RHM in Iran.
Keywords: Haplotypes, KHDC3L protein, human, Hydatidiform mole, Founder effect, Mutatio} -
Unexplained infertility (UI) is one of the most common diagnoses in the fertility care. Seminal plasma (SP) plays a crucial role in the regulation of female immune responses and the success of a pregnancy. In vitro fertilization (IVF) is a well-known method for the treatment of UI. In this study, we aimed to investigate the effect of SP on the differentiation of T helper (Th) cell subsets and the relationship between these subsets with the rate of IVF success in a group of women complicated with UI compared to those with normal pregnancy. This study was conducted on 20 UI couples (ten with successful and ten with unsuccessful IVF outcome) and 10 fertile couples as the control group. Four color flow cytometry technique was used to detect Th cell subsets in the peripheral blood mononuclear cells (PBMC) with or without stimulation by SP. Results indicated that the frequencies of IL-17+ and Foxp3+ T cells after incubation with SP was significantly increased in couples with unsuccessful IVF outcome as compared to successful and healthy groups (p<0.05). Additionally, a positive correlation was observed between Th1 and Th2 cells in the unsuccessful IVF group (R=0.6, p=0.03). In summary, the results of the present study demonstrated that exposure to SP might increase Th17 and Treg cell frequencies in infertile women with unsuccessful IVF, and might also balance inflammatory to regulatory responses to finally tune-up the Th1/Th2/Th17/Treg balance and support the success of IVF.Keywords: Flow cytometry, In vitro fertilization, Seminal plasma, T helper subsets, Unexplained infertility}
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Polycystic ovary syndrome (PCOS) is correlated with low-grade chronic inflammation. Interleukin-17A (IL-17A) and Interleukin-32 (IL-32) are two members of the pro-inflammatory cytokines which act as significant components of the immune system during certain inflammatory diseases. Along with immunological processes, genetic factors play major roles in predisposition to PCOS. There are myriad single nucleotide polymorphisms (SNPs) within IL-17A and IL-32 genes that may affect their production and the susceptibility of individuals to PCOS. The objective of the present research was to investigate the association between IL-17A (rs2275913) and IL-32 (rs9927163, rs4786370) SNPs, and also their serum levels with susceptibility to PCOS in a group of Iranian women. In this case-control study, 150 PCOS patients (mean age of 29.1 years) and 150 healthy women (mean age of 26.1 years) were analyzed in terms of IL-17A and IL-32 SNPs via polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Furthermore, serum levels of IL-17A and IL-32 cytokines were measured through the use of ELISA method. There were significant differences between PCOS and healthy women regarding IL-17A rs2275913 alleles, genotypes frequencies (p=0.005, and 0.01, respectively) and the allelic distribution of IL-32 rs9927163 SNP (p=0.03). Additionally, significant differences were indicated between two groups concerning the AG genotype against AA+GG genotypes (p=0.009) and the GG genotype against AA+AG genotypes (p=0.006) in IL-17A rs2275913 SNP. In the matter of IL-32 gene SNPs, GC haplotype frequency was significantly different between patients and controls (p=0.05). Furthermore, IL-32 serum level was not significantly different between the two studied groups and the serum level of IL-17A was not detectable. In conclusion, IL-17A and IL-32 SNPs might be associated with predisposition to PCOS in Iranian women.Keywords: Interleukin-17A, Interleukin-32, Polycystic ovary syndrome}
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BackgroundThe purpose of this study was to compare the effects of Glycyrrhiza glabra (Licorice), a cyclooxyge- nase-2 inhibitor (Celecoxib) and a gonadotropin-releasing hormone analog (Diphereline®), with a control group on endometrial implants in rats.Materials and MethodsIn this experimental study, endometriosis was induced in rats by auto transplantation and after confirmation, the rats were divided into 4 groups that were treated for 6 weeks with normal saline (0.5 ml/day, orally), licorice extract (3000 mg/kg/day, orally), celecoxib (50 mg/kg, twice a day, orally) or diphereline (3 mg/kg, intramuscularly). At the end of treatments, the mean area, volume, histopathology and hemosiderin-laden macrophage (HLM) counts of the endometrial implants were evaluated and compared among the four groups.ResultsThe mean area, volume and HLM counts of the implants in the licorice group were significantly lower than those of the control group (P<0.001). The histopathologic grades of endometrial implants were significantly decreased by licorice compared to the control group (P<0.001). There was no significant change in the mentioned parameters in rats treated with celecoxib compared to the control group. Diphereline was the most potent agent for suppressing the growth of endometrial implants in terms of all of the above-mentioned parameters.ConclusionLicorice decreased the growth and histopathologic grades of auto-transplanted endometrial implants. However, while celcoxib had no significant effect, diphereline showed the highest potency for decreasing the endome- trial growth. Licorice may have the potential to be used as an alternative medication for the treatment of endometriosis.Keywords: Celecoxib, Cyclooxygenase-2 Inhibitor, Endometriosis, Glycyrrhiza glabra, Gonadotropin Releasing Hormone}
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BackgroundReligious obligation helps people to develop mental health by creating internal commitment to special rules This meta-analysis aimed to determine the relationship between religious orientation and anxiety among college students.MethodsMajor scientific databases including PubMed, Web of Science, Science Direct, EBSCO, ProQuest and PsycINFO were searched for original research articles published 1987-2016. A random effect model was used to combine Correlation coefficient. All analyses were performed using Stata MP.ResultsAfter screening of 7235 documents, 13 articles including 5620 participants met inclusion criteria in this meta-analysis. Correlation coefficient was -0.08 (95% CI= -0.19, -0.03) which indicated with increasing religious orientation, anxiety and depression reduced (P<0.001). Characteristics such as sex, geographic region, and type of religions were potential sources of heterogeneity. Based on fill-and-trim method the adjusted pooled r was obtained, -0.06 (95% CI= -0.16, -0.04).ConclusionThere was a weakness relationship between religious orientation and mental anxiety and de-pression. Therefore, it needs to improve knowledge of student about advantages of religious orientation.Keywords: Religious orientation, Anxiety, Depression, Meta-analysis}
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Spontaneous Retroperitoneal hemorrhage in pregnancy is a rare condition. Renal angiomyolipoma (RA) is the most common cause of this hemorrhage. To the best of our knowledge, this is the first reported case of Wunderlich syndrome (WS) due to renal cell carcinoma (RCC) diagnosed in the second trimester of pregnancy.Keywords: nephrectomy, pregnancy, renal cell carcinoma}
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Based on numerous written works of Persian scholars of Middle ages, Traditional Persian Medicine (TPM) has its own capabilities and strengths. According to TPM, vaginal drug delivery was prioritized to treat gynecological disorders because of the adjacency of uterine and cervix to vagina. This study was carried out to introduce and extract vaginal multi-component dosage forms, suggested by eight key medicinal manuscripts. Traditional terms of abzan, bakhour, fetileh, forzjeh, jalous, hamoul, hoghneh, and shiaf were sought as keywords. More than 670 vaginal formulations had been found for various gynecological disorders such as abortion, amenorrhea, and cervical stenosis. Vaginal dosage forms were categorized based on three physical conditions including solid (forzjeh, fetileh, hamoul, and shiaf), liquid (abzan, jalous, and hoghneh), and gas or smoke (bakhour). More detailed analysis of each vaginal dosage form based on traditional documents is suggested.Keywords: Vaginal drug delivery, Vaginal dosage form, Traditional Persian Medicine}
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BackgroundAssisted reproductive technology (ART) helps infertility treatment. In this study, the researchers tried to find several prognostic factors for ART success.MethodsData of 189 couples that had undergone ART at Qadir-Mother and Child hospital, were retrospectively explored. Cycles were classified as succeeded/failed and female/male/combined causes. Three classes of ovarian response based on the number of retrieved oocytes were determined. Duration of ovarian stimulation, dosages of gonadotropins, and sperm parameters were evaluated. Chi square, t-test and Pearson correlation were used for the analysis.ResultsCouples with male factor infertility had a higher success rate. Female age had a negative correlation with follicle count (r = -0.25), retrieved oocytes (r = -0.25), fertilized oocytes (r= -0.2), and clinical pregnancy (r = -0.21). Female age was negatively correlated with AMH, although not significant. The fertilization rate had a reverse correlation with the basal FSH (r = -0.22, P= 0.01) and LH (r= -0.18, P= 0.05). Finally, ART success rate was positively correlated with the number of follicles before (r = 0.18, P = 0.05) and after retrieval (r = 0.15, P = 0.05) and fertilized oocyte (r = 0.23, P = 0.01).ConclusionsFemale age, the number of mature follicles before retrieval, the number of retrieved oocyte, and fertilized oocytes are predictive factors in ART outcomes.Keywords: Assisted Reproductive Technology, Infertility, Ovarian Response}
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BackgroundPolycystic ovary syndrome (PCOS) is considered as the most common cause of female infertility that affects 4-10% of women in the reproductive age. Previous studies have shown the role of a balanced immune response in a successful pregnancy and fertility.ObjectiveTo investigate the T helper cells type 1 (Th1) /Th2/Th17/Treg paradigms in peripheral blood of infertile PCOS compared with normal fertile women.MethodsPeripheral blood mononuclear cells (PBMCs) were isolated at the late follicular phase from 10 PCOS and 10 fertile women. PBMCs were stimulated with PMA and ionomycin in the presence of Berefeldin A as Golgi stop agent to detect intracellular cytokine production (IFN-γ, IL-17, and IL-4) from CD3+CD4+T cells population indicating T helper (Th) cells subsets by flowcytometry. Moreover, regulatory T cells were enumerated using CD25 and Foxp3 markers.ResultsIn this study, we report that the frequency of Th1 cells was increased compared to Th2 cells in infertile PCOS when considering Th1/Th2 ratio (P=0.05). Analysis of Th17/Th2 ratio showed a significant difference with a bias toward Th17 dominancy in PCOS (P=0.02). The proportion of CD4+CD25+Foxp3+ regulatory T cells was significantly lower in PCOS patients than that of healthy fertile women (P=0.02).ConclusionIn summary, Th1 and Th17 bias and reduction of Treg and Th2 cells as regulators of immune responses might be involved in the pathogenesis of PCOS. These results are suggestive of an altered immune response to inflammatory status in PCOS patients, likely causing some complications such as infertility in these patienKeywords: FlowCytometry, Polycystic Ovary Syndrome, T Helper Cell Subsets}
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Ovarian hyperstimulation syndrome (OHSS) is a serious complication of ovulation induction that usually occurs after gonadotropin stimulation, followed by human chorionic gonadotropin administration, for infertility treatment. The existing knowledge about the pathophysiology, risk factors, and primary and secondary methods for the prevention of OHSS is reviewed in this manuscript. The clinical manifestations and characteristics of mild, moderate, severe, and critical forms of the syndrome are defined. The methods of handling affected cases as outpatient or in-hospital management methods as well as indications for hospitalization are summarized in this review. The clinical and biochemical routes of assessing and monitoring hospitalized patients with OHSS, various drugs and medical treatment strategies including indications for aspiration of the ascitic fluid and pleural effusion, and also rare indications for surgery are briefly explained in this article. Severe OHSS, which two decades ago was considered an iatrogenic life-threatening condition, can now be effectively prevented or managed during the early stages. An OHSS-free clinic can be established nowadays by carefully considering the endocrinology of ovulation and using appropriate and dose-adjusted pharmaceutical agents, which are summarized and discussed in this review.Keywords: Ovarian hyperstimulation syndrome, Pathophysiology, Risk factors, Prevention, Classification, Fertilization in vitro}
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BackgroundY chromosome deletions (YCDs) in azoospermia factor (AZF) region are associated with ab- normal spermatogenesis and may lead to azoospermia or severe oligozoospermia. Assisted reproductive tech- nologies (ART) by intracytoplasmic sperm injection (ICSI) and testicular sperm extraction (TESE) are com- monly required for infertility management of patients carrying YCDs. The aim of this study was to estimate the frequency of YCDs, to find the most frequent variant in infertile men candidate for ART and to compare YCD distribution with a control fertile group. The semen parameters, hormonal profiles and ART outcomes of the infertile group were studied.Materials And MethodsThis case-control study consisted of 97 oligozoospermic or non-obstructive azoospermic (NOA) infertile men, who had undergone ART, as the case group and 100 fertile men as the control group. DNA samples were extracted from blood samples taken from all 197 participants and YCDs were identified by multiplex polymerase chain reaction (PCR) of eight known sequence-tagged sites. The chi-square test was used to compare the mean values of hormone and sperm parameters between the two groups. PResultsNo YCD was detected in the control group. However, 20 out of 97 (20.6%) infertile men had a YCD. AZFc, AZFbc and AZFabc deletions were detected in 15 (75%), four (20%) and one (5%) YCD-positive patients. No fer- tilization or clinical pregnancy was seen following ICSI in this sub-group with YCD. The mean level of FSH was significantly higher in the group with YCD (28.45 ± 22.2 vs. 4.8 ± 3.17 and 10.83 ± 7.23 in YCD-negative patients with and without clinical pregnancy respectively).ConclusionYCD is frequent among NOA men and YCD screening before ART and patient counseling is thus strongly recommended.Keywords: Assisted Reproductive Technologies, Non-obstructive Azoospermia, Y Chromosome Deletion}
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