Journal of Reproduction & Infertility
Year:2007 | Volume:8 | Issue:1 (30)|Papers Count:11

Introduction: The world population is growing rapidly and most contraceptive methods are female-based with a broad range of side effects. Therefore, the research for effective male contraceptives is gathering pace and strength. One of the topics under study is the inhibitory effects of Neem or Melia indica fruit extract on male reproductive activities. This plant is native to India and has been studied for its contraceptive, spermicidal, antifungal and antidiabetes activities. Due to the abundant growth of Neem in the southern parts of Iran and the presence of another similar species named Persian lilac or Melia azedarach, in the northern parts of the country, a study was designed to compare attributed pharmacological activities of both plants.Materials & Methods: The two plant species, Melia indica and Melia azedarach are from the Meliaceae family, which were collected from Bandar Abbas and Gorgan respectively. After identification of the plants in the herbarium of the faculty of pharmacy, hydralcoholic extracts of the plants were prepared and concentrated by a percolator and a rota-evaporator. The hydralcoholic extracts were injected subcutaneously in 50mg/kg and 150mg/kg doses into 55 to 65-day-old male rats kept in the rat chow of the faculty with water ad labitum, constant light-dark cycles and at 22° centigrades for 60 days. The control group received normal saline during the same period. Determination of reproductive indices including Sperm Motility, Sperm Viability, Epididymal Sperm Reserve (ESR), Daily Sperm Production (DSP), Gonadosomatic Index (GSI), and fertility were done as an indication of contraceptive activity of the extracts.Results: Sperm motility showed a significant difference for those receiving Melia indica 150mg/kg doses) and Melia azedarach (50mg/kg and 150mg/kg doses) respectively compared to that of the controls. Daily sperm production (DSP) showed a significant reduction for those on Melia azedarach with 150mg/kg doses in comparison to the control group (p<0.05). The results also demonstrated a significant reduction in fertility rate by Melia indica at 150mg/kg (p<0.05) and Melia azedarach at 50 and 150mg/kg doses (p<0.01) compared to the controls. Therefore, Melia indica and Melia azedarach are able to decrease fertility rate indices significantly (p<0.05 and p<0.01 respectively).Conclusion: These two species of plants, especially Melia azedarach, are able to decrease fertility indices. Due to the well-known reputation of Indian neem in Europe and America for its multiple therapeutic effects and the presence of different formulations, these two species are to be studied more extensively and introduced more widely to the world for having male contraceptive potentials.

Introduction: Nitric oxide (NO) is a small fast acting neurotransmitter, which is synthesized from L-arginine by nitric oxide synthase. Studies show that NO affects a wide range of reproductive functions. Steroidal hormones synthesis, LH surge during ovulation, follicular growth and ovulation are all affected by NO. Therefore, the objective of this study was to evaluate the relationship between NO and estradiol (E2) production in ovarian follicles and cysts in bovines.Materials & Methods: Two experiment groups were formed and serum and follicular fluid levels of NO and estradiol (E2) was measured. In the first group, follicular fluids were obtained from 30 slaughtered cows. Follicles were divided into three groups according to follicular diameter: Small follicles, <5mm, medium-sized follicles, 5 to 10mm, and large follicles, >10mm. 30 follicles were randomly selected within each group. Blood samples were obtained via jugular vein. NO concentrations in blood and ovarian follicular fluids were measured by Griess reaction method and radioimmunoassay respectively. In the second group: 12 cows in follicular phase and with cystic follicles were selected and a cystic follicle was obtained from each. NO and E2 levels were measured as done for the first experiment group. The data were analyzed by SAS software using ANOVA and Duncan’s test.Results: NO concentrations of follicular fluids from large follicles were significantly higher than those of the medium and small-sized ones. There were significant differences in the concentrations of nitrite and nitrate (Stable metabolites of NO) between large and cystic follicles, with extremely low NO and high E2 levels in cystic follicles (p<0.01).Conclusion: The results suggest that paracrine effects of NO may play an important role in the control of ovarian follicle growth and development of cystic follicles in bovines. It seems that NO dictates its effects through inhibition of ovarian steroidal synthesis.

Introduction: Polycystic Ovary Syndrome (PCOS), which affects 2-20% of women of reproductive age, is associated with insulin resistance, hyperandrogenic anovulation and consequently infertility. In addition, in case of getting pregnant, there is a higher risk of spontaneous abortion. This study was done to evaluate the effects of continuing metformin throughout the first trimester of pregnancy.Materials & Methods: Seventy six PCOS patients who became pregnant while on ovulation induction medications and metformin were allocated to three groups in three different clinics during 2004-2005, as it follows: Group A, continuing metformin until the end of the 8th week, group B, until the end of the 12th week and group C, cessation of taking metformin immediately after confirmation of pregnancy (5-6th week of pregnancy). Pregnancy outcomes and complications were followed until the end of pregnancies. The data were analyzed by using SPSS (Version 9) and χ2, t-test, ANOVA, Kruskal Wallis, McNemar′s test and logistic regression calculations. A p-value <0.05 was considered as the level of significance.Results: The mean age of women in the two groups was 28.72±3.57 years, duration of infertility 3.38±2.19 years, BMI 25.7±5.28 and history of abortions 0.40±0.65. In comparison to the rates in previous pregnancies, significant reduction in spontaneous abortion rates were seen in group B from 40% to 8% using McNemar′s test (p<0.01) and in group A from 32% to 4% (p=0.002). In group C, despite a lowered rate of spontaneous abortion (From 23.1% to 4.2%), the difference was not statistically significant. No fetal anomalies were seen in the two groups.Conclusion: Taking metformin not only has therapeutic effects on infertility but also its consumption during the first trimester of pregnancy may have beneficial effects on the course of pregnancy without an increased risk of teratogenicity. Proving the beneficial effects of metformin during pregnancy and its harmlessness requires studies with larger sample sizes of PCOS patients with precise recording of data while considering its use before and during pregnancy and accurate recording of pregnancy outcomes.

Introduction: Premature rupture of membranes (PROM) is defined as rupture of membranes before the onset of labor at any time during the gestational period, which occurs in 2-25% of pregnancies. Based on complications related to PROM, such as preterm labor and increased perinatal mortalities, the importance of correct and on-time diagnosis of PROM and high false positive and negative results of diagnostic tests, this research was conducted to compare the diagnostic power of qualitative and quantitative measurements of b-hCG in cervicovaginal washing-fluid for the diagnosis of PROM in pregnant women attending Vali-e- Asr Hospital in Zanjan, Iran during 2006. Materials & Methods: This case-control research process design was done on cervicovaginal samples collected from 86 singleton pregnancies between 14-41 weeks of gestational age. Data were collected through a questionnaire, which included demographic data, pregnancy histories and a checklist for entering the result of speculum examination, fern and nitrazine tests, ELISA and qualitative strip tests for b-hCG.Subjects with a chief complaint of amniotic fluid leakage, who had been matched for gestational age, were divided into two 43-member groups: 1- Confirmed PROM by speculum examination, with positives result of amniotic fluid pooling, nitrazine paper test and fern test and 2- The control group undergoing speculum examination with negative results of amniotic fluid pooling, nitrazine paper test and fern test. Cervicovaginal fluids were collected from the posterior vaginal fornix by 5ml of sterile saline irrigation and aspiration technique. Subsequently, b-hCG was checked by quantitative ELISA and one-step qualitative pregnancy test.Results: The mean b-hCG levels were 250.60±118.6mIU/ml and 6.2±10.6mIU/ml in PROM and the control groups respectively. Calculations of receiving operating characteristic curve showed that the cut-off point for ELISA was 22.32mIU/ml and its sensitivity, specificity, positive and negative predictive values and accuracy were 95.3%, 97.7%, 97.6%, 95.5% and 96%, respectively. The one-step qualitative pregnancy test was positive in 42 PROM subjects, (97.7%), and in 5 of the control group, therefore, its sensitivity, specificity, positive and negative predictive values and accuracy were 97.7%, 88.4%, 89.4%, 97.5% and 93%, respectively. It seems that a very good agreement exists between the results of the two methods based on a Kappa coefficient value of 0.86.Conclusion: It seems that qualitative and quantitative measurements of cervicovaginal washing-fluid b- hCG are accurate, fast and simple for the diagnosis of PROM, especially in suspicious cases.

Introduction: Approximately 10-15% of all epithelial ovarian tumors fall into the category of low malignant potential tumors (Borderline ovarian tumors) which tend to be confined to the ovary for a long period. Biologically, these tumors have low aggressive behavior and malignant potentials, therefore, early diagnosis, recognition of the signs and symptoms and management of these patients is of significant importance. The purpose of this study was to determine the prevalence, evaluate some risk factors and discuss the management of patients with borderline ovarian tumors.Materials & Methods: This descriptive analytical retrospective study was performed on the medical files of 132 patients with ovarian epithelial cancers who had referred to the oncology departments of Ghaem and Omid Hospitals of Mashad University of Medical Sciences from 1994 to 2003. A questionnaire comprising of demographic data was filled for each patient. Statistical analysis was done by a computer using SPSS software for the calculation of t-test and χ2. The confidence interval was regarded 95%, while p<0.05 was considered significant.Results: 16.6% of the patients had borderline ovarian tumors. The mean age of the patients was 25.07±3.25 SD years. The most common pathological type of tumor was borderline mucinous cystadenoma (71.3%). The majority of patients were in stage I of the disease (78.4%). Elevated CA-125 tumor marker was discovered in 42.1% of the patients. Conservative surgical management was performed in 42.1% and radical surgery for the rest of the patients. Recurrence had been seen in 21.3% of the patients. 21.3% of the patients had died because of extraovarian dissemination of the disease.Conclusion: Borderline ovarian tumors are almost associated with good prognosis but because of probable recurrence and death, post-treatment serial follow-ups of these patients are recommended.

Introduction: Primary dysmenorrhea (PD) is seen in more than 95% of women of childbearing years. PD causes absence from school and workplace and has annually resulted in 600 million work-hours of absenteeism and two billion dollars of financial loss in America. Considering the known side-effects of chemical drugs in the management of primary dysmenorrhea, and the use of Foeniculum vulgare (FV) in traditional medicine practices as an energizing, tranquilizing and anti-spasmodic medicinal herb, this study was done to determine the effects of FV’s extract on the reduction of pain and other systemic symptoms accompanying PD in female students at Shahid Beheshti University in 2005.Materials & Methods: In this double-blind clinical trial, 90 randomly selected subjects diagnosed with PD were studied (46 cases and 44 controls). Five capsules containing 46 mg of Foeniculum vulgare and identical placebos were provided to be taken daily by the case and control groups respectively, during the first three days following the onset of dysmenorrheal pain whenever they needed the medications. Severity of dysmenorrheal and systematic symptoms were assessed and compared before the study and during two consecutive menses with Andersch and Milsom′s verbal multidimensional scoring system. The results were analyzed by SPSS (Version 10) through calculations of Friedman test, non-parametric repeated measures, and Mann-Whitney test to compare the two groups.Results: Severity of pain in the treated group with Foeniculum vulgare extract in comparison with the placebo group, showed a significant statistical difference (p<0.001). Despite a reduction in the severity of systemic symptoms in both groups, statistically significant differences were not observed considering systemic symptoms except for fatigue within borderline limits (p=0.058).Conclusion: In accordance to the results of this study, it seems that Foeniculum vulgare extract can be effective in reducing the severity of dysmenorrhea. More research with larger sample sizes and longer periods of time are required to confidently declare the mentioned results.

Introduction: Some studies demonstrate that depression, stress, low self-esteem and sexual dissatisfaction may be psychological outcomes of infertility. Depression and sexual satisfaction may play a significant role in the life of infertile couples, their infertility treatment follow-ups and their hopefulness for the future. This study was done to determine and compare rates of depression and sexual satisfaction among infertile and fertile couples referring to Al-Zahra medical educational center in Tabriz during 2006.Materials & Methods: This was a comparative-descriptive study in which depression and sexual satisfaction rates were studied and compared in 150 randomly selected infertile versus 150 fertile couples. Data gathering was done by using a questionnaire with 3 parts 1) Demographic characteristics, 2) Beck Depression Inventory (BDI) and 3) Larson′s standard questionnaire for determining sexual satisfaction. The data gathered from this study were analyzed by SPSS software (Version 14) through calculations of descriptive statistical methods (Frequency, mean and standard deviation), tests of association (χ2 and correlation coefficient) and the mean difference tests (T-test for independent and paired groups plus one-way ANOVA). P<0.05 was considered significant.Results: The mean differences for depression between infertile and fertile men and women were significant, but for sexual satisfaction, they were not statistically significant. The mean difference for depression in infertile women was higher than that of their husbands′ but sexual satisfaction scores in men and women were not much different. Also, there was a negative correlation between sexual satisfaction and depression.Conclusion: Infertile couples need rigorous care and treatment for their psychological problems. Active participation of infertile couples during treatment process and presence of psychiatrists and psychologists in the treatment of emotional and psychological problems of the couples are of great importance.

Introduction: Attachment theory not only focuses on child development but also it involves development through life span. This study has compared the attachment styles of mothers who had abortion (Induced or spontaneous) and mothers who did not have a history of abortion.Materials & Methods: 86 mothers who had a history of abortion (42 mothers with induced and 44 with spontaneous abortions) and 45 mothers who had no histories of abortion were selected.All the subjects were asked to fill a researcher devised and the Adult Attachment Style (AAS) questionnaires (Hazan & Shaver, 1987). The data were analyzed by SPSS software. Statistical methods such as descriptive analysis, chi-squared, one-way, and two-way ANOVAs were employed and level of significance was regarded as p<0.05.Results: The findings indicated a significant association between maternal attachment styles and abortion, denoting that mothers with induced abortion had more insecure attachment styles than those who did not have abortion and showed secure attachment styles. The results of variance analyses showed that the scores of secure and insecure attachment styles had significant differences among the three groups of mothers. AAS also showed significant differences in different attachment style scores. Secure attachment style in mothers with no histories of abortion, those with spontaneous abortions and mothers with histories of induced abortions had the highest means.Conclusion: Attachment styles influence individuals’ attitude towards relationship and control of close relationships (Through positive or negative representation of self and others and positive or negative characteristics of relationships). On the other hand, attachment styles bet-ween mother and fetus have an impact pact on mothers attitude toward parenting and their relationship with the child.

Introduction: One of the effective methods in family planning is sterilization of women.However, some women who choose this method may later suffer from a neurotic syndrome, which is demonstrated by pain, depression, hypochondriasis and loss of libido. With respect to the long-term psychological sequelae of sterilization, among which post-operation regret tops the rest, this study was designed to determine post-operation regret rates, request for reversal and attempt to reverse the operation, as well as secondary objectives, rates of depression and anxiety.Materials & Methods: The study design was a descriptive-analytical one, in which 150 sterilized women, who had been operated 1-10 years prior to the study, were selected through cluster random sampling. Data collection was done by two questionnaires:1) A questionnaire on demographic characteristics and post-sterilization regret and 2) Zung self-rating depression and anxiety scale. The data were analyzed by SPSS, version 11.5.Results: In this study, 6% of the sterilized women expressed regret and 2.7% requested a reversal surgery. None of the subjects had undergone a reversal surgery. 13.3% and 24.7% of the sterilized women had some degrees of depression and anxiety respectively. The means of depression and anxiety scores were significantly lower in women who expressed adequate poststerilization rest (p=0.008 and p=0.02 respectively).Conclusion: The results of this research, as well as personality differences and adaptability to changes, revealed that pre-sterilization counseling and post-sterilization follow-ups have an important role in women's psychological health promotion.

Introduction: Unwanted pregnancy remains a major public health concern. In Iran, 8.7% of women of reproductive age (15-49) have an unwanted pregnancy during use of a reversible method of contraception, and 5.6% of these pregnancies occur among Oral Contraceptive (OC) users. OC use is the most popular and widely used method among Iranian women. The recent Iran Demogra-phic and Health Survey (IDHS) reported that only half (51.5%) of OC users take it correctly. The aim of this study was to investigate the influence of the women’s self-efficacy on their oral contra-ceptive performance. Materials & Methods: This study was a cross-sectional survey on oral contraceptives that investi-gated contraceptive behavior based on steps to behavior change (SBC) model and self efficacy theory of OC users in Iran. The survey was conducted from July 2005 to May 2006 in family planning clinics of Mashad Health Centers. Three hundred and fifty two OC users were interview-ed. The collected data were analyzed by SPSS software. Statistical methods such as descriptive analysis, spearman correlation and multiple regressions were employed.Results: Family planning self-efficacy was significantly related to knowledge, approval, intention, practice and advocacy, among which, intention and advocacy had the highest correlation and predictability power. Standard multiple regression analysis revealed that this model had worked extremely well. Indeed, the independent variables accounted for 54.5% of the variance in intention.Conclusion: This study confirms that the hypothesis of improving family planning self-efficacy can be effective in consistent and correct use of oral contraceptive pills and it can produce positive outcomes. It is suggested that the findings of present study be used as a basis for interventions designed to enhance better performance in the concerned area.