Reproductive Medicine
Samira Negahdari; Maede Nilechi; Mehdi Forouzesh; Seyed Farzad Hosseini; Azin Samimi; Mohsen Maleknia; Samira Valiyari; Marzieh Tavalaee
Volume 8, Issue 2 , January and February 2023, , Pages 95-104
Abstract
Surrogacy is an assisted reproductive technology in which the intended parents allocate the gestation and birth to another woman named the surrogate mother. From this view of surrogacy, although there is no genetic relationship between surrogate mother and fetus, this approach is faced with some ...
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Surrogacy is an assisted reproductive technology in which the intended parents allocate the gestation and birth to another woman named the surrogate mother. From this view of surrogacy, although there is no genetic relationship between surrogate mother and fetus, this approach is faced with some issues such as the epigenetic effect, which is the environmental influence on gene expression. Epigenetics plays a critical role in ovulation, spermatogenesis, and embryonic growth, development, and health. DNA methylation, histone modification, and non-coding RNAs activity are the major epigenetic mechanisms. In this mini-review, we focus on the possibility of epigenetic alterations during in vivo embryo culture and intrauterine life.
Reproductive Medicine
Marzieh Mehrafza; Azadeh Raoufi; Elmira Hosseinzadeh; Gholam Reza Pourseify; Tahereh Zare Yousefi; Termeh Shakery; Amirhossein Tamimi
Volume 7, Issue 6 , September and October 2022, , Pages 518-523
Abstract
Background & Objective: Autologous platelet-rich plasma consists of concentrated autologous plasma and several cytokines and growth factors released by activated platelets in injury and inflammation. There is an increasing trend towards the effectiveness of intrauterine PRP infusion in repeated implantation ...
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Background & Objective: Autologous platelet-rich plasma consists of concentrated autologous plasma and several cytokines and growth factors released by activated platelets in injury and inflammation. There is an increasing trend towards the effectiveness of intrauterine PRP infusion in repeated implantation failure patients. The aim of the present study was to describe the impact of intrauterine platelet-rich plasma infusion on the live birth rate in patients with repeated implantation failure.Materials & Methods: The present retrospective uncontrolled study was performed on 96 patients with more than two failed intracytoplasmic sperm injection cycles at Mehr medical institute between 2019 and 2021. Forty-eight hours before embryo transfer, patients received 1 mL lympho-platelet-rich plasma through an intrauterine insemination catheter. Patients were evaluated for pregnancy rate. Endometrial preparation for frozen-thawed embryo transfer was performed.Results: Participants' basal and stimulation characteristics, including gonadotropin dosage, the total number of oocytes, metaphase II oocytes and embryos, endometrial thickness, embryo transfer, quality of transferred embryos, and blastocyst transfer rate were evaluated. A total of 33 and 27 chemical (34.3%) and clinical pregnancies (28.1%) were achieved. Twenty (20.8%) and nineteen (20%) cycles resulted in ongoing pregnancies or live births, respectively. Conclusion: The current study suggests that platelet-rich plasma infusion 48 hours before frozen-thawed embryo transfer may be a good option for repeated implantation failure patients and results in 20% live birth.
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
Ayman S. Dawood; Walid M. Atallah; Tamer M. Assar
Volume 7, Issue 5 , July and August 2022, , Pages 437-444
Abstract
Background & Objective: Secondary infertility resulting from tubal adhesions following cesarean section are not uncommon. The decision to do adhesiolysis or direct IVF/ICSI is to some extent difficult. This study was conducted to evaluate the benefits/risks of either adhesiolysis or direct IVF/ICSI ...
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Background & Objective: Secondary infertility resulting from tubal adhesions following cesarean section are not uncommon. The decision to do adhesiolysis or direct IVF/ICSI is to some extent difficult. This study was conducted to evaluate the benefits/risks of either adhesiolysis or direct IVF/ICSI for patients with secondary infertility due to post-cesarean tubal adhesions.Materials & Methods: Three hundred infertile women with post-cesarean adhesion were recruited and divided into 2 groups either laparoscopic adhesiolysis or ICSI procedure.Results: Demographic data of enrolled patients in both groups were comparable. Regarding types of adhesions, mild adhesions were found in (47.65%) cases, moderate adhesions in (24.83%) cases and severe adhesions in (27.52%) cases. Pregnancy rates were found to be higher in cases with mild adhesions (62.67%) when compared to cases with moderate or severe adhesions (28.00%) and (9.33%) respectively. The overall pregnancy rate in group 1 was 67 (44.97%), while it was 83 (55.70%) in group 2. The pregnancy rate was higher in group 2 but didn't reach statistical significance. The cost of the procedure was significantly higher in group 2 but with significantly lower complication rates. Conclusion: Although assisted reproduction gives the patient higher pregnancy rates with less possibility of complications, it should not be considered the first-choice treatment for patients with post-cesarean adhesions, especially in mild and moderate cases.
Reproductive Medicine
Caspian Ostadian; Marzieh Mehrafza; Azadeh Eftekhari; Shahrzad Aghajani; Hajar Vahabzadeh; Mahdis Gholami; Azadeh Raoufi; Sajedeh Samadnia; Elmira Hosseinzadeh; Ahmad Hosseini
Volume 7, Issue 4 , March and April 2022, , Pages 323-328
Abstract
Background & Objective: The effect of storage time and temperature on the prepared semen sample was evaluated, but the optimal condition is unclear. The aim of this study was to assess the effect of long-term incubation of prepared sperm at testicular temperature versus room temperature on semen ...
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Background & Objective: The effect of storage time and temperature on the prepared semen sample was evaluated, but the optimal condition is unclear. The aim of this study was to assess the effect of long-term incubation of prepared sperm at testicular temperature versus room temperature on semen parameters and DNA fragmentation index (DFI).Materials & Methods: Sperm samples were collected from 40 patients between 2019 and 2020. Each sample was separated into two parts and underwent a non-direct swim-up method. One group was placed in a 35°C incubator, and the other group was kept at room temperature (26°C) in the dark. Both groups were evaluated at intervals of 45 minutes, 24 hours and 48 hours after sampling in terms of sperm concentration, motility, morphology, and DFI. Student t-test and repeated measures analysis of variance were used.Results: Sperm count (P < /em>=0.007) and motility (P < /em><0.001) at 26°C in three-time intervals of 45 minutes, 24 hours and 48 hours were significantly higher than 35°C. The proportion of normal morphology spermatozoa at 26 and 35°C at 45 min, 24 h, and 48 h did not show a significant difference (P < /em>=0.08). DFI at 26°C in three-time intervals was significantly lower than 35°C (P < /em>=0.008).Conclusion: The results of this study indicated that when the prepared sperm samples are incubated for 24 h at 26°C compared to 35°C, they show significantly better quality and good quality of sperm can be retained for several hours if stored at room temperature.
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.
Reproductive Medicine
Ayman Dawood; Mohamed Elnamoury; Walid Atallah
Volume 7, Issue 2 , September and October 2021, , Pages 99-104
Abstract
Background & Objective: Multifetal reduction not only lowers the number of fetuses but also improves pregnancy outcomes. A great conflict emerges when obstetrician faces triplet or higher order multifetal pregnancies. Decision-making is so difficult whether to continue pregnancy as such with ...
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Background & Objective: Multifetal reduction not only lowers the number of fetuses but also improves pregnancy outcomes. A great conflict emerges when obstetrician faces triplet or higher order multifetal pregnancies. Decision-making is so difficult whether to continue pregnancy as such with its risks or reduce the number of fetuses to improve outcomes. This study aimed to assess the obstetrical outcomes of Embryo Reduction to Twins (ERTT) procedures in IVF/ICSI centers in Egypt.Materials & Methods: This retrospective cross-sectional study was conducted from June 2017 to December 2020. Data of the patients in five IVF/ICSI centers were accessed using the computer-stored patients' files. Patients who got pregnant spontaneously or after IVF/ICSI procedures with 3 or more embryos were recruited in the study. The patients were counseled for ERTT and those who accepted the procedure were included. The measured obstetrical outcomes were abortion rate, preterm labor, and preeclampsia, premature rupture of membranes, and neonatal morbidity and mortality.Results: One hundred and twenty four cases were included in this study from 5 IVF/ICSI centers. Most cases (83.87%) of multifetal pregnancies were due to IVF/ICSI procedures. The mean age was 28.3 ± 2.5 years and the mean gestational age at reduction was 8.4 ± 0.6 weeks. The great majority of cases (72.58%) were operated by aspiration. The abortion rate was 29.84%. The mean gestation age at delivery was 34.51 ± 1.82 weeks. The incubator admission rate was 41.93% and the overall postoperative complication was 9.68%.Conclusion: Embryo Reduction to Twins in triplets or higher order pregnancies was considered feasible, safe and linked to minimal complications. The ERTT procedure improved obstetrical and neonatal outcomes.
Reproductive Medicine
Mohammad Nasir Hematian; Mahnaz Ghiasi; Somayeh Baharian; Sedighe Safaie; Mojgan Rahmanian; ُُShirin Torabi; Samaneh Vahdatnia
Volume 7, Issue 1 , September and October 2021, , Pages 7-14
Abstract
Background and Objective: Concerns about adaptation to a new situation can cause anxiousness in pregnant women, which could lead to dangerous consequences. The aim of this study was to evaluate the severity of pregnancy anxiety in mothers with fetuses having cardiac anomalies and their association with ...
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Background and Objective: Concerns about adaptation to a new situation can cause anxiousness in pregnant women, which could lead to dangerous consequences. The aim of this study was to evaluate the severity of pregnancy anxiety in mothers with fetuses having cardiac anomalies and their association with birth outcomes.Materials and Methods: A number of 50 pregnant women were enrolled as the accessible sampling. The diagnosis of congenital heart anomaly was considered in prenatal ultrasound screening (NT ultrasound and anomaly scan). The General Health Questionnaire (GHQ-28), Spielberger State-Trait Anxiety Inventory (STAI), Cambridge Worry Scale (CWS), and Pregnancy Concern Questionnaire (PCQ) were used to evaluate fear, concern and anxiety. Data were analyzed using Wilcoxon statistical test.Results: Six infants had fetal outcomes including low birth weight (IUGR). Fetal prematurity was observed in only one infant. The highest and the lowest levels of anxiety were reported before the echocardiography and within one week after the echocardiography. There was a significant difference between maternal general health score before and 5 days after echocardiography as well as 5 days after echo and 35th week of pregnancy (P < /em><0.05). A significant difference between maternal general health score was observed before fetal echocardiography and at 35th week of pregnancy (P < /em><0.05).Conclusion: The results showed that mothers' anxiety increased significantly after the diagnosis of fetal cardiac anomaly. However, after fetal echocardiography and in the late pregnancy period, the anxiety level reduced in both stages. It was clear that receiving information about unhealthy fetus can cause significant anxiety in mothers.
Reproductive Medicine
Shahrzad Zademodares; Masoumeh Abbaspour; Maryam Anbarluei; Nayereh Rahmati; Marzieh Fathi; Zahra Naeiji
Volume 6, Issue 4 , August 2021, , Pages 161-166
Abstract
Background & Objective: This retrospective study aims to evaluate the impact of pre-gestational maternal age and body weight on the outcome of IVF in women with polycystic ovary syndrome (PCOS). Materials & Methods: Medical records of 200 known cases of PCOS treated in a third level ...
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Background & Objective: This retrospective study aims to evaluate the impact of pre-gestational maternal age and body weight on the outcome of IVF in women with polycystic ovary syndrome (PCOS). Materials & Methods: Medical records of 200 known cases of PCOS treated in a third level referral center by the same therapeutic protocol were evaluated retrospectively. Demographic data, maternal body mass index (BMI), hormonal profile (LH, FSH, estradiol, and anti-mullerian), IVF cycle parameters and outcomes were documented. Patients were categorized into three groups based on their BMI (normal=18.5-24.9, overweight=25-30, obese≥30). IVF cycle parameters and outcomes were compared in the three groups. Effect of age was also evaluated by comparing the results in patients aged <35 and ≥35.Results: Mean age of patients was 32.5 (±5.2). A number of 72 patients had normal BMI, 85 patients were overweighed and 43 cases were obese. Baseline hormonal profile was similar in the three groups. Total dose of administered FSH was similar in the three groups. Number of retrieved oocytes was significantly higher in patients with BMI>30 but the number of mature oocytes and number of embryos were statistically lower in this group. Size of follicles showed no statistically significant difference in the three groups. Clinical pregnancy rate was significantly lower in patients with BMI>30 kg/m2 and age>35 years old.Conclusion: BMI>30 and age>35 years old have a statistically significant negative impact on IVF success rate.
Reproductive Medicine
Khadijeh Saravani; Omid Bameri; Ideh Baradaran Kayal; Pantea Ramezan Nejad
Volume 5, Issue 4 , December 2020, , Pages 131-136
Abstract
Trichomonas vaginitis is the most common non-viral disease that is transmitted sexually. Although metronidazole is the most effective medication for this disease, it has some adverse effects. Herbal medicines have fewer side effects and are more popular among people. This study aimed to review the plants, ...
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Trichomonas vaginitis is the most common non-viral disease that is transmitted sexually. Although metronidazole is the most effective medication for this disease, it has some adverse effects. Herbal medicines have fewer side effects and are more popular among people. This study aimed to review the plants, which are effective against Trichomonas vaginalis and their therapeutic effects. For this purpose, the databases of Scopus, PubMed, Medline, Google Scholar, SID, and Magiran were searched for the articles published during 2000-2019 by keywords, such as Trichomonas vaginalis, complimentary, complementary therapies, herbal medicine, medicinal plants, and their Persian equivalents. All in vivo and in vitro trial studies were included in the present review. The data indicated that some compounds, including eucalyptus, case, and garlic were effective in inhibiting the growth of T. vaginalis.
Reproductive Medicine
Shamim Ashrafi Mahabadi; Farzaneh Tafvizi
Volume 5, Issue 4 , December 2020, , Pages 149-158
Abstract
Background and Objectives: Soluble Leptin Receptor (sOB-R) is the most important leptin-binding protein that can affect the level of active biological leptin. The Gln223Arg polymorphism in the leptin receptor gene is associated with obesity, which can be a factor for infertility. The purpose of ...
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Background and Objectives: Soluble Leptin Receptor (sOB-R) is the most important leptin-binding protein that can affect the level of active biological leptin. The Gln223Arg polymorphism in the leptin receptor gene is associated with obesity, which can be a factor for infertility. The purpose of this study was to evaluate the sOB-R levels in women with unexplained infertility and to investigate the effect of leptin receptor (LEPR) gene polymorphism on sOB-R serum level.Methods: One hundred and two women with unexplained infertility and 112 fertile women were studied in this case-control study. The subjects in both groups had a normal hormonal profile with the age below 40 years. The sOB-R levels were measured using ELISA method.Results: There was a 2-fold decrease in sOB-R level in the infertile group compared to the control group (P < /em>=0.001). Although sOB-R levels were lower in overweight and obese infertile subjects, this difference was not significant. However, this difference was significant compared to the control group. There was a direct correlation between BMI, age, and infertility. Although sOB-R levels in Arg/Arg genotypes were higher in the infertile group than Gln/Gln and Arg/Gln genotypes, they were not statistically significant. A significant decrease was observed in sOB-R levels of Gln/Gln and Arg/Gln genotypes in the infertile group compared to the control.Conclusion: There was a reverse correlation between sOB-R levels and unexplained infertility. It seems that by a decrease in serum sOB-R, the serum leptin levels increase which can enhance leptin inhibitory effects in infertility.
Reproductive Medicine
Zahra Rezaei; Mehrnaz Valadan; Pooneh Shojaee Asl
Volume 5, Issue 3 , November 2020, , Pages 84-87
Abstract
Background & objective: Insulin resistance can be seen in most overweight women with polycystic ovary syndrome (PCOS). Insulin resistance seems to play a key role in the pathophysiology of PCOS and infertility. This study aimed to evaluate the effects of insulin resistance on pregnancy rate ...
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Background & objective: Insulin resistance can be seen in most overweight women with polycystic ovary syndrome (PCOS). Insulin resistance seems to play a key role in the pathophysiology of PCOS and infertility. This study aimed to evaluate the effects of insulin resistance on pregnancy rate and regulation of the menstrual cycle following laparoscopic ovarian electrocautery (LOE).Materials & Methods: This prospective cohort study was conducted on 54 infertile metformin- and clomiphene citrate-resistant women with PCOS at Yas Hospital in 2007. These patients initially took a glucose tolerance test and then classified into two groups (i.e., insulin-resistant and non-insulin-resistant) based on the obtained results. Both groups, then, underwent LOE. Patients were evaluated for pregnancy rate and regulation of the menstrual cycle up to six months.Results: Out of 54 patients, 37 patients (68.5%) were non-insulin-resistant, and 17 patients (31.5%) were insulin-resistant. In the insulin-resistant group, after six months, menstrual cycles were less regular than those of the non-insulin-resistant group (OR=0.2; 95%CI, 0.07-0.87). Fifteen (40.5%) women in the non-insulin-resistant group became pregnant; in contrast, three (17.6%) women in the insulin-resistant group became pregnant. In the logistic regression analysis, the results demonstrated that age, duration of infertility, body mass index (BMI), and insulin resistance had no significant effects on pregnancy rate.Conclusion: Insulin resistance can be an important marker of the poor outcomes of PCOS infertility treatment, and LOE significantly improves insulin resistance in women with PCOS.
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.