International Journal of Reproductive BioMedicine
Year:2020 | Volume:18 | Issue:12|Papers Count:10

The authors have been informed of an error that occurred on Table III, page 248 in which the correct form of the table is as follows: Table III. Comparison of mean scores of body image concern and self-esteem and its changes before the intervention, after the intervention, and follow-up in two groups

Background: Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 appeared in December 2019 in Wuhan, China. Objective: To investigate the clinical manifestations including signs and symptoms, laboratory results, and perinatal outcomes in pregnant women with COVID-19. Materials and Methods: Scholarly databases such as PubMed via LitCovid hub, Embase, Scopus, Web of sciences, and Google scholar were searched on April 7, 2020. Meta-analysis was performed via comprehensive meta-analysis software using the Mantel-Haenszel method. The event rate with 95% CI was calculated for each variable. Results: Ten studies were selected. The pooled prevalence for fever, post-partum fever, cough, myalgia, fatigue, dyspnea, sore throat, and diarrhea were 66. 8%, 37. 1%, 35%, 24. 6 %, 14. 9%, 14. 6%, 11. 5%, and 7. 6%, respectively. Laboratory test results were 49. 8% for lymphopenia, 47. 7% for leukocytosis, 83. 7% for elevated neutrophil ratio, 57% for elevated C-reactive protein, and 71. 4% for decreased lymphocyte ratio. The rate of cesarean section for delivery in all cases was 84%. Of the newborns of the coronapositive mothers, only one had a positive test result. Also, there was only one death due to a decreased lymphocyte ratio. Conclusion: Fever was the most common sign and symptom in pregnant women with COVID-19. Among the laboratory tests, the highest amount was related to elevated neutrophil ratio. It seems that due to the differences between pregnant women and the general population, special measures should be considered to treat these patients.

Background: To increase the results of infertility treatment, many efforts have been made to improve the treatment methods. As assisted reproductive technology is mainly using cell culture methods, one of the approaches to improve this technology is conditioned medium from different sources. It is desirable to apply in vitro maturation (IVM) and use oocytes from normal cycles instead of stimulating ovulation. Objective: To investigate the effect of human cumulus cell condition medium (hCCCM) on the IVM of immature mouse oocytes and morphology. Materials and Methods: In this experimental study, 240 germinal vesile oocytes were collected from four-six wk-old mice after 48 hr of 5IU pregnant mare serum gonadotropin (PMSG) injection and cultured in hCCCM (test group, n = 120) and DMEM + 20% FBS (control group, n = 120). The IVM rates and changes in perivitelline space (PVS) and shape were investigated at 8, 16, and 24 hr following the culture. The mature (MII) oocytes were subjected to in vitro fertilization (IVF) and the fertilization rate was assessed in three days. Results: A significant difference was observed between the maturation rates in the hCCCM and control groups (24. 16% vs 0%; p = 0. 001), as well as morphologic changes between the two groups (p = 0. 04, p = 0. 05). The development rate for MII oocytes attained from IVM in the hCCCM group was 27. 58% (2-cell) and 6. 89% (4-cell). Data displayed that hCCCM is an effective medium for oocytes maturation compared to the control medium. Conclusion: hCCCM supports oocyte in vitro growth and maturation. Moreover, hCCCM changes the oocyte shape and size of perivitelline space.

Background: Evidence suggests that Oxidative stress has been shown to plays an important role in gestational diabetes mellitus (GDM) etiology. On the other hand, women with GDM are at an increased risk for complications such as endothelial dysfunction and cardiovascular diseases. Objective: To investigate the effects of alpha-lipoic acid (ALA) on the maternal circulating values of lipid profile and lipid ratios in women with GDM. Materials and Methods: Sixty women with GDM were participated in the present study. The ALA group (n = 30) received ALA (100 mg/day) and the placebo group (n = 30) received cellulose acetate (100 mg/day) for eight wk. The maternal circulating values of hemoglobin A1C, triglyceride (TG), total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, triglyceride-glucose (TyG) index, atherogenic index of plasma (AIP), non-HDL-C, and lipid ratios were assessed before and after the intervention. P-value < 0. 05 was considered as statistically significant. Results: The values of TyG index (p < 0. 001), TG (p = 0. 006), TG/HDL-C (p = 0. 003), and AIP (p = 0. 005) decreased significantly in the ALA group after the intervention. Conclusion: Maternal circulating values of TyG index, TG, TG/HDL, AIP decreased after eight wk of ALA supplementation in women with GDM.

Background: Few studies have focused to determine the peculiarities of the course of pregnancy and pregnancy outcomes after treatment in women with idiopathic hyperprolactinemia. Objective: To determine the peculiarities of the course of pregnancy and pregnancy outcomes in women treated for idiopathic hyperprolactinemia, with history of infertility and/or recurrent pregnancy loss. Materials and Methods: A non-randomized controlled study was conducted at the Center for Reproductive Medicine “ Universe” and Medical Clinic “ Medhealth” during 2016-2018, involving 96 women with idiopathic hyperprolactinemia, aged 20-44 yr with infertility and/or a history of recurrent pregnancy loss. Prolactin (PRL), follicle-stimulating hormone, luteinizing hormone, estradiol (E2), free testosterone, and progesterone were studied in blood serum using immunoassay analysis method. Before the occurrence of pregnancy, hyperprolactinemia was treated with bromocriptine. Dydrogesterone was used to support the luteal phase. Results: PRL levels decreased significantly and normalized within two-five months, regular menstrual cycle was restored in two-four months, ovulation was restored in three-seven months, and pregnancy was achieved in three-fourteen months. E2 and progesterone levels increased significantly (p < 0. 001). Prior to the treatment, significant negative correlation between PRL and E2 (r =-0. 386, p = 0. 007), PRL and progesterone (r =-0. 420, p = 0. 003) was detected. Threatened early abortion prevailed among pregnancy complications. Pregnancy loss in the first trimester was recorded in 3. 12% of cases. Conclusion: Pregnancy outcomes in women with idiopathic hyperprolactinemia are improved by prolonged and continuous treatment with bromocriptine before pregnancy and administration of dydrogesterone in support of the luteal insufficiency.

Background: While polycystic ovary syndrome (PCOS) is often associated with psychological distress, its most frequent clinical characteristics include acne, hirsutism and increased level of androgen hormones. Objective: To evaluate the level of depression and anxiety, hirsutism, acne, and level of androgen hormones in PCOS and control group and its association with cognitive function. Materials and Methods: This cross-sectional study was conducted on 53 women with PCOS and 50 healthy women as a control group. Data were collected using a questionnaire including the samples’ demographic information, clinical features, clinical findings of hyperandrogenism, and the Beck Depression and Anxiety questionnaire. In addition, the acne and hirsutism levels of the subjects were evaluated using the global acne grading system and the Ferriman-Gallwey scoring system, respectively. The Montreal Cognitive Assessment (MoCA) is a screening test for cognitive impairment that covers major cognitive domains. Results: A significant difference was found between the two groups in the mean levels of acne, hirsutism, total testosterone, free androgen index, depression, and anxiety. However, some mean values of the MoCA were lower in the women of case group compared to the control group. Additionally, a significant difference was observed between the two groups in the domains of visual-spatial ability (p = 0. 009), executive function (p = 0. 05), attention (p = 0. 03), and total MoCA scores (p = 0. 002). Conclusion: The PCOS women demonstrated significantly lower performance on the tests of executive function, attention, and visual-spatial function than the healthy control women.

Background: Despite numerous reports about temporal changes in semen quality from all over the world, the debates continue. The latest systemic review has shown an overtime decrease in semen quality worldwide. Objective: To assess the temporal changes in the semen quality among Iranian population referred to an infertility center. Materials and Methods: In this retrospective cross-sectional study, semen parameters including concentration, motility, and morphology were compared between Iranian men reffered to Research and Clinical Center for Infertility, Yazd between 1990 to 1992 (group 1, n = 707) and 2010 to 2012 (group 2, n = 1108). Demographic characteristics and semen analysis were collected from the records. The effect of age on semen parameters was also investigated. Results: Despite the increase in sperm concentration l in group 2, sperm with normal morphology decreased significantly (p < 0. 001). Grade-A motility decreased (p < 0. 001), grade B motility increased (p < 0. 001), and grade C and D motile sperm remained constant (p = 0. 303 and p = 0. 315, respectively). Also, no significant correlation between the age and semen parameters were observed. Conclusion: This study showed inconsistent temporal changes in the participant semen quality. Significant temporal decline were obtained between various semen parameters, sperm morphology and grade A motility. These results should be further evaluated by larger studies in the future.

Background: Poor ovarian reserve and a high rate of pregnancy failure associated with low quality and quantity of oocytes are observed in poor responders to in vitro fertilization. Objective: To assess the effect of age, body mass index (BMI), endometriosis, and history of ovarian surgery on ovarian reserve in a group of poor responders. Materials and Methods: In this cross-sectional study 749 women who referred to Yasmin Clinic of Dr. Cipto Mangunkusumo National General Hospital from January 2013 to June 2017 were enrolled. Two definitions of poor responders and Poseidon criteria and consecutive sampling techniques were used. Participants were divided into good and poor responder groups based on the ovarian reserve test; participant with oocyte ≤ 3 was classified as a poor responder. Based on this, 188 participants with nine (4-47) oocytes were included in the poor responder group. While, good responder comprised of two (0-3) oocytes. Results: Age and anti-Mullerian hormone level (AMH) were significantly associated with ovarian reserve in the poor-responder group (p < 0. 001). However, in multivariate analyses, age was the only significant predictor of ovarian response in the poorresponder group (p = 0. 004). While endometriosis was the significant predictor of Poseidon groups 1 and 4, surgical history was the significant predictor of Poseidon groups 2 and 3. Meanwhile, an increase in BMI decreased the risk of classification under Poseidon group 3. Conclusion: Age, AMH, BMI, endometriosis, and history of ovarian surgery affected the risk of classification of the Poseidon group.

Background: The spermatogenesis system includes highly radiosensitive cells. Hence, this system is a potential target for toxic effects of ionizing radiation during radiotherapy of abdomen and pelvis cancers, as well as after accidental radiation events. Accordingly, metformin and melatonin are two important radioprotectors that have shown an ability to prevent cell death through neutralization of free radicals and stimulating DNA damage responses. Objective: To evaluate the radioprotective effects of melatonin and metformin on mice spermatogenesis when administered alone or as a combination. Materials and Methods: In this histological Study, 40 (6-8 wk, 30 gr) NMRI mice were divided into 8 groups (n = 5/each) as control, metformin, melatonin, melatonin + metformin, radiation, radiation + melatonin, radiation + metformin, and radiation + melatonin + metformin. 37 days after the irradiation, the testicular tissues were collected for histological evaluation. Results: Single administration of melatonin could ameliorate effectively radiation toxicity in mice testis. Metformin showed radioprotective effects on some parameters such as the numbers of spermatogonia and mature sperms. Interestingly, the melatonin and metformin combination reversed the reduced number of sperms rather than single drug administration. Conclusion: The combination of melatonin with metformin can protect mice spermatogenesis against ionizing radiation more effectively compared to the single forms of these drugs.

Background: The use of autologous platelet-rich plasma as an ovarian treatment has not been standardized and remains controversial. Case Presentation: A 41½-year old woman with diminished ovarian reserve (serum anti-Mü llerian hormone = 0. 163 mg/mL) and a history of 10 unsuccessful in vitro fertilization cycles presented for reproductive endocrinology consult. She and her partner declined donor oocyte in vitro fertilization. They were both in good general health and laboratory tests were unremarkable, except for mild thrombocytosis (platelets = 386K; normal range 150-379K) discovered in the female. The patient underwent intraovarian injection of fresh platelet-derived growth factor concentrate administered as an enriched cellfree substrate. Serum anti-Mü llerian hormone increased by 115% within 6 wks of treatment. Spontaneous ovulation occurred the month after injection and subsequently the serum human chorionic gonadotropin was noted at 804 mIU/mL. Following an uneventful obstetrical course, a male infant was delivered at term without complication. Conclusion: This is the first description of intraovarian injection of enriched plateletderived growth factors followed by unassisted pregnancy and live birth. As a refinement of conventional ovarian platelet-rich plasma therapy, this procedure may be particularly valuable for refractory cases where prognosis for pregnancy appears especially bleak. A putative role for thrombocytosis is also viewed in parallel with mechanisms of action as advanced earlier. With continued experience in ovarian application of autologous platelet growth factors, additional research will evaluate laboratory protocol/sample preparation, injection technique, and patient selection.