Journal of Reproduction & Infertility
Year:2010 | Volume:11 | Issue:2 (43)|Papers Count:11

Introduction: Antineoplastic chemotherapy is usually accompanied by fertility im-pairment and the aim of this study was to investigate the possible protective effects of melatonin, a pineal gland hormone with potent antioxidant activity, on busulfan-treated adult male mice. Materials and Methods: This study was performed on 32, eight-week old adult male mice. The animals were divided into four groups consisting of a control and three experimental groups. The animals in the control group received dimethyl sulfoxide (DMSO), a solvent, the second group a single dose of intraperitoneal busulfan (20 mg/kg), the third group a single dose of intraperitoneal melatonin (10 mg/kg) for five days and the fourth group melatonin (10 mg/kg) for five days upon an initial dose of busulfan (20 mg/kg). Thirty-five days after the treatments, all the animals were sacri-ficed and dissected. Johnson's score were determined by examining the morphometric characteristics of seminiferous tubules and estimating Leydig cell volumes and germ cell counts.Results: Busulfan-treated mice showed reductions in Johnson's score and quality of spermatogenesis (p<0.001) in comparison to the controls. The quantitative values of seminiferous tubules (p<0.05) and the nuclear volume of Leydig cells (p<0.05) were significantly lower in the busulfan-treated mice relative to the controls. In the fourth group, melatonin not only caused a remarkable normalization in seminiferous tubule indices (p<0.05), but also increased the nuclear volume of Leydig cells (p<0.001), the relevant Johnson's score (p<0.001) and all germ cells in comparison to the second group (p<0.05). Conclusion: Melatonin might have a possible protective effect against busulfan-induced testicular damage. Although the protective mechanism of melatonin has not been fully revealed, the protection seems to be through a decrease in oxidative stress.

Introduction: Ecstasy drug abuse is relatively common among the youth undergoing psychosocial stresses. Categorized as a stimulant drug, ecstasy has nervous, cardiac and immunological side-effects. The endocrine system is not spared from the harmful effects of the drug and it could influence ovulation by exerting its effects on the hypothalamic-hypophyseal-gonadal axis. The aim of this study was to evaluate the effects of ecstasy on the quality of oocytes and on fertilization rate in mice.Materials and Methods: Thirty female NMRI mice were divided into three groups, after checking for their estrous cycles. At the beginning of each cycle, ecstasy was administered intraperitoneally to the animals in groups A (a minimum dose of 5 mg/kg/day) and B (a maximum dose of 20 mg/kg/day). At the end of the second day, 10 IU PMSG, and at the end of the 4th day, 10 IU HCG were administered intra-peritoneally. The mice in group C underwent the same procedures except receiving ecstasy. All the mice were sacrificed on the fifth day to aspirate their oocytes for further evaluation. In-vitro fertilization was done using mature or MII oocytes and fertilization was checked after 5 hours. The results were later statistically analyzed.Results: The number of retrieved oocytes was similar between the experimental and control groups. However, the rate of mature oocytes (MII) was significantly higher (p=0.0001) in the controls (31.2%) than the mice in groups A (15.2%) and B (12.8%). Moreover, fertilization rate was significantly higher in the controls than the experi-mental groups. Conclusion: Administration of Ecstasy in mice can affect both oocyte maturity and the fertilization potential of oocytes. The overall effects of ecstasy on embryo devel-opment and implantation needs further studies to reach a definitive conclusion.

Introduction: Preeclampsia is one of the most common medical complications during pregnancy that can be a major cause of prenatal morbidity and mortality. One of the most studied biomarkers in the prediction of preeclampsia is C-reactive protein. The objective of this study was to assess the relationship between maternal serum CRP concentrations in early pregnancy and the onset of preeclampsia during the gestational period.Materials and Methods: In this prospective cohort study, serum CRP levels were measured in 400 pregnant women in their 20th week of gestation. They were all followed up till delivery. The data were finally analyzed statistically.Results: After controlling for the effects of maternal age (<19 and >35 years), multiple regression analysis for primiparity, supplementary calcium intake, BMI and CRP depicted a statistically significant relationship between CRP levels and mild (OR=1.71, 95% CI=1.39-2.11) and severe (OR=2.45, 95% CI=1.80-3.34) pre-eclampsia onsets. Among all the aforementioned variables, only supplementary calcium intake was significantly effective in the prevention of preeclampsia. In ROC curve analysis, the CRP cut-off point in moderate preeclampsia was 5.35 mg/l (with 94% sensitivity and 81% specificity), and in severe preeclampsia it was 5.45 mg/l (with 94.4% sensitivity and 82.5% specificity).Conclusion: It seems that CRP can help identify pregnant women who are at high-risks of preeclampsia but larger studies are needed to establish a definitive relation-ship.

Introduction: Polycystic ovary syndrome (PCOS) is associated with insulin-induced elevations of plasminogen activator inhibitor (PAI-1), the most potent inhibitor of fibrinolysis. Hypofibrinolysis due to increased PAI-1 levels in PCOS patients bears a high risk for miscarriage and some other pregnancy complications which are probably due to increased thrombophilic states. In this study we compared thrombophilic factors in women with PCOS with those of healthy women.Materials and Methods: This analytical study was performed on 123 infertile women with PCOS as the case group, and 73 women non-PCOS women with male factor infertility as the control group. All the individuals attended Rouin Tan Arsh Hospital for receiving fertility treatment in Tehran, Iran during 2008. Blood samples were taken from both groups on the third day of menstrual cycle for the evaluation of protein S, activated protein C resistance (APC-R), hemocysteine, FSH, LH, prolactin, testosterone, FBS and 2-hr GTT. Results: The mean protein S and APC-R values were lower in the case group compared to the controls, but the differences were not statistically significant (p=0.752 and p=0.603, respectively). The mean hemocysteine value was higher in the control than the case groups (13.25 mmol/l vs. 12.49 mmol/l, respectively) but this difference was not significant either (p=0.157). PCOS and older age tended to elevate hemocysteine (p<0.05).Conclusion: Comparison of thrombophilic factors in women with PCOS and women without the disease showed no significant statistical differences. PCOS and older age seemed to raise the risk for abnormal changes in hemocysteine levels.

Introduction: Preeclampsia is a complication of pregnancy that is associated with high blood pressure with an unknown etiology. There is much evidence that altered endothelial cell functions may play an important role in the pathogenesis of preeclampsia. The aims of this study were to determine serum levels of nitrite, nitrate and malondialdehyde (MDA) in pregnant women with and without preeclampsia. Materials and Methods: This observational-analytical study was performed in the third trimester of pregnancy on 35 pregnant primiparas with preeclampsia and 35 women with normal blood pressure. The women were recruited for the study among the mothers attending Andimeshk Urban Health Centers during March 2008 to March 2009. Aside from the demographic data, the gestational age and blood pres-sure were recorded too at the time of blood sampling. Serum levels of nitrite and nitrate were measured by Griess and MDA by thiobarbituric acid reactions. The data were statistically analyzed and compared between the two groups. Results: Serum levels of nitrite, nitrate and MDA, respectively were 12.6±3.8, 23.8±8.6 and 9.7±2.8mol/l in women with preeclampsia and 8.7±2.5 (p<0.001), 16.4±5.4 (p<0.01) and 6.34±1.6mol/l (p<0.001) in the controls. The results depicted significantly higher serum concentrations of the three analyses in pregnant women with preeclampsia relative to the controls.   Conclusion: Significantly higher serum concentrations of nitrite, nitrate and MDA in pregnant women with preeclampsia are suggestive of the role of these substances in the pathogenesis of the disease. Use of the three parameters may be useful in the early screening of preeclampsia. 

Introduction: Gestational diabetes is the most common metabolic disorder in pregnancy. Glucose Challenge Test (GCT) is done for all pregnant women during the 24th to 28th weeks of gestation. If the GCT value is more than 130 mg/dl a Glucose Tolerance Test (GTT) is asked and if GTT is impaired, gestational diabetes mellitus (GDM) is diagnosed and she will receive treatment accordingly. Some studies have illustrated that impaired GCT can cause unfavorable pregnancy outcomes. Therefore, the goal of this study was to determine the pregnancy outcome in pregnant women with abnormal GCTs.Materials and Methods: This study was done on all pregnant women attending Babol Shahid Yahyanezhad Hospital for prenatal care during 1999 to 2009. GCT was done for all the participants during the 24th to 28th weeks of gestation. Pregnancy outcomes of 225 pregnant women with abnormal GCTs and normal GTTs were compared with those of 225 pregnant women with normal GCTs as the controls. The individuals were compared for pregnancy outcomes such as macrosomia, premature rupture of membranes (PROM) and the need for a cesarean section (C/S).Results: The average birth weight of the neonates were 3.5±0.5 kg and 3.3±0.4 kg (p<0.001) in the cases and controls, respectively. Twenty-five neonates in the case group (12.1%) and eight neonates in the control group (3.6%) had macrosomia (p=0.003). Frequency of PROM was 17.85% (40) in the cases and 8.9% (20) in the controls (p=0.008). The cases had a higher frequency for preeclampsia 4.4% (10) than the controls 1.8% (4), (p=0.17). And pregnancy in the cases lead to a greater number of Cesarean sections, 42.2% (95) in comparison to the controls, 28% (63), (p<0.001).Conclusion: Prevalence of macrosomia, PROM and C/S were higher in pregnant women with abnormal GCTs. Due to the aforementioned unfavorable conditions that bear the risk of a poor perinatal outcome, early diagnosis and proper follow up of women with GDM is suggested during the prenatal period.

Introduction: Although numerous studies have depicted the association between ad-verse pregnancy outcomes and the future fertility status, this relationship has not been clearly outlined. A positive past medical history for adverse pregnancy outcomes, such as induced abortion, ectopic pregnancy, postpartum infection, premature rupture of membranes can affects women’s fertility prospects. The main goal of this study was to determine the relationship between previous pregnancy outcomes and second-ary infertility.Materials and Methods: This retrospective case-control study was done on 182 (92 infertile and 90 pregnant women), 15–45 years old patients during a six-month period in 2008 – 2009.  The study took place in Imam Djavad Hospital in Naghan, Chaharmahal Bakhtiari province, in Iran. The outcomes of prior pregnancies such as abortion, ectopic pregnancy, postpartum infection, prolonged labor, premature rupture of membranes, manual removal of the placenta and postpartum curettage were com-pared to those of the controls. The data were analyzed by t-test and chi-square. Results: In the case group, induced abortion and postpartum infection were signifi-cantly higher than the control group (p < 0.05). No significant differences were found between the two groups regarding a history for spontaneous abortion, ectopic preg-nancy, prolonged labor, premature rupture of membranes, manual removal of placenta or postpartum curettage.Conclusion: A past medical history of induced abortion and postpartum infection can negatively affects prospective pregnancy outcomes. By educating women and health-care providers, we may help prevent the detrimental effects of these disease states on women’s future fertility status.

Introduction: Ambiguous genitalia is a medical emergency in newborns and effort is made to perform sex reassignment and reconstructive surgery as soon as possible. However, conflict between the assigned sex and later gender identity are still present in many cases. This discrepancy between sexual and gender identities leads to several complications that are the focus of the present study. Materials and Methods: The literature review was performed by searching some knowledge-based databases such as Medline/PubMed (from the National Library of Medicine), Scopus, PsyClic and the Iranian Scientific Information Database (SID) on the internet and all the available articles in relevant journals published up to August 2009. Results: A significant number of intersex individuals suffer from incoherence be-tween the sex reassigned to them by the medical team, and their gender identity revealed to them in teen ages or adulthood. As an adult, a large number of these indi-viduals do not live according to their early reassigned sex and some may seek further sex reassignment congruent to their gender identity. A number of these cases have spoken out against the treatments performed during their childhood. They believe that the current treatment strategies for intersex individuals are paternalistic and incompat-ible with codes of medical ethics and human rights.Conclusion: The current knowledge about the complexities of sexual identity devel-opment, gender identity, gender role and sexual orientation is sparse and incompre-hensive. The current approach for the management of infants with ambiguous geni-talia seems to need major reevaluation. It seems better to defer any sex reassignment and reconstructive surgery until their gender is revealed and they are legally eligible to decide about these issues by themselves.

The published article by Dr. Ai, et al. (1) on the secretion of vascular endothelial growth factor (VEGF) in a three-dimensional endometrial cul-ture was of great surprise to me as this model had been earlier introduced by Fasciani, et al. (2) in 2003. This model was later developed by me (3, 4) and endometrial effects of different medica-tions were evaluated in this model.

Regarding the questions raised and comments made on the paper authored by me "Secretion of Vascular Endothelial Growth Factor in a Three-Dimensional Culture of Human Endometrium; an In-Vitro Model for Endometriosis" I have pro-vided the following response for more clarification.