International Journal of Fertility & Sterility
Year:2021 | Volume:15 | Issue:1|Papers Count:12

Background: Follicle-stimulating hormone (FSH) plays a crucial role in spermatogenesis; in this study, we assessed the effect of recombinant human FSH (rhFSH) on sperm parameters, chromatin status and clinical outcomes of infertile oligozoospermic men candidates for intracytoplasmic sperm injection (ICSI). Materials and Methods: This interventional randomized clinical trials (IRCT) included 40 infertile oligozoospermic men undergoing ICSI. These individuals were randomized into two groups: 20 men received rhFSH drug for three months and the other 20 men who did not receive rhFSH drug were considered the control group. Before and 3 months after treatment initiation, sperm parameters (using computer-assisted semen analysis) and chromatin status [using chromomycin A3, aniline blue, and sperm chromatin dispersion (SCD) tests] were assessed in these individuals. Furthermore, hormonal profile was assessed using enzyme-linked immunosorbent assay (ELISA). Clinical outcomes of ICSI were also compared between the two groups. Results: The rhFSH treated group showed a significant increase in the level of FSH, luteinizing hormone (LH), testosterone (T) and prolactin (PRL), as well as significant improvements in sperm parameters compared to the control group. Also, after administration of rhFSH, there was asignificant reduction in the percentage of sperm DNA damage, protamine deficiency and chromatin immaturity, while such a reduction in these parameters was not observed in the control group. Moreover, the percentage of embryos with grade Aquality, was significantly higher in the rhFSH group compared to the control group. The pregnancy rate in the rhFSH group was higher than the control group but the difference was insignificant. Conclusion: Administration of rhFSH improves sperm quality in infertile oligozoospermic men and results in higher rates of good quality embryos post-ICSI (Registration number: IRCT20170923036334N2).

Background: Male infertility may originate from a wide spectrum of conditions while in 30-40 percent of cases, no significant reason can be identified. Thereby, it is recognized as male idiopathic infertility. This study was undertaken to investigate the effect of daily intake of selenium, vitamin E and folic acid on sperm parameters in males with idiopathic infertility. Materials and Methods: Seventy infertile men were selected to participate in this single-blind, randomized controlled clinical trial using convenience sampling. They were equally divided into two groups via permuted block randomization method. The intervention group received selenium tablet (200 μ g per day, oral), vitamin E capsule (400 IU per day, oral) and folic acid tablet (5 mg per day, oral). The placebo group received matching placebo for three months. Semen volume, total sperm motility, sperm concentration, progressive sperm motility, normal sperm morphology, sperm motility index (SMI) and functional sperm concentration (FSC) were assessed by sperm quality analyzer-v (SQAV) before and after the intervention. Paired t test, and independent t test were used to compare the results within and between the groups, respectively. The IBM SPSS V. 16. 005 was used for data analysis. A P<0. 05 was considered statistically significant. Results: After three months, according to within-group analysis, a significant difference was found in mean SMI (P=0. 007) and FSC (P=0. 001) in the intervention group. According to between-group analysis, no significant difference was found in mean semen volume (P=0. 610), sperm concentration (P=0. 126), total sperm motility (P=0. 765), progressive sperm motility (P=0. 767), normal sperm morph (P=0. 403), SMI (P=0. 556) or FSC (P=0. 706) between the groups. Conclusion: Consumption of selenium, vitamin E and folic acid in infertile men with asthenozoospermia was not effective (Registration number: IRCT2017012432153N1).

Background: We evaluated the effect of fish oil (FO) and FO in addition to vitamin E (VE) supplementation on total antioxidant activity of dog seminal plasma, and further assessed oxidative stress. Additionally, we measured the effect of this supplementation on hematological parameters and serum biochemistry. Materials and Methods: In this experimental study, six male dogs were assigned to one of the following three groups for a period of 60 days using a replicated 3×3 Latin square design: control (CG), FO (FOG) and FO in addition to VE (FOEG). On days 0 and 60 of the trial, semen and blood samples were obtained. 2, 2V-azino-bis (3-ethylbenzothiazoline-6-sulfonate) (ABTS) and ferric reducing antioxidant power (FRAP) assays were used to determine total antioxidant activity. Oxidative stress was determined by measuring total sulfhydryl group (T-SH). Results: Dogs supplemented with FO alone had a lower total antioxidant activity in seminal plasma (ABTS:-59. 86% vs. CG and-57. 3% vs. FOEG; and FRAP:-37. 3% vs. CG and-40. 5% vs. FOEG), and higher oxidative stress (T-SH: +53. 0% vs. CG and+60. 2% vs. FOEG) compared with the other two groups (P<0. 05). Serum triglyceride (TG) concentration decreased in FOG and FOEG compared with CG, on day 60 (P<0. 01). Conclusion: We concluded that total antioxidant activitydecreased and oxidative stress increased in seminal plasma of dogs after FO supplementation for 60 days.

Background: The relation between key enzymes in regulation of folate metabolism and male infertility is the subject of numerous studies. We aimed to determine whether 5, 10-methylenetetrahydrofolate reductase (MTHFR) C677T and methionine synthase reductase (MTRR) A66G genotypes are associated with male infertility in Iranian men and to evaluate its effect on seminal levels of folate and vitamin B12. Materials and Methods: In this retrospective study, semen and peripheral blood samples were collected from 254 men with oligoasthenoteratozoospermia (OAT) and 77 normozoospermic men who attended Avicenna infertility clinic. Single nucleotide polymorphism (SNP) analysis was carried out in genomic DNA by polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) method for MTHFR C677T and MTRR A66G gene polymorphisms. Results: In MTHFR C677T, our founding showed that T carrier was conversely lower in OAT than normozoospermic men (χ 2-test=7. 245, P=0. 02) whereas in MTRR A66G, A and G carrier showed no significant difference between the two groups (χ 2-test=1. 079, P=0. 53). The concentration of seminal folate was not different between normozoospermic (18. 83 ± 17. 1 ng/ ml) and OAT (16. 96 ± 14. 2 ng/ml) men (P=0. 47). The concentration of vitamin B12 was slightly higher in normozospermic men (522. 6 ± 388. 1 pg/ml) compared to OAT men (412. 9 ± 303. 6 pg/ml, P=0. 058). Conclusion: The MTHFR C677T and MTRR A66G have no effect on the concentrations of seminal folate and vitamin B12. The present study showed that two SNPs of MTRR A66G and MTHFR C677T cannot be seen as a risk factor for male factor subfertility.

Background: Premature menopause is characterized by amenorrhea before age of 40 years, markedly raised serum luteinizing hormone (LH) level, follicle-stimulating hormone (FSH) level and reduced serum level of estradiol. Genome-wide analysis suggested several loci associated with premature menopause. Here, we aimed to analyze association of variants at the MCM8, FNDC4, PRRC2A, TLK1, ZNF346 and TMEM150B gene loci with premature menopause. Materials and Methods: In this cross-sectional study, a total of 117 women with premature menopause were compared to 183 healthy women. Anthropometric indices were measured in all participants: height, weight, body mass index (BMI), waist circumference (WC) and wrist circumference. Eight single-nucleotide polymorphisms (SNPs) of the indicated genes (rs16991615, rs244715, rs451417, rs1046089, rs7246479, rs4806660, rs10183486 and rs2303369) were identified from the literature. Genotyping was performed using tetra-ARMS polymerase chain reaction (PCR) and ASO-PCR methods. Results: T allele of the rs16991615, rs1046089, rs7246479 and rs10183486, C allele of rs244715, rs451417 and rs4806660 as well as TT genotype of rs2303369 were associated with an increased risk of premature menopause, likely causing susceptibility to primary ovarian insufficiency (POI) in comparison with C allele. We also found an association between the rs16991615 SNP with premature menopause. Frequency of the minor allele in cases was increased for all SNPs in comparison with controls. All minor alleles, except for rs2303369, showed a statistically significant increased odds ratio (OR). However, after Bonferroni correction for multiple testing, none of the P values were remained significant. Conclusion: The selected polymorphisms in MCM8, FNDC4, PRRC2A, TLK1, ZNF346 and TMEM150B genes may potentially affect susceptibility to premature menopause, although replication of the results in larger cohort could clarify this.

Background: Luteal phase support (LPS) is essential for hormone replacement therapy (HRT) for frozen-thawed embryo transfer (FET). However, the optimal dose and serum progesterone (P4) levels required for pregnancy are controversial. We attempted to determine the association between pregnancy outcomes and serum P4 levels administered via vaginal suppository for HRT-FET cycles on embryo transfer day. Materials and Methods: This was a secondary analysis of the dataset from the EXCULL trial, which prospectively investigated pregnancy outcomes of four different P4 vaginal suppositories (Lutinus, Utrogestan, Luteum, and Crinone) for HRT-FET. It was conducted at a private fertility clinic between December 2016 to December 2017. During this trial, 235 cycles were divided into four groups based on serum P4 values (quartile [Q] 1 group: <7. 8 ng/mL; Q2 group: 7. 8-10. 8 ng/mL; Q3 group: 10. 8-13. 7 ng/mL; Q4 group: >13. 7 ng/mL). We investigated clinical pregnancy rate (CPR), positive fetal heart rate (FHR), live birth rate (LBR), and miscarriage rate (MR) for each group. A logistic regression analysis was performed using age, body mass index (BMI), and transferred embryos as covariates. Results: Serum P4 values (ng/mL) of each drug were as follows: Lutinus, 13. 3 ± 4. 9; Utrogestan, 9. 3 ± 3. 3; Luteum, 13. 6 ± 4. 2; and Crinone, 8. 7 ± 3. 2 (mean ± standard deviation, P<0. 001). The percentages of Utrogestan and Crinone were higher in the Q1 group, while the percentages of Lutinus and Luteum were higher in the Q4 group. Nonetheless, there were no statistical differences between the Q1 and Q4 groups in CPR, FHR, LBR, and MR. Conclusion: When vaginal P4 was used for FET, although serum P4 levels on transfer day differed based on the drug that was administered, no relationship was observed between serum progesteronelevels and pregnancy outcomes (Registration number: UMIN000032997).

Abstract Background: This study was conducted to determine the correlation of anti-Mullerian hormone (AMH) level and antral follicle count (AFC) with oocyte count in women who had received controlled ovarian hyperstimulation in an in vitro fertilization (IVF) program. Materials and Methods: We retrospectively gathered the data of 42 patients who underwent IVF during 2005-2017 at Aster Clinic in Dr. Hasan Sadikin Hospital and Bandung Fertility Center Limijati Hospital, Indonesia. Details of the subjects such as identity, characteristics, history of illness, history of previous therapy, levels of ovarian reserve markers examined (AFC and AMH), follicle-stimulating hormone (FSH) dose given, and number of oocytes produced were recorded. Results: A significant positive correlation between AMH (P≤ 0. 001, r=0. 530), AFC (P≤ 0. 001, r=0. 687), and AMHAFC combination (P≤ 0. 001, r=0. 652), and the number of oocytes was found at the FSH dose of 225 IU. Conclusion: AFC and AMH are able to reliably predict ovarian response to FSH.

Background: Angiogenesis disturbances are common in women with polycystic ovary syndrome (PCOS). Vitamin E has antiangiogenic properties. Data on the effects of vitamin E on angiogenesis in PCOS is limited, so the current study was conducted to evaluate its effects on angiogenic indices in PCOS patients. Materials and Methods: This randomized, double-blind, placebo-controlled trial was performed on 43 women aged 20-40 years, diagnosed with PCOS (Rotterdam criteria). It was performed at the referral clinic affiliated to Tabriz University of Medical Sciences, Tabriz, Iran, from April 2017 to September 2017. Patients were randomly assigned into two groups to receive either 400 IU/day vitamin E-as alpha tocopheryl acetate-(n=22) or placebo (n=21), for 8 weeks. Anthropometric, and angiogenic parameters including body weight, fat mass and fat free mass, vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), angiopoietin-1 (Ang-1), and angiopoietin-2 (Ang-2) were measured by standard methods at the beginning and at the end of study. Statistical Package for Social Science version 25 was used for statistical analysis and P<0. 05 were considered significant. Results: After adjusting for potential confounders, we observed that vitamin E supplementation significantly reduced body weight, fat mass, Ang-1, Ang-1/Ang-2 ratio and VEGF (P<0. 01). We did not observe any considerable effect for vitamin E on Ang-2 level or bFGF. Conclusion: Vitamin E supplementation for 8 weeks in the PCOS women had beneficial effects on body weight, Ang-1, Ang-1/Ang-2 ratio, and VEGF level (Registration number: IRCT201610193140N18).

Background: This research investigated the symbiotic supplement influences on serum glycemic indices and lipids as well as apelin rates and obesity values in polycystic ovary syndrome (PCOS) patients. Materials and Methods: A total of 68 obese or overweight patients (20-44 years old) with PCOS were enrolled to conduct a randomized double-blinded placebo-controlled clinical trial. A total of 34 people in the synbiotic group received a synbiotic supplement and 34 people in the placebo group received placebo, daily for 8 weeks. Fasting blood specimens, anthropometric measurements and dietary intake data were gathered three times during the study. The information was analyzed by independent t test, paired t test, analysis of covariance and chi-square test. Results: Synbiotic supplementation significantly decreased serum fasting glucose (P=0. 02), insulin (P=0. 001), homeostatic model assessment for insulin resistance (IR, P=0. 001), weight (P=0. 02), body mass index (BMI, P=0. 02), waist circumference (WC, P=0. 01), hip circumference (HC, P=0. 02), and waist-to-height ratio (WHtR, P=0. 02) but significantly increased high-density lipoprotein (HDL) cholesterol (P=0. 02) compared to the placebo. At the end of the trial, no significant differences were seen in serum total cholesterol, triglyceride (TG), low-density lipoprotein (LDL) cholesterol, or apelin levels as well as waist-to-hip ratio (WHR) between the two groups. Conclusion: Synbiotic supplementation improved glycemic indices, lipid profile and obesity values in women with PCOS. These beneficial effects were not related with alterations in serum apelin levels (Registration number: IRCT20100408003664N19).

Background: Sexual self-concept has a considerable impact on mental and sexual health. However, the relationship between sexual self-concept and infertility is unknown. This study aimed to compare sexual self-concept between fertile and infertile women. Materials and Methods: This cross-sectional study was conducted on a sample of 250 fertile and 250 infertile women who had referred to 9 health centers affiliated to Medical universities in Tehran and Royan infertility treatment clinics in Tehran, Iran in 2017. Sexual self-concept was measured using the Multidimensional Sexual Self-Concept Questionnaire (MSSCQ) consisting of 20 subscales. Analysis of covariance (ANCOVA) was performed to compare sexual self-concept between the two groups. Results: The mean age of fertile and infertile women was 34 ± 5. 62 and 29. 74 ± 5. 29 years, respectively. The highest score in both groups was for the sexual self-schemata subscale (mean score for fertile=3. 21 ± 0. 68 and for infertile= 3. 42 ± 0. 62). The lowest score was for sexual-depression subscale (mean score for fertile=0. 59 ± 0. 81 and for infertile=0. 61 ± 0. 76). After adjustment for the age of each subject, the husband's age, duration of marriage, and women’ s education, we analyzed the sexual-satisfaction, the power-other sexual control, and the fear-of-sex subscales, which were found to be significantly lower in infertile women (P<0. 05). No other significant differences between the fertile and infertile groups were observed. Conclusion: We observed significant differences between fertile and infertile women in terms of sexual-satisfaction, the power-other sexual control, and the fear-of-sex, but not in other sexual self-concept subscales. These findings suggest that there is need to improve sexual self-concept among both fertile and infertile women. Indeed implementation of educational and counseling programs by reproductive health specialists might play an important role in enhancing sexual self-concept among these populations.

Background: The aim of this study was to examine sexual function and its correlates among infertile women with polycystic ovary syndrome (PCOS) in comparison with their non-PCOS counterparts. Materials and Methods: In this case-control study, 209 infertile women (116 PCOS and 93 non-PCOS) from Tehran, Iran, were evaluated in February and March 2018. Female sexual function index (FSFI), hormonal status, and documented reports of hyperandrogenic manifestations of the patients were investigated. Results: The mean age of the patients was 32. 00 ± 5. 00 years old. Eighty-four (40. 2%) patients including 42. 2% of the PCOS patients and 37. 6% of the non-PCOS cases (P>0. 05), were suspected of female sexual dysfunction (FSD). The most impaired functions in both groups were desire and arousal. Sexual function was not significantly different between the groups. However, PCOS women had more orgasm problems and acne worsened their sexual function. Total FSFI was positively associated with prolactin level but negatively associated with central obesity in the non-PCOS group; it was negatively correlated with marital duration in the PCOS group. Luteinizing hormone (LH) and pain, prolactin level and lubrication, and central obesity and arousal were correlated in the non-PCOS women. Prolactin level and orgasm, marital duration and arousal, and marital duration and the total FSFI were correlated in the PCOS women. Conclusion: Sexual function was similarly low in infertile PCOS and non-PCOS women. However, orgasm problems and the negative effect of acne varied between the two groups. Further investigations may target how hormonal profile may affect sexual function. Practitioners should scrutinize the specific impaired sexual domains and their correlated conditions in PCOS women, notably orgasm, acne, and prolactin level. Interventions should be well tailored based on particular needs of infertile PCOS women.

Background: Human cloning is a recent occurrence that is not confined to bio-issues; rather, it has provoked numerous questions worldwide and presented scientific and religious challenges. These series of articles aim to examine the proposed approaches and analyze the aspects of human cloning in terms of tenets, morals, jurisprudence, and laws. In this paper, we analyze the ideological and theological evidences, regardless of scientific, ethical and legal problems that exist in the reproduction method. Materials and Methods: We used a descriptive-analytical method to consider the challenges of human cloning according to the “ system of Divine creativity” and “ the will of God” , as well as the “ pairing system” and “ diversity in nature” with emphasis on the Holy Qur’ an and Qur’ anic commentaries. Results: According to the Qur’ an, although any type of physical changes and retouching of the human body are forbidden, the alteration of God's creation may not prove the prohibition of cloning. Cloning is not contradictory to the principle, precedent, and rule of coupling, and it may be one of the hidden precedents of creation. Therefore, not only does a clone not contradict the precedent of the variety of men, but this variety is a sign for men and not a precedent predominated over the order of nature. Conclusion: It is proven that cloning does not give life; instead, it utilizes the life bestowed by God. This technique does not contradict the precedents of existence. It is a way to discover some precedents of God and is under the order of cause and effect of the world. Cloning is not considered as a challenge to human beliefs, nor is it a change in Divine creation. Moreover, cloning does not contradict the theological teachings and concepts of the Holy Qur’ an and Shiite Muslims.