firoozeh akbari asbagh

This study aimed to measure the correlation of sperm DNA fragmentation with semen parameters, lifestyle, and fertility outcomes after intracytoplasmic injection (ICSI).

The partners who were candidates for ICSI with a history of one In vitro fertilization (IVF) failure or male factor were recruited in the study. Semen parameters including sperm count, motility, and morphology as well as DNA fragmentation index (DFI) (that were divided into 2 groups as high (>15%), and low (≤15%) fragmentation scales) were evaluated either. The correlation of DFI with semen parameters, lifestyle, and clinical pregnancy after ICSI were compared between groups.

In 120 included couples, 59 men (49.2%) had DFIs ≤ 15% and 61 (50.8%) cases had DFIs >15%. In the group with higher DFI, abnormal morphology (p=0.010) was higher whereas, progressive motility (p=0.001), total motility (p<0.001), and total count (p<0.001) of sperm were significantly lower. In addition, the DFI was significantly higher in the subgroup of male infertility (0.012). Logistic regression showed that a lower risk of DFI>15% was associated with higher values of progressive motility (OR=0.97, p=0.001), total motility (OR=0.96, p=<0.001), count (OR=0.96, p=<0.001) and even clinical pregnancy (OR=0.27, p=0.011). However, a history of testicular surgery was associated with a higher risk of DFI>15% (OR=3.37, p=0.046). Although no correlation was found between male age and lifestyle components with DFI, the number of embryos was lower in DFI≥15% (p<0.001).

DFI provide a clinically important measurement of sperm quality and have an impact on IVF outcomes; however, lifestyle components may not correlate with DFI.

COVID-19 can have potential pathogenic effects on the oocyte and embryos, but there is limited data about its impact. This study aimed to investigate the COVID-19 impact on the outcome of Assisted Reproduction Techniques (ART) methods.

This case-control study was conducted on 190 infertile women who underwent oocyte retrieval at Yas Hospital in vitro fertilization (IVF) department affiliated to Tehran University of Medical Sciences, from October 2021 to October 2022. The case group was defined as women whose PCR test was positive on puncture day and the control group was women with COVID-19 negative tests on puncture day. The study outcome measurements included the number of oocytes retrieved and the number and quality of embryos. Finally, the data were analyzed by SPSS 24.

The mean age of the participants was 32.89 ± 5.58 years with an age range of 18-49 years. No significant difference was observed between the two groups regarding baseline variables.  The mean number of oocytes was significantly (p =0.001) lower in the case (6.68±4.25) group versus the control (9.07±4.10) group. While there was no statistically significant difference regarding the mean number of embryos in the study groups, No grade A embryos were observed in more than half (57.5%) of the women in the case group. Furthermore, the frequency of grade C embryos on average was 1.08±1.11 in the case group and 0.57±0.75 in the control group, with a statistically significant difference (p =0.010).

The findings of this research highlighted that women infected with COVID-19 on the puncture day have a lower number of oocytes and also good-quality embryos.

A low progesterone level on the embryo transfer (ET) day significantly reduces the pregnancy rate. Therefore,the present study aims to investigate the effect of adding daily 50 mg intramuscular progesterone to a total of 800mg progesterone suppository on the in vitro fertilization (IVF) success rate in women with low progesterone levels. This parallel open-label clinical trial was performed on 218 IVF candidate infertile womenwho had <9.2 ng/ml progesterone levels on the ET day. These women were randomised to the intervention or controlgroup using the randomisation allocation rule. In the intervention group, 50 mg progesterone was prescribed intramuscularlyonce daily in addition to 400 mg of progesterone suppository every 12 hours from the day of ET. The controlgroup received only 400 mg of progesterone suppositories every 12 hours. In the case of pregnancy, the drugs abovewere continued until 12 weeks after the ET. Clinical pregnancy occurred in 54 (50.0%) women in the intervention group and in 39 (36.8%) women in thecontrol group, which was significantly different (P=0.035). Ongoing pregnancy occurred in 47 (43.5%) women in theintervention group, and 33 (31.1%) women in the control group, which was significantly different (P=0.042). Therewere no significant differences in terms of abortion and multiple pregnancy rates between the two groups. Intramuscular injection of 50 mg progesterone significantly increases the clinical and ongoing pregnancyrates (registration number: IRCT20150105020558N6).

Poor ovarian responder (POR) women, whose ovarian response to gonadotropin stimulation has decreased, are at higher risk of unsuccessful in-vitro fertilization (IVF). Therefore, this study designed to evaluate the effect of intra-ovarian platelet rich plasma (PRP) on POR women.

This single-arm trial research was done on 20 POR women referred to the IVF Unit, university-based hospital, Tehran, Iran between October 2020 and September 2021. For all participants, autologous PRP was injected into each ovary by transvaginal ultrasound guidance under spinal anesthesia between days 12 and 14 of the menstrual cycle. After 12 weeks of PRP injection, embryo transfers were carried out following our routine IVF department protocol. The study outcomes were the number of mature oocytes, and pregnancy rates.

The average age of the participants was 41.80±1.82 yr. The average infertility duration was 9.70±1.89 yrs., with 80% primary infertility type. After PRP injection, follicle-stimulating hormone levels dropped about 1% (P=0.499), anti-Mullerian hormone levels were on average 4.5% higher (P=0.356), and estradiol levels raised by 1.2% (P=0.681). The average number of oocytes and their quality increased after PRP injection, while these changes were not significant (p-value>0.05). Chemical pregnancy was detected in 3 (15%) women and clinical pregnancy was detected only in one person.

This study revealed that PRP injection into ovaries of POR women is safe and had a tendency to improve ovarian reserve markers and serum levels of AMH, estradiol, number and quality of oocytes.

According to previous reports, treatment of infertile women who are candidates for in vitro fertilization (IVF), about 15% of the oocytes remains immature. Therefore, finding an efficient approach to make these types of oocytes usable in the clinic, especially in women with limited oocytes, is necessary. One of these approaches is the laboratory culture of immature oocytes in such a way that the expression of genes involved in cytoplasmic maturation increases.

Forty-eight infertile women candidates for IVF donated their immature oocytes at the time of oocyte retrieval. The obtained immature oocytes were randomly divided into two groups: the control group without in-Vitro culture and the intervention group in the form of 24-hour culture. The total oocytes of both groups (ninety-five immature oocytes) were pooled separately and analyzed by quantitative polymerase chain reaction (q-PCR).

The level of expression of MT-ATP6 and BMP15 genes in the intervention group has a significant increase compared to the control group, with a fold change of 7.867± 3.12 and 6.327 ± 0.78, respectively (P<0.001). Furthermore, according to the morphological changes, 54% of the immature oocytes in the intervention group had resumed meiosis.

Increasing the expression of two cytoplasmic maturation genes, MT-ATP6 and BMP15 can cause the resumption of meiosis in immature oocytes. Therefore, this strategy can be promising in women with low eggs.

Assisted reproductive therapy (ART) has been developed remarkably in these decades; however, the rate of unsuccessful embryo implantation especially in the frozen-thawed embryo transfer (FET) cycles remains high and is reported up to 70%.  The current study was designed to compare the effect of intramuscular injection of hCG on endometrium preparation and embryo implantation, in women undergoing FET compared to the control group.

This clinical trial was done on 140 infertile women that underwent FET. The study sample was randomly allocated to the intervention group (two 5000 unit ampoules of hCG were injected intramuscularly before the first dose of progesterone administration) and the control group (without hCG injection). In both groups, 4 days after progesterone administration, the cleavage stage embryos were transferred. The study outcomes were biochemical pregnancy, clinical pregnancy and abortion rate.

The average age of intervention and control group was 32.65±6.05 and 33.11±5.36 years, respectively. The basic information between two study groups did not differ significantly. The chemical (30% vs. 17.1%, P=0.073, relative risk (RR)=0.57) and clinical (28.6% vs. 14.3%, P=0.039, RR=0.50) pregnancy rates were higher in the intervention group compared to the control group; these higher ratios were only significant in clinical pregnancy rate. Abortion rate was not significantly (P=0.620) different between the intervention and control groups (4.3% vs. 1.4%, respectively).

This study showed that intramuscular injection of 10000 IU hCG before the endometrial secretory transformation phase in cleavage-stage embryo, improves IVF cycle outcomes.

To evaluate the in vitro fertilization success rate by transferring top- versus low-quality embryos.

This prospective cohort study was conducted on 199 infertile women. Ninety-nine patients underwent an agonist cycle (70 fresh embryo transfer [ET] and 29 frozen ET), and 100 patients received an antagonist cycle (28 fresh ET and 72 frozen ET) in the infertility department of a tertiary university-based hospital between May 2019 and March 2020. The blastocysts classified as AA, AB, and BB, as well as AC, BC, and CC were considered as top- and poor-quality embryos (TQE and PQE). The study outcomes were biochemical and clinical and determined the rate of pregnancy.

The average age of the participants was 32.44±5.25 years old. Women with TQE were significantly younger than those with PQE (31.35±4.97 vs. 34.09±5.27, P<0.001). In addition, the duration of women’s infertility was significantly (P<0.001) correlated with the embryo’s top quality. A positive β-human chorionic gonadotropin was detected in 12.6% (n=25) of women while clinical pregnancy was investigated in 8% (n=16) of them. The fetal heart rate was detected in 7.5% (n=15). Eventually, the clinical (P=0.020) and determined (P=0.030) pregnancy rates significantly differed between two study groups with a higher level in the TQE group.

It seems that TQP transfer should be the first recommendation for infertile women, but when the double-embryo transfer (DET) is needed according to the patient’s condition, she should be informed that the quality of the second embryo may have an adverse impact on pregnancy consequences.

The common causes of infertility in women with endometriosis are folliculogenesis alternation, steroidogenesis and fertilization impairment, oocyte and embryo quality reduction, and implantation defect.

To compare in vitro fertilization (IVF) cycle success rates of women with endometriosis who were treated with letrozole + gonadotropin (LA) vs. placebo + gonadotropin (PA).

This double-blind, randomized clinical trial study was conducted with 94 infertile women with endometriosis (47 in the LA group and 47 in the PA group) who were candidates for IVF, from April-June 2021. For all participants, the long agonist protocol was applied. In both groups, gonadotropin-releasing hormone agonist was prescribed in the mid-luteal stage and from the third day of the cycle, and gonadotropin was started and its doses were regulated based on the patient’s age, serum anti-Mullerian hormone and follicle-stimulating hormone. From the third day of the menstrual cycle, 5 mg of letrozole daily for 5 days prescribed for LA group, while placebo prescribed for PA on the identical days and duration. After embryo transfer, biochemical and clinical pregnancy were measured in the 2 groups.

The gonadotropin dosage (p < 0.01) and estradiol level (p = 0.02) on the human chorionic gonadotropin administration day were significantly lower in the LA group compared with in the PA group. Fetus transfer was done for 32 women. No significant differences were detected between the study groups regarding biochemical or clinical pregnancy (p = 0.72 for both).

Letrozole as a co-treatment drug in the IVF cycle of women with endometriosis can significantly reduce the gonadotropin dosage and estradiol level with the same pregnancy rates.

Adverse effects of air pollution on human health has been identified as a major concern worldwide. We conducted this study to investigate the association between prenatal exposure to ambient air pollution and Low Birth Weight (LBW) and preterm among newborns in the megacity of Tehran.

This cross-sectional study was carried out on 1605 newborns. Data on the residential locations of mothers were collected from birth certificates. To estimate the prenatal exposure to air pollutants, data of 21 air quality monitoring stations in Tehran were used. The Man-Whitney test was used to estimate the association between exposure to ambient air pollution and LBW and preterm.

The mean birth weight in our analyses was 3117 g. A significant association was found between maternal exposure to particulate matter less than 2.5 µm (PM2.5) in the first trimester and incidence of preterm (p=0.011) and LBW (p=0.003) in newborns. Also, a close association was observed between exposure to Carbon Monoxide (CO) in the first and second trimesters and LBW (p=0.002, p=0.015). There were no statistically significant associations in LBW in the case of Particulate Matter less than 10 µm (PM10), Sulfur Dioxide (SO2), and Ozone (O3).

The results revealed that the higher risk for LBW was related to ambient PM2.5 and CO. Since many factors may affect LBW, and the pathogenic mechanisms of the effect of air pollution on LBW have not been completely elucidated, the findings should be interpreted with caution and further studies need to be conducted on this issue considering the large sample size

Ectopic pregnancy (EP) is considered a main reproductive health challenge. According to the side effects of using methotrexate (MTX), it is rational to find safer drugs in the management of EP. This randomized controlled trial aimed to evaluate the efficacy and safety of adding letrozole to the single-dose MTX in the management of EPs. This study was conducted in an academic hospital affiliated to Tehran University of Medical Sciences. Women with EP and stable vital signs with β-hCG levels ≤3500 were assigned randomly to receive MTX + placebo or MTX + letrozole. The regression pattern of β-hCG, need for further surgery, and potential side effects were compared between groups. A total of 90 women were assigned equally to the study groups and were matched in age, body mass index (BMI), serum biochemistry, and primary levels of β-hCG. No drug-related side effects were observed in groups. The rates of further surgery (p = 0.614) and second dose of MTX (p = 0.809) were not significant between groups. In the MTX + placebo group, we observed a minor increase in β-hCG levels on day 4 followed by a decreasing pattern on days 7 and 14. But, in MTX + letrozole group, a decreasing pattern in β-hCG levels from day 1 through day 14 was perceived. The results support using MTX + letrozole to treat stable women diagnosed with tubal EP as a safe and efficient method. Further studies are required to evaluate letrozole alone as an alternative therapy in EPs.

Infertility presents extensive psychological effects on infertile couple’s marital life, especially in women during infertility treatment. Studying the essential psychological factors and their correlations on a large scale could rehabilitate the mental health of infertile women and facilitate the stressful process of infertility treatment. This systematic review aimed to study the literature and relationships among self-compassion, positive and negative affect, and marital quality in infertile women.

To examine the considered association, a comprehensive literature search was performed to identify relevant articles in English and Persian published from 2000 to May 2020 and indexed in Pubmed, Google Scholar, Scopus, Science Direct, Jstore, Cochrane Library, Medline, SID, Irandoc, Civilica, and Magiran. The study eligibility criteria included only infertile couples/women who were clinically diagnosed with infertility. The measurement tools used by studies consisted of at least one of the following: Self-Compassion Scale (SCS); Positive and Negative Affect Schedule (PANAS); Revised Dyadic Adjustment Scale (RDAS), and infertility-related questionnaires. The search strategy of this review was per PICO (Population, Intervention, Control, and Outcomes) and included the terms Self-Compassion (SC), Positive and Negative Affect (PANA), and Marital Quality (MQ) in infertile women. To identify further eligible studies, the bibliographies of primary articles were manually searched to meet the inclusion criteria. The quality of studies was graded by GRADE from the Cochrane handbook. The studies were investigated concerning design, risk of bias, inconsistency, indirectness, imprecision, and publication.

SC could play a mediating role in the relationship with PANA, and MQ in infertile women undergoing infertility treatment.

This systematic review highlighted the importance of addressing psychological characteristics which can affect the biopsychological health of infertile women undergoing infertility treatment.

Vitamin D deficiency and infertility are two important health problems in Iran. Some studies suggest that vitamin D may influence Anti-Müllerian hormone (AMH) and antral follicle count (AFC) as an ovarian reserve.

The present study aimed to investigate the impact of vitamin D on AMH serum concentrations/AFC.

three hundred and five infertile women referred to the IVF Unit of Yas hospital, between July and December 2017, were enrolled in this cross-sectional study. The demographic characteristics of the participants, as well as the serum levels of vitamin D, AMH, and ultrasonic examination of AFC were recorded.

Finally, 287 infertile women were included in the analysis with a mean age of 29.95 ± 4.73 yr (18-45 yr) and a mean Body mass indexof 25.11 ± 4.41 kg/m2. The median AMH and vitamin D levels were 3.20 and 22.82 ng/ml, respectively. Considering the cut-off level of 20 ng/ml, 58.7% were vitamin D deficient. Regression analysis showed no association between AMH and vitamin D levels (p = 0.161), even after adjusting for baseline variables (p = 0.182). A total of 120 patients had an AFC < 6 and 164 ≥ 6, which was not statistically different between the groups with normal level or deficient vitamin D (p = 0.133).

The present cross-sectional study showed no significant association between serum levels of vitamin D and AMH or AFC in infertile women, even after adjusting for baseline variables.

In vitro fertilization (IVF)success depends on many factors whose independent roles have not been fully investigated. The aim of this study was to evaluate the role of associated factors in women undergoing IVF in Iran.
In a prospective cohort study, 160 women who referred to infertility center of Moheb-Yas hospital for IVF between March 2015 and March 2016 were enrolled. A long ovarian stimulation protocol was administered using a gonadotropin-releasing hormone agonist (GnRH). Anti-Mullerian hormone (AMH), progesterone, estradiol, and endometrial thickness were measured. Two expert embryologists categorized blastocysts as good or poor. Pregnancy was judged by serum human chorionic gonadotropin measurement 14–15 days after embryo transfer. Mean age of the cases was 32 years and mean body mass index (BMI) was 20 kg/m2. Clinical pregnancy rate was 20.6%. A significant relationship was found between IVF success and AMH, the number of FSH injections, endometrial thickness, grade of the embryos, and the number of embryos produced. Logistic regression analysis showed that only AMH > 0.6 was an independent predictor of IVF success (odds ratio [OR] = 6.22, CI [2.4-16.2]). Further analysis showed a significant relationship between AMH level and IVF success in women ≤35.
The overall success rate of IVF/ET was 20.6%. AMH is a significant predictor of IVF success and may be an important factor in IVF success in young women.

Almost 50% of infertilities are associated with males and among them 30to 50% are idiopathic. Empirical treatments are used in idiopathic male infertility, yet not enough scientific evidence is available for the application of such remedies. date palm pollen (DPP) is one of the drugs suggested for such patients in Iranian traditional medicine (ITM).
This study was performed on a 35-year-old male patient with idiopathic infertility. He previously had severe oligoasthenoteratozoospermia and was under medical supervision at Yas hospital of the Tehran University of Medical Sciences from August 2016 to February 2017, where he was treated with DPP at a dose of 3 g twice daily, for three months. The second semen analysis was carried out after a quarter of the treatment period, followed by re-analyses after one and three months of finalizing the treatment period. The results obtained showed impressive improvement in the quality of semen parameters. Within six months, the initial values of normal morphology (1%), total motility (3%), progressive motility (0.0), and sperm concentration (0.1 million) increased to 20%, 60%, 10%, and 10 million, respectively.
The results of this study indicate that the drug may be operative in improving semen parameters in such patients, and more clinical studies are required in this regard.

Infertility is defined as failure to achieve pregnancy after one year of unprotected sexual intercourse. Infertility can be related to male or female factors. Varicocele is the most common cause of infertility in men that is correctable with surgery. The purpose of this study was to determine the effects of recombinant follicle-stimulating hormone (rFSH) on semen parameters in infertile men. This randomized clinical trial was done on 96 infertile men admitted to the Women's General Hospital Mohebe-Yas from September 2014 to September 2015. Inclusion criteria were to include varicocelectomy for unilateral idiopathic varicoceles and consent to participate in the study. Allergy to the drug combination and patient dissatisfaction were exclusion criteria. Patients participating in the study were divided into two groups randomly, one group received recombinant FSH three times a week and the other group received a placebo (normal saline) in the same way. After three months, the improvement of semen parameters, including motility, morphology and sperm count as well as the complications were determined in both groups. The data were analyzed with statistical software SPSS version 13 (Chicago, IL, USA). A total of 96 patients were enrolled in two groups of 48 men and women; both groups were matched in terms of underlying factors. The rate of improvement in the morphology and motility of sperm in the treated group was significantly more than the placebo group (P= 0.0001); but the changes in sperm count were not significantly different between the groups (P= 0.495). In summary, based on the results obtained in this study, it can be concluded that recombinant FSH is effective on improving semen parameters in infertile men after varicocelectomy compared with a placebo group and its major impact is on the morphology and motility of sperm.

Ovarian pregnancy is a rare form of extra uterine pregnancy. Serous cyst adenoma is a benign variant of epithelial cell tumors of ovary. The coexistence of a cyst adenoma with an ovarian pregnancy in the same ovary is extremely rare. Some studies suggested that infertility or ovulation-inducing drugs can be involved in increased risk of ovarian tumors and ovarian pregnancies. A 28-year-old infertile woman presented with a ruptured ovarian pregnancy following ovulation induction with metformin. She had a concurrent benign serous cyst adenoma in the same ovary. Resection of both ovarian pregnancy and tumoral mass were performed. The ovary was preserved. Removal of gestational tissue and preservation of the involved ovary are the best options for management of ovarian pregnancy in young patient. Although there is an association between infertility/ovulation inducting medications and ovarian gestation, their connections with serous cyst adenoma are undetermined.

Intracytoplasmic sperm injection (ICSI) has revolutionized the treatment of azoospermic men. The aim of this study was to evaluate the factors interfering in the success of ICSI, including sperm collection method, testicular histology, age and hormonal assay of the couple, the number of retrieved oocytes, and the number of transferred embryos. In this retrospective cohort study, 246 azoospemic men (52 with obstructive azoosprmia (OA) and 194 with non obstructive azoospermia (NOA)) who were underwent sperm retrieval with PESA or TESE and ICSI protocol were studied. By long protocol of ovarian stimulation, oocytes were retrieved 36h after hCG administration. After 48h, cleaved embryos were replaced in the uterine cavity. Clinical pregnancy rates (21.1% in OA versus 10.8% in NOA) was significantly correlated with sperm origin (P<0.05). Female partner’s age and serum FSH significantly influenced pregnancy rates in both groups (p<0.001) and also pregnancy rates was significantly influenced by number of retrieved oocytes and transferred embryos in NOA groups (P<0.05). ICSI can make a chance for fertility in azoospermic men. Higher success rates in OA patients can be related to better quality of sperm. The value of male hormonal assay and testicular biopsy was not remarkable.

Premature ovarian failure (POF) affects 1% of young women. This condition has significant psychological sequelae and major health implications. POF seriously interferes with fertility and family planning. Diverse etiologies are associated with POF. Literature review related to the causes and pathogenesis of POF, cited between the year 1900 and May 2010. POF may be either spontaneous or induced. The known causes include: - Genetic disorders, which could involve the X chromosome or autosomes. However, the growing body of literature demonstrates a list of newly discovered mutations that may be responsible for causing POF. Most of these mutations are extremely rare, and most cases of POF are still considered to be idiopathic. - Autoimmune causes; there is some evidence of an association of POF with lymphocytic oophoritis and other autoimmune disorders. Antiovarian antibodies are reported in POF, but their specificity and pathogenic role are obscure. - Iatrogenic causes; chemotherapy, radiotherapy and pelvic surgery can lead to POF. - Infectious Causes; some viral and microbial infections can be followed by POF. - Environmental toxins, such as cigarette smoking are reported as risk factors of spontaneous POF. - Idiopathic; in most cases, no identifiable etiology can be recognized after complete evaluation.

Controlled ovarian hyperstimulation and intrauterine insemination (IUI) cycle is an ideal protocol for some subfertile patients. So, we decided to try this therapeutic protocol for the patients with unilateral tubal blockage diagnosed by hysterosalpingography (HSG).

To evaluate the effect of unilateral tubal blockage diagnosed by HSG on cumulative pregnancy rate (CPR) of the stimulated IUI cycles.

A cross-sectional analysis was performed between October 2006 and October 2009 in an academic reproductive endocrinology and infertility center. Two groups of patients undergoing stimulated IUI cycles were compared. Sixty-four infertile couples with unilateral tubal blockage diagnosed by HSG as the sole cause of infertility in the group (?), and two hundred couples with unexplained infertility in the group (II). The patients underwent 3 consecutive ovarian hyperstimulation (Clomiphen citrate and human menopausal gonadotropin) and IUI cycles. The main outcome measurements were the CPRs per patients for 3 consecutive stimulated IUI cycles.

Cycle characteristics were found to be homogenous between the both groups. CPRs were similar in group? (26.6%) and group II (28%) (p=0.87; OR=1.075; 95% CI: 0.57 -2.28).

Unilateral tubal blockage (diagnosed on HSG) has no effect on success rate of stimulated IUI cycles, so COH and IUI could be recommended as the initial therapeutic protocol in these patients.

Premature ovarian failure (POF) is a common condition; its incidence is estimated to be as great as 1 in 100 by the age of 40 years. Physiologic replacement of ovarian steroid hormones seems rational until the age of normal menopause. Temporary return of ovarian function and pregnancy may occur rarely in women with POF. We report a case of POF who conceived during hormone replacement therapy.

Case:

 A 30 years-old woman with confirmed POF after pelvic surgery and sever emotional stress conceived spontaneously.

Return of ovarian function and achievement of pregnancy is possible in women with POF.

To assess the efficacy of luteal phase support (LPS) with vaginal progesterone (P) on pregnancy rates of the stimulated intrauterine insemination (IUI) cycles in couples with unexplained infertility (UEI). This was a single-center, prospective, randomized, blinded control trial undertaken at a tertiary care university fertility center between October 2007 and December 2008. A total of 200 couples with UEI underwent 511 consecutive stimulated IUI cycles. Clomiphene citrate (Cc) and human menopausal gonadotropin (hMG) were used for ovulation induction. After IUI, patients were randomized into two groups. The study group (n=98) received intra-vaginal P (Cyclogest) for LPS. The patients randomized into the control group (n=102) received no drug for LPS. The main outcome was the comparison of clinical pregnancy rate (PR) and live birth rate (BR) per cycle and patient between the control and study groups. There were no differences in demographic characteristics between the groups. PR per patient and cycle were similar in the study group (30.6% and 11.5%, respectively) and in the control group [25.5% and 10.03%, respectively] (p>0.05). There were no statistically significant increases in BR per patient and cycle between the study group (19.4% and 7.5%, respectively) and the control group [14.7% and 5.7%, respectively] (p> 0.05). Administration of vaginal P (Cyclogest) for LPS does not improve the reproductive outcome of stimulated IUI cycles (Registeration Number: IRCT1389 01283737N1).

Insulin resistance is common in women with Polycystic Ovary Syndrome and can cause poor outcome of infertility treatment. The aim of our study was to assess the effect of treatment with metformin on outcome of Intra Cytoplasmic Sperm Injection in infertile PCOS women. A randomized clinical trial study was carried out in infertile women with PCOS, before ICSI, referred to infertility clinic of Mirza Koochackhan Hospital, Tehran, Iran, between 2006 and 2008. The patients were randomized in two groups of metformin 500 mg Po, three times daily, six weeks before the ICSI cycle and placebo patients in each group were divided into BMI <28 kg/m2 and BMI ≥28 kg/m2

In spite of their key role in various immunological processes occurring in the endometrium, T cells- especially ab+ subtype- residing in this mucosal tissue, have not been extensively explored. We present here the profile of expressed genes for variable region of b chain of T cell receptor (TCR) in normal endometrium as compared to peripheral blood. Samples from endometrium were taken from normal fertile women during routine check-up by Pipelle pipette or after hysterectomy operation. Total RNA from both blood and endometrial samples was extracted and RT-PCR using BV gene specific primers was performed. After southern blotting, hybridization with radiolabelled specific probe and autoradiography, relative expression of each BV family was determined. Clonal expansions of the over-expressed genes were studied by determining their CDR3 length polymorphism. A total of 12 blood and 14 endometrial samples were collected. Only one TCRBV gene (TCRBV7) was expressed significantly more and 3 genes less frequently in the endometrium compared to blood. Also, two other genes (TCRBV10 and 12) were found marginally more frequent in the endometrium. As for their clonality, all 3 TCRBV genes examined here showed a rather restricted (oligoclonal) and in some cases, very restricted (probably monoclonal) pattern in the endometrium in contrast to polyclonal patterns in the blood. Our results indicate the similarities between T cells residing in different mucosal tissues and support their common recruitment and functional potentials. Moreover, our findings provide a basis for future investigations about endometrial T cell involvement and their antigen specificities in different gynecological problems.