Journal of Reproduction & Infertility
Year:2013 | Volume:14 | Issue:1 (54)|Papers Count:10

Primary ovarian insufficiency or premature ovarian failure (POI/POF) is one the causes of female infertility. POI is defined as cessation of menstrual periods, increased levels of FSH and diminished levels of estrogens before the age of 40. POI occurs in about 1% of women between 30 to 40 years of age, 0.1% of those under 30 and 0.01% of women under the age of 20. Fertility of women with POI is severely diminished, but unlike menopause, POI may be accompanied with spontaneous ovarian activity and natural pregnancies. The major causes of POI include autoimmunity, genetic and environmental factors. At the same increased prevalence of gynecological and other cancers, improvement in the treatment procedures has led to better survival rates but increased incidence of POI in women during reproductive age during the past few decades (1).

Apparent rise in the incidence of infertility in females and the trend shifting towards delayed child bearing brought up the concept of ovarian ageing. Women in their early thirties show poor ovarian reserve which is an entity named as early ovarian ageing. Early ovarian ageing is mostly genetically determined, but acquired modifiable factors like smoking, or ovarian surgery have some roles. Infertility and subfertility are the only clinical recognizable sequelae in the early ovarian ageing. The worrisome fact is that the outcome of assisted reproductive techniques is also not that much encouraging. Even if ovarian priming with DHEA has raised hope in the assisted reproductive techniques for these patients, but more randomized trials are needed to support this. Screening of these women with antimullerian hormone, antral follicle count and genetic analysis may be useful for recommendation at appropriate biological time regarding conception or fertility preservation.

Background: The cells of mammalian female reproductive tract have been widely used for in vitro fertilization (IVF). This study was designed to study the effects of oviductal epithelial cells (OECs) and their conditioned medium during IVF on subsequent embryonic development and the relative abundance of zygote arrest 1 (Zar1) transcript in ovine zygotes.Methods: The in vitro matured ovine oocytes were randomly fertilized in the following culture conditions: I) SOFaaBSA+20% sheep serum (control), II) SOFaa BSA+20% sheep serum (50 ml) in the presence of OECs, III) SOFaaBSA+20% sheep serum (100 ml) in the presence of OECs, and IV) OECs conditioned medium (CM). Sigma Stat (Version 2.0) software and one-way ANOVA were considered for statistical analysis. A p<0.05 was considered statistically significant.Results: The cleavage, blastocyst, and hatched blastocyst rates in OECs and CM groups were significantly lower than the control group (p<0.01). In co-cultured groups, the application of two different volumes of IVF medium showed no difference in embryonic developmental indices. The Zar1 gene expression in zygotes produced in the presence of OECs was significantly higher than those produced in the control and CM groups (p<0.05).Conclusion: Neither the presence of oviductal epithelial cells nor their conditioned medium could improve the developmental potential of ovine embryos during IVF. Moreover, no relationship was observed between the relative abundance of Zar1 transcript in zygotes produced in different conditions and the corresponding subsequent embryonic development.

Background: Spermatogonial stem cells are subpopulation of spermatogonial cells in testis tissue that support beginning and maintenance of spermatogenesis. Ubiquitin carboxy-terminal hydrolase L1 (UCHL1) could be a specific marker for identification of spermatogonial stem cells including spermatogonial sperm cells (SSCs) in testis tissue and during the culture; therefore we undertook this study to culture these human testicular stem cells (hTSCs) in vitro and approved the presence of human testicular stem cells (hTSCs) by UCHL1, also known as PGP9.5.Methods: Enzymatic digestion of human testicular biopsies was done by colla-genase IV (4 mg/ml) and trypsin (0.25%). Differential plating of testicular cells in DMEM/F12 and 10% FBS was applied for 16 hr. Floating cells were collected and transferred onto laminin-coated plates with Stem-Pro 34 media supplemented with growth factors of GDNF, bFGF, EGF and LIF to support self-renewal divisions; testicular stem cell clusters were passaged every 14 days for two months. Spermato-gonial cells propagation was studied through Expression of UCHL1 in testis tissue and the entire testicular stem cell culture.Results: Testicular stem cell clusters from 10 patients with obstructive azoospermia were cultured on laminin-coated plates and subsequently propagated for two months. The average of harvested viable cells was approximately 89.6%. UCHL1 was expressed as specific marker in testicular stem cells entire the culture.Conclusion: Human testicular stem cells could be obtained from human testicular tissue by a simple digestion, culturing and propagation method for long-term in vitro conditions. Propagation of these cells approved by specific marker UCHL1, during the culture period.

Background: This study was undertaken to evaluate the role of day 3 FSH/LH ratio and day 3 LH level as predictors of IVF cycle outcomes.Methods: This prospective observational study was undertaken in the IVF and Reproductive Biology Centre and Lok Nayak Hospital, affiliated to Maulana Azad Medical College, in New Delhi, India. The study included 105 women who underwent controlled ovarian hyperstimulation for in vitro fertilization. Characteristics of IVF cycles and outcomes were studied in patient subgroups based on day 3 FSH/LH ratio (<2 and ³2) and day 3 LH levels (>3 and £3 mIU/ml). The student t-test, Bartlett's test, chi-squred (c2) and Fisher's exact test, and linear regression model were used for data analysis. A p-value less than 0.05 was considered as statistically significant.Results: Women with an elevated FSH/LH ratio ³2 (n=31) required higher doses of gonadotrophins (3019.34 vs. 2482.43 IU). The outcome of IVF was poor in these patients and they had fewer number of mature follicles (>16 mm) (5.44 vs. 6.09), less E2/mature follicle ratio (4.65 vs. 6.36), fewer retrieved oocytes (6.67 vs. 9.09) and fewer pregnancy rates (11.1% vs. 33.8%). On the other hand, patients with low basal LH levels (£3 mIU/ml) did not differ significantly in terms of response to controlled ovarian hyperstimulation except for fewer number of retrieved oocytes (7.33 vs. 7.91) but there was a trend towards poor pregnancy rates (7.33 vs. 7.91) but there was a trend towards poor pregnancy rates as compared to subgroup with LH levels >3 mIU/ml.Conclusion: Elevated day 3 FSH/LH ratio is associated with inferior outcome in IVF treatment cycles and it could be used as an additional predictor of decreased ovarian reserve.

Background: Chlamydia trachomatis is the most reported bacterial sexually transmitted disease, especially among young women worldwide. The aim of this study was comparison the prevalence of Chlamydia trachomatis infection in woman with tubal infertility by means of PCR and cell culture techniques.Methods: Fifty-one women with confirmed TFI were enrolled in this study in (avicenna infertility Clinic) between January 2010 and January 2011. Cervical swab and cytobrush specimens were collected from each patient by gynecologists and sent to laboratory in transport media. Detection of Chlamydia trachomatis in samples was performed using PCR and bacteria culture in MacCoy cell line. The data were analyzed by Fisher’s exact test and independent t-test. Statistical significance was established at a p-value <0.05.Results: A significant relation was observed between increased the age of first intercourse and chlamydial infection. Six (11.7%) samples had positive PCR result, whereas cell culture results were positive in only 2 (3.9%) samples. A significant relation was also identified between the duration of infertility and infection (p<0.05) by PCR versus cell culture method.Conclusion: The results showed that PCR is a rapid method, compared to cell culture for detecting Chlamydial organism. It also became clear that the age at first intercourse is important to predict the likelihood of Chlamydia trachomatis.

Background: Sexual practices as an important aspect of reproductive health have many physical and psychological effects on people’s lives, there is limited evidence on such practices and their pattern among Iranian women. Hence we aimed to determine different types of sexual practices among 1945 year old married Iranian women.Methods: This cross-sectional study was conducted among 200 married women, aged 19-45 years, attending Taleghani Public Health Center for annual gynecologic examination during November 2008 to May 2009 using convenient sampling. The participants were enquired about their experience regarding different types of sex, as well as their views and feelings about such practices, using an anonymous questionnaire.Results: The mean age of the participants was 34 years. All had ever experienced vaginal sex and 50.9% reported ever experience of other types of sex (non-vaginal), as well. Due to some stigma attached to non-vaginal sexual practices among women in Iran, the feelings of women with regard to different sexual practices were also examined in this paper.Conclusion: This study showed that non-vaginal sex among women is considerable and because of less favourable views of women towards such practices, it seems that these practices might have psychologically impacts on women’s life. Hence, counseling and educational programs designed for married men and women can include some factual information about different types of sex.

Background: A bulk of contraceptives on the market is women-oriented today. The aim of this study was to investigate the effect of a medicinal herb, Acacia nilotica on various parameters of male fertility using a rat model.Methods: Male Wistar rats (n=40) were randomly divided in to two groups. One group received Acacia nilotica, while the other acted as controls. Ten animals from each group were sacrificed after 16 weeks. Treatment was withdrawn for the remaining animals for 8 weeks. Blood was collected for hormonal analysis. The testis was removed for histological examination, while epididymal spermatozoa were retrieved for motility and morphological analysis. The data were analyzed using ANOVA and Bonferroni post hoc test. A value of p<0.05 was considered statistically significant.Results: Sperm motility, progressive motility and sperm concentration significantly decreased in treated animals compared to the controls (p<0.05). Withdrawing the treatment did not restore these parameters (p<0.05). Abnormal sperm morphology significantly increased in both the treated and treatment withdrawn groups when compared to the controls (p<0.05). Testosterone concentrations were significantly lower in the treated group when compared to the controls (p<0.05) and no significant differences were observed between the controls and the treated animals when treatment was withdrawn. Histological observations showed that Acacia nilotica treatment disrupted semeniferous tubule architechture and consequently the spermatogenesis process.Conclusion: These results show that Acacia nilotica severely affects sperm morphology, progressive motility and sperm concentration irreversibly in Wistar rats.

Background: Uterine rupture at the site of a previous cesarean scar is an uncommon but catastrophic complication of pregnancy, which is associated with significant maternal and fetal morbidity and mortality.Case Presentation: A 30-year old woman at 24th week of gestation and complaint of pain, contractions and spotting was admitted in Royan Institute in Tehran, Iran. She had a past medical history of an EP and a cesarean section delivery, respectively 4 and 2 years before hospitalization. Herniation of an amniotic membrane into the maternal bladder was found on ultrasound examination.Conclusion: Risk factors of cesarean scar rupture should be considered in women undergoing subsequent pregnancies as they need extra care. Ultrasonography can be used to evaluate women with previous cesarean section to assess the risks of scar rupture during subsequent pregnancies.

Endometriosis is a gynecologic disorder characterized by the presence of viable, extrauterine endometrial tissue, predominantly on the ovary and pelvic peritoneum (1-3). Typical symptoms consist of pelvic pain, dysmenorrhea, and infertility (1, 2). This condition takes place only in women of menstrual age, can grow or bleed cyclically and may cause adhesions (1, 2). Endometriosis represents a worldwide social disease compromising quality of life (1, 2).