Journal of Reproduction & Infertility
Year:2008 | Volume:8 | Issue:4 (33)|Papers Count:9

Introduction: The active form of vitamin D3 (1, 25 (OH) 2 vitamin D3) plays a critical role in the male or female reproductive organs. The activity of this hormone is mediated by an intranuclear receptor. The synthesis of this receptor is itself modulated by several hormones including estrogen. In this study, the expression of the nuclear receptor for 1, 25 (OH) 2 D3 (Vitamin D receptor, VDR) in reproductive organs of cycling mice has been addressed.Materials & Methods: The estrous phases of Balb/c mice, including proestrus, metoestrus, estrus and diestrus were determined by cytomorphological study of vaginal smears. The mice were killed at each phase and endometrial samples were collected. Expression of VDR mRNA was assayed by semi-quantitative RT-PCR. Immunohistochemical analysis was used for the evaluation of VDR protein expression in uterus, ovary and fallopian tubes.Results: VDR-specific transcripts were expressed in the endometrium of all stages of estrus cycle. The relative expression of VDR mRNA at estrus phase was more prominent compared to the other phases (p<0.001). Immunohistochemical analysis revealed that almost all endometrial cells, including stromal, luminal and glandular epithelial cells, Theca interna, Theca externa and Cumulus oophorus cells of ovary and fallopian epithelial cells highly express VDR. Conclusion: In rodents, mating occurs exclusively at estrus phase and having considered the potent immunosuppressive effects of 1, 25 (OH) 2 D3, high expression of VDR at estrus phase might be a fundamental mechanism for the induction of active tolerance against paternal allogenic sperm antigens.

Introduction: Chemotherapy has adverse effects on spermatogenesis and results in reversible or irreversible oligozoospermia or azoospermia. Little is known about the ultra structural alterations of male germ cells following busulfan administration, as an anti-cancer drug. The present study aimed to study the ultrastructural alterations or apoptotic features of male mouse germ cells, following administration of various doses of busulfan.Materials & Methods: This study was performed on thirty-two 8-week-old adult male mice. Animals were divided into four groups. The mice on the control group were treated with DMSO and in the second, third and forth groups were treated with 10mg/kg, 20mg/kg and 40mg/kg busulfan, respectively. Busulfan was injected as a single dose intraperitoneally. Thirty-five days after the treatment, the mice testes were dissected and prepared for apoptosis study by trans-mission electron microscopy (TEM) and TUNEL assays. The results were analyzed by ANOVA test using SPSS software and a p<0.05 was regarded statistically significant. Results: A single dose of busulfan induced ultrastructural features of apoptosis in all the experi-mental groups such as: chromatin marginalization of germ cell nuclei, especially in spermatogo-nia, deformation of nuclei, separation of germ cells and presence of large spaces between adjacent cells, cell shrinkage, occasional presence of vacuoles in germ cells and apoptotic bodies in sertoli cells. Ultrastructural features of apoptosis were more frequent in spermatogonia and primary sper-matocytes. Apoptosis was observed less frequently in the control group (2.77±0.57%), particularly in primary spermatocytes. However, the number of apoptotic cells in 10mg/kg and 20mg/kg busulfan treated groups were (58.23±7.32% and 54.09±6.23%) significantly higher than the number of apoptotic cells in 40mg/kg treated group (28.16±5.67%), (p<0.001).Conclusion: Administration of a single dose of busulfan in various doses of 10mg/kg, 20mg/kg and 40mg/kg, induces apoptosis in male germ cells, especially in spermatogonia and primary spermatocytes. Degree of apoptosis in male germ cells in busulfan treated groups is not dose dependent. Fewer number of apoptotic cells in 40mg/kg buulfan treated group may be due to more declines in the number of germ cells in comparison to 10 and 20mg/kg busulfan treated groups.

Introduction: Polycystic ovary syndrome (PCOS) is the most common cause of oligoovulation and anovulation in infertile women. Prolonged endometrial exposure to estrogen and unopposed by the inhibitory effects of progesterone in these patients makes them susceptible to endometrial hyperplasia. The objectives of this study, was to determine the prevalence of hyperplasia in PCOS patients and effect of factors such as age, body mass index and endometrial thickness on the abnormality. Materials & Methods: This cross-sectional study was conducted in Roointan-Arash Hospital during 2006 and out of 135 infertile women with PCOS, 106 patients were included in the analysis after considering the exclusion criteria. Patients were admitted in the first week of follicular phase (In patients with amenorrhea, at the time of referral to the clinic) in order to evaluate their endometrial thickness (ET) by transvaginal sonography and endometrial biopsy. The rest of the information was obtained by conducting interviews. The data were tested by X2, t-test and logistic regression and statistical analysis was performed by using JMP software (Version 4; SAS Institute, USA). P-values less than 0.05 were considered significant. Results: Examination of endometrial biopsies (106) by one pathologist revealed that 46 (43.4%) cases had endometrial hyperplasias (EH), which were subsequently classified into 37 cases of simple and three cases of complex hyperplasias but six cases had cytological atypia. Meanwhile, 53 patients (50%) had proliferative and five (4.7%) had secretory endometria. Two cases, aged 28 and 38 years, were diagnosed as endometrial adenocarcinoma. The patients were divide into two groups with or without EH, except the two with adenocarcinoma. Mean age, BMI, and endometrial thickness were significantly higher in the hyperplasic group. Age >35 years (OR=3.62, p<0.01), BMI ≥30 (OR=5.86, p<0.001) and endometrial thickness >7mm (OR=5.86, p<0.001) were identified as risk factors for endometrial hyperplasia. In multiple logistic regression analysis of age, BMI and ET, age (p<0.0001) and ET (p<0.01) were each an independent factor for the development of endometrial hyperplasia following adjustment for the other two variables. Inter-menstrual spotting and menstrual irregularity were seen in 37 (80.43%) and 45 cases (97.83%) respectively.Conclusion: The chances for EH in infertile women with PCOS will increase by age, obesity and ET thickness more than 7mm. However, age and ET were recognized as independent risk factors for EH.

Introduction: Opioids and morphine are increasingly abused in modern societies, especially in recent years. Therefore, the present study was designed to evaluate the effects of morphine dependency on rats’ sexual and maternal behaviors, birth rate, sex ratio and the rate of stillbirths.Materials & Methods: Adult male and female rats were allocated into treatment and control groups. The treatment group was sub-divided into two morphine-dependent groups, group I) consisting of a number of male couples and group II) of both parents. Morphine dependency was induced by gradual administration of oral morphine with a final dose of 0.4 mg/ml dispensed in drinking water for 14 days. Morphine dependency was confirmed by the observation of changes induced by naloxane administration. Sexual behavior was determined by vaginal plague observation. Weight gain during pregnancy, rate of stillbirths, sex ratio, and maternity behavior (Caring for the neonates or eating them) were assessed in the groups. For statistical tests, one-way ANOVA with its non-parametric equivalent and for comparing means, X2 were used while employing SPSS software, version 13, for statistical analysis. The level of significance was regarded as p<0.05.Results: A non-significant decline in sexual tendency was observed in groups I (60%) and II (67%), compared to the control group (80%). In the control group, 69% of all matings resulted in delivery compared to 39% and 38% in groups I and II respectively (p<0.05). Weight gain in groups I, II and the controls were 46±38, 28±28 and 62±33 grams respectively. Weight gain difference between the control group and group II was statistically significant (p<0.05). Sex ratio was 1.17, 1 and 1.57 in groups I, II and the controls, respectively. No stillbirths were seen in group I, while the rate of stillbirth in group II (67%) was statistically significant (p<0.001); one stillbirth was also seen in the control group. The rate of pup cannibalism in female rats on group II (37%) was significantly higher (p<0.001) than group I and the controls.Conclusion: Morphine dependency neither had effects on sex drive nor on fertilizing capacity in male or female rats but it increased the rate of pseudo-pregnancy. Morphine also increased the rate of stillbirths but it adversely affected maternal weight gain during pregnancy. Maternal behavior was highly affected by morphine dependency as well.

Introduction: Regret after sterilization, not only requires an expensive surgical procedure for recanalization, but also can affect the couples’ inter and intra-relationships. Whence, undergoing sterilization in Sistan and Baluchestan has the lowest rate compared to other provinces, the habitants’ regret after sterilization may further discourage other volunteers of the procedures. Therefore, this study was launched to determine the regret rate among sterilized people and to explore the underlying causes to help policy-makers improve the way people approach contra-caption and increase their participation. Materials & Methods: this cross-sectional study was done on 100 men and 144 sterilized women selected based on random sampling from 12 rural health and vasectomy counseling centers in Zahedan and Zabol during 2006. A questionnaire was developed and completed by the researchers through interviews. The questionnaire included questions on demographic characteristics, reason (s) for sterilization, reason (s) for regret and kind of complications upon sterilization, and their sources of information on the issue. The data were analyzed by using frequency tables, chi-squared, t-test, and logistic regressions. A p-value <0.05 was considered as the level of significance. Results: The mean age of sterilized men and women was 41.8±7.6 and 40.6±5.5 years and mean age at the time of sterilization was 38.2±6.7 and 36.3±4.3, respectively. Completion of family size was reported to be the main reason for sterilization by 44% percent of men and 58% of women. In the two groups, 17% of men and 12.5% of women expressed regret after sterilization and believed complications were the most important factor; mostly due to physical complications, and partly because of psychological factors and mood disorders ─ although, it seems that some of these complications have no direct relationship to sterilization. The chi-square test showed significant differences between the rate of complications and regret rates after sterilization in both men and women (p<0.001).Conclusion: The results showed that complications due to sterilization are the main causes of regret. Therefore, it is necessary to pay more attention to mentioning the probable complications of the procedures such as low back pain, weight gain and mood disorders in women and pain, swelling and decreased libido in men during pre-sterilization counseling; post-sterilization counseling is also encouraged for increasing satisfaction rate in these volunteers.

Introduction: Induced abortion is illegal in Iran and most other countries but in case pregnancy threatens maternal or fetal life, one can terminate the pregnancy, while doing illegal or clandestine and perhaps septic abortions usually leads to various undesirable life-threatening outcomes. The importance of exploring different aspects of illegal abortion and its related causes is an obvious subject. Therefore, this study investigates the experiences and views of some women and the outlook of authorities on illegal abortion practices.Materials & Methods: In this qualitative content analysis study, women that had a history of abortion and people with theological, political, legal or scientific (The patient care team) views were interviewed on illegal abortion outcomes in Karaj and Tehran, from March to September 2006. The data were content analyzed.Results: Five main themes emerged from this qualitative study. Only the results of one theme, “Assessment of condition”, with three main categories will be discussed in this article. These main categories included reactions, religious and personal beliefs and socio-political restrictions. The major reactions were divided into two minor subgroups 1) the treatment team, family and friends and the society. The medical team was further subdivided into two minor 2) supportive and preventive categories. The preventive subdivision 3) was divided into three minor divisions of abstaining from cooperation, caution and encouragement. Conclusion: Reactions of family and friends and the medical team to illegal abortions are regarded as important for decision-making by pregnant women who want to commit them. False beliefs or incertitude in Sharia, and considering abortion of more benefit to the family compared to continuing it, all favor a state to ignore prohibitive ethical issues. The patient care team’s support also affects the way social restrictions are confronted and the pregnant women eventually commit abortion. Therefore, providing a separate consultation in health centers for women who have unwanted pregnancies could reduce abortion rates committed due to economic, social and family problems or being unaware of ethical and religious issues. Evaluation of the causes for assistance by the patient care team could help solve this health problem too.

Introduction: The “Six Ethical Codes for Research” in Iran includes ethical guidelines for “Genetic researches”, “Research on vulnerable groups”, “Research on animals”, “Research on gametes and embryos”, “Organ and tissue transplantation research” and “Clinical trials”. The policy-making council of the Ministry of Health and Medical Education and Tehran University of Medical Sciences’ Medical Ethics and History of Medicine Research Center prepared the codes in 2006. The purpose of these codes is to lay down moral guidelines for conducting research in the new aforementioned medical and biotechnological fields that have given rise to ethical and legal controversies. However, certain ambiguities and deficiencies seem to exist in these codes. This paper is a critical study of the “Six Ethical Codes for Research”.Conclusion: A desirable ethical code is supposed to embody a general, consistent and justifiable moral theory in accordance with which precise and clear guidelines are set out for relevant problems. The “Six Codes” does not represent such a theory and, hence, lacks clarity, comprehensiveness and precision. Moreover, certain parts of the codes deal with non-moral (e.g. legal) and scientific (Technical) issues which definitely exceed the arbitrary ethical line.

In spite of the great deal of research in assisted reproductive techniques, more than 80% of transferred embryos by IVF/ICSI methods fail to be implanted. The causes for repeated implantation failures (RIF) may be reduced endometrial receptivity or other various uterine pathologies, such as thin endometrium, altered expression of adhesive molecules or immunological factors; whereas genetic abnormalities of male or female individuals, sperm defects, embryonic aneuploidy or zona hardening are other etiologies for implantation failures. Clinically, endometriosis, polycystic ovaries and hydrosalpinx may decrease implantation following embryo transfer due to dual disorders in the quality of embryos or endometrium. In this study, probable causes and methods of evaluation for RIF patients have been reviewed and the suggested methods for their treatment, including myomectomy, endometrial stimulation, immunotherapy, hysteroscopy, preimplantation genetic screening (PGS), assisted hatching, zygote intra-fallopian transfer (ZIFT), co-culture, blastocyst transfer, cytoplasmic transfer, tailoring stimulation proto-cols, intracytoplasmic sperm injection (ICSI) and salpingectomy for hydrosalpinges have been discussed.