International Journal Of Fertility and Sterility
Volume:17 Issue: 3, Jul-Sep 2023

Infertility due to the male factor is one of the major problems of infertile couples. One of the factors contributing tomale infertility could be the herpes simplex virus (HSV). The aim of this systematic review was to evaluate the impactof HSV on semen parameters. This systematic review was performed according to the Preferred Reporting Items forSystematic reviews and Meta-Analyses (PRISMA). Different English and Persian databases including Web of Science,PubMed, Scopus, Cochrane Library, EMBASE, ProQuest as well as SID, Magiran and Iranmedex were searchedby two researchers, independently, without time limit until April 15, 2022. Observational studies that reported therelationship between HSV and semen parameters in men with idiopathic infertility were included in this review. TheNewcastle-Ottawa Quality Assessment Scale was used for quality assessment of the included studies. Out of 356retrieved articles, 12 observational studies comprising a total of 1460 patients were reviewed. Four studies examinedthe effect of HSV1 virus, two studies examined the effect of HSV2 virus and five studies examined the effect of bothviruses on semen parameters. Seven studies reported at least one significant association between HSV infection andsemen parameters. Sperm count and sperm motility were semen parameters further affected by the virus. In conclusion,HSV can be one of the risk factors for male infertility and it can affect semen parameters. However, due to thedearth of studies, further research with more robust designs are recommended.

Infertility is a serious health issue in the world affecting approximately 8-10% of couples worldwide. The meta-analysisstudy was performed to assess the prevalence and etiologic factors associated with infertility in Iran. We made surethat the implementation of study and reporting the results were consistent with the MOOSE and PRISMA guidelines,respectively. All stages of the research were conducted by two authors, and the disagreement at each stage of the researchwas resolved by consensus. On January 1, 2020, we started a detailed literature search on international onlinedatabases, and Iranian Online databases, as well as specialized journals, several authentic international publishers andGoogle Scholar. We reviewed the reference list of identified articles for missed articles and then searched online forthem. Data analysis was performed to estimate the prevalence using a random effects model. The lifetime infertilityprevalence was found to be 11.3% [95% confidence interval (CI): 8.6-14.7] and the current infertility was evaluated tobe 3.7% (95% CI: 3.2-4.3). The prevalence of primary infertility (based on 45 articles consisting of 51,021 samples)as well as secondary infertility (based on 13 articles consisting of 35,683 samples) in Iran were estimated to be 18.3%(95% CI: 15.4-21.6) and 2.5% (95% CI: 1.6-4.0), respectively. The prevalence of female, male, both and unexplainedcauses was estimated to be 32.0% (95% CI: 27.6-36.8), 43.3% (95% CI: 38.2-48.6), 12.5% (95% CI: 9.6-16.2) and13.6% (95% CI: 10.2-17.8), respectively. The prevalence of causes related to ovulation, uterine tubes, and endometriosisin infertile women was estimated to be 54.0% (95% CI: 45.6-62.2), 15.5% (95% CI: 11.3-21.0), 6.2% (95%CI: 3.5-10.6), and 5.4% (95% CI: 2.5-11.3), respectively. In summary, the estimate of infertility burden in Iran didnot change between 1990 and 2017 and its prevalence remains high. This research presents a unified and up-to-dateoverview regarding the burden of infertility in Iran.

Infertility is a stressful condition that can lead to either emotional disturbance or personal growth. Maritalrelationship is one of the factors affecting the consequences of infertility. This study aimed to explore the role ofmarital relationship quality in development of women's personal growth after experiencing infertility. In the cross-sectional study, 122 infertile women (mean age 28.79 ± 6.3) were invited tocomplete the survey, including ENRICH Marital Satisfaction Scale, Posttraumatic Growth, Fertility problem inventory,State-Trait Anxiety Inventory, and Beck Inventory Depression. Higher scores of quality of marital relationships were a protective factor against infertility stress and state/trait anxiety. Additionally, infertility stress was a strong negative predictor of personal growth. Furthermore, infertilewomen with a high level of marital relationships may have more chances to experience personal growth rather thanstress in infertility treatments. The study suggests that high quality of marital relationships may provide positive opportunities for women’spersonal growth after experiencing infertility.

To detect the predictive value of beta human chorionic gonadotropin (β-hCG) levels 16 days postembryo transfer (ET) regarding detection of an ectopic pregnancy (EP) in assisted reproductive technology(ART) cycles.

In this cross-sectional study, we reviewed the database of Royan Institute from January2011 to December 2014 and from January 2017 to December 2019 retrospectively. All cases with positive β-hCGlevels sixteen days after ET were screened (n=4149). The pregnancies with oocyte or embryo donation and the multiplepregnancies based on the first ultrasound were excluded. All eligible singleton pregnancies with documentedserum β-hCG levels at Royan institute laboratory (n=765) were included and then classified according to the typeof pregnancy: EP (n=189) or non-EP (n=576). The data of the treatment cycle was extracted from the patients’ files.A receiver operating characteristic (ROC) curve was used to detect the predictive power of the first measurementof β-hCG level in distinguishing EP from ongoing pregnancy in the ART and intrauterine insemination (IUI) cyclesseparately. Sensitivity, specificity, area under the ROC curve and 95% confidence intervals (CI) were calculated foreach of the estimates.

The mean levels of β-hCG 16 days after ET were remarkably higher in the ongoing pregnancy group thanthe EP group (1592.35 ± 87 IU/L vs. 369.69 ± 50.61 IU/L, P<0.001). The β-hCG thresholds predictive of ongoingpregnancy were 278 IU/L as the most suitable cut-off to predict viable pregnancy with a sensitivity of 72.8%, aspecificity of 67.5%, a positive predictive value of 77.8%, standard error of 0.02, and a confidence interval of 73.8-81.7%. However, this relationship was not found in IUI cycles.

Based on these findings, if β-hCG levels 16 days after ET are below 278 IU/l, close follow-up is recommended,until either the diagnosis of EP or miscarriage is established.

This study aimed to determine whether syzygium aromaticum (clove) could help polycystic ovarysyndrome (PCOS) rats. In this experimental study, forty adult female Wistar rats (weighing 250 ± 10 g) were dividedrandomly into five groups; G1: control, G2: PCOS group, G3: PCOS+clove (30 mg/kg/ orally/daily) group, G4:PCOS+clove (60 mg/kg/orally/daily) group, and G5: PCOS+gonadectomy group. The PCOS was induced by a singledose injection of estradiol valerate (16 mg/kg/IM). Following PCOS induction, the rats were treated for 14 days. Histologicalparameters, follicle apoptosis, mRNA expression of autophagy markers (Lc3, Beclin1), oxidative stress markers,insulin and blood glucose levels, as well as serum levels of aromatase and testosterone were evaluated in these rats.Finally, the ratio of serum luteinizing hormone (LH) to follicle-stimulating hormone (FSH) levels was also calculated. The autophagy markers (Lc3, Beclin1), histological parameters, oxidative stress, insulin, and hormone levelschanged significantly in the PCOS rats (G2). In G3 and G5 groups, it was observed that the levels of LH/FSH and testosteronedecreased significantly in comparison to the PCOS group, and inhibition of autophagy was also observed inthese groups. Treatment with cloves in the G3 group significantly improved oxidative stress, histological parameters,and insulin levels. These findings demonstrated that oxidative stress, apoptosis, and excessive autophagy could be improvedby treatment with low doses of clove and gonadectomy. Cloves may help to improve these parameters by regulating andinhibiting excessive autophagy. However, discovering the direct role of this extract in regulating the parameters suchas oxidative stress, insulin, and androgens requires further investigation. In the present study, P<0.05 was consideredstatistically significant.

Timing of frozen embryo transfer (FET) within a purported window of implantation is of increasing interest,and there is a paucity of evidence surrounding the transfer of frozen embryos early within these frozen embryo transferprotocols. This study aimed to evaluate whether live birth rates were equivalent after FET of blastocysts 4 days afterluteinizing hormone (LH) surge in a true natural cycle protocol, compared to a hormone replacement (HR) protocol. Single-centre, retrospective cohort study involving patients undergoing autologous frozenblastocyst transfer from January 1st, 2013, to December 31st, 2016. Cycles were grouped according to their protocol:true natural cycle (hormonal detection of LH surge with FET scheduled four days later) versus HR cycle (lutealphase gonadotropin-releasing hormone agonist suppression, oral or vaginal estradiol and intramuscular progesteronestarting five days before FET). A total of 850 cycles were included, 501 true natural cycles and 349 HR cycles. Theprimary outcome was the live birth rate, secondary outcomes included clinical pregnancy rate and miscarriage. Logbinomialregression models were performed adjusting for a priori selected variables. Adjusted resulted in live birth rates of 38.7 and 40.4%, [adjusted risk ratio (aRR): 0.96, 95% confidence interval(CI): 0.76-1.22, P=0.729] in the natural cycle and HR groups, respectively. The secondary outcome analyses didnot demonstrate any statistically significant difference in the rate of positive human chorionic gonadotropin (hCG),clinical intrauterine pregnancy rate, or miscarriage rate. The timing of the FET four days after LH surge in a true natural cycle protocol results in equivalent livebirth rates compared to a HR protocol. Results of this study suggest that the window of implantation within the naturalcycle may be less finite than currently believed and further prospective studies evaluating the timing of frozen embryotransfer are warranted.

Accumulating evidences suggest that date palm pollen (DPP) induces antioxidant activity and improvessemen parameters in male rats. However, there is a few scientific evidences in support of the DPP effects on humanmale fertility. Hence, the effect of oral consumption of DPP on sperm parameters and expression pattern of Peroxiredoxin-1 (PRDX1) and Peroxiredoxin-6 (PRDX6) genes was evaluated in men with infertility. The current controlled clinical trial included 40 men with infertility (DPP group) and 10 normospermicfertile men as controls. The DPP group received gelatinous capsules of DPP (400 mg/kg) for 74 days. Semensampling was done before and after treatment in the both groups. Semen analysis and 8-isoprostane concentration assessmentswere performed by computer-assisted sperm analysis and ELISA methods, respectively. Quantitative reverse transcriptionpolymerase chain reaction (qRT-PCR) assays were employed to explore expression of PRDX1 and PRDX6 genes. DPP consumption significantly improved semen volume (P=0.030), count (P<0.001) and morphology ofsperm (P=0.023). Concentration of 8-isoprostane was significantly decreased after intervention in the DPP group(P<0.001). DPP consumption led to a significant elevation in the expression of PRDX1 and PRDX6 genes (P<0.001).Elevated gene expression of PRDX6 and PRDX1 was positively correlated with improved parameters of sperm includingcount, volume, motility and morphology. Taken together, DPP seems to promote sperm quality through a decrease in reactive oxygen species(ROS) by increasing expression of antioxidant genes. Further large-scale studies are required to challenge this hypothesis(registration number: IRCT2015021221014N2)

Semen hyperviscosity is a threatening cause of abnormal spermatozoa and infertility in men. We aimedto evaluate oxidative stress, antioxidants depletion and sperm apoptosis as main reasons for poor quality of spermatozoain men with hyperviscous semen.

In this cross-sectional study, ejaculate specimens were collected from fertile (n=102) andinfertile men with hyperviscous semen (n=123) and without semen hyperviscosity (n=143). Total antioxidant capacity(TAC), glutathione (GSH), malondialdehyde (MDA), protein carbonyl (PC), 8-hydroxydeoxyguanosine (8-OHdG),and were measured in semen samples to estimate oxidative stress status. Gene expression pattern of BAX, CASPASE-9,CASPASE-3, and BCL2 was assessed to estimate sperm apoptosis.

The average of sperm count, normal morphology, normal motility, and sperm vitality in men with hyperviscoussemen was significantly lower than infertile subjects without hyperviscous semen (P<0.01). Men with hyperviscous semenexhibited higher levels of PC (8.34 ± 1.03 nmol/mg vs. 6.01 ± 0.93 nmol/mg, P=0.008), MDA (1.14 ± 0.27 nmol/ml vs. 0.89 ± 0.22 nmol/ml, P=0.031), 8-OHdG (259.71 ± 24.59 ng/ml vs. 197.13 ± 18.47 ng/ml, P=0.009), but lowerTAC contents (1250.44 ± 66.23 μM/L vs. 1784.31 ± 89.87 μM/L, P=0.018) and GSH (3.82 ± 1.05 μM vs. 5.89 ± 0.87μM, P=0.021) than men with non-viscous semen. The expression of BAX, CASPASE-3 and CASPASE-9 genes in menwith hyperviscous semen was significantly increased by 1.39-fold (P=0.041), 1.47-fold (P=0.046), 1.29-fold (P=0.048),respectively, as compared with the infertile subjects without hyperviscous semen. However, BCL2 expression in infertilemen without hyperviscous semen was higher compared to those with hyperviscous semen (1.36-fold, P=0.044).

Hyperviscous semen is markedly associated with depletion of seminal plasma antioxidants, sperm membranelipid peroxidation, DNA and protein oxidation, and sperm apoptosis. Antioxidant therapy might be considered as avaluable strategy to protect sperm cells against oxidative damage in cases with seminal fluid hyperviscosity.

Ring chromosomes are the result of breakage and re-union of distal ends of chromosomal arms. They have a generalfrequency of 1 in 50,000 and 1 in 58,000 for chromosome 13. Ring chromosome 13 is usually presented as a syndromicsituation stigmatized by particular features, including developmental delay, mental retardation and CNS, skeletalor organ anomalies. As an experimental study, here we report a 31 years old male with no major phenotypic manifestationwho was evaluated for azoospermia, while his karyotype revealed presence of a mosaic ring chromosome 13. Hehad a history of bilateral varicocelectomy and no other major finding in his routine infertility work up was determined.Genetic counseling did not provide any clue for mental disability or dysmorphic features. Pathology examination ofthe testicular tissue revealed very scarce number of spermatid/spermatozoa within the tubules in conjunction withdegrees of maturation arrest mostly in spermatocyte stage. In our knowledge, this is the first report of a ring chromosome13, manifested by an isolated male infertility.