Journal of Reproduction & Infertility
Year:2015 | Volume:16 | Issue:2|Papers Count:10

Evolutionary development of the immune system dates back to the emergence of life in the universe. Immune system emerges early in the course of embryogenesis; immune-restricted progenitor cells appear very early during development in the yolk sac and contribute later to the emergence of lymphoid and myeloid components of the immune system. Immune system consists of biological structures, entities, players and processes with a multiplex and intricate interaction with other body systems. It inspects and senses every subtle change in the expression level, stereochemical composition and conformation of the molecules and accordingly mounts regulatory responses. In physiological condition, immune system remains steady and delicately balanced; a small change in the normal physiological processes is concomitantly followed by immediate counter-regulatory mechanisms of the immune system leading to establishment of a new level of immunological balance.

Background: The human seminal fluid is a complex body fluid. It is not known how many proteins are expressed in the seminal plasma; however in analog with the blood it is possible up to 10,000 proteins are expressed in the seminal plasma. The human seminal fluid is a rich source of potential biomarkers for male infertility and reproduction disorder.Methods: In this review, the ongoing list of proteins identified from the human seminal fluid was collected. To date, 4188 redundant proteins of the seminal fluid are identified using different proteomics technology, including 2-DE, SDS-PAGE-LC-MS/MS, MudPIT. However, this was reduced to a database of 2168 non-redundant protein using UniProtKB/Swiss-Prot reviewed database.Results: The core concept of proteome were analyzed including pI, MW, Amino Acids, Chromosome and PTM distribution in the human seminal plasma proteome. Additionally, the biological process, molecular function and KEGG pathway were investigated using DAVID software. Finally, the biomarker identified in different male reproductive system disorder was investigated using proteomics platforms so far.Conclusion: In this study, an attempt was made to update the human seminal plasma proteome database. Our finding showed that human seminal plasma studies used to date seem to have converged on a set of proteins that are repeatedly identified in many studies and that represent only a small fraction of the entire human seminal plasma proteome.

Background: Toll-like receptor (TLR)-mediated inflammatory processes are supposed to be involved in pathophysiology of spontaneous abortion and preterm labor. Here, we investigated functional responses of human endometrial stromal cells (ESCs) and whole endometrial cells (WECs) to lipopolysaccharide (LPS) and lipoteichoic acid (LTA).Methods: Endometrial tissues were obtained from 15 cycling women who underwent laparoscopic tubal ligation. Modulation of TLR2, TLR4 and MyD88 expression and production of pro-inflammatory cytokines by WECs and ESCs in response to LPS and LTA were assessed.Results: WECs and ESCs expressed significant levels of TLR4 and MyD88 transcripts but, unlike WECs, ESCs failed to express TLR2 gene. Regardless of positive results of Western blotting, ESCs did not express TLR4 at their surface as judged by flow cytome-try. Immunofluorescent staining revealed intracellular localization of TLR4 with pre-dominant perinuclear pattern. LPS stimulation marginally increased TLR4 gene expression in both cell types, whereas such treatment significantly upregulated MyD88 gene expression after 8 hr (p<0.05). At the protein level, however, LPS activation significantly increased TLR4 expression by ESCs (p<0.05). LTA stimulation of WECs was accompanied with non-significant increase of TLR2 and MyD88 transcripts. LPS and LTA stimulation of WECs caused significant production of IL-6 and IL-8 in a dose-dependent manner (p<0.05). Similarly, ESCs produced significant amounts of IL-6, IL-8 and also TNF-α in response to LPS activation (p<0.05).Conclusion: Our results provided further evidence of initiation of inflammatory processes following endometrial TLR activation by bacterial components which could potentially be harmful to developing fetus.

Background: Genital Chlamydia infection (GCI) and the associated pathologies have been implicated in tubal infertility. Though the actual pathologic mechanisms are still uncertain, oxidative stress and other factors have been implicated. The purpose of the study was to determine the possible contribution of female reproductive hormones and biomarkers of oxidative stress in genital Chlamydial infection to tubal occlusion.Methods: This prospective case control study was carried out by recruiting 150 age matched women grouped into infertile Chlamydia positive women (n=50), fertile Chlamydia positive women (n=50) and fertile Chlamydia negative women as controls (n=50). High vaginal swabs and endocervical swabs were collected for screening Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, Trepo-nema pallidum, Staphylococcus aureus, and Candida albicans. Sera were collected for estimation of Chlamydia trachomatis antibody, female reproductive hormones [Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), Oestradiol (E2), Progesterone (P4), Prolactin (PRL)] and biomarkers of oxidative stress [Total Antioxidant Capacity (TAC) and 8-hydroxyl-2-deoxyguanosine (8-OHdG)] by enzyme immunoassay (EIA). Data were analyzed using chi square, analysis of variance and LSD Post hoc to determine mean differences at p=0.05.Results: Among women with GCI, higher levels of LH and 8-OHdG were observed in infertile Chlamydia positive women compared to fertile Chlamydia positive women (p<0.05). Higher levels of LH and 8-OHdG and lower TAC levels were observed in infertile Chlamydia positive women compared to fertile Chlamydia negative controls (p<0.05).Conclusion: Mechanisms including oxidative DNA damage and reduced antioxidant capacity may be involved in the pathology of Chlamydia induced tubal damage.

Background: placenta previa (PP) is an obstetric complication that can affect maternal and fetal morbidity and mortality. Its prevalence is rising due to cesarean sections. There is no quantitative data of placenta in PP. In this study, quantitative parameters of placenta in cases with PP in comparison with normally implanted controls were investigated.Methods: In this quasi experimental study, placentas from pregnancies with PP and normally implanted controls (n=10) were obtained from women who underwent cesarean section. Three full-thickness columns of each placenta were sampled using systematic uniform random sampling (SURS). Columns were cut into slices and slices were sectioned with 4 mm thickness. SURS selected sections were stained by Masson’s trichrome. Stereological analysis was done on 8-10 SURS microscopic fields of each section. Absolute volume and volume density of chorionic villi, inter-villous space, syncytiotrophoblast, fibrin and blood vessels in chorionic villi were estimated in both groups. Statistical analysis was done using Mann Whitney-U test and significant level was set at p<0.05.Results: There was a significant reduction in total volume and volume density of fibrin deposits on the surface of chorionic villi (p<0.05), and a significant increment in total volume and volume density of chorionic villous blood vessels in PP group in comparison with C group (p<0.05).Conclusion: Results showed that impairment in situation of implantation in PP can cause significant changes in the structure of placenta. These changes probably can be influential on the evolution and survival of fetus.

Background: GnRH agonist administration in the luteal phase has been suggested to beneficially affect the outcome of intracytoplasmic sperm injection (ICSI) and embryo transfer (ET) cycles. This blind randomized controlled study evaluates the effect of GnRH (Gonadotropine Releasing Hormone) agonist administration on ICSI outcome in GnRH antagonist ovarian stimulation protocol in women with 2 or more previous IVF/ICSI-ET failures.Methods: One hundred IVF failure women who underwent ICSI cycles and stimulated with GnRH antagonist ovarian stimulation protocol, were included in the study. Women were randomly assigned to intervention (received a single dose injection of GnRH agonist (0.1 mg of Decapeptil) subcutaneously 6 days after oocyte retrieval) and control (did not receive GnRH agonist) groups. Implantation and clinical pregnancy rates were the primary outcome measures.Results: Although the age of women, the number of embryos transferred in the current cycle and the quality of the transferred embryos were similar in the two groups, there was a significantly higher rate of implantation (Mann Whitney test, p=0.041) and pregnancy (32.6% vs. 12.5%, p=0.030, OR=3.3, 95%CI, 1.08 to 10.4) in the intervention group.Conclusion: Our results suggested that, in addition to routine luteal phase support using progesterone, administration of 0.1 mg of Decapeptil 6 days after oocyte retrieval in women with previous history of 2 or more IVF/ICSI failures led to a significant improvement in implantation and pregnancy rates after ICSI following ovarian stimulation with GnRH antagonist protocol.

Background: Sexual affairs are one of the physiological needs affecting human health. Sexual functioning disorders can reduce individual’s capabilities and creativities. Sexual relations are in the center of women’s quality of life. The most important family planning is to prevent unintended pregnancies. Injectable contraceptives protect women exposed to many complications and mortality due to unintended pregnancies, with tolerable effects on other aspects of women’s life. An important aspect of women’s life is sexual health. This study aimed to compare sexual function of women using DMPA with women using Cyclofem presented to health centers affiliated to Shahid Beheshti University of Medical Sciences in Tehran, Iran in 2013.Methods: This descriptive-comparative study was conducted on 240 women in health centers in Tehran, Iran. They were selected by multistage sampling. The data was collected using a questionnaire completed by interviewing. The questionnaire had 2 parts, demographic characteristic section and Female Sexual Function Index (FSFI). Data was analyzed by descriptive statistics, independent T-test, U-test, Chi-square, Fisher exact test. The p-value less than 0.05 were applied for all statistical tests as significance level.Results: The difference in sexual function between Cyclofem and DMPA groups was insignificant, but in terms of sexual desire in DMPA users better than and sexual pain them less than in Cyclofem users, the difference between the groups was significant (p<0.05).Conclusion: In introducing hormonal contraceptive methods, health workers should emphasize their adverse effects on sexual function. Women who use Cyclofem and DMPA should be aware that they may experience some changes in libido and sexual pain.

Background: It has been demonstrated that insulin signaling pathway related genes have important roles in polycystic ovary syndrome (PCOS) risk. The goal of present investigation was to assess the potential association between INSR/NsiI (rs2059806) and INSR/PmlI (rs1799817) SNPs and PCOS.Methods: 50 women with PCOS and 47 normal controls entered the study. NsiI and PmlI SNPs in the INSR gene were determined by RFLP-PCR.Results: INSR/NsiI (rs2059806) SNP GG, GA, AA, G and A genotypic and allelic frequencies were 45(90%), 5(10%), 0(0%), 95 (95%) and 5 (5%) in cases and 41 (87.2%), 6 (12.8%), 0 (0%), 88 (93.6%) and 6(6.38%) in controls, respectively. INSR/ PmlI (rs1799817) SNPs resulted in three genotypes of CC, CT, and TT with C and T alleles. The frequencies of PmlI (rs1799817) SNPs in the INSR gene were 37 (37%) and 63 (63%) in cases, also 39 (41.49%) and 55 (58.51%) in controls regarding T and C alleles. The frequencies of PmlI (rs1799817) SNPs in the INSR gene were 4 (8%), 29 (58%), and 17 (34%) in cases, also 5(10.64%), 29 (61.7%), and 13 (27.66%) in controls regarding TT, TC, and CC genotypes, respectively.Conclusion: The present study as the first investigation of its own kind in Iranian Azeri Turkish women, reported no association between NsiI (rs2059806) and PmlI (rs1799817) SNPs in the INSR gene and PCOS risk.

Background: Posterior urethral valve presenting in adulthood is uncommon. This can be an unusual cause of primary male infertility as a result of abnormalities in sexual function.Case Presentation: This report describes a 40 year old man who presented to us on account of inability to impregnate his wife after 2 years of marriage. History revealed poor stream of urine since childhood and passage of scanty ejaculate during intercourse. A micturating cystourethrogram revealed dilated posterior urethra in keeping with posterior urethral valves. Endoscopic valve ablation was done with subsequent improvement in ejaculate volume and urine stream. His spouse achieved pregnancy thereafter.Conclusion: In this report, it was found that adult posterior urethral valve though uncommon may be a cause of male infertility. Restoration of fertility potential can be achieved following valve ablation.

Background: Globozoospermia is a rare (incidence of 0.1% among andrological patients) and poorly understood condition, but a severe disorder in male infertility. This case report detailed the course of treatment and protocol of a patient with type 1 globozoospermia using Intracytoplasmic Sperm Injection (ICSI) and oocyte activation by calcium ionophore, which yielded conception and birth of a healthy baby after six previous unsuccessful attempts, using ICSI alone.Case Presentation: A 39-year-old male with normal findings on routine examination presented to TDV 29 Mayis Hospital, Assisted Reproduction Unit (ART) with his 37-year-old wife. Her examination was also within normal limits and ovulatory cycle was regular. The male’s diagnostic screening revealed normal karyotype (46, XY) and no Y-microdeletion. However, the spermogram was abnormal; sperm count of 14 million/ml with 35% active motility and 100% morphologically abnormal sperm, indicating globozoospermia. Ovarian stimulation was provided using classic long down-regulation protocol and 13 MII oocytes were collected. Next, calcium ionophore was applied following the ICSI procedure to improve the chances for fertilization. The case report compared quantitative procedural and diagnostic screening data, and fertilization rates. On day 5, two grade 1 blastocysts out of 5 embryos were transferred, yielding positive beta-human chorionic gonadotropin (beta hCG), and ultimately a healthy delivery.Conclusion: ICSI with assisted oocyte activation by calcium ionophore may overcome male infertility where there is total globozoospermia.