Journal of Reproduction & Infertility
Year:2020 | Volume:21 | Issue:2|Papers Count:11

The development of medical sciences is due to efforts of scientists and clinicians to conduct various studies to answer questions and solve the health problems. Currently, scientists in organizations, institutes, and universities are trying for recognizing priorities in scientific discovery and improving medical sciences through increasing their scientific output, as well as raising their national and international rankings. Therefore, the role of scientific studies and subsequently published articles in the progress and development of countries is obvious to everyone. But the history of scientific studies during the last century shows that human standards, human rights and ethical considerations have not been met in a large number of human researches particularly in the field of medicine and biosciences. Also, it sometimes led to irreparable damage to the scientific body of society and even to the scientific position of academic staff. Therefore, ethical obligation of submitted manuscript is a critical criterion for acceptance and publication of biomedical findings...

Background: Morbid obesity has been known to decrease fertility in both men and women. This review aimed to examine current evidence of the effects of bariatric surgeries on fertility parameters including sex hormones in both men and women, seminal outcomes in men, menstrual cycle, PCOS symptoms, and pregnancy in women, and sexual function in both men and women. Methods: Three databases (PubMed, Web of Science, and Academic Search Premier) were used with key terms of bariatric surgery, bariatric surgical procedures, infertility, reproductive health, pregnancy, and fertility. Studies with male and/or female patients were included. Study types included retrospective chart reviews, observational, qualitative, cross-sectional, cohort, and longitudinal studies published in January 2008– June 2018. The search was performed on June 21-26, 2018. Quality assessment and data synthesis were conducted. Results: A total of 18 articles were included in the final review. Seven studies included only men, ten included only women, and one included both men and women. Bariatric surgery significantly improved hormonal balance and sexual functions in both males and females, sperm count in males, and pregnancy in females. The strongest evidence was found on bariatric surgery’ s effects on sex hormones. No study with males asked whether the participants actually conceived a child with their partners after the bariatric surgery. Most weaknesses in all articles reviewed were lack of discussion on confounding variables and many did not differentiate surgical types. Conclusion: Bariatric surgery most effectively improved sex hormones. Further research is needed on direct pregnancy outcomes for both men and women.

Background: Embryo implantation is a critical and multifactorial phenomenon which can be affected by any alteration in molecular micro construction of endometrium. The aim of the current study was to evaluate the effects of diabetes on osteopontin (OPN) and α 3β 1 integrin proteins level at the time of endometrial receptivity. Methods: Twenty-eight female rats were divided into control, diabetic, pioglitazonetreated and metformin-treated groups. Western blot was performed to determine the OPN and α 3β 1 integrin proteins in rats’ endometrium at the time of implantation. Data were analyzed by analysis of variance (ANOVA) and p<0. 05 was considered statistically significant. Results: OPN increased significantly in the diabetic group in comparison with control (p<0. 001), metformin-treated (p=0. 008) and pioglitazone-treated groups (p< 0. 001). Furthermore, α 3β 1 integrin protein level in diabetic group had a significant difference in comparison with that of the control (p<0. 001), metformin-treated (p= 0. 026) and pioglitazone-treated groups (p<0. 001). Conclusion: OPN and α 3β 1 integrin proteins are involved in embryo implantation and their changes in diabetic condition can affect fertility. Treatment with pioglitazone and metformin improved the level of OPN and α 3β 1 integrin proteins while pioglitazone was more effective.

Background: The aim of ovarian follicle in vitro culture is to obtain mature oocytes. To evaluate the efficiency of in vitro culture system, the status of the cultured oocyte can be analyzed. Methods: The preantral ovarian follicles retrieved from 14-day-old C57Bl/6J mice were cultured in 3D alginate hydrogel. The status of oocytes obtained from mature (3 months old, group A) and immature (3 weeks old, group B) mice was compared to the status of oocytes retrieved from ovarian follicles cultured in vitro (Group C) using qRT-PCR analysis and time-lapse microscopy. In the qRT-PCR analysis, 8 samples for group A (80 oocytes), 8 samples for group B (80 oocytes), and 6 samples for group C (60 oocytes) were included. Time-lapse analysis was performed in group A (oocytes n=31), group B (n=45), and group C (n=21). Statistical analysis was done by Kruskal-Wallis and chi-square tests and differences were considered statistically significant if p<0, 05. Results: The diameter of group C oocytes is lower in comparison to group A oocytes (67 μ m vs. 75 μ m, correspondingly). Groups B and C oocytes exhibited delayed meiosis in comparison to group A oocytes. Expression levels of six oocyte maturation genes (Ccnb, CDK1, Ccnh, Wee2, Mos and Epab) were evaluated using qRTPCR analysis. Expression levels of Ccnh and Epab are lowered in group C oocytes compared to the expression levels of these genes in groups A and B oocytes (p< 0. 05). Conclusion: Oocytes obtained after ovarian follicles in vitro culture have reduced development competence, future fundamental changes of in vitro culture systems can be expected.

Background: The purpose of this study was to assess whether the outcomes from IVF-preimplantation genetic testing (IVF-PGT) cycles for single gene defects (SGD) (PGT-M) differ between a privately funded period (PRP) and publicly funded period (PUP). Methods: A retrospective cohort study was conducted in a North-American single tertiary center. The PRP (March 1998 to July 2010) comprised 56 PGT-M cycles from 58 IVF cycles in 38 couples, and the PUP (August 2010 to May 2015) comprised 59 PGT-M cycles from 87 IVF cycles in 38 couples. One PGT-M cycle is defined as one biopsy procedure from one or serial IVF cycles. A p-value of 0. 05 was considered statistically significant. Results: The clinical pregnancy rates (CPR) per PGT-M cycle were 30. 4% and 52. 5% in each period, respectively (p=0. 021). The live birth rates (LBR) per PGT-M cycle were 21. 5% versus 40. 9% in each period, respectively (p=0. 037). A sub-analysis within the PUP comparing 39 PGT-M cycles from 39 IVF cycles with 20 PGTM cycles from 49 IVF cycles yielded CPRs per PGT-M cycle of 64. 1% and 30. 0% and LBRs per PGT-M cycle of 53. 8% and 15. 0%, in each group, respectively (p< 0. 05 for both). Conclusion: The transition from private to public funding and a single embryo transfer (ET) guideline has little impact on embryological and clinical outcomes of PGT-M cycles, and results in lower rates of multiple pregnancies. However, these two systems may serve different populations.

Background: Multinucleated embryos exhibit impaired implantation potential, but whether the presence of multinucleated embryos in an embryo cohort reflects the quality of the entire cohort is controversial. No data exists on multinucleation rate among frozen-thawed embryos. Methods: De novo multinucleation and the number of multinucleated embryos on day two of embryo culture before freezing (D2) (n=415), at thawing (D2t) (n=320) and after an overnight culture after thawing (D3t) (n=265) was recorded. Associations between multinucleation before and after cryopreservation, female age and ovarian sensitivity to hormonal stimulation were assessed. Results: The occurrence of at least one multinucleated embryo per embryo cohort was 62. 4% on D2, 16. 3% on D2t and 31. 7% on D3t. The presence of multinucleated embryos prior to freezing was not associated with de novo multinucleation during post-thaw culture (p=0. 845). On D2, multinucleation was high in young women, irrespective of the number of collected oocytes (p=0. 702). In older age groups, multinucleation was highest if >17 oocytes were obtained (p<0. 001) and the odds for multinucleation was the lowest if the consumption of recombinant follicle-stimulating hormone was >238 IU/oocyte (In the age group of 30– 35 years OR 0. 25 [0. 13– 0. 47], and the age group of 36– 40 years OR 0. 35 [0. 20– 0. 63]. Conclusion: Multinucleation is commonly seen in embryos and good-quality day two embryo cohorts before freezing. The presence of multinucleated embryos prior to freezing does not illustrate multinucleation in sibling embryos after thawing. Embryo multinucleation is associated with factors related to good prognosis in assisted reproduction treatments.

Background: Genital tract infection is one of the causes of male infertility. Several studies have shown a role for human cytomegalovirus (CMV) in this context. In the present study, the prevalence of CMV in a population of male partners of infertile couples was estimated and the impact of CMV on sperm parameters was determined. Methods: In this cross sectional study, CMV DNA and virus copy number were examined in the semen of 150 participants including 80 with normal semen analysis (SA) and 70 with abnormal SA, by quantitative Real-Time PCR. Sperm parameters were compared between CMV positive and negative groups. Comparisons with pvalues under 0. 05 were considered significant. Logistic regression was performed to control the effect of some variables with p<0. 25 on sperm parameters. Results: CMV DNA was detected in the semen of 28 (18. 6%) individuals. 21 men (30%) with abnormal SA and 7 (8. 8%) with normal SA were positive for CMV DNA (p=0. 001). The mean virus copy number was 883. 1± 4662. 01 for the men with abnormal SA and 2525. 7± 12680. 9 for those with normal SA (p=0. 001). Sperm count was (32. 1± 23. 5) x106 in CMV positive and (44. 2± 24. 1) x106 in CMV negative groups (p=0. 022). Normal sperm morphology was 2. 73± 2. 83% and 5. 99± 5. 44% in CMV positive and negative groups, respectively (p<0. 001). After controlling some variables, the sperm morphology remains the only statistically significant sperm parameter that was reduced by CMV. Conclusion: The higher CMV prevalence in the semen of males with abnormal SA compared to normal SA and significant reduction of sperm morphology in the presence of CMV, are in favor of the negative impact of CMV on male fertility.

Background: The present study aimed to determine the association between pregnancy-associated plasma protein A (PAPP-A) and Gestational Diabetes Methods (GDM) to detect a risk factor for predicting GDM at gestational weeks 11-14. Methods: This analytical prospective study recruited 284 pregnant women presenting to six healthcare centers of Qazvin, Iran from February to December 2016. PAPP-A was measured at gestational weeks 11-14 and glucose tolerance test was conducted at gestational weeks 24-28. The participants were assigned into two groups of exposure (reduced PAPP-A) and non-exposure (normal PAPP-A). The association between GDM and PAPP-A was studied. The number of women in exposure group were 201 and 83 in the non-exposure group. Differences between groups were assessed by the Mann– Whitney, Chi-square, T test, logistic regression analysis and ROC Curve with a significance level of 0. 05. Results: Twenty eight (33. 73%) patients of the exposure group and 17 (8. 46%) of non-exposure group developed GDM. There was a significant difference between the two groups in terms of GDM (p<0. 001) and the risk of GDM was 3. 98 fold higher in the exposure group (reduced PAPPA mu/L) than that of the non-exposure group (CI=2. 39-6. 65, p<0. 001). Also, 53. 3% of the exposure group and 46. 7% of the nonexposure group were diagnosed with GDM (p=0. 02). There was a significant difference in GDM between the groups and the risk of GDM was 1. 85 times higher in the exposure group (reduced PAPPA MOM) than that in the control group (CI=1. 09-3. 15, p=0. 020). According to the ROC curve results, PAPP-A and MOM are acceptable indicators for predicting GDM. Conclusion: A low PAPP-A level (MOM, MU/L) as a new risk factor for GDM can help early prediction and prevent maternal and fetal complication by timely treatment.

Background: Birth weight plays an important role in infant mortality and morbidity, child development, and future health of the child. Reports showed that low birth weight is one of the critical issues in Gugare zone that causes many babies short-term and long-term health consequences and tends to have higher mortality and morbidity. This study examined and identified the determinants of weight of children at birth in Gurage zone. Methods: The survey or the information has been collected on a total of 735, 109 reproductive mothers in Gurage zone. Children with age less than 59 months were considered in this study. Ordinal logistic regression techniques used for data analysis using maternal and socio-demographic variables as explanatory variables and size of a baby at birth as the response variable and statistical package for social science (SPSS) version 23 and STATA were used for data analysis purpose. Results: According to our study, from the sampled children, 30. 1%, 44. 4% and 25. 5% were small in size, medium in size and large in size, respectively. Mater-nal related variables were statistically significant like uneducated mother (β =0. 26, p= 0. 013), mothers who get antenatal visit care 2-3 times (β =-0. 210, p=0. 10), source of drinking water (β =0. 844, p<0. 001) and malaria affected mothers (β =0. 344, p< 0. 001). Conclusion: Children from rural mothers, uneducated families, mothers who did not get more antenatal care visits, poor families, mothers who drink non-improved water, mothers who are affected by malaria during pregnancy, teen-ager mothers are small in size at birth.

Background: The objective of this case presentation was describing a live birth in an advanced-age woman with an extremely enlarged uterus, an ovary with blocked fallopian tubes, hypothyroidism and generalized anxiety disorder caused by childbirth following intracytoplasmic sperm injection/embryo transfer (ICSI-ET) with autologous oocytes. Case Presentation: A 47-year-old patient with an enlarged uterus due to recurrent multiple fibroids following myomectomy was referred to clinical laboratory with a high level of desire to follow the prescribed recommendations and approaches to retrieve her fertility. The patient underwent two cycles of oocyte retrieval and two rounds of frozen-thawed embryo transfer. To achieve a successful pregnancy after oocyte retrieval (birth weight of 3300 g at 38 weeks of gestation), a frozen/thawed embryo in the second cycle of ET was transferred. Conclusion: Usage of efficient planning and management of ICSI treatments in patient with autologous oocytes and concurrent disorders, can be used as a new approach to cure the affected individuals.

Background: Fibroma or leiomyoma is the most common benign tumor of the female reproductive system, which is usually found in the uterus, but may also occur in other places, such as the ovary, the broad ligament, and in rare cases in the abdominal wall. The formation of the abdominal wall leiomyoma may result from the implantation of myometrium tissue following surgical removal of the uterine leiomyoma, but sometimes these masses occur in a person who has no history of myomectomy. Case Presentation: This case was a patient who became a candidate for laparoscopy due to abnormal uterine bleeding and pain in the right upper quadrant of the abdomen and ovarian mass. The patient underwent laparotomy due to the inability of surgeons to insert the veress needle because of the presence of mass in the abdominal wall. The pathologic report of the abdominal mass was leiomyoma. This article has been approved by the Ethics Committee of the University (6562276). Conclusion: The formation of myoma on the abdominal wall is rare but given the fact that leiomyoma can be created at each part of the body with smooth muscles, including the anterior abdominal wall, this diagnosis should be considered for the differential diagnosis of abdominal masses.