Journal of Reproduction & Infertility
Year:2003 | Volume:4 | Issue:3 (15)|Papers Count:10

It has been shown that male factor is a common cause of more than half of the infertilities from which 10% are azoospermic patients. Despite multiple testis biopsies, any sperm for microinjection couldn't be obtained in 40% of nonobstructive azoospermic patients. However, recent reports showed successful use of spermatids instead of mature spermatozoa for ICSI which opened a new horizon instead of mature spermatozoa for ICSI which opened a new horizon for spermatids in for these patients. In the present study, 67 nonobstructive azoospermia patients with no sperm in their testis biopsies were enrolled, from whom round spermatilization were extracted from testis and used as male gamete for ovum fertilization. The results including fertilization rate, embryo formation, transfer rate and pregnancy rate were evaluated. Patients were selected based on their history and physical examination, semen analysis, FSH assay and results of multiple testis biopsies with no sperm. Necessary information about use of spermatid as male gamete in microinjection was presented to the patients and their consent were taken. In appropriate time, female cycles were began and simultaneous to egg collection, testis biopsy was performed Mean age of male and female were 32±6.5 and 29.5±8 years, respectively. Mean size of right and left testis were 11±1 and 10.4±0.6 mL, respectively and the mean of FSH level was 21.1±3.2 mIU/mL. Form 760 collected eggs, 537 ovums were injected with spermatids and fertilization rate was 38.2%. Totally, 182 embryos (88.8%) were transferred to the uterus. One chemical pregnancy was observed and documented by ultrasonography, although it was aborted at fourth week. Based on the results of this study, the efficiency of spermatid use in azoospermic patients with no sperm in TEST as a treatment option for their infertility was doubted.

Nutritional status during pregnancy and intake of essential nutrients affect pregnancy outcome and child health. In most previous studies, high doses of calcium supplements were used during pregnancy to evaluate the effect of calcium intake on pregnancy outcome and their results showed no consistency. In addition, those studies have been mainly carried out to determine the effect of calcium supplementation on relative risk of preeclampsia. The aim of this double blind, placebo controlled, randomized clinical trail on healthy pregnant women during the third trimester of pregnancy was to determine the effect of calcium supplementation (1 g/day, as two 500 mg calcium carbonate capsules) on pregnancy outcome. Participants were 68 healthy pregnant women, allocated randomly into Calcium supplement (n=33) or Placebo (n=35) groups from the 28th-30th weeks of gestation through delivery. Factors such as blood pressure, weight, height and BMI were analyzed in both groups. Hemoglobin and blood glucose concentration were determined on the basis of patients records and dietary calcium intake was estimated by FFQ. Anthropometric parameters of neonates including weight, head circumference and length were recorded. Student t. test and X2 were used for analyses of the continuous quantitative and qualitative variables, respectively and p-value <0.05 was considered as statistically significant. There was no difference between our 2 groups regarding such factors as age, parity, height, weight, pre-pregnancy body mass index (BMI), blood pressure, and dietary calcium intake. Compliance was >80% in both groups and there was no significant and meaningful difference between them regarding this factor. As compared to the placebo, calcium supplementation in creased the mean birth weight in the Calcium Supplement group (P<0.05) the observed effect remained unchanged after removing four neonates born before the 37th weed of gestation (251 g, P<0.05). It is concluded that calcium supplementation in healthy pregnant mothers may increase birth weight independent of gestational age.

Having baby is a desire which plays a major role in everybody"s life. Infertility as unsuccess in achieving this is an annoying matter, affecting approximately 20% of couples. However, this fact should not be ignored that there is still many unknown problem related to infertility. Polycystic ovarian syndrome (PCOS) is one of these Problems. In our study, recovery of immature oocytes followed by in vitro maturation (IVM) of these oocytes was developed as a new method for the first time in Iran for treatment of patients with infertility due to PCOS. The purpose of this study was to reduce the side effects of the currently used treatments such as ovarian hyperstimulation syndrome, ascites, circulation dysfunction, renal dysfunction, thrombosis, multiple pregnancy, …, as well as their expensive cost. Immature oocytes were collected by transvaginal ultrasound and then transferred to maturation medium for culture. After 24 and 48h of incubation, mature oocytes were transferred to endometrium. Spermatozoa for ICSI were prepared by Swim up, and injected to the mature oocyte with micromanipulator system. A total of 52 immature oocytes were retrieved, all of which matured after incubation (100%); 49 mature oocytes were injected and 35 were cleaved (71%). Satisfactory results of IVM have been published, thus due to its advantages and surprising reduction of the medical cost, it could be as a miracle in curing infertility.

Male reproductive function is known to be highly sensitive to many chemicals and physical agents generated by industrial or agricultural activities. Alterations in sperm in count or semen quality have been documented for a number of occupational exposures. These exposures include, pesticides, solvents, heat, metals, radiation, estrogens and etc. Because of the infertility and individual and social problems, stress and also expensive treatment, prevention of these exposures should be emphasized and the distinction of occupational type of infertility from idiopathic form is necessary. The present study determined the frequency of occupational exposures and seminal characteristics among groups of men with abnormal semen parameter (idiopathic or unexplained) referred to Royan Instituted. A total of 1550 consecutive men whose spouses were unable to conceive were recruited from an infertility clinic. Of these, 500 men were found to have un known cause for their reduced semen quality. They had at least two semen analyses and the results of recent semen analysis were linked exposures known to be hazardous to fertility was present in 164 men (32.8%K). Among the exposed group, 36 men (22%) were exposed to pesticides, 46 men (28%) to solvents, 56 men (34%) to heat and 26 men (15.9%) to mixed agents. Frequency of high risk occupational groups were farmers 6.8% (n=34), drivers 7.8% (n-40), welders 4.4% (n=22). Frequency of semen characteristics of this group was astenoszoospermia (98.2%), teratozoospermia, oligozoospermia, oloigoasthenozoospermi and Azoospermia, respectively. Abnormal sperm reports especially oligozoospermia and oligoasthenozoospermia mean semen parameters including, total sperm count, motility and normal morphology was less in exposed group. We concluded that occupational exposures play an important role in idiopathic infertile men, affecting 33% of patients. Therefore, Identification of potential reproductive hazards, education and advocation of patients and reduction of exposure level via Industrial health programs can be helpful.

According to World Health Organization (WHO) report, anemia is the most common disease related to nutritional defects, which affects about 2 Billion people in the world, and among this huge population, children and pregnant women are the two major high risk groups. The purpose of the present study was to determine the prevalence of anemia in pregnant women and its relationship to mother's age and gestational age. This study was done on 214 pregnant women visiting Yahyanejad Gyn & Obs clinic, during the period of March-Aug 2000. Complete Blood Count (CBC) was done at the first visit and if Hemoglobin (Hb) was less than 11mg/dl in first & third trimester or less than 10.5 in the 2nd trimester, they were considered to have the anemia of pregnancy. For diagnosis the type of anemia, the other lab tests were done. Frequency of anemia in different age groups and mean pregnancy trimester were studied. Mean age of cases was 24.6±5 years old and hemoglobin was 12.6±1.6 mg/dl overall, 20 (9.4%) pregnant women had anemia; the highest frequency of anemia (12.78%) was seen in women at 21-30 year old group. Frequency of anemia in high risk pregnancies (mothers age of less than 18 &more than 35 years old) was less than normal age group (19-34 years old) (P<0.05). Anemia was more common in third trimester than first & second trimesters (P<0.05). Iron deficiency anemia was the most common anemia in pregnant women. Due to higher frequency of anemia in third trimester, it is highly advisable to start iron replacement therapy from second trimester and the mother's Hematocrit level be checked at early third trimester.

Despite decades of hard attempts of our predecessors during the last century, resulting in a thought and system of human rights at both national and international level, we still witness emotional, violent and irrational conflict and fight between opponents and proponents of abortion. This practical battle could not be tackled unless on probes in depth into theoretical foundations of the subject so as to construct a justifiable view in this regard. For this aim, this article attempt to set forth claims of major theories of abortion and also to evaluate those claims. Accordingly, at first stage, the problem of abortion will be depicted from a theoretical perspective. Secondly, as one of the oldest theories, theory of life sacredness shall be delineated. This attitude is known as the pro-life theory. Also, it is worth noting that many of religious/ethical claims are put forward in this term. Thirdly, theory of free-will in defense of abortion will be explicated. This theory, known as the pro-choice attitude, has been a vehicle for most of liberal and feminist claims on the issue. It appears that the last mentioned two theories have taken a general and simple stance for or against the termination of fetus life. Could one avoid such a simple and general attitude and take another stance? Fourthly, and in this regard, theory of investment value that approaches to the problem in a different way shall be elucidated. From this perspective, the question of termination of fetus life is entirely dependent on the amount of investment and its value. Fifthly, another theory that endeavors to put forth a different analysis of the problem, theory of person or conscious entity shall be spelled out. Advocates of such a theory make an effort to sufficiently attend to all constituent elements of the problem-such as freedom, life, value of investment, parents and fetus-that might seem conflicting or even contradictory. Finally, it will be attempted to make a conclusion. Abortion, entangled between facts related to emotions, population growth rate and economics, on one hand, and religious, ideological and ethical value judgments, on the other, requires a theoretical attention by scholars and policy makers of a "human" and "dynamic" society.

Similar to other countries, Iran is under influence of various and complex developmental and social factors which predispose young people to the risks associated with reproduction and sexual high risk behaviors. Therefore, any planning to develop appropriate strategies to meet their needs requires assessing the status of adolescent's reproductive health. The objective of this study was to explore knowledge, attitude and behavior of Tehran adolescent boys (15-18 years old) with regard to reproductive health. This study was conducted among 1385 adolescent males aged 15-18 years in Tehran (Iran) in 2002 using the World Health Organization questionnaire which was adapted according to Iranian culture. The method of randomized cluster sampling was applied. The results revealed a limited knowledge on reproductive physiology among Tehran adolescent boys (51.1%). A considerable percentage (12.6%) of adolescents had absolutely no information about contraceptive methods. Among different contraceptive methods, condom and pills were known mostly by adolescent boys (72.2% & 58%, respectively). However the in-dept and correct information about condom was limited, so as 40% did not know that condom should be used once or 37% did not identified condom as an effective contraceptive method. Most adolescents (94.7%) had heard about sexual transmitted diseases previously but yet a great percentage of them held some misconceptions on STDs and HIV, so as, 16.6% were unaware about the lack of easy cure for AIDS at the present time and 23/1% from the existence of healthy appearance in HIV positive patients. Most (56.6%) adolescent males reported an experience of sexual contact. Chi-Square test revealed that school drop out (P<0.0001), education in night schools (P<0.0001), lack of dependency on religion (P<0.0001), absence of both parents in the household father's death (P=0.007) difficulties communication with mother (P-0.002), easy access to satellite (P=0.0017), smoking (P<0.0001) and alcohol consumption (P<0.0001) were among factors which were significantly related to the experience of previous sexual contact. According to the results of the present study, the high risk behaviours which might emerge due to the lack of appropriate knowledge among Iranian adolescents should be acknowledged more than before.

Pericentric inversion of chromosome 9 is a common phenomenon which is considered as normal variant by some cytogeneticists. A phenotipically normal couple was referred for cytogenetic evaluation due to ten recurrent spontaneous abortions and one intrauterine fetal death. The history of infertility, recurrent abortion and intrauterine fetal death were seen in the family and in the first and second degree relatives of the female. Chromosomal analysis from peripheral blood was performed according to standard cytogenetic methods using G-banding and C-banding techniques. Husbands karyotype was normal. Wife's karyotype has shown pericentric inversion of chromosome 9, inv (9) (pll-q13). Culture of peripheral blood, umbilical cord, chorionic villi and muscle biopsy were done on the last aborted fetus. Chromosomal study of the fetus revealed 46XY without any significant problem except for elongation of centromeric region of chromosome 9.It seems that pericentric inversion of chromosome 9 is frequently observed in individuals with recurrent abortion, intrauterine fetal death, stillbirth, but as the etiology, the clinical significance is still uncertain we discuss this issue in our report.