International Journal of Reproductive BioMedicine
Volume:8 Issue: 4, Apr 2010

Pinopodes are suggested as biological markers of uterine receptivity, but their molecular components are unknown.

Co-expression of galectin-3 and v3 integrin at human pinopodes has been examined in this study to propose a role for them during adhesion phase of embryo implantation.

Biopsies were obtained from early and mid luteal phase endometrium of 12 fertile women with regular menstrual periods (25-35 days) and the mean age of 37 years (range 25–45). Then, they were examined under light and scanning electron microscopy for detection and dating of pinopodes. Using immunofluorescent staining and immunogold electron microscopy, the expression of galectin-3 and v3 integrin in human endometrium and pinopodes was detected. Further, statistical analysis was performed using immunogold electron microscopy to investigate the expression and subcellular distribution of these, before and during the frame of implantation window.

The results demonstrated that pinopodes of luminal epithelial cells exhibited immunoreactivity for both galectin-3 and v3 integrin, which was increased statistically significant (p< 0.05) at the time of implantation window. Furthermore, area-related distribution of these proteins was found higher in pinopodes compared to the neighboring apical membrane without pinopode.

Temporal and spatial expression of galectin-3 and v3 integrin at pinopodes proposes a role for pinopodes in the adhesion of embryo and the involvement of galectin-3 as a binding partner of integrins in the human utero-fetal complex.

Evidences suggest an association between the prevalence of thyroid peroxidase (anti-TPO) and anti thyroglobulin (anti-Tg) with recurrent abortions and infertility. Iodine deficiency was once endemic in Iran and little data is available about the prevalence of these antibodies in different groups of fertile or infertile individuals.

This case control study was designed to compare the presence of anti-TPO and anti-Tg in four groups of women to reveal their role in the etiology of recurrent abortion and infertility.

Four groups of euthyroid women referring to Avicenna Infertility Clinic in Tehran were selected; 95 cases as fertile controls and 70, 78 and 137 cases with male and female factor infertility and recurrent abortion respectively. TSH, anti-TPO and anti-Tg were evaluated by chemiluminescent immunoassay.

The prevalence of the above mentioned autoantibodies in euthyroid controls was about 25% and the percentage of people with an anti-Tg >500 was two times bigger in the abortion group compared to the control group (p<0.05) and the proportion of people with an anti-Tg >500 in younger cases in the abortion group was significantly higher than the rest of the cases (p<0.05). Anti-TPO distribution had no significant differences.

There were no statistically significant differences among four groups. It seems that more comprehensive studies are needed to reach a common conclusion about thyroid autoantibodies in women with recurrent abortions in different groups and different parts of Iran. In addition, dividing the recurrent abortion and infertility groups on the basis of their etiologies could be effective.

Determination of oocyte and embryo quality are one of the most important goals in IVF. Anti-mullerian hormone (AMH) is secreted by the ovarian granulosa cells into blood flow and follicular fluid. Follicular fluid anti-mullerian hormone level is probably a marker of activity of granulose cells.

To evaluate whether high level of follicular fluid anti-mullerian hormone level is related to success of fertilization and better embryo quality.

62 women, whose follicular fluid sample was obtained from a single follicle in each patient, underwent IVF with GnRH-agonist long protocol. Based on oocyte fertilization, the patients were divided into fertilized group (n=42) and non-fertilized group (n=20). FF AMH levels were measured in both groups and the quality of embryos was determined in fertilized group.

Median of FF AMH level in fertilized group was higher than that in non-fertilized group (5.7ng/ml v.s. 2.7ng/ml) and a statistically significant difference was observed between the two groups. There was a significant difference between FF AMH level and scores of embryos (p<0.001). The medians levels of FF AMH were 6.7ng/ml in good quality embryos and 3.80ng/ml in fair quality embryos.

Our results indicate that FF AMH level has positive correlation with fertilization and embryo quality; therefore, it can be considered as a marker of IVF outcome.

Anti-mullerian hormone (AMH) levels may represent the ovarian follicular pool and could be a useful marker of ovarian reserve. The clinical application of AMH measurement has been proposed in the prediction of quantitative and qualitative aspects in assisted reproductive technologies.

This study aimed to assess the relationship between the serum levels of AMH and results of assisted reproductive technique (ART) outcome in polycystic ovary syndrome (PCOS) patients versus control group.

This cohort study was conducted on 61 (PCOS) patients and 28 patients without PCOS (controls) candidates for assisted reproductive technique. Serum levels of AMH were measured on the 3rd day of menstrual cycle and all the patients underwent controlled ovarian hyper stimulation and ART. The relationship between AMH serum level with retrieved oocytes, mature oocytes and pregnancy rate were assessed.

There was significant correlation between the AMH level with number of total retrieved oocytes and mature oocytes in patients with PCOS and controls (p=0.001). In PCOS and control groups AMH level in pregnant patients was higher, but it was not statistically significant (p=0.65, p=0.46, respectively). The major outcome of the study (pregnancy) did not differ significantly between two groups.

This study revealed that AMH level was higher in pregnant patients undergoing ART; but AMH may not be an accurate predictor for pregnancy in PCOS patients.

Doppler indices of umbilical artery are used as indicator of fetal well being.

To compare Doppler parameters of umbilical artery including pulsatility index (PI) and resistance index (RI) in patients with preeclampsia with those of normal pregnancies and to evaluate the diagnostic characteristics of these parameters in preeclampsia.

In a case control study, umbilical artery pulsatility and resistance indices were calculated at a free loop of umbilical cord in 25 preeclamptic patients and 75 uneventful pregnancies. Measurements were compared and diagnostic characteristics of the indices were determined.

Mean of pulsatility and resistance index were significantly higher in preeclampsia patients than the control group. Besides, patients with severe preeclampsia showed significantly higher values of PI and RI in comparison to those with mild preeclampsia. For PI, the cut-off of ≥0.98 yielded the highest sensitivity and specificity. Also, RI of 0.64 acquired a sensitivity of 100% and specificity of 44%.

Umbilical artery pulsatility index and resistance index increase in preeclampsia and these changes tend to be greater in severe preeclampsia. Umbilical artery PI and RI seem to be more appropriate in excluding preeclampsia rather than confirming it, and we propose the cut-off values of 0.98 for PI and/or 0.64 for RI, to rule-out the disease.

The sperm count and function may be affected by karyotype abnormalities or microdeletion in Y chromosome. These genetic abnormalities can probably transmit to the children.

In this study, we tried to determine the frequency of karyotype abnormalities and Y chromosome microdeletions in severe oligospermic or azoospermic men who fathered sons by ICSI.

This study comprised of fathers who had at least a son with ICSI due to severe oligospermia or azoospermia. General examinations were done and blood sample were obtained for karyotype and Y chromosome studies.

The total of 60 fathers was evaluated along with their 70 sons. The mean duration of infertility was 8.7 years and the sons were 2.4 years in average at the time of examination. The mean age of neonates at the time of delivery was 33 weeks; 42.9% were delivered prematurely; and 40.5% of them were twins. 8.6% of the sons had hypospadiasis and 7.1% had UDT. Most of the side effects were due to prematurity. In total 6 of fathers had karyotype anomaly, meanwhile 4 of their sons had also karyotype anomaly. Only one son had karyotype anomaly without affected father. No case of Y chromosome microdeletion was found in the fathers.

Y chromosome microdeletion is not prevalent in fathers with successful ICSI and it is not necessary to be analyzed before ICSI performance. Karyotype anomaly may transmit to the sons. All together ICSI is reliable and safe. Most of the complications are the result of premature delivery.

Cassia italica or Senna is a wild plant distributed in south of Iran. It increased water consumption and has a laxative effect. In traditional medicine this plant has been used for the dysmenorrheal.

In this study we investigated the effect of aqueous extract of Cassia italica on uterus contraction.

Virgin Wistar rats 200-300g were purchased. After laparatomy, a piece of uterus (1.5cm) was excised and mounted in an organ bath (10ml) containing De Jalon (29°C) and isometric contractions were recorded under 1g tension. KCl (60mM) was used to produce contractions. Cassia italica extracts after washing were added at 0.5, 1, 2 and 4 mg/ml cumulatively to the organ bath and the contractions were recorded. Uterus was separately incubated with atropine sulfate (10mM), metoclopramide (10mM) and oxytocin (10mU/ml) and the tissue spasmodic effect of the extract were recorded.

Cumulative concentrations of the extract (0.5-4 mg/ml) increased the basal, peak and frequency of uterus contractions, dose-dependently (p<0.001). Incubation of the tissue with atropine sulfate and metoclopramide did not reduce the spasmodic effect of the extract. Cassia italica extract was shown the oxytocic activity on the uterine smooth muscle which most concentrations of the extract (4mg/ml) were more potent than of oxytocin (10mU/ml).

Cassia italica stimulated the uterus contractions without involving dopaminergic (D2), and muscarinic receptors. This extract has oxytocin mimetic effects on uterus. Since the extract has uterus contraction, therefore we suggest that more study will be necessary about abortive or contraceptive effects of this plant on pregnant uterus.

Azadirachta indica is a tree with most of the parts having various medicinal values. It is however popular because of its high potencies, as antimalarial and anti-fertility agents, which the locals still exploit.

We investigated the effect of the methanol leaf extract on the serum levels of the pituitary-gonad hormones and the histo-morphology of the ovary and uterus of adult female rats.

Eighteen adult female Wistar rats were divided into three groups (A, B and C) of six animals each. Group A was the control group that received distilled water orally, while groups B and C were the experimental groups that received 200mg/kg and 400mg/kg of the extract respectively by oral intubation for fourteen days. The animals were sacrificed on the fifteenth day, and blood was collected from the left ventricles of the hearts and subsequently spurned in heparinized bottles for serum hormonal assay. The ovaries and the uteri were then dissected out and preserved in Bouin’s fluid. Routine haematoxylin and eosin method was used to stain them.

There were significant (p<0.0001) lower serum levels of luteinizing hormone (LH) in the treatment groups, especially in the 400mg/kg group, while there were significant (p<0.0001) higher progesterone (PH) levels in the treatment groups. The follicle stimulating hormone (FSH) levels were however not different (p=0.0502) from the control. The histo-morphologic studies revealed no obvious pathological changes in the ovaries and uteri of the treatment groups.

200mg/kg and 400mg/kg of methanol extract of the leaf of A. indica does not have any obvious effect on the histo-morphologies of the ovary and uterus, but showed significant changes in the serum levels of LH and PH of female Wistar rat, implying that the effect of the extract may have been at a level other than these organs of study.

When family planning programmes offer a wide variety of contraceptives, contraceptive prevalence would be higher overall.

To determine the acceptability of Cyclofem© and to evaluate its side effects and continuation rate in Iran.

An introductory study of Cyclofem© was conducted in seven districts of Kerman Province, the largest province of Iran, in three phases. At first, 14394 women attending randomly selected urban and rural health centers representing different socioeconomic classes were invited to choose Cyclofem© after a standard schedule of counselling. At the second phase 418 of those who accepted Cyclofem© and 354 of those who refused to use the method were randomly selected to participate in an interview. At the third phase the first group was followed up for one year at regular one-month intervals.

Nearly 12.6% (n=1809) of 14394 women counselled to choose Cyclofem© accepted the contraceptive method. They had a mean (±SD) age of 28.5 (±6.5) years. Fear of side effects was the most common cause of refusal to use Cyclofem©. The one-year continuation rate was 21.2%. The three main side effects leading to early discontinuation of Cyclofem© were nausea (18%), prolonged menses (15.8%), and amenorrhea (14.7%), respectively.

The one-year continuation rate of Cyclofem© use in Iran has been lower than other countries. Further research is necessary to improve continuation rates.

C-reactive protein (CRP) can be increased after hormonal stimulations. The changes of CRP might affect the success of in-vitro fertilization (IVF).

The aim of this study was to determine the possible relationship between the serum CRP level and outcome of controlled ovarian stimulation, and pregnancy rate in patients undergoing IVF or intra cytoplasmic sperm injection (ICSI).

This prospective cross sectional study was performed in Avicenna Infertility Clinic on 70 consecutive infertile patients (Jan 2008-Aug 2009) who were candidate for IVF/ICSI, using standard long GnRH agonist protocol. Blood was drawn 4 times during the cycle, on first day of stimulation, the day of HCG injection, the day of ovum pick up, and the day of embryo transfer.

In 82.2% of cases, the serum CRP level was higher in day of HCG injection than first day of stimulation and also the day of ovum pick up than the day of HCG injection. The ratio of CRP level in the day of transfer to the day of ovum pick up, was significantly higher (ratio ≥1.23) in patients who became pregnant after ICSI (p =0001). All patients with less than this Ratio have not been pregnant.

Controlled ovarian hyper stimulation and puncture of ovaries can potentiate systemic stimulation. Increasing serum CRP level in day of embryo transfer rather than ovum pick up can predict the success in patients undergoing IVF/ICSI.