International Journal of Reproductive BioMedicine
Volume:6 Issue: 4, Mar 2008

With the technical development, ultrasound tends to overpass its limits and to become the main investigation tool even for situations when it was traditionally considered “second best”. It is more convenient both for patient and doctor, less expensive and has real diagnostic value.

The present paper, and its graphic back-up, are intended as a visual testimony of the fact that the newer three dimensional (3D) ultrasound technique is much more than a simple generator of “nice”, commercial, images. Moreover, its use may be extended from obstetrics to gynecological pathology, especially in cases related to infertility.

We performed a review of the main local infertility causes and their perception by the 3D ultrasound, as compared to the conventional methods. General literature citations were completed with personal cases and images. In our research, we used a Kretz – Voluson Expert 730 ultrasound machine with a full logistic equipment. Our database was completed over a period of 18 months and included various pathology, such as uterine anomalies, fibroids, polyps, ovarian cysts and many others.

Three dimensional ultrasound represents the best tool in evaluating the uterine cavity, the endometrium, assessing its volume and vascularity pattern. It also offers a very good image of the uterine structure, the adnexal morphology and their relationship. It performs a thorough pelvic assessment by a single examination. Moreover, it may realize a histerosalpingography, which is as efficient as the radiological method, but easier and with fewer side effects.

Even though it is technically more difficult and time consuming, a good practice and high quality ultrasound equipment offer a series of benefits over any other kind of investigation.

Gonadotropin releasing hormone conjugate (GnRH-BSA) raises antibodies against biologically active gonadotropin releasing hormone (GnRH) which affects body weight, gonadosomatic indices (GSI) and sperm quality in male mice.

The objective of this experimental investigation is to develop an effective and reliable hormonal immunocontraceptive vaccine to suppress spermatogenesis by using GnRH-BSA conjugate.

Forty sexually mature mice, Mus musculus were divided into two groups of twenty each. Group 1, served as control, while group 2 were immunized at monthly intervals for four times against GnRH with a GnRH-BSA conjugate (50 µg) with aqueous adjuvant (Freund''s adjuvant). After 30 days of each immunization, body weight, GSI and sperm quality were observed in the immunized groups and compared with the control group.

Body weight showed alterations in immunized animals as compared to control. However, GSI, sperm motility, sperm count and sperm morphology were significantly decreased in immunized animals throughout the experimental investigation and these effects were more prominent and significant in the later part of the experiment.

These results suggested that the active immunization against GnRH produced bioeffective antibodies as indicated by significant reduction in GSI level and sperm quality and induced infertility in male mice.

The preparation of endometrium for embryo reception and implantation are controlled by ovarian hormones. These hormones have distinct cyclical changes during estrus cycle.

The aim of this study was to evaluate the changes in morphology and morphometrical indices of endometrium by daily injections of estrogen and progesterone in ovariectomized mouse.

In total 60 adult NMRI female mice were ovariectomized and after two weeks, they were randomly divided into five groups: control, sham group, estrogen treated mice (which received daily dosage of 0.5 ml/mouse of hormone for five days), progesterone treated mice (which received daily dosage of 0.2 ml/mouse of progesterone hormone for five days) and estrogen-progesterone treated mice (they received 0.5 ml/mouse estrogen on the first day and 0.2 ml/mouse progesterone injections from the second day to the fifth day of treatment). The mice were sacrificed in every day (n=5) up to five days after treatment and their uterine horns were obtained and processed for morphological and morphometrical studies.

On the second day of treatment, the diameter of glands was observed to be more in the progesterone group (53.75±6.32μ) than this in the estrogen (45.13±7.78 μ) and estrogen-progesterone treated groups (48.17±13.58 μ). While, the number of glands (76.25±17.37) and thickness of endometrium (39.58±3.37 μ) were observed to be more in the estrogen treated group (p=0.01).

Progesterone had effect on the gland whereas estrogen caused increased in height of surface epithelium of endometrium. Overall, the day 2 after treatment (in all experimental groups) is suitable day for sampling for further studies.

The application of luteal phase supplementation hormones to increase the implantation rate is on debate among researchers.

In this study, the morphological and morphometrical assessment of superovulated mice endometrium were investigated at window implantation period superovulated mice.

Female mice were superovualated then were mated with vasectomized mice; the mice were divided in experimental and control groups. Experimental group included five groups which in them pseudopregnant mice were given a four consecutive daily injection of 1-progesterone (P), 2-estrogen (E), 3-estrogen + progesterone, 4-antiprogesterone+estrogen and 5-sham group. The uterine of all groups were collected after 4.5 day of pseudopregnancy and were prepared for histological and morphometrical studies.

Morphological studies of endometrial tissue showed that the luminal epithelium in group P appeared cuboidal shape. Endometrial folding was very high in group E+P. The luminal epithelium in groups E, E+P and RU 486 + E were seen in different morphology in comparison to control group. Morphometrical evaluation also showed height of luminal epithelium in group E (32.7±0.67) and E+P (33.6±1.3) were higher than those were seen in control (22.5±1.5) and group P (15.3±1.2).

Progesterone caused the lowest endometrial development compare to other groups. It is concluded that the adding of E to P may improve endometrial condition to implant at luteal phase.

I read with interest the papers written by Peyghambari et al (2008) and Niknafs et al nd et al et al et al et al et al et al et al (1994) did not observe any advantage in the pregnancy rates when adding estrogen+progesterone at luteal phase in patients undergoing IVF (6). In conclusion, the mechanism of luteal phase support in assisted reproduction is complex and a controversial issue, which demands further experimented and clinical studies. (2005) noticed that administration of estrogen + progesterone during luteal phase was involved with higher pregnancy rates in IVF cases (5). In contrast, Lewin (1990) who observed that elevated progesterone level caused decline in endometrial receptivity following ovarian hyperstimulation in an animal model (4). In clinical setting, however, Alsian (2006) reported that ovarian hyperstimulation with luteal support using progesterone injection altered the endometrial receptivity. This could be related to the alteration in the ratio of progesterone to estrogen after administration of exogenous gonadotropins (3). Similar results were reported by Kramer (2008) used ovarectomized mice for their study. In their previous work, Salehnia (2008) used superovulated mice using gonadotropins, while Payghambari (2008), on the other hand, reported that injection of progesterone alone at luteal phase did not supply an appropriate endometrial morphology for implantation. It was shown that application of estrogen + progesterone provided an ideal endometrial state for embryo implantation. They believed that hyperstimulation of ovary may induce the morphological alterations which may decrease the endometrial receptivity during implantation. It is important to note that in their study, Niknafs day after estrogen injection. This may suggest that endometrial proliferation in response to estrogen is a common phenomenon in the uterus of ovarectomized mice. They also found that treatment of progesterone priming with estrogen maintained the stromal proliferation, but was unsuccessful in stimulation of epithelial cells proliferation. The formation of uterine glands was found to be more prominent in progesterone treated mice than with estrogen+progesterone treated group. Niknafs (2008) on the complex issue of luteal phase support on endometrial function in mice. I would like to comment on the data generated from their studies. Luteal supplementation with either hCG or progestrone significantly improves fertility outcomes compared with no treatment (Pritts and Atwood, 2002) (1). Also, Walter et al (2005) reported that estrogen promotes endometrial proliferation, while progesterone is necessary for stimulating endometrial proliferation (2). Peyghambari and associates (2008) found that uterine epithelial proliferation was optimized on 2

In most mammals, the testis is always maintained at a lower temperature than that in the abdomen, and exposure of the testis to body temperature causes degeneration of germ cells.

In this research, the long effect of heat exposure on sperm parameters and microstructure of mouse testis were investigated. Cryptorchid mouse were induced by exposure to abdominal heat.

Immature mice were anesthetized and a small incision was made in the abdominal skin, then fat pad at the upper end of testis was sutured to peritoneum. Weight of testis, spermatogenic cell numbers, tubular ectasis (rate of tubular lumen comparing to the thickness of germinal epithelium) as well as epididymal sperm parameters were measured.

The results showed that spermatogenesis was arrested and testicular weights, seminiferouse tubular diameters and epididymal sperm parameters were significantly reduced in the bilateral undescended testis compared with unilateral undescended testis and the control mice. However, complete depletion of seminiferous tubules and absence of germ cells was not found in the animals.

In general, high temperature caused a decreased in all analyzed parameters except spermatogonial cell number probably due to the apoptosis and these changes significantly increase in bilateral groups compared with unilateral groups. We believe that the present model is a suitable tool for enrichment of spermatogonial stem cells, also it is useful for treatment of cryptorchidism and further biological research on spermatogenesis.

The increase in the rate of infertility in women has prompted the need to search for plants with antifertility potentials.

The effect of administration of aqueous extract of Cnidoscolous aconitifolius leaves for seven days on reproductive hormones of female Wistar rats was investigated.

Sixty female albino rats were grouped into four (A, B, C and D) of 15 each. Group A (the control) received orally 6.5 ml kg-1 body weight of distilled water on daily basis for 7 days. Groups B, C and D were treated like the control except that they received 250, 500 and 1000 mg kg-1 body weight of the extract.

Phytochemical screening of the extract revealed the presence of alkaloids, saponins, phenolics, tannins, flavonoids, anthraquinones, phlobatannins and triterpenes. Administration of the extract produced significant increase (p<0.05) in the serum prolactin concentration whereas those of estradiol, progesterone, follicle stimulating and luteinizing hormones were significantly reduced.

The alterations in the female rat reproductive hormones by the extract are indications of adverse effect on the maturation and ovulation of follicles. Consequently, the extract may impair fertility and conception in female rats. Thus, the Cnidoscolous aconitifolius leaf extract may be explored as a female contraceptive.

Backgrand: Cotinine (COT) is a major degradation product of nicotine (NIC). The participation of leptin in female reproduction is well-established, but any role in male reproductive function is at the best tenuous.

The aim of this study was to evaluate the in-vitro effects of nicotine, cotinine and leptin on sperm parameters in normal semen of non-smokers fertile men.

Ten healthy nonsmokers aged 25-40 years old were devided into 7 groups, Thier semens were divided into 7 aliquots. (A) was layered with basal solution 70 ng/ml NIC, (B) 35 µg/ml NIC, (C) 300 ng/ml COT, (D) 200 µg/ml COT, (E) 30 ng/ml leptin, (F) 300 ng/ml leptin respectively and (G) was layered with mHTF. After migration, the samples were examined at time 0, +1, +2, +4, +8, and + 24 h of incubation.

These findings were obtained: sperm count: 75.66±66.25x10 6 /ml, forward motility: 75.55±14.80%, progress: 33.66±13.01, VSL: 51.58±6.99 µm/s, VCL: 103.33±14.52 µm/s, ALH: 4.33±0.77 µm, BCF: 25.60±2.97 HZ, STR: 79.33±8.04 %, LIN: 52.55±10.52 %, ELO: 74.22 ± 12.76 % and ARE: 3.04 ± 1.50 u/sq. The parameters were similar before 8 hr and were being decreased after that.

According to the results. nicotin and cotinin have negative effects on the sperm parameters but despite the positive effect of leptin, there is no correlation between leptin concentration in semen and its physical characteristics.

According to the text book of obstetrics and Gynecology, prematurity is the first cause of perinatal mortality. Therefore postponing delivery will become mandatory to prevent complications of prematurity. Parental MgSO4 is one of the most common and the safest medications for this purpose.

Case report:

 We present a primigravida patient with multiple uterine myoma who had premature labor and received intravenous MgSO4 for 58 days in order to postpone her delivery while having a cervical dilation of 4-5 cm. The patient underwent C/S at the gestational age of 34 weeks because of reducing fetal movements and Breech presentation.

Because of many side effects of long term management with MgSO4 and bed rest, this protocol isn''t recommended for all patients.