Reproductive Medicine
Kong Chi Pham; Viet Quoc Dao; Le Thi Phuong Nguyen; Vinh Dinh Tran
Articles in Press, Accepted Manuscript, Available Online from 07 October 2023
Abstract
Objective: To determine the causes of infertility of couples examined at Da Nang Hospital for Women and Children. Methods: A cross-sectional descriptive study included 512 reproductive-age couples diagnosed with infertility and treated at Da Nang Hospital for Women and Children from August 2018 to August ...
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Objective: To determine the causes of infertility of couples examined at Da Nang Hospital for Women and Children. Methods: A cross-sectional descriptive study included 512 reproductive-age couples diagnosed with infertility and treated at Da Nang Hospital for Women and Children from August 2018 to August 2020. Results: The mean age of the men and women was 31.0 ± 4.4 years and 33.5±5.0 years, respectively. Primary infertility accounted for 70.9%, whereas secondary infertility was only 29.1%. The mean time of infertility was 3.0±2.5 years. Male factor infertility accounted for the highest rate (39.6%), followed by female infertility (30.5%). Infertility due to both male and female factors was18.0%. Among the causes of male infertility, abnormal semen analysis accounted for the highest rate (57.6%), followed by varicocele (19.3%). Among the abnormalities of semen parameters, oligo-astheno-teratozoospermia (OAT) represented the highest rate (37.5%). There were 46 cases of azoospermia, accounting for 9.0%. Endometriosis accounted for the highest rate (17.6%) among causes of female factor infertility, followed by PCOS (15.6%). There were 51 cases of diminished ovarian reserve, accounting for 9.9%. Conclusion: Male factor infertility accounted for the highest rate in this study. Among the causes of male infertility, abnormal semen analysis had the highest rate. Endometriosis and PCOS were common causes of female infertility.
Obstetrics and Gynecology
Fariba Seyedoshohadaei; Masomeh Rezaie; Nasrin Sofizadeh; farnaz zandvakili; Khaled Rahmani; Hosna liravi
Articles in Press, Accepted Manuscript, Available Online from 29 November 2023
Abstract
Introduction: This study aims to determine the effectiveness of simultaneous use of aspirin with clomiphene citrate and letrozole on the success rate of ovulation induction in women with PCOS.
Materials and methods: This study was a double-blind randomized clinical trial. 120 patients with PCOS with ...
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Introduction: This study aims to determine the effectiveness of simultaneous use of aspirin with clomiphene citrate and letrozole on the success rate of ovulation induction in women with PCOS.
Materials and methods: This study was a double-blind randomized clinical trial. 120 patients with PCOS with complaints of infertility due to lack of ovulation were randomly divided into four groups using clomiphene citrate + placebo, letrozole + placebo, clomiphene citrate + Aspirin, and letrozole + aspirin divided by block randomizes. Follicometry was performed with the help of transvaginal ultrasound on the 14th day of the cycle. In the case of a positive pregnancy, the patients underwent transvaginal ultrasound in the 6th week of pregnancy to observe the gestational sac. Patients were followed up until the 12th week of pregnancy in terms of the abortion rate.
Results: This study showed that there was no significant difference in the number of follicles of 14 to 18 mm, follicles larger than 18 mm, and the thickness of the endometrium of the studied women in the four investigated groups (p>0.05). The pregnancy test results showed that the clomiphene citrate + aspirin group and the letrozole + aspirin group each had the highest pregnancy rate with 13 people (36.1%) having a positive test.
conclusion: Although the addition of aspirin to letrozole or clomiphene citrate does not affect the number of mature follicles and the thickness of the endometrium, it can increase the probability of pregnancy.
Obstetrics and Gynecology
Roshan Nikbakht; Narges Dibavand; Shabnam Salemi; Ali Reza Sattari; Maryam Farzaneh
Volume 9, Issue 1 , January and February 2024, , Pages 22-28
Abstract
Background & Objective: The presence of air in the catheter was found to affect the success of embryo transfer into the uterine cavity. This study determined the chances of achieving pregnancy using the intrauterine insemination (IUI) method with different air volumes inside the IUI catheter.Materials ...
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Background & Objective: The presence of air in the catheter was found to affect the success of embryo transfer into the uterine cavity. This study determined the chances of achieving pregnancy using the intrauterine insemination (IUI) method with different air volumes inside the IUI catheter.Materials & Methods: This clinical trial study was performed on 521 IUI cycles among 270 couples from 2013 to 2014. The patients were divided into three groups (each group of 90 patients), based on three volumes of air inside the catheter (0.0 ml, 0.5 ml, and 1 ml). Other variables, include the woman’s age, menstrual cycle status, duration of infertility, type of infertility, sperm morphology, total motile sperm count (TMSC), number of motile sperm inseminated (NMSI), and pregnancy rate or the success rates of IUI were evaluated.Results: The mean age of women and men were 33 and 30 years, respectively. Based on three volumes of air inside the catheter (0.0 ml, 0.5 ml, and 1.0 ml), the pregnancy rates were 5%, 9.4%, and 16.5%, respectively. TMSC of more than 5.6x106 and NMSI of more than 3.4x106 were associated with the chance of IUI achievement. At the same time, there was no significant relationship between the woman’s age, irregular menstrual cycles, and duration of infertility with the success rate of IUI. We found that the air volume of 1.0 ml inside the IUI catheter significantly increased the pregnancy rate compared to other groups.Conclusion: The volume of air within the catheter had a significant relationship with the success rate of IUI.
Obstetrics and Gynecology
Ahmed Elkhyat; Amal Elsokary; Shereef Elshwaikh
Volume 9, Issue 1 , January and February 2024, , Pages 70-75
Abstract
Background & Objective: To evaluate the effect of weight gain in lean patients with polycystic ovary syndrome (PCOS) on ovulation and pregnancy rates.Materials & Methods: Lean patients with PCOS seeking fertility were invited to participate in the study. Weight gain was commenced by ...
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Background & Objective: To evaluate the effect of weight gain in lean patients with polycystic ovary syndrome (PCOS) on ovulation and pregnancy rates.Materials & Methods: Lean patients with PCOS seeking fertility were invited to participate in the study. Weight gain was commenced by dietary modifications. Patients were classified later into respondent and non-respondent. All patients were stimulated with Letrozole 2.5 mg twice daily for five days for six cycles. Ovulation and pregnancy rates were assessed.Results: From 84 patients who were enrolled in our study, 33 patients were allocated into non responder group and 28 patients were allocated to the responder group, and it was found that despite there was statistical difference between both groups as regard weight gain, weight after six months and BMI after six months, there was no significant difference between both groups as regard the ovulation rate, pregnancy rate and complications to ovulation induction ovarian hyperstimulation syndrome (OHSS).Conclusion: weight gain in lean PCOS patients - although non-significant- but it may improve the reproductive outcomes (ovulation rate and pregnancy rate) and the need of further study with larger number and longer duration of follow up for confirmation of these results.
Gynecology Oncology
May Kassim Khalaf; Fadia J Alizzi; Ammar Mohammed Qassim
Volume 8, Issue 6 , November and December 2023, , Pages 599-606
Abstract
Background & Objective: Gonadotropin-releasing hormone acts on the anterior pituitary and promotes the release of both follicle-stimulating hormone (FSH) and luteinizing hormone (LH), both of great importance in the ovarian cycle.Materials & Methods: In a prospective cross-sectional ...
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Background & Objective: Gonadotropin-releasing hormone acts on the anterior pituitary and promotes the release of both follicle-stimulating hormone (FSH) and luteinizing hormone (LH), both of great importance in the ovarian cycle.Materials & Methods: In a prospective cross-sectional study conducted at the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies / Al-Nahrain University and Kamal Al-Sameraie Hospital for Infertility and In Vitro Fertilization, Baghdad, Iraq during the period from April 2022 to April 2023, women received rFSH in a single daily dose of (150-300 IU) for ovarian stimulation. Women in groups B and C received ovarian stimulation antagonists, while those in group A did not.Results: Both clinical and ongoing pregnancy rates were measured for each group. A positive hCG test was found in 27 (79.4%) in Group A while it was positive in 19 (55.9%) in Group B with a significant difference (P=0.03), clinical pregnancy was 25 (73.5%) in Group A while it was positive in 17 (50.0%) in Group B with a significant difference (P=0.04), and ongoing pregnancy was found in 24 (70.6%) in Group A while it was positive in 15 (44.1%) in Group B with significant difference (P=0.01).Conclusion: Women with LH <4 IU presented with a significantly higher pregnancy rate than those with ≥4 IU, and do not need GnRH antagonist addition as co-treatment.
Obstetrics and Gynecology
Omarov Nazarbek Bakytbeko; Thaiba Abdulrazzaq; Entsar Hachim Muhammad; Sundus Mohammed Ali Al Bazi; Mazin A. A. Najm; Talib Kh. Hussein; Zahraa Hamzaa Abd Alzahraa; Sarah A. Hamood
Volume 8, Issue 5 , September and October 2023, , Pages 501-508
Abstract
Background & Objective: The birth of a baby with a low birth-weight (LBW), which has numerous consequences, is one of the most significant problems associated with childbirth. By evaluating the factors influencing LBW in infants, therapeutic interventions can be improved to mitigate its effects. ...
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Background & Objective: The birth of a baby with a low birth-weight (LBW), which has numerous consequences, is one of the most significant problems associated with childbirth. By evaluating the factors influencing LBW in infants, therapeutic interventions can be improved to mitigate its effects. In this regard, the present study aims to identify the causes of LBW in infants and assess these causes' impact.Materials & Methods: In the current retrospective observational study, the required data regarding demographic variables and history of pregnancy and childbirth was extracted from 730 electronic records of deliveries performed from Alwiyah Hospital for Obstetrics and Gynecology in Baghdad in 2021 involving infants with LBW. The SPSS.23 software,the t-test, independent t-test, and multiple logistic regression were used to analyze the data. The results' significance level was deemed to be less than 0.05.Results: The multiple logistic regression analysis model included variables with a significance level of less than 0.05. The results show that the variables of mother's age at delivery, the number of babies born in the current delivery, history of infertility, and iron deficiency anemia increase the chances of LBW by 0.48, 3.12, 0.38, and 0.56, respectively, and had a significant relationship with LBW infants (P<0.001).Conclusion: Paying particular attention to the treatment and improvement of the practical factors in LBW before birth in pregnant women is crucial.
Anesthesia
Aseel Alfil; Lubna AL Anbari
Volume 8, Issue 5 , September and October 2023, , Pages 509-513
Abstract
Background & Objective: Granulosa cells, the endometrium, and the placenta all play a role in the secretion of G-CSF in the reproductive tract. G-CSF affects immunological regulation, which is crucial for enhancing pregnancy viability and maintenance. To evaluate the effects of granulocyte-colony ...
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Background & Objective: Granulosa cells, the endometrium, and the placenta all play a role in the secretion of G-CSF in the reproductive tract. G-CSF affects immunological regulation, which is crucial for enhancing pregnancy viability and maintenance. To evaluate the effects of granulocyte-colony stimulating factor subcutaneous injection on the miscarriage rate, ongoing pregnancy rate, and livebirth rate after single and multiple doses of G-CSF factor.Materials & Methods: At the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies at Al-Nahrain University, a prospective comparison study with a random sample selection was conducted from December 2021 to December 2022. It included 121 infertile women who had previously unsuccessful intracytoplasmic sperm injection (ICSI) procedures and who had finished ICSI protocols and reached the embryo transfer day. Patients were divided into three groups on the day of the embryo transfer: The non-G-CSF group (49 patients) received no additional treatment; the single-G-CSF group (31 patients) received a single subcutaneous injection of granulocyte-colony stimulating factor one hour after embryo transfer; and the multiple-G-CSF group (41 patients) received weekly injections of G-CSF until a fetal heartbeat could be detected, starting one hour after the embryo transfer.Results: The multiple G-CSF group had better results in the miscarriage rate, ongoing pregnancy rate, and livebirth rate (23.5%, 34.1%, and 31.7%, respectively) when compared to the single G-CSF group (42.9%, 16.1, and 12.9%, respectively) and the non-G-CSF group (37.5%, 12.2%, and 10.2%, respectively).Conclusion: Multiple subcutaneous G-CSF doses can improve the miscarriage rate, ongoing pregnancy rate, and live birth rate. A single dose of G-CSF for infertile women has no appreciable benefits.
Obstetrics and Gynecology
Roya Kaboodmehri; Seyedeh Hajar Sharami; Sodabeh Kazemi; Mandana Mansour Ghanaei; Seyedeh Fatemeh Dalil Heirati; Zahra Pourhabibi; Sina Montazeri
Volume 8, Issue 4 , July and August 2023, , Pages 350-356
Abstract
Background & Objective: Anti Mullerian hormone (AMH) level is a practical index of ovarian reserve and an indicator of ovarian response in infertile women. The aim of this study was to evaluate the relationship between AMH levels and demographic factors.Materials & Methods: In this ...
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Background & Objective: Anti Mullerian hormone (AMH) level is a practical index of ovarian reserve and an indicator of ovarian response in infertile women. The aim of this study was to evaluate the relationship between AMH levels and demographic factors.Materials & Methods: In this cross-sectional study, conducted in Al-Zahra hospital Rasht in the north of Iran, 234 patients, 18-45 years old, were enrolled. The demographic parameters (e.g. age, education, habitat and etc.) and AMH levels were recorded for each patient. The patients were divided into two groups based on their AMH levels [group 1: less than 1.1 (ng/ml) vs. group 2: more than (1.1 ng/ml)]. The data was analyzed by SPSS-21 software.Results: The mean AMH level was 2.66 ng/ml. Age, education status and habitat showed significant differences among subjects with AMH levels, so that with aging the AMH levels decreased. Patients living in villages or the ones with low educational degrees and those with higher parities also revealed lower levels of AMH (p<0.05).Conclusion: There was a significant relationship between age, educational status and habitat with AMH values. Similar to other studies, we believe that with aging the AMH levels decrease. Furthermore, the other two aforementioned demographic features could affect a woman’s ovarian reserve and fertility status, too.
Obstetrics and Gynecology
Zena M. Al Hindawi
Volume 8, Issue 2 , March and April 2023, , Pages 137-142
Abstract
Background & Objective: Infertility in women can be attributed to a wide variety of factors, including inherited and acquired abnormalities of the uterus. Ultrasonography is used for determining the thickness of the endometrium during various phases of the menstrual cycle. The purpose of this ...
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Background & Objective: Infertility in women can be attributed to a wide variety of factors, including inherited and acquired abnormalities of the uterus. Ultrasonography is used for determining the thickness of the endometrium during various phases of the menstrual cycle. The purpose of this study is to determine the thickness of the endometrium in women who are unable to conceive using ultrasound imaging during the secretory phase.Materials & Methods: A total of 134 adult females between the ages of 22 and 45 were examined by means of an endo-vaginal and transabdominal approach with EVN 4-9 MHZ and CA1-7AD probes, respectively, during the course of this research project, which took place in Imam Al-Hujjah Charitable Hospital, Karbala, Iraq, between February 2021 and April 2022.Results: The findings showed that primary infertility accounted for 69.4% of cases, which was significantly higher than women with secondary infertility, which accounted for 30.6% of cases. There were 68.8% of women who presented with primary infertility who had endometrial thickness between 9-12 mm, and there were 31.1% of women who presented with secondary infertility who had this thickness. 65.8% of women who are experiencing primary infertility and 34.1% of women who are experiencing secondary infertility have an endometrial thickness of 14-18 mm. Our study showed that 40% of women who suffer from primary infertility and 60% of those who have secondary infertility have an endometrial thickness of 19-23 mm.Conclusion: When it comes to diagnosing and treating infertility, ultrasound is a crucial tool for measuring the thickness of the endometrium in women.
Obstetrics and Gynecology
Roshan Nikbakht; Mahvash Zargar; Farideh Morammezi; Asma Motaharifard; Maryam Seyedtabib
Volume 8, Issue 2 , March and April 2023, , Pages 143-149
Abstract
Background & Objective: Frozen embryo replacement (FER) cycle is a procedure that assists in, in vitro fertilization (IVF) outcome by using the storage and transfer of excess embryos. This study evaluated the success of FER using Spinnbarkeit and endometrial thickness.Materials & Methods: This ...
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Background & Objective: Frozen embryo replacement (FER) cycle is a procedure that assists in, in vitro fertilization (IVF) outcome by using the storage and transfer of excess embryos. This study evaluated the success of FER using Spinnbarkeit and endometrial thickness.Materials & Methods: This cross-sectional study was performed on 97 infertile women at the Imam Khomeini hospital of Ahvaz, from March 2019 to March 2020. Endometrium was prepared with Estradiol valerate from the third day of menstruation and followed by serial vaginal ultrasound till the thickness of the endometrium attained seven millimeters to eight millimeters. The cervical secretions were collected from the external Os and were estimated based on centimeters. Also, endometrial thickness was recorded.Results: no substantial difference between endometrial thickness and spinnbarkeit in the FER cycles with pregnancy outcomes was observed (P>0.05).Conclusion: Some variables such as endometrial thickness, spinnbarkiet, estradiol dose intake, and quality of embryos have no relationship with the success of FER cycles.
Obstetrics and Gynecology
Fadhil Hussam; Shaymaa Abdulhameed Khudair; Waleed K. Alkhafaje; Yasir S. Alnassar; Rashad M. Kaoud; Ahmed Najm Abed; Haneen Saad Jabbar; Hiba Ali Numan
Volume 8, Issue 1 , January and February 2023, , Pages 47-52
Abstract
Background & Objective: Infertility is the inability to become pregnant despite trying for at least a year. Infertility is also referred to as when a woman continues to experience miscarriages. Environmental factors, lifestyle, hormone issues, physical problems, and age can all contribute to ...
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Background & Objective: Infertility is the inability to become pregnant despite trying for at least a year. Infertility is also referred to as when a woman continues to experience miscarriages. Environmental factors, lifestyle, hormone issues, physical problems, and age can all contribute to female infertility. About 10-12% of couples struggle with infertility, a multifaceted issue with ramifications for society, the economy, and culture. The majority of female infertility cases are caused by issues with egg production. By analyzing samples from infertility clinics, the current study aims to investigate the degree of female infertility in Erbil, Iraq, while covering all facets of the condition.Materials & Methods: 595 infertile females receiving medical counseling from three infertile institutions between February 2020 to December 2021 were screened for the current study. In addition to anthropometric measurements, information about the etiology, duration, and lifestyle, factors of infertility has been gathered using a standardized questionnaire. Additionally, the sample was subjected to clinical examinations. Five groups of reproductive abnormalities were identified. Around 61.79% of women in the infertile group for the first two years had tubal obstruction, and 49.92% had hormonal deficiencies. Ovulation defects (4.62%) and undersized uteri (4.82%) predominated in the >10-year infertile group. Both weight and body mass index have shown a favorable association with infertility duration.Results: Our findings demonstrated a significant correlation between body mass index and infertility. Most academic and wealthy groups pursued medical advice to resolve issues related to infertility.Conclusion: Finally, it is suggested that female infertility can be managed and cured with hormone therapy, laparoscopic procedures, minor surgical procedures, and medicine.
Obstetrics and Gynecology
Neda Hashemi; Zahra Soleimani
Volume 7, Issue 6 , September and October 2022, , Pages 513-517
Abstract
Background & Objective: The association of Trichomonas vaginalis (T. vaginalis) and infertility is controversial. There is a doubt regarding the relation between T. vaginalis infection and female infertility. This study is the first meta-analysis that investigated the association between T. vaginalis ...
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Background & Objective: The association of Trichomonas vaginalis (T. vaginalis) and infertility is controversial. There is a doubt regarding the relation between T. vaginalis infection and female infertility. This study is the first meta-analysis that investigated the association between T. vaginalis infection and risk of female infertility.Materials & Methods: Web of Science, PubMed and Scopus were searched using appropriate keywords as major international electronic bibliographic databases up to January 2020. Q-test and I2 statistic were used for evaluating heterogeneity between studies as well as Begg's and Egger's tests for exploring publication. Results were reported by pooled odds ratio (OR) estimate from individual studies by choosing random-effects model.Results: In total, 650 articles were obtained by initial search until January 2020 with 9779 women. Results of the pooled OR estimates showed a significant association between T. vaginalis and infertility in adjusted studies (OR=1.95; 95% CI: 1.46, 2.43). Based on Begg's and Egger's tests, there was no evidence of publication bias (P < /i>=0.532 and P < /i>=0.896, respectively).Conclusion: There was a significant association between T. vaginalis and female infertility. However, more evidence is necessary to prove the potential association of T. vaginalis with an increased risk of female infertility.
Reproductive Medicine
Adeola Oluboyo
Volume 7, Issue 5 , July and August 2022, , Pages 374-381
Abstract
Infertility is an important world-wide reproductive disorder and some couples are being affected everyday as the population increases. The study aimed to evaluate the levels of selected trace elements (zinc, magnesium, selenium) and glutathione peroxidase in female subjects diagnosed with infertility. ...
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Infertility is an important world-wide reproductive disorder and some couples are being affected everyday as the population increases. The study aimed to evaluate the levels of selected trace elements (zinc, magnesium, selenium) and glutathione peroxidase in female subjects diagnosed with infertility. The study investigated a total of 90 subjects; 25 subjects diagnosed of primary infertility, 25 subjects diagnosed with secondary infertility and 40 apparently healthy individuals which served as the control group within the age range of 20-45years. Samples were obtained from the patients who attended the obstetrics and gynecology department, Federal Medical Centre, Ido-Ekiti, Ekiti State, Nigeria. Zinc (Zn) and selenium (Se) were estimated using atomic absorption spectrophotometer (AAS), magnesium (Mg) was estimated spectrophotometrically, while glutathione peroxidase (GPx) was evaluated using enzyme linked immunosorbent assay (ELISA) technique. Zinc (Zn), magnesium (Mg) and glutathione peroxidase (GPx), were significantly lower (P < /i>>0.05) in subjects with infertility in relation to the control subjects, while selenium (Se) was found to be significantly higher (P < /i><0.05) in subjects with infertility compared with control subjects. Selenium (Se) and magnesium (Mg) were significantly lower (P < /i><0.05) in subjects diagnosed with primary infertility compared with subjects diagnosed with secondary infertility. No significant difference (P < /i><0.05) was found in serum zinc (Zn) levels and glutathione peroxidase (GPx) between subjects with primary and secondary infertility. The study concluded that the parameters are useful and should be included in the routine assessment, diagnosis and monitoring of cases of infertility.
Reproductive Medicine
Hamideh Mohaddesi; Hamid Reza Khalkhali; Tahereh Behrozi-lak; Javad Rasouli; Reyhan Edalat Nemoon; Somayeh Ghasemzadeh
Volume 7, Issue 4 , March and April 2022, , Pages 341-347
Abstract
Background & Objective: Fertility is important in developing personality, and infertility is a disorder that often bears unintended and sometimes untreatable consequences for couples. As an element of personal features, mental health is often related to marital satisfaction. In this study, the ...
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Background & Objective: Fertility is important in developing personality, and infertility is a disorder that often bears unintended and sometimes untreatable consequences for couples. As an element of personal features, mental health is often related to marital satisfaction. In this study, the correlation between mental health and marital satisfaction is investigated in infertile couples referring to the Kosar Infertility Center of Urmia, Iran.Materials & Methods: This cross-sectional study was performed on 186 infertile couples referred to Kosar Infertility Center, Iran. They were randomly selected in 2018. The data were collected using General Health Questionnaire and Enrich Marital Satisfaction Questionnaire completed by the participants. In the present study, to conduct data analysis, SPSS version 25.0 was used along with inferential and descriptive statistics.Results: Idealistic distortion had a significant relationship with mental health in infertile couples (P < /em>=0.015). Moreover, leisure activities (P < /em>=0.043) and financial management (P < /em>=0.017) had a significant inverse relationship with mental health in infertile couples.Conclusion: According to the findings, based on the association between marital satisfaction and mental health, mental health can be improved by solving marital problems and enhancing the satisfaction of infertile couples. Hence, the health status of families is improved, denoting the considerable contribution of family counseling centers.
General Gynecology and Pelvic Floor
Sarah Lotfi; Abbas Ahmadi
Volume 7, Issue 4 , March and April 2022, , Pages 354-355
Abstract
Infertility is the failure of the male or female reproductive system to conceive after 12 months or more of regular unprotected sexual intercourse (1). Failure to ovulate, problems in the menstrual cycle, infections, inadequate egg maturation, ejaculation problems, antibodies that attack sperm and tumors ...
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Infertility is the failure of the male or female reproductive system to conceive after 12 months or more of regular unprotected sexual intercourse (1). Failure to ovulate, problems in the menstrual cycle, infections, inadequate egg maturation, ejaculation problems, antibodies that attack sperm and tumors are some of the reasons that can make a man or a woman infertile. COVID-19 is a disease caused by a new type of coronavirus; it is an infectious disease caused by the acute respiratory syndrome of coronavirus 2 (SARS-CoV-2).This article is about the fact that patients with COVID-19 are more prone to infertility than other normal people. There is a possibility that this coronavirus could have a pathophysiological effect on the testes. Additional data have shown that active COVID-19 infection significantly reduces the ratio of testosterone to LH, showing a significant effect on the response of Leydig cells to LH stimulation (2). Men are said to be more likely to get COVID-19 than women; even the mortality rate is higher (3). The testes can be a potential target for the SARS-CoV-2 virus, and testicular damage and subsequent infertility after COVID-19 infection can be explained theoretically (4). It was only in May that six semen samples were positive for SARS-CoV-2 (5).
Reproductive Medicine
Mitra Bakhtiari; Tahereh Babaei; Mostafa Safarpour; Mojtaba Esmaeili; Mojtaba Esmaeili; Rezvan Asgari
Volume 5, Issue 3 , November 2020, , Pages 115-125
Abstract
Background & objective: Various parameters can affect the success of intra cytoplasmic sperm injection (ICSI). This study aims to compare the results of fertility in formerly infertile couples who underwent ICSI considering different parameters.Materials & Methods: In this retrospective ...
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Background & objective: Various parameters can affect the success of intra cytoplasmic sperm injection (ICSI). This study aims to compare the results of fertility in formerly infertile couples who underwent ICSI considering different parameters.Materials & Methods: In this retrospective study, 261 cases of infertile couples who referred to Motazedi Infertility Center in Kermanshah, and had successful ICSI from 2011 to 2017, were examined. Statistical analysis was performed after collecting the data.Results: The highest ICSI success rates were in the age range of 31-40 years (58.2%), and 21-30 years (55.8%), in men and women, respectively. Regarding the duration of infertility, the highest success rate was observed in couples who were infertile for less than five years (51.8%). In this study, all the patients’ endometrial thicknesses were normally higher than 4 mm. In terms of the number of embryos formed, the success percentage was 68% with three formed embryos. The hormonal variations and distribution percentages were as following: AMH ranging from 1.01 to 5 ng/mL (55.6%), TES ranging from 0 to 50 nmol/L (53%), TSH ranging from 1.01 to 5 μU/mL (81.6%), FSH ranging from 5.01 to 10 IU/L (58.9%), PRO ranging from 5.01 to 10 ng/mL (24%), LH ranging from 1.01 to 5 IU/L (46.7%), and DHEA-S ranging from 1.01 to 5 ng/mL (18.9%).Conclusion: According to the results, it seems that the success of ICSI technique in infertile couples depends on some parameters including variations in reproductive hormones, number of embryos, couples’ ages, and duration of infertility.
Obstetrics and Gynecology
Zahra Rezaei; Mehrnaz Valadan; Elahe Zabihi Soltani
Volume 5, Issue 2 , October 2020, , Pages 44-48
Abstract
Background & Objective: Laparoscopic ovarian drilling (LOD) is a method for ovulation induction in polycystic ovary syndrome (PCOS) patients. The aim of this study was to evaluate the serum levels of anti-Mullerian hormone (AMH) and follicle-stimulating hormone (FSH) before and after LOD in one or ...
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Background & Objective: Laparoscopic ovarian drilling (LOD) is a method for ovulation induction in polycystic ovary syndrome (PCOS) patients. The aim of this study was to evaluate the serum levels of anti-Mullerian hormone (AMH) and follicle-stimulating hormone (FSH) before and after LOD in one or two ovaries in women with PCOS.Materials & Methods: This study was a prospective cohort study. The study population included infertile women with PCOS resistant to clomiphene referred to the Infertility Clinic of Yas Hospital. They were candidates for LOD in 2016–2017. The serum levels of AMH and FSH were measured before and after three months in two groups of unilateral and bilateral LOD. Data were analyzed using Stata software.Results: A total of 35 female patients were enrolled in the study, 18 (51.4%) in bilateral and 17 (46%) in unilateral LOD groups; the average age of patients was 27 ± 3.4 years old. AMH levels significantly (P < /em><0.001) decreased in both unilateral and bilateral groups after LOD. FSH levels significantly (P < /em><0.001) increased in both groups after LOD, but this increase was higher in the unilateral group than in the bilateral group, and this difference was statistically significant (P < /em><0.001).Conclusion: It seems women with clomiphene-resistant PCOS when underwent unilateral or bilateral ovarian drilling experienced a significant decrease in AMH and a significant increase in FSH, indicating a decrease in their ovarian reserve.
Obstetrics and Gynecology
Zahra Rezaei; Sedigheh Taghdisi
Volume 5, Issue 2 , October 2020, , Pages 61-67
Abstract
Background & Objective: Many factors are essential for a pregnancy to be successful. Recognizing the factors caused by surgical trauma may be effective in guiding pregnancies toward success using the assisted reproductive treatment methods. Surgery changes the natural anatomical relation ...
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Background & Objective: Many factors are essential for a pregnancy to be successful. Recognizing the factors caused by surgical trauma may be effective in guiding pregnancies toward success using the assisted reproductive treatment methods. Surgery changes the natural anatomical relation between the ovaries and fallopian tubes. Tubal surgery is hypothesized to reduce ovarian reserve due to the anatomical relationship between the ovarian arteries and nerves and fallopian tubes. There is no consensus on whether or not salpingectomy affects ovarian reserve. Some authors believe that salpingectomy has no effects, while others suggest that it diminishes ovarian reserve. Therefore, comparing fertility rates between women undergoing in vitro fertilization with tubal factor infertility with surgery, tubal factor infertility without surgery, and unexplained infertility can provide valuable data.Materials & Methods: Eighty patients who met the inclusion criteria were studied. Study groups included people with a history of tubal surgery, individuals who had tubal problems without a history of surgery, and cases with unexplained infertility. Anti-Mullerian hormone (AMH) was measured every day of the cycle and other hormones, including follicle-stimulating hormone (FSH), luteinizing hormone, prolactin, and thyroid-stimulating hormone (TSH) were assessed on days 2-5 of the cycle. On the third day of the menstrual cycle, the uterus, endometrial thickness, ovaries, the size of the ovaries, and antral follicle count were evaluated using transvaginal sonography. Following ovulation induction, treatment-related factors, namely endometrial thickness, gonadotropin (Gn) time and count, E2, viable embryos, and good quality embryos, were examined.Results: Our findings showed no difference between the study groups in terms of treatment-related factors. No significant correlation was observed between the studied groups and chemical pregnancy (P < /em>=0.9514). moreover, the studied groups were not significantly correlated with clinical pregnancy (P < /em>=0.5052).Conclusion: The AMH was correlated with FSH, AFC, E2, and gonadotropin time and count. According to the results of the present study, tubal surgery does not affect the outcome of assisted reproductive cycles.
Mahdieh Kafaee Ghaeini; Mohammad Reza Amin-Naseri; Marzieh Aghahoseini
Volume 3, Issue 4 , November and December 2018, , Pages 149-155
Abstract
Background & Objective: Studies have shown that despite the numerous research carried out regarding infertility treatment, there is still a long way to treat this disease satisfactorily. Spending a lot of time and money on infertility treatments proves the necessity of designing a model which could ...
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Background & Objective: Studies have shown that despite the numerous research carried out regarding infertility treatment, there is still a long way to treat this disease satisfactorily. Spending a lot of time and money on infertility treatments proves the necessity of designing a model which could predict the result of treatment methods with an acceptable accuracy; a model that could help physicians to get rid of trial and error for treatment methods which should step by step be applied on an infertile couple. Intracytoplasmic Sperm Injection (ICSI) is one of the assisted reproductive techniques. Statistics have indicated that the probability of pregnancy occurrence is only about 30% using this method. In this paper, a model which could predict the result of (ICSI) was presented using the decision tree and support vector machine methods.
Materials & Methods: The applied data were collected in seven months from December 2012 to June 2013 by analyzing 251 treatment cycles in Omid Fertility Clinic. Input variables of the model were parameters like couple’s medical records, hormonal tests, the cause of infertility, and the like. The output variable was the occurrence or nonoccurrence of the clinical pregnancy (the pregnancy resulting in the formation of the fetal heart). One of the innovations of this study was that the input variables of the model were only preoperative, while in previous studies, having information about some of the surgery stages, such as quality of the egg and the like, was required to anticipate the result of the surgery.
Results: The obtained accuracy using the decision tree and support vector machine methods were 70.3% and 75.7%, respectively.
Conclusion: The results of the current study demonstrated that the support vector machine method had a better performance compared to the decision tree method. Presented model predicts the occurrence or nonoccurrence of a clinical pregnancy follows (ICSI), with a precision of 75.7%.
Setareh Akhavan; Jila Agah; Abbas Alipour
Volume 3, Issue 2 , May and June 2018, , Pages 59-63
Abstract
Aims: Ovarian cancer is the 4th cause of women’s mortality occurring due to cancer. Malignant germ cell tumors (GCTs) account for 5% of malignant ovarian tumors and 70% of ovarian tumors in women between the ages of 10-30 years old. The aim of the present study was to detect the frequency of malignant ...
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Aims: Ovarian cancer is the 4th cause of women’s mortality occurring due to cancer. Malignant germ cell tumors (GCTs) account for 5% of malignant ovarian tumors and 70% of ovarian tumors in women between the ages of 10-30 years old. The aim of the present study was to detect the frequency of malignant ovarian germ cell tumor and distribution of demographic features in the most crowded gynecology oncology clinic.
Materials and Methods: This cohort descriptive-analytical study was conducted on cases with malignant ovarian tumor managed in Vali-Asr hospital, Tehran, Iran, from 2001 to 2018 (n=1540). The malignant germ cell tumors cases were extracted (n=128) and evaluated in point of epidemiologic and demographic data via the software SPSS 24.
Findings: 128 patients (8.3%) had GCTs. The average age was 23.88±7.85 years. 79.7% lived in the city, 76.6% had medium economic status and 53.6% had normal body mass index. Premature puberty was revealed in one person. Karyotype XY was detected in 5 persons. About 70.3% of the patients had no parity. In parous women, the highest percentage was related to a childbirth (55.0%). A history of infertility was detected at 6.1%. In 10 patients, the tumor was detected during pregnancy.
Conclusion: The highest frequency is related to the early young women with no considerable association with socioeconomic and weight status. It is possible that parity would be a protective factor for this tumor. In the case of adnexal mass during pregnancy, Malignant Germ cell tumors should be rolled out.
Mina Jafarabadi; Fatemeh Ramezanzadeh; Samarand Salimi; Tahereh Forooghifar
Volume 2, Issue 1 , March and April 2017
Abstract
Background: Both in-vitro maturation and in-vitro fertilization have been used successfully to treat females with polycystic ovarian syndrome, who plan to have child. This study compared outcome of these two approaches to fertilize females with polycystic ovary side effects.
Methods: This prospective ...
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Background: Both in-vitro maturation and in-vitro fertilization have been used successfully to treat females with polycystic ovarian syndrome, who plan to have child. This study compared outcome of these two approaches to fertilize females with polycystic ovary side effects.
Methods: This prospective study was conducted at Vali-Asr reproductive health research center and included all females with polycystic ovarian syndrome, who underwent in-vitro maturation or in-vitro fertilization from January 2005 to January 2008. Measurements included demographic data, total cost (including drug and laboratory procedures), outcome (chemical and clinical pregnancy), and systemic complication (ovarian hyper-stimulation syndrome), obtained from the patients’ clinical files. Patients were informed about the procedures, side effects and goals, and the signed consent form for surgical approaches and use of their data in medical research. Finally, these variables were compared between the two groups.
Results: The in-vitro maturation and in-vitro fertilization groups included 20 and 22 patients, respectively. The range of body mass index was between 17.4 and 28.3 kg/m2 and the mean age of the patients was 29.35 ± 4.94 and 28.95 ± 3.84 years, respectively (P > 0.05). The total cost was significantly lower in in-vitro maturation group compared to in-vitro fertilization (201.6 ± 60.1 USD versus 380.5 ± 143.8 USD, respectively, P < 0.001). Positive outcomes were achieved significantly more frequently with the in-vitro fertilization method (1 chemical and no clinical pregnancy in in-vitro maturation versus 7 and 6 in in-vitro fertilization group, respectively, P < 0.001). Although, the rate of ovarian hyper-stimulation syndrome was higher in in-vitro fertilization than in in-vitro maturation approach, yet, it was not statistically significant (P = 0.233).
Conclusions: Our findings showed the superiority of execution of the in-vitro fertilization approach compared with the in-vitro maturation method in infertile females with polycystic ovary syndrome, who planned to have a child. However, in-vitro maturation approach is cheaper than in-vitro fertilization and is also associated with lower risk of ovarian hyper-stimulation syndrome.
