Journal of Reproduction & Infertility
Year:2002 | Volume:3 | Issue:1 (9)|Papers Count:9

GnRH analogue, HMG and HCG administration are common protocol for ovulation induction in assisted reproductive technology (ART). Since implantation rate in stimulated ART cycles is lower than unstimulated cycles and as endometrium plays an important role in embryo receptivity, effect of this protocol on the ultrastructure of human endometrial glandular epithelium was studied at LH+4 (embryo transfer time). In this research endometrial biopsies were obtained from fertile women as well as infertile women who had undergone this protocol at LH+4. Quantitative and qualitative studies on endometrial glandular epithelium were performed by transmission electron microscopy (TEM) and morphometry and the results were statistically compared between the two groups. Qualitative results revealed presence of nuclear channel system (NCS), sub vacuole of glycogen and giant mitochondria (GM) in both groups. Similarly, in quantitative analysis, the volume fractions (Vv) of glycogen, mitochondria and rough endoplasmic reticulum to cell and also the Vv of euchromatin to nucleus were statistically not different (P> 0.05). These results suggest that ovulation induction by GnRH analogue, HMG and HCG are not associated with advanced endometrial development and consequently, embryo transfer at this stage (before advanced endometrial development which occurs normally at LH+7 to LH+10) may cause a lower rate of implantation.

Prevention of implantation is considered as one of the suitable methods for contraception or interception. Therefore during this study the effect of human follicular fluid (FF) on mouse implantation was evaluated. The results obtained during this study show that FF contains enzymes and upon incubation with mouse uterine tissue, results in delimitation of epithelium. This effect was inhibited by heat inactivation or addition of EDTA to FF. In vivo uterine wash with follicular fluid on days 3, 4, 5 and 6-post mating prevents implantation and therefore significantly reduces implantation and pregnancy rate. However uterine wash on day 7 post mating with FF had no effect on implantation and pregnancy rate. On day 3, 4, 5, 6 and 7 with Hams 10 as control had no effect on implantation or pregnancy rate. Addition of EDTA also prevented the in vivo effect of FF, suggesting that the active agent present in FF is likely to be a metalloprotoinase which inactivates with heat and addition of EDTA. Taking into consideration the fact that FF does not affect the pregnancy of the next cycles, thus the FF or its active agent can be considered as good interceptive agent for prevention of pregnancy rate.

Various immunological mechanisms are known to be involved in maintenance of pregnancy but mechanisms underlying the failure of pregnancy in spontaneous abortion are poorly understood. Leukocytes consist a substantial percentage of endometrial stroma cells and classic natural killer cells have been proposed as immunological factor in spontaneous abortion. This study was performed to clarify the immunological role of classic NK cells in women with recurrent spontaneous abortion in the first trimester and of unknown etiology. This cell population was studied in 30 samples of decidua tissue of women with spontaneous abortion (test group) and compared with 30 samples of decidua of women undergoing elective pregnancy termination (control group). Paraffin embedded sections were prepared from endometrial tissue samples of both groups and were dyed with specific monoclonal antibody against CD57 marker by using avidin-biotin-peroxides technique. NK cells positive for CD57 were then evaluated and counted under light microscopy with 400 magnification. Z-test was used to statistically compare NK population between test and control groups. Result showed that NK cells were scattered through stroma cells in both normal and abotion group. There was few NK cells observed in normal decidua tissue, where as this cell population was significantly increased in women with spontaneous abortion (P<0.003). It seems that NK cells play key role in recurrent spontaneous abortion during the first trimester of pregnancy. Probably classic NK cells are activated by local cytokines and attack trophoblast cells of placenta and are thus involved in induction of spontaneous abortion.

Age, education and parity are interrelated with energy equation and body weight in women, however independent relation of parity with weight and fat distribution is not clear. In this cross sectional study, the relation of parity and level of education were investigated with body mass index (BMI) and waist to hip ratio (WHR) among 403 Iranian women, between 22-45 years old. Findings revealed, by controlling the age, women with higher education (12 years>) in compare with women with lower level of education (12 years<) had lower BMI (24.8±4.3 vs. 28.3±4.9, P<0.01), Lower WHR (0.83±0.06 vs. 0.88±0.08, P<0.01) and Lower Parity (0.19±0.59 vs. 0.59±1.03, P>0.01). Any significant relation was not observed between parity and body mass index by controlling the age and education, however there was significant relation between parity and WHR by controlling age, education and body mass index (P<0.005, r=0.14). In multiple regression analysis also, age and education explained 43% of BMI variation and parity, BMI and education explained 51.2% of WHR variation. Present study indicated that high parity might be as a risk factor in increasing upper body fat, while it was not related to body mass index after controlling the age and education.

Next to lung cancer, breast cancer is the second cause of mortality among women. Although the prevalence of this disease has been increased, but the rate of mortality has not been changed during last three decades, this may be due to early diagnosis at the first stage of disease. The aim of this study is to determine fertility risk factor of breast cancel in women. This research is a case-control study which was performed in 1999 on three educational treatment centers related to Ministry of Health and Medical Education in Tehran. Personal, fertile characteristics in women with breast cancer were determined and compared with control group. 120 patients with breast cancer were selected randomly and compared with 120 healthy women. Results showed that majority (70%) of women with breast cancer were between 35 to 54 years old and there was significant relation between marital status and breast cancer (P<0.006).There was no relation between cancer and age of first menstruation, marriage age, number of pregnancy, age of first and last pregnancy, history of multiple pregnancy, history of breast feeding, duration of using OCP and age of menopause. But there was significant relation between number of abortion (P<0.046). In this study, risk factors of breast cancer were marital status, and there was a weak relation between number of abortion and breast cancer. Unfortunately some of these factors are not preventable, but for those factors which are manageable, proper program should be provided in order to make people aware of risk factors and ways of their prevention.

Inversion of the uterus is a rare clinical problem. It is encountered as an obstetric emergency and a diagnostic challenge in gynecology. Non-puerperal inversion usually results from a tumor implanted on fundus of the uterus. Treatment depends on the associated pathology and the stage. A rare case of non-puerperal uterine inversion caused by a large fundal leiomyoma was reported in Bahounar Hospital, Kerman, in a 38 years old woman resulting in severe lower abdominal pain and profuse vaginal bleeding. After incomplete myomectomy, reduce the inversion vaginally was successful and abdominal hysterectomy was performed.

Maternal and infantile mortality are important health indicators of every society due to pregnancy incidents. Maternal and infant mortality and also neonatal tetanus incidents have direct relation with delivery condition. Neonatal tetanus and mortality among mothers and newborns have direct relation with delivery in non-hygienic condition. Non-hygienic delivery rate is very high in Sistan and Baluchestan province. Even in the city of Zahedan with a population of 450000, where as access to maternity hospital is possible for all residents of this city, 50-60 % deliveries take place at home. In this study, the reasons of women were investigated for not referring to maternity hospital for delivery. The method of research was case control. Case group was selected from those women whose last deliveries had not taken place in maternity hospital and referred to health centers to vaccinate their children (no. 482). Control group was selected randomly among women who referred to hospital to give birth (no. 198). Hospitals high fee (38%), easy delivery at home (19%), fear from cesarean and drugs adverse reaction (13%) were the most prevalent reason for not giving birth at hospital. Employment and literacy rates of those women who had given birth at home were lower than control group. They were mainly from Suni and Baluch ethnic.In order to minimize the cultural barriers of referring to maternal hospital, we advise the respectful officers, to make insurance public, lower the treatments fee, held training programs and provide hygienic conditions with low cost for out of hospital deliveries.

Infertility affects different aspects of the individual's life and perhaps it is one of the main life stressors. Individuals under major stress are more exposed to disease such as depression, anxiety, low self confidence and dissatisfaction. The present study focuses on the role of gender on mental health in infertile couples. The sample was 50 infertile couples. The results indicated, infertile women have more psychological problems than infertile men, perceive infertility as more negative than men and hope to the future and to marital life, and the sense of meaning in life have determining roles in predicting mental health of infertile couples.

The questionnaire of morality in biotechnological research that has been drafted by this writer includes four sections dealing with various aspects of a research in this field. The first section contains general questions such as the aim and the anticipated achievement(s) of the research. The second section includes question concerning the subject. Regarding the human being as the subject of research the questionnaire is mainly concerned with such issues as informed consent, confidentiality, health and the safety of the subject. The third section is dealing with the issues of the safety and the health of researchers(s) themselves. Finally the forth section is concentrating on such questions as environmental concerns and the like. I have offered in this Article some explanations about moral principles underling the questionnaire.