sedigheh esmaelzadeh

Vitamin D is associated with numerous disorders, including infertility. Accordingly, the goal of this research was to find out the level of vitamin D and messenger RNA (mRNA) expression of vitamin D receptor (VDR) in the sperm of male subjects with unexplained infertility.

Twenty-four unexplained infertile men as the case group and 22 healthy fertile men as the control group were recruited. Vitamin D levels were evaluated in seminal fluid using enzyme-linked immunosorbent assay (ELISA). Afterwards, the swim-up test was performed to isolate motile sperm cells. From these cells, RNA was extracted, complementary DNA (cDNA) was synthesized, and mRNA expression of the VDR gene was evaluated with quantitative real-time polymerase chain reaction (PCR).

A decrease in VDR mRNA expression levels was detected in the case group compared to the control group, but this reduction was not statistically significant (p>0.05). Besides, the level of vitamin D in seminal fluid was not detectable in both groups.

The sperm of unexplained infertile men express VDR gene mRNA, although there was no vitamin D in seminal samples. Hence, vitamin D and VDR signaling might not be effective in the etiopathogenesis of unexplained infertility in men.

Isolated fallopian tube torsion is a rare situation in reproductive-aged women. The gold standard for diagnosis is laparoscopic evaluation, and the treatment of choice is salpingectomy without oophorectomy to preserve fertility. Still, inpatient with a presentation of the acute abdomen or hemodynamically unstable, urgent laparotomy is the treatment of choice. Here, we reported a 15-year-old virgin girl presented with acute abdominal pain and evidence of adnexal torsion on the abdominal ultrasonography. Urgent laparotomy revealed an isolated right fallopian tube torsion. Due to irreversible necrosis of the tube, right salpingectomy was performed. It's crucial to consider isolated fallopian tube torsion as a potential cause of abdominal pain in reproductive-aged women and use appropriate diagnostic measures to diagnose it early and preserve their future fertility.

Infertility is when a couple have been having unprotected regular intercourse for one year without pregnancy. Fallopian tubes play important roles in infertility and are known as curable reasons of infertility. To examine the fallopian tubes, laparoscopy is golden standard test, but HSG (Hysterosalpingography) has been suggested as screening test in clinical evaluations because laparoscopy has side effects. The aim of this study was comparing of Hysterosalpingography with Laparoscopy findings in patients with primary and secondary infertility.
In this study, all patients with infertility referred to Fatemeh Al-Zahra infertility center from 2002 to 2009 whom have been investigated by HSG and then laparoscopy were included. Demographic characteristics and HSG and laparoscopy findings and infertility type were recorded from their files. In order to comparing of each method's findings, data were recorded to 18th version of SPSS software and then get analyzed.
In diagnosis of adhesion around the tubes, the degree of agreement of findings of HSG and Laparoscopy in both patients with primary and secondary infertility was poor. In diagnosis of womb abnormalities, the degrees of agreement of findings of HSG and Laparoscopy in both groups were medium and in diagnosis of womb tube obstruction, degree of agreement in patients with primary infertility was medium and in secondary infertility it was good.
According to findings of this study, HSG findings are reliable in diagnosing womb abnormalities and womb tube obstruction, but not reliable in diagnosing tube side adhesion.

This study evaluated in vitro maturation (IVM) of oocytes in the germinal vesicle (GV) stage in stimulated intracytoplasmic sperm injection (ICSI) cycles. A total of 26 women, aged 18 -37 years, who were candidates for ICSI at the Fatemeh Zahra Infertility and Health Reproductive Research Center in 2007 were recruited for this study. We used the standard long protocol for ovarian stimulation. Follicles >11 mm were punctured 36-38 hours after administration of 10000 IU human chorionic gonadotrophin (hCG). Immature oocytes were cultured for 24-30 hours. Oocytes that liberated polar bodies were injected by sperm prepared within the previous day. IVM fertilized oocytes were cultured an additional 24-30 hours for cleavage. The rates of maturation, fertilization and cleavage in IVM oocytes were recorded and statistically compared to in vivo matured sibling oocytes. There were 279 collected oocytes (mean±SD: 10.73 ± 6.2), of which 4.08±2.79 were subjected to IVM. An average of 2.73 ± 2.15 GV oocytes (70%) developed to metaphase II (MII). Although the maturation rate significantly differed between the IVM and in vivo MII sibling oocyte groups (p=0.027), the numbers of fertilized oocytes (p=0.795) and cleaved embryos (p=0.529) were not significantly high in the in vivo group. Transfer of IVM embryos occurred in only three cases with one pregnancy that resulted in the delivery of a healthy baby. This study shows that culturing GV oocytes can produce acceptable numbers of four-cell embryos on the transfer day. The developmental competence of oocytes is not significantly different between early stage IVM and in vivo sibling embryos.

One of the causes of infertility is due to male factors (Sperm count, sperm motility and morphology). Male factor infertility may be due to disorders in the number of spermatozoa, sperm motility or sperm morphology. Intrauterine insemination (IUI) is routinely used to help couples with male factor infertility. The criteria used to evaluate semen quality include sperm concentration, sperm motility and the percentage of sperm with normal morpho-logy. Several studies have been done on motility and sperm concentration but few studies have been done on sperm morphology. In this study, we evaluated IUI success rates in normal sperm morphologies that were greater or fewer than 5% in the Northern part of Iran (Mazandaran). This analytical study was performed on patients referred to two inferti-lity centers in Babol after ovulation induction. After collecting sperm specimens from the cases, the samples were kept in sterile tubes and then they were washed and swum up before perform-ing IUIs. Sperm concentration, motility and morphology were evaluated according to NAFA and ESHRE-SIGA criteria (2002). Statistical analysis was done by SPSS software using logistic regression, paired t-tests and Fisher’s exact test. A p–value < 0.05 was considered significant. Out of 561 patients, IUIs were successful in 103 (20.2%) patients with normal sperm morphology greater than 5% and in 4 (7.7%) patients with normal sperm morphology fewer than 5%; the difference being statistically significant (p<0.05). In 504 cases with sperm concen-trations greater than 20 million/ml, IUI success rates in subjects with normal sperm morphology greater than 5 % were significantly higher than cases with normal sperm morphology fewer than 5% (21.4:5.6), (p<0.01). In 543 cases with sperm motility greater than 50%, IUI success rates were significantly higher in patients with normal sperm morphology greater than 5% compared to the cases with normal sperm morphology fewer than 5% (20.5:8.3), (p<0.05). It seems that normal sperm morphology >5% is an important and effective factor in IUI outcomes and normal sperm morphology, alongside sperm counts and normal motility, has an essential role in increasing pregnancy rates. Therefore, it is suggested that in addition to sperm counts and motility, evaluations of sperm morphology be included in the work up too.

Multiple factors have been suggested for prediction of pregnancy in Intracytoplasmic sperm injection (ICSI) cycles such as the number of injected oocytes, fertilization rate, embryo morphology and quality of transferred embryos. Predictive value of these factors is important in ICSI outcome.

To evaluate the role of embryo morphology for prediction of pregnancy in ICSI cycles.

This retrospective study was done on 97 patients who were treated by ICSI in Fatemeh Zahra Fertility and Infertility Centre from April 2004 to March 2005. Number of retrieved oocytes, number of injected oocytes, fertilization rate, zygote morphology, rate of cytoplasmic fragmentation, number of four cell transferred embryos, and quality of embryo transfer, as predictors of pregnancy in ICSI cycles were evaluated. The results analysed by T-test, Mann-Whitney U test and Fisher's exact test. Logistic regression was used to estimate the significance of variables in the prediction of pregnancy probability.

Out of 97 patients, 42 cases of pregnancy were detected (Pregnancy rate: 43.3%). The number of four cell transferred embryos was 112 (53.84%) in pregnant group. Pregnancy occurred in 33 (58.9%) patients with at least one good quality zygote. The mean number of four cell transferred embryos and the quality of zygotes had significant difference between pregnant and not pregnant groups (p=0.006 and p=0.000 respectively). In logistic regression analysis, the number of four-cell transferred embryos (p=0.007) and the quality of zygotes (p=0.003) were significant predictors of the pregnancy outcome.

Our results suggest that the number of four-cell transferred embryos with ≤ 15% cytoplasmic fragmentation and zygotes with centralized, apposed and polarized pronuclei in women <38 years old are significant predictors for pregnancy in ICSI cycles.