Journal of Reproduction & Infertility
Year:2003 | Volume:4 | Issue:2 (14)|Papers Count:9

Adequate fetal movement is one of is health markers, and can be altered under influence of pathologic and nonpathologic causes. Since, glucose is an energetic agent, and its availability for central nervous system (CNS) provides better coordination of movements through the complex control of CNS, So in present study, we evaluated the effect of maternal glucose infusion on fetal movements accompanied by fetal heart rate acceleration. This 6 month trial was performed on 40 pregnant women, who were admitted to yahyanejad Hospital in Babol. They were divided into two groups with 20 numbers via frequency matching. Patient selection criteria were: age less than 30 years, GA 28-36 weed, no history of medical or pregnancy disorders, and normal sonographic findings of fetus. We started the test with blood sampling in order to determine the basal blood sugar, fetal movements counting, heart monitoring with infusion of 25 g glucose (to case group) and the assessed at 15, 30, 45 and 60 minutes later. Data entered to SPSS and analyzed by test and pierreson correlation test. There were significant increases in blood glucose level (P=0.006) and fetal movements (P=0.007) between two groups at minute 15, 30 and 45. But the correlation of them was incomplete pierreson type. The maximum fetal movements were at minute 30, and the maximum of bleed glucose level was at minute 15. So, the infusion of glucose to pregnant women had positive effect on increasing fetal movements, but it didn't have direct correlation. Need to adequate time for glucose metabolization is responsible for delayed correlation between fetal movements and blood glucose level.

Embryonic stem cells are pluripotent cells with self renewal ability that are derived from inner cell mass of blastocysts. It is possible to differentiate the cells under appropriate culture conditions into specific cells. Moreover, manipulation of their genome in-vitro allows the creation of transgenic and knockout mice. Owing to the significance of ES cells, this study was conducted to produce new lines of mice blastocysts aged 3.5 days were recovered from BALB/c mouse strain and cultured on mouse embryonic fibroblasts in ES media supplemented with 1000 IU/ml or 5000 IU/ml leukemia inhibitory factor (LIF). Established lines were analyzed for simple karyotype, C-banding, polymerase chain reaction of SRY gene (PCR-SRY), alkaline phosphates, and Oct-4 expression (RT-PCR). Three ES cell lines were produced morphologically. These lines were isolated in 5000 IU/ml LIF only. All three lines were male. Two lines had normal karyotye (40 chromosomes) and one line was tetraploid C-banding and SRY-PCR showed that all lines had XY sex chromosome composition. Also, all lines had alkaline phosphates activity and expressed Oct-4. These results indicated that two male murine ES cell lines with normal karyotype, alkaline phosphates and Oct-4 positive properties were established from BALB/c strain.

Polycystic Ovary Syndrome (PCOS) is a common cause of chronic an ovulation and is frequently associated with different clinical symptoms. The main objective of this clinical trial was to evaluate the therapeutic effects of single dose of metrodin administration to induce follicular response in PCOS patients at Shariati hospital (2001-2002). PCOS was the main cause of the infertility in selected patients. All the patients were treated with maximal dose of clomiphene citrate (150 mg/d) from the 3rd to the 7th days of their menstrual cycle while controlling with vaginal sonography for the follicular response. Sixty patients with follicular response were selected and studied we combined the previous strategy of clomiphene citrate administration with muscular injection of single dose (75 IU) of metrodin at the 3th day of cycle. The positive follicular response was the appearance of dominant with 18 mm diameters in the 14th to 16th days. In the presence of positive follicular response, 1000 IU of HCG was injected at the same day. Intercourse was allowed that night and the 2 subsequent days. Progesterone level was measured in the 21th day of the cycle, with levels equal or above the 3 ng/ml suggesting ovulation. Β-HCG level was measured in the 32th days of the cycle, if the menstruation was delayed. Te levels equal or more than 200 IU/l or significant increase in β-HCG level suggested chemical pregnancy. To confirm a normal intrauterine pregnancy, vaginal sonography monitoring of fetal heart rate were suggestive. Among total sixty patients, 31 (%51.7) had positive follicular response, 30 (%50) had ovulation and 15 had positive pregnancy tests. One patient had spontaneous abortion after positive pregnancy test and before sonography. Two patients had spontaneous abortion after positive sonography and two patients had preterm labor. Nine patients had term pregnancy. Complications were observed in four patients. The achieved data were analyzed, by fisher and X2 tests. Although there was no significant correlation between follicular response and variants such as age, BMI, infertility type or menstrual state, there was a statistically response and variants such as age, BMI, infertility type or menstrual state, there was a statistically high correlation between pregnancy rate and progesterone level 21th day of cycle (P<0.0001). The result of this study suggests that using a single dose metrodin administration, has a significant influence on follicular response, induction of ovulation and creating pregnancy.

Polycystic ovary syndrome (PCO) is the most common problem among ovarian dysfunctions that accompany infertility and ovulation problem. The prevalence of ovulation dysfunction is reported as high as 40% in general population .the first step in management of PCO is weight reduction and then drug therapy. Clomiphen citrate is the first choice for ovulation induction. Considering the resistance of some patients to this the first choice for ovulation induction. Considering the resistance of some patients to this drug, other methods have been also employed. This study evaluated whether metformin had beneficial effect in clomiphen resistant patients with polycystic ovarian syndrome in an infertility clinic or not. Thirty-four patients resistant to clomiphene were randomly divided in to 2 groups. One group was treated with metformin plus HMG (group A) and the other with HMG alone (group B).Hormonal assessment and GTT were preformed before administration of 1500 g of in to 2 groups. One group was treated with metformin and GTT were performed before administration of 1500 g of metformin (500 mg three times daily). HMG was injected the next month. The response was assessed by the restoration of follicle growth (16-18mm) and pregnancy rate. The findings were analyzed by T-test and Chi-Square. In the first group we had 2.4±1.9. Adequate follicle response in each patient. In the second group we had 1.3±1.4 adequate follicle responses. For the first group the number of HMG was 6.2±1.4 while for the second group it was 6.1±1. In the first group (P=0.17) the stimulation length was 10.5±1.4 days (P=0.77), and in the second group, it was 10±1.4 days. There was no significant difference in length of stimulation and total HMG received among the two groups. For the first group, the pregnancy rate was 29.4% and in the second groups, the rate appeared to be 11.8% (P=0.199), the difference was not statistically significant. In the first group, there were four patients with hyperinsulinemia, all of them had follicle growth. But in the second group, there were five patients with hyperinsulinemia but only one of them had follicle response. Metformin is not always beneficial when given to clomiphene-resistant infertile women with PCO in clinical practice, We recommend that the use of metfornin in PCO patients with hyperinsulinemia.

Infertility with an incidence of about 10-15% is a social problem that sometimes threatens the continuity of the family life. Clomiphen Citrate (C.C) is one of the most commonly used drugs in the treatment of infertility. The purpose of this study was to compare the pregnancy and abortion rates after IUI in two groups of patients who received clomiphen citrate alone or C.C in combination with ethinyl E2 to stimulate ovulation in patients undergoing IUI. This was a randomized clinical trial study performed at the Infertility Center of Mashhad Medical Science University. The subjects were 159 women, aged 20-30 years with infertility back ground of 1-10 years who were randomly assigned to two groups. The first group received C.C. Plus ethinyl E2 and the other group C.C alone. The number and diameter of the follicles, endometrial thickness, and pregnancy and abortion rates were evaluated by transvaginal ultrasonography and analyzed by chi-square and T-test. There was a significant difference in endometrial thickness between the two treatment groups (7.88 mm in group I vs. 7.02 mm in group II, P=0.001). There were no significant differences between pregnancy and abortion rates in the two groups. Pregnancy rate was 18.6% in group I vs. 14.5% in group II and first trimester abortion rate was in group I, 21% vs in group II ,25%Ethiny E2 can modulate the deleterious effects of C.C on endometrial thickness, which could not contribute to higher pregnancy rates and lower spontaneous abortion rates.

Pronucleus size, morphology and orientation are known to affect embryo quality, implantation and pregnancy success. The present study was aimed at evaluation of the possible relationship between sperm chromatin maturity tests (CMA3, aniline blue, SDS, SDS+EDTA) and semen parameters with percentage of zygotes with pronucleus size asynchrony. Semen of 115 men from IVF and ICST couples were analyzed for sperm concentration, motility, morphology and the said tests. At least 17-19 hours after sperm insemination or. ICSI, oocytes were scored for presence and relative size of their pronuclei and then the relationship between percentage of zygotes with pronucleus size asynchrony and semen parameters and the above tests was evaluated. A positive significant relationship was obtained between percentages of zygotes with unequal pronucleus size with protamine deficiency, however, no correlation was observed between this phenomenon and any of semen parameters and aforementioned tests in IVF cases. The result of this study and other studies show that evaluation of chromatin status is of paramount importance, since protamine deficiency not only directly affects fertilization rate, but also affects pronuclear morphology which influences embryo development, implantation and pregnancy success in IVF and ICSI. The effect of abnormal chromatin status on development of zygote might be mediated via abnormal pronucleus formation since sperms with abnormal chromatin are injected into oocytes during ICSI.

There are many psychological and physiological changes during pregnancy and postpartum periods that are sometimes they become pathologic. Thus, it is necessary for a medical team to identify those patients and their families who have a predisposition to mental disorders and to guide them through this period. Aimed at assessing the prevalence and predisposing factors of mental disorders during pregnancy, an analytical-descriptive and cross-sectional study was performed on 267 pregnant women. The data were collected through interview using the General Health Questionnaire and the questionnaire of the predisposing factors. Mental health was assessed with GHQ through the first second and third trimesters of pregnancy, and predisposing factors were assessed with the questionnaire of the predisposing factors in the third trimester. Results showed that the prevalence of mental disorders in the first trimester was 29.7%, in the second trimester 28.6% and in the third trimester 39.6%. There was a significant correlation between mental disorders and personal, psychological and socioeconomic predisposing factors (P<0.05). There fore. Taking into account the high prevalence and different predisposing factors of mental disorders, it can be said that mental health card during pregnancy is as important as physical care, Based on the results of this study, susceptible mothers may be defined and identified, and measures may be taken to prevent such disorders.

Sexual behavior as a response to biological instinct is essential for survival, and affects ones satisfaction from marital life. The prevalence of sexual dysfunction reaches 30-50% in both sexes. It can be of adverse consequences on the couples' life. Vaginismus is one of the frequently observed sexual dysfunction in women. It is accompanied by anxiety, phobia and avoidance reactions. The aim of this study is to assess the prevalence of anxiety features in patients suffering from vaginismus. Symptom check list-90 questionnaire was given to 27 patients diagnosed as vaginismus by Gynecologist referred to in a private psychiatric clinic. "Generalized anxiety, phobia and obsession - compulsion" subscales of SCL-90 questionnaire were particularly investigated. Data were analyzed by Chi-Square and Fishers exact tests. Anxiety, 10 patients (37%) from phobia and 19 patients (70.4%) from obsession compulsion symptoms. The results were consistent with those of other studies on this subject. Integrated approach to vaginismus consisting of both psycho therapy and pharmacotherapy is there fore recommended.