Journal of Reproduction & Infertility
Year:2005 | Volume:6 | Issue:2 (22)|Papers Count:11

Introduction: Infertility is considered as one of the major problems associated with spinal cord injured (SCI) men. Anejaculation as well as diminished sperm quality such as low sperm viability, low motility, and increased abnormal sperm morphology are the factors involved with infertililty following SCI. Since, epididymal autonomic innervation is impaired following SCI, the sperma-tozoa may remain in epididymis for an unnecessary longer time. This may subsequently disturb the sperm functional capability, motility potential, and sperm nuclear maturity with the presence of free oxygen species (ROS). The main objective was to evaluate the effect of chronic SCI on chro-matin integrity and DNA of spermatozoa aspirated from epididymis of Wistar rats. Materials and Methods: A total of 45 adult Wistar rats were divided into 3 groups of SCI, sham, control. Following laminectomy, SCI was induced with a 15g weight dropped from a distance of 10cm onto exposed dura matter (T10). Sham group underwent laminectomy of T10 only; while, control rats were not exposed to any type of injury or medication. The epididymal sperms were aspirated after 8 weeks for analysis of sperm parameters and sperm chromatin integrity with aniline blue, chromomycin A3(CMA3), SDS, and acridine orange(AO) tests. The data were analy-zed with SPSS (version 10).Results: The sperm parameters of SCI rats were significantly changed compared with other groups (p<0.05). Also, aniline blue as well as CMA3 tests were not changed in different samples (p>0.01). However, SDS and AO tests were significantly changed in SCI samples when compared with other groups of sham and control.Conclusion: Sperm chromatin condensation takes place during two phases of testicular and epididymal. Following SCI, testicular phase (histone replacement with protamine) is not affected; while, epididymal disulphide bond formation within protamine molecules is disturbed. Therefore, chronic SCI disturbs sperm parameters as well as sperm nuclear maturity, and DNA integrity. This may directly reduce the fertility potential following SCI.

Introduction: Cryopreservation is a branch of cryo biology concern with the maintenance of cells during prolonged storage in the frozen state at ultra low temperature. Sperm cryopreservation is routinely perfor-med in andrology laboratory and fertility centers and industry.Cryopreservation decrease sperm quality and its Fertilizing capacity. Evaluation of different sperm cryo-media and methods have been performed for several years. Yet, it is not known the best media and technique for sperm cryopreservstion. Thus it seems very necessary to set a sperm cryo-media and method base on experimental finding. Therefore, the aim of this study is the assessment of sperm survival and motility during cryopreservation by three different media including HSPM (Human Sperm Preservation Medium), TYBG (Test-Yolk Buffer) and GEYC (Glycerol Egg Yolk Citrate) and two different cryo-techniques including programmable (with apparatus) and using vapor phase (without apparatus).Materials and Methods: 22 samples were collected of normal male into sterile container. Sperm analysis was performed on the base of WHO criteria and freezing program including programmable and vapor pha-se was performed. Prefreezing sperm concentration and motility was evaluated before and after freezing and subsequently survival rate (CSF) was calculated. Each sample was divided in three parts and mixed with three different medium, subsequently at least two straws filled of each sample. One straw freezed with equipment and another one in vapor phase. The SPSS (Edition 11.0) statistical program was utilized for statistical analysis and t-test was used to compare sperm motility prefreezing and post thawing with two different cryopreservation methods and ANOVA/LSD was used to compare sperm motility with three different cryopreservation media. Significant level was considered p<0.05. Results: Base on our result, sperm motility was %46.13± 8.29 prefreezing , but considerably decreased post thawing by programmable technique in HSPM (%16.9± 5), GEYC (%16.31±4.57) and TYBG (%16.04±4.75) and also by using vapor phase technique in HSPM (%16.95± 4.55), GEYC (%14.13±5.14) and TYBG (%14.18± 4.47). There was significantly difference between programmable and vapor phase technique in GEYC (p=0.001) and TYBG (p=0.007). There was also significant difference between HSPM and both other media (p=0.05). Conclusion: According to our study, sperm thawing after its freezing by liquid Nitrogen vapor phase in three different media (HSPM, GEYC, TYBG) leads to significant reduction in sperm motility. The best result in sperm motility and survival achieved through programmable thawing with apparatus and in comp-aring freezing media, HSPM media significantly has higher survival rate in comparison with TYBG and GEYC media (p-value= 0.05). Since the freezing apparatus is not available in most centers therefore, utilizing HSPM freezing media and vapor phase freezing method would be recommended for normal semen samples.

Introduction: Oxidative stress (OS) is an important factor in the etiology of male infertility which presents abnormal increase in the production of free radicals with negative influences on reproduction. The aim of present study is evaluation effect of mercury (Hg) (600& 1200 micro molar) and nicotine (0.75 mM), in vitro, on membrane integrity (LPO), GSH content, motility, and acrosome reaction of bull spermatozoa with/ without manganese (Mn) and albumin (BSA). Materials and Methods: Lipid peroxidation (LPO) was assessed by measurement of MDA levels. Reduced glutathione (GSH) content evaluated by levels of reduced DTNB and acrosome reaction evaluated by gelatin digestion test. Sperm motility was assessed by under phase contrast micro-scopy at room temperature until 120 min. Statistical analysis performed using SPSS software by t- test, at p<0.05 significance level.Results: Our results showed that addition of Hg and nicotine to the sperm samples resulted in elevation of LPO rate (p<0.001). Meanwhile, Hg and nicotine treatments caused a significant reduction in the GSH content, motility, and acrosome reaction of bull sperm cells. Concomitantly, there was also an improvement in the mentioned altered processes following albumin and manganese addition. Here, Mn had better results than BSA. We found that BSA act as a pro-oxidant when added to medium containing high concentrations of metal ions, imposing more deleterious effects on bull spermatozoa [more increase in the LPO and decrease in GSH level (p<0.01), decreased acrosome reaction (p<0.001) and dropped motility]. Conclusion: According to our results, Hg and nicotine may impose sperm dysfunction in bull spermatozoa via altering some biochemical and physiological aspects of sperm like membrane integrity and cell movement. Our data suggest BSA and Mn that involved in antioxidant capacity are as double-edged swords (particularly BSA), which may show unwanted and negative effects.

Introduction: In assisted reproductive techniques (ART), ovarian hyperstimulation drugs are used to retrieve several mature oocytes. International studies report that complete absence of MII oocytes known as "complete oocyte maturation arrest (COMA)" is a very rare phenomenon. The main objective of this retrospective study was to evaluate the ART cycles with COMA along with results from the subsequent treatment cycles. Materials and Methods: A total of 38 cases with COMA were evaluated for age of patients, ovulation induction protocols, and number of follicles and oocytes (GV & MI). Three different protocols of short, long and HMG/HCG were administered on patients. Also, type of infertility was divided into male, female and unexplained.Results: The results showed that out of 38 cases, 17 and 7 of the couples were respectively retu-rned for the subsequent treatment cycles. The mean of age for men and women was 34.2±3.3 and 29.4±3.1, respectively. Also, the majority were diagnosed with female factor infertility (22 cases). 21 women were under 35 years old and the rest were between ages of 35-41. In second and third treatment cycles, the mean number of immature oocyte (GV+MI) was 3.13±1.5 and 2.9±0.96, respectively. In addition mean number of MII oocytes were increased from 0 in first to 2.06±1.3 in second and 2.02±0.7 in third cycles. HMG/HCG protocol was in direct relation with the lowest rate of immature egg retrieval. The results also showed that older women (>35) had the highest rate of immature oocytes. Conclusion: the results indicate that the prevalence of COMA is very high in our patients which could be related to the women's age. However, the COMA was reduced in patients who were re-turned for the second or third times for ART treatments. This may show that extrinsic factors related to the ovulation induction protocol and Induction drugs such as the type, manufacturing company, purchasing, and preservation could be the main cause in COMA taking place in some of our cases.

Introduction: Hypothalamic amenorrhea is one of the most prevalent problems leading to anovu-lation which is due to decrease in pulsatile release of GnRH. This diagnosis can be confirmed only after exclusion of ovarian and pituitary causes lead to anovulation. The most prevalent form, which leads to suppress of reproductive physiology is termed functional hypothalamic amenorrhea. It is a kind of psycho-biological answer to events in life. Patients affected with hypothalamic amenorrhea who want to become pregnant must be induced by exogenous gonadotropin or GnRH to ovulate. Continuous and pulsatile forms of GnRH are administerred intra venously or subcutaneously by a portable mini-pump. Most patients consider this method inappropriate because they are obliged to hold a mini-pump with themselves even while they are sleeping. The GnRH pump is not available in Iran. Consequently, exogenous gonadotropin is used for an ovulation induction, then timed intercourse (TI) or intrauterine insemination (IUI) are recommended. More over, In vitro fertiliza-tion (IVF) or even intracytoplasmic sperm injection (ICSI) techniques could be used. TI is an easier and cheaper method in comparison with IVF and IUI. The objective of this study is to compare the pregnancy success rate of the two methods of TI and IUI. Materials and Methods: In this clinically retrospective study, hypothalamic amenorrhea patients referred to infertility clinics of Reproductive Health Research Center, Tehran, Iran. They registered between April 1999 to March 2005 were considered. Patients were selected based on meeting the entrance criteria of this study. TI or IUI, after induction of ovulation was administered and the rate of successful pregnancies was compareed. Among Entrance criteria, age between 20 to 40 years and normal spermogram could be cited. The cases with infertility due to the male factor, uterine anoma-ly and fallopian tube obstruction were excluded. Results: In the TI group, from 27 cycles, there were 19 pregnant women (70.37%). In the IUI group, from 29 cycles, there were seven pregnant women (24.13%). The difference between these two methods was significant (p=0.05). Differences in the number of abortions and ectopic pregnancies between the two groups were not significant. Duration of infertility, mean age, and other demogra-phic characteristic were not significant different factor between the two groups.Conclusion: The results of this study support the TI as the first-line treatment method of hypotha-lamic amenorrhea. Taking into consideration the easy usage, low cost, and lack of demand for equi-pment in this method could be recommended as the first step for treatment of hypothalamic ameno-rrheas infertile patients.

Introduction: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine dis-eases in women. This syndrome is characterized by hyperandrogenism, an ovulation, infertility and obesity. The recognition of insulin resistance as a principle factor in the pathogenesis of polycystic ovarian syndrome (PCOS) has lead to the use of insulin-lowering agents, also called’ insulin-sensitizing drugs, for its treatment. The use of metformin in this syndrome is one of the therapeutic option. The patients with this syndrome had long term sequel such as infertility, endometrial and breast cancer and cardio vascular disease, it is necessary to evaluate the effect of metformin on this complication. Materials and Methods: The purpose of this study is to evaluate the role of metformin on clinical and Laboratory finding of single girl with polycystic ovarian syndrome. Between April 2001 to April 2002, 36 single girls who were considered to have clinical and sonographic find-ings of polycystic ovarian syndrome, were studied in Gynecology division of babol university of medical sciences they were treated with metformin 500 mg three times daily Hormonal assay (FSH, LH, DHEA, Testestrone, 17 OH progesterone, Estradiol) and biochemistry assay (TG, Cholestrol, HDL, LDL) and also clinical changes were monitored pre and post treatment. Results: After treatment with metformin significant decrease in weight (p=0.004), BMI (p= 0.006) was seen. After treatment TG (p=0.03), LDL (p=0.01) was lowed and HDL (p=0.003) was increased. Also we find a significant decrease in LH(p=0.006), Estradiol (p=0.005), DHEA (p=0.001) and Testostrone (p=0.001). Conclusion: Our results showed improvement in acne (P=0.02) and hirsotism (P=0.026). Our results showed remarkable effects of metformin in improvement of clinical and laboratory parameters. Therefore research of longer duration for effect of this drug would be necessary.

Introduction: Dysmenorrhea is one of the most gynecologic problems. Primary dysmenorrhea defines as painful menstruation in the absence of pelvic disease. Prostaglandin released from the endometrium at the time of menstruation causes primary dysmenorrhea. The Frequent treatment in pain relief for primary dismenomhea are taking non steroidal anti inflammatory drugs (NSAIDs) and oral contraceptives. In order to achieve an appropriate pain relief in primary dysmenorrhea in patients who do not have a good response to NSAIDs, this study was designed to compare the therapeutic effect of Mefenamic acid plus placebo with Mefenamic acid plus vitamin E. Materials and Methods: In this double blind clinical trial 64 single girls who were below 30 years old and suffered from primary dysmenorrhea were randomly divided in two groups. In one group Mefenamic acid plus vitamin E and in the other group Mefenamic acid plus placebo were given for their two subsequent menstruations. Results: The results confirm that the mean pain intensity before and after treatment in the group who received Mefenamic Acid and Vit E was (48.53±17.52) and in the group who received Mefenamic Acid and placebo was (25.94±21).  Pain relief in the group who received Mefenamic acid and vitamin E was better than the group who received Mefenamic acid and placebo (p<0.001). Conclusion: In patients with primary dysmenorrhea who do not achieve appropriate pain relief with Mefenamic acid, we suggest to intake Mefenamic acid plus vitamin E instead.

ََIntroduction: As infertility is known as a physiological effect, it is also a psycho-social effect. Recently, there are a lot of developing research showing that psychological factors can be a cause of infertility, and also infertility can have psychological outcomes. From psychological factors, it should be to address of infertility- related stress, Internal- External locus of control and self esteem .The Objective of the Study was to investigate the relationship between infertility- related stress (sexual, social, relationship, rejection of child- free life style and need for parenthood) with self- esteem and locus of control in non- related infertile men and women in Tehran, Iran. Materials and Methods: sixty infertile men and women (Not related together), were selected randomly from Royan Infertility clinic in summer-winter, 2003, they were completed Newton`s Fert-ility Problem Inventory(1999), Rosenberg’s Self-Esteem Questionnaire(1990), and Levenson`s Inter-nality, Powerful-Others and Chance Locus of Control Scales (1975). Statistical Analysis was done with by using SPSS software. Results: The results showed a significant negative relationship (p<0.05) between self- esteem and components of (sexual, social, relationship, rejection of child- free life style and need for parenth-ood) infertility- related stress. Sexual issues had the highest correlation with self-esteem. Significant relationship (p<0.05) was found between external locus of control (believing in powerful others) and sexual, relationship, social, and rejection of child- free life style. The relationship between external locus of control (chance) and the relationship and need for parenthood components were also signi-ficant (p<0.05). Although the difference between infertility- related stress of men and women was significant, women in comparison with men had higher scores in all components. Sexual issues in women and relationship issues in men had the highest correlation with their self- esteem of all the components. Conclusion: According our result in infertility investigation, the psychological factors have Relative importance, and in the future researches, it is necessary to go behind psychological factors such as social factors.