International Journal of Reproductive BioMedicine
Year:2012 | Volume:10 | Issue:5|Papers Count:15

Background: Progress achieved in culture media formulations have resulted led to an improvement in maintaining the mammalian embryo in culture throughout the preimplantation and pre-attachment period.Objective: The objective of this study was to evaluate the effect of various concentrations of myo-inositol during in vitro fertilization of bovine oocytes on subsequent embryo development.Materials and Methods: Bovine cumulus oocytes complexes (COCs) were matured in vitro at 39oC, in humidified 5% CO2 atmosphere for 22-24 h. The COCs were co-incubated with epididymal spermatozoa of post mortem bulls in modified TALP medium for 22-24hr. The fertilization medium used was: 1) TALP medium without myo-inositol (control); 2) control+0.02 g/l myo-inositol; 3) control+0.03 g/l myo-inositol; 4) control+0.04 g/l myo-inositol. Zygotes were cultured in vitro for 8 days when the ratios of in vitro embryo development of the hatched blastocysts were assessed and compared with the control group (p<0.05).Results: The presence of 0.04 g/l myo-inpsitol significantly improved overall morula and blastocyst rates (46.94%) compared to control (32.19%), but there was no difference in the percentage of embryos successfully developed to the morula and blastocyst stage when different levels of myo-inositol were used (46.94, 36.36 and 37.33% respectively). The mean percentage of cleavage rate was not significantly affected by treatments.Conclusion: These results suggest that, addition of 0.04 g/l myo-inositol in TALP medium is more beneficial for subsequent bovine embryonic development.

Background: Nowadays artificially assisted reproductive techniques are used to cure infertility. These methods are highly expensive, time-consuming and have low success rates which are usually around 20-40%. One of the best alternate methods for infertility treatment that can be considered is adoption that often decreases the treatment costs and the psychological impact within an infertile couple.Objective: This study has been done with the aim of determining adoption acceptance rates and the effective factors of adoption in infertile couples.Materials and Methods: A cross-sectional study was performed between Octobers 2009-2010 on 200 infertile couples who had been referred to Infertility Center of Shahid Sadoughi University of Medical Sciences. Information gathered through face-to-face interview and questionnaires. The data analyzed through a SPSS software program using ANOVA test.Results: There was a significant statistical relationship between adoption acceptance value scores and marriage duration of a couple (p=0.002 in men, p=0.004 in women) and presence of adoption backgrounds in male relatives (p=0.004). There was no statistically significant relationship between age, gender, education level, and onus of infertility, the number of previous referrals for an infertility solution and presence of adoption backgrounds in female relatives.Conclusion: Adoption as an alternative option to infertility treatment need to be more considered as a medical, social and cultural issue.

Background: Carbaryl is a carbamate insecticide widely used to control pests in agriculture and farm. Carbaryl adversely affect the reproductive endocrine systems in animals.Objective: The aim of this study was to evaluate Carbaryl effects on the pituitary-gonad axis in rats.Materials and Methods: In this experimental - analytical study, 60 adult male rats were divided into four equal groups: control, sham and experimental (1 and 2) groups that received 10 and 30 mg/kg Carbaryl via intraperitoneally injection. The sham group was subjected to intraperitoneally injection with olive oil while the control group did not receive any injection. Animals were sacrificed 35 days after the last treatment. Tissue sections were prepared from testes to investigate possible changes occurring in spermatogenic and Leydig cells. Blood samples were collected in which the levels of testosterone, luteinizing hormones (LH) and follicle stimulating hormone (FSH) were measured.Results: The results showed significant reduction in testes weight (p=0.042) and seminiferous diameters (p<0.001) within the experimental groups compared with control group. Also, the number of germ cells, spermatocyts, spermatids and Leydig cells on the testes of the experimental groups was significantly decreased (p<0.001). Accordingly, significant decline in the testosterone levels (p<0.001) and increase in LH and FSH levels were observed (p<0.05).Conclusion: These results demonstrated that Carbaryl has capacity to exert adverse effects on fertility. Therefore, have to be taken to account in applying Carbaryl for any studies and or commercial use.

Background: Sexual dysfunction is one of the most common problems in men after coronary artery bypass graft (CABG). Etiology of sexual dysfunction in these patients may be psychological or organic due to hormonal changes.Objective: The purpose was to evaluate the incidence and type of sexual dysfunction and changes in serum concentration of sex hormones in male patients undergoing on-pump CABG.Materials and Methods: In this before and after study we enrolled 40 men aged less than 70 years who were candidate for on-pump CABG. Interviews were done by a physician before and 12 weeks after the operation in regard to the impact of surgery on their sexual activities. The serum levels of 6 sex hormones were also determined. The statistical tests used for data analysis included analysis of variance, McNemar's test and chi-square analysis.Results: The mean±SD age of the patients was 51.27±7.86 years. Incidence of sexual dysfunction was 22.5% (9 cases) before and 47.7% (19 cases) after operation. Types of sexual dysfunction were premature ejaculation (5% before, 2.5% after), impotence (7.5% before, 12.5% after) and loss of libido (10% before, 32% after). The level of sex hormones were generally decreased after operation but it was statistically significant only for estrogen (p-value=0.02).Conclusion: Sexual dysfunction and reduction in serum level of sex hormones are common in patients before on-pump CABG and mostly get worse after surgery. Complementary studies are suggested for prevention and treatment of sexual dysfunction.

Background: There are many reasons why some couples do not become parents. Some are infertile, some do not want kids, children can be in a social context unacceptable and for others different life goals are more important.Objective: This study was designed to determine barriers of child adoption in infertile couples in Iran.Materials and Methods: This cross-sectional study was carried out at Iran from April 2010 to June 2011. The research program was comprised consecutively in 240 infertile couples. Experts in Guidance and Counseling vetted the instrument and set that it has content validity. Test re-test reliability was conducted by the investigators using a sample of 20 couples who have filled questionnaire.Results: Although 230 (96%) of the respondents heard of child adoption, only 89 (37.3%) of couples knew correct meaning of child adoption. Fifty four women (24%) knew how to adopt a baby while the rest did not; 196 (82%) respondents expressed their unwillingness to adopt a baby. Hoping of childbearing (78%) was the main barrier to adopt a child.Conclusion: The barriers mentioned were cultural practices, stigmatization, financial implications, and technical problems. Most of the infertile Iranian couples prefer to stay even so without children or think about new treatment.

Background: It has been claimed that by using different washing methods, the sperms can be separated according to size, motility, density, chromosomal content and surface markings and charge. These methods also reduce sperm chromatin deficiencies and screen the sperms before applying in assisted reproduction techniques.Objective: This study compared simple density gradient methods and a combined method with albumin density gradient and PureSperm separation (alb/PureSperm) for sex preselection by double fluorescence in situ hybridization (FISH) versus chromomycin A3 staining to determine chromatin integrity.Materials and Methods: 30 normal semen samples were prepared with PureSperm, albumin gradients and alb/PureSperm. All samples were then stained by FISH and chromomycin A3. The results were compared with SPSS 11.5 and the Kruskal-Wallis test.Results: The proportion of X-bearing spermatozoa by PureSperm separation (47.58±5.67) and Y-bearing spermatozoa by albumin gradient (46.13±3.83) methods were slightly higher than in putative normal sperm samples (1: 1), but there were no significant differences in the X- or Y- bearing spermatozoa counts among the three methods. Albumin gradient separation tended to underestimate abnormal spermatozoa compared to PureSperm and combined alb/PureSperm.Conclusion: Routine separation methods slightly enriched X- or Y- bearing spermatozoa, but the differences were not significant for clinical purposes. The combined alb/PureSperm method had no advantages for assessing sex ratio or chromatin integrity compared to simpler gradient methods.

Background: The most frequent physical finding in infertile men is varicocele, in which one of the mechanisms that can affect seminal parameters is oxidative stress.Objective: Our study aimed, for the first time, to compare the efficacy of recombinant human follicle-stimulating hormone (rhFSH), human chorionic gonadotropin (HCG) and human menopausal gonadotropin (HMG) on sperm parameters and fertility after varicocelectomy.Materials and Methods: 113 infertile men with varicocele were divided into four groups. Group A received HCG 5000 IU weekly, group B received HMG 75 IU three times a week, group C received rhFSH 75 IU three times a week and group D received no medical treatment after varicocelectomy.Results: After three months, in group A sperm morphology improved (p=0.007), causing a 32% pregnancy rate. In group B, sperm motility (p=0.023) and morphology (p=0.014) improved, causing a 57% pregnancy rate. In group C, all of the investigated semen parameters increased (p<0.05), causing a 62.5% pregnancy rate. Only rhFSH improved sperm concentrations to>20×106 mL (p=0.027). In group D, sperm morphology increased (p=0.038), but other parameters remained unchanged and no pregnancies occurred.Conclusion: It can be concluded that drugs can reduce induction time for spermatogenesis and fertility in comparison with varicocelectomy alone. For these purposes, rhFSH is more effective than other drugs.

Background: Cryopreservation and in vitro maturation (IVM) of oocyte is becoming an important technique in infertility treatment and fertility preservation. Also it has been proposed to establish a genetic resource bank for endangered or commercially important animal species.Objective: The aim of this study was to evaluate viability, maturation and fertilization rate of mouse immature oocytes after single and stepwise vitrification procedure.Materials and Methods: Oocytes were obtained from 4 weeks old female mice 48h after intraperitoneal injection of 7.5 IU pregnant mare serum gonadotropin (PMSG). Collected oocytes before vitrification were exposed to cryoprotectant, which was composed of 30% (v/v) ethylene glycol, 18% (w/v) Ficoll-70, and 0.3 M sucrose, either by single step or in a step-wise way. After vitrification and storage in liquid nitrogen, the oocytes were warmed and washed two times in medium TCM199 and then subjected to IVM, fertilization and subsequent development to blastocysts.Results: The oocytes survival rates after vitrifying-warming (88.96%), maturation rate (73.23%), the capacity of fertilization (57.80%) and embryonic development to blastocyst (16.41%) in the step-wise exposure were significantly higher (p<0.001) compared with corresponding rate in the single step procedure.Conclusion: The results suggest that vitrification with step-wise procedure has positive effects on maturation and developmental capacity of mice germinal vesicle oocytes in compare with single step vitrification procedure.

Background: Low birth weight (LBW or birth weight<2500 g) is one of the most serious health problems in today's world.Objective: The purpose of this study was to evaluate growth parameters of neonatal intensive care unit (NICU) admitted LBW preterm neonates at corrected ages of 6 and 12 months.Materials and Methods: In a prospective cohort (follow up) study, all LBW preterm neonates whom were admitted to Shahid Sadoughi Hospital NICU in 2008, followed up for one year and their weight, height and head circumference evaluated at ages of 6 and 12 months.Results: Twenty four boys and 26 girls with mean gestational age of 31.3±2.7 weeks and mean birth weight of 1480.3±422.8gr were evaluated. The most frequency of underweight and short stature was seen at the age of six months. Exclusive breast feeding infants had the lowest frequency of underweight at the age of six. Frequency of underweight at the age of six months and NICU stay days were more in neonates with birth weight of less than 1000 gr.Conclusion: It is necessary to emphasize on the importance of growth assessment of LBW children and proper education of their mothers about nutrition of their children for early and timely diagnosis and management of growth retardation and prevention of subsequent problems.

Background: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in females of reproductive age. Insulin resistance is a frequent metabolic disturbance in PCOS. Vitamin D deficiency is a common problem. Accumulating evidence suggests that vitamin D has a role on insulin sensitivity so may contribute to reduction of hyperandrogenemia.Objective: The aim was to determine the effects of vitamin D treatment in metabolic components and ovulation evidence in PCOS.Materials and Methods: Fifty one untreated PCOS patients were randomly divided into three groups and treated with calcitriol, metformin, or placebo. Before and 3 months after treatment, ovulation evidence was assessed by ovarian trans abdominal sonography. Plasma fasting glucose, insulin, homeostasis model assessment insulin resistance (HOMA-IR), 25-hydroxyvitamin D, parathyroid hormone and androgen levels were measured before and after treatment. A 75gr glucose test was performed before and after treatment and two set of results was compared.Results: Three patients did not continue this study. Only 11 patient (22.9%) had sufficient vitamin D levels (>30 ng/ml). Metformin caused a significant decrease in weight (p=0.027), insulin level (p=0.043), and insulin resistance (p=0.048). Systolic blood pressure and PTH significantly improved after calcitriol (p=0.029, p=0.009 respectively). An improvement in ovulation was detected after calcitriol and seven patients, without evidence of ovulation before treatment, illustrated ovulation after 3 months. Difference with calcitriol in ovulation was significant versus other two methods (p=0.02).Conclusion: Calcitriol treatment in PCOS may be prior to metformin in ovulation induction.

Background: Progressions in science and technology have generated several methods for delaying preterm delivery and abortion; therefore, discovering an easy, non-invasive, practical, and non-expensive predictive factor can help us to perform preventive methods in healthy pregnant women, without any risk factors.Objective: To indicate an appropriate index for predicting abortion in early pregnancy.Materials and Methods: In a prospective study, 73 pregnant women who had a singleton pregnancy, had no complications or history of abortion or disease, and were referred to Mahdieh and Taleghani Hospitals between 2007-2009, were evaluated. Blood and cervical fluid samples were obtained thrice from all patients: at the first visit, after 1 week, and 1-2 weeks later. They were followed up until the 12th week of gestation.Results: Using the receiver-operator characteristic (ROC) curve analysis, 1.62 was obtained as the cut-off point for the cervical fluid: serum human chorionic gonadotropin concentration ratio; 14 patients (19.2%) experienced abortion, and 12 women (70.6%) had a ratio ≥1.62. Of the pregnant women with a ratio of<1.62, 3.6% had an abortion.Conclusion: Pregnant women who do not show any signs of abortion and have a high cervical fluid: serum HCG concentration ratio are at risk of abortion; therefore, the cut-off point might be an appropriate index for predicting abortion in early pregnancy.

Background: Determination of oocyte fertilization and embryo quality are one of the most important purposes in ART cycles. Follicular fluid provides an important microenvironment for development of oocytes and some biochemical characteristics of the follicular fluid, such as pregnancy-associated plasma protein-A (PAPP-A), may play an important role in prediction of success rate of ART.Objective: This study was performed to evaluate whether there was any difference in follicular fluid PAPP-A, fertilization, and embryo quality between GnRH agonist long protocol and flexible GnRH antagonist multiple-dose protocol in ART cycles.Materials and Methods: A total of 100 women who were candidates for ART were enrolled the study and were divided into two groups, GnRH agonist (GnRHa) long protocol (n=51) and flexible GnRH antagonist (GnRHant) multiple-dose protocol (n=49). Follicular fluid sample was obtained from a single mature follicle and follicular fluid PAPP-A level; fertilization and embryo quality of the same oocyte were evaluated in both groups.Results: There was no significant difference in the mean levels of follicular fluid PAPP-A between the GnRHa protocol and GnRHant protocol (3.5±1.4 vs.3.8±1.9, respectively). The mean levels of follicular fluid PAPP-A in fertilized oocyte and good quality embryo were comparable in GnRHa and GnRHant protocols.Conclusion: Our data indicated that no differences of follicular fluid PAPP-A levels were observed between cycles using GnRHa long protocol and those of using flexible GnRHant multiple-dose protocol.

Background: Infertility is a stressful event that can give rise to psychological difficulties. Now, a wide range of psychosocial interventions for infertile couples has been developed.Objective: Purpose of this study was to determine the effect of group cognitive behavioral therapy (CBT) to reduce stress, anxiety and depression of women undergoing assisted reproductive therapy (ART).Materials and Methods: This study was an experimental study (before and after study with control group) on infertile women who were referring to Gynecological clinics of Jahrom University of Medical Sciences to receive ART.31 women who had criteria to enter the study were randomly divided into experimental group (n=15) and control group (n=16). The participants in the experimental group received 1 hour and 30 minute weekly session’s group therapy in 15 week as intervention. For gathering data, depression, anxiety and stress scale (DASS) normalized Persian version and Ahvaz Hardiness Test (AHT) were used to assess psychological distress and psychological hardiness in pre-posttest.Results: There were significant differences in mean score of infertile psychological distress, anxiety, depression, and stress in experimental group pretest with posttest. Furthermore, the results indicated that there were significant differences between hardiness in two groups. The experimental group had higher scores in hardiness than control group (p=0.001).Conclusion: It seems to be, that group therapy interventions, specially, cognitive behavioral therapy (CBT) can be useful and applicable to women who receiving ART.

Background: Idiopathic thrombocytopenic purpura (ITP) is a disease that commonly affects women of reproductive age and is associated with maternal and fetal complications.Objective: The aim of the present study was to report the perinatal outcome in pregnant women with ITP.Materials and Methods: Twenty one pregnant women with ITP admitted in a teaching hospital in Tehran, from October 2008 to February 2010, were enrolled in this prospective historical cohort study; course and perinatal outcome of pregnancies were studied.Results: Seven (33.3%) cases had been diagnosed before pregnancy, while the other fourteen (66.7%) were diagnosed during pregnancy. During hospitalization, thirteen (62%) patients required treatment, eight (61.5%) of them with steroids, two (15.3%) received intravenous immunoglobulin (IVIG), and three (23%) were treated with steroids and IVIG. Three babies were delivered vaginally (14.3%), seventeen (81%) through cesarean section and one patient aborted her fetus. Nine mothers (42.9%) had platelet counts<50000/ml at the time of delivery; but postpartum hemorrhage occurred in 4 (19%) women and one women received platelet transfusion during cesarean section. Six (28.6%) women developed gestational diabetes. Pregnancy was complicated by preeclampsia in one woman and by abruptio placenta in another. One pregnancy terminated in intrauterine fetal death. Seventeen infants (89.5%) had normal platelet counts, and two (10.5%) had moderate thrombocytopenia. No infant showed signs of hemorrhage, but 2 neonates (10.5%) were diagnosed with intrauterine growth restriction.Conclusion: Rate of gestational diabetes in pregnant women with ITP is higher than the general population. Rate of gestinational diabetes is 3-5% and postpartum hemorrhage is 5-7% in general. Postpartum hemorrhage is common in these women. Severe thrombocytopenia and bleeding in the newborns are uncommon.

Dear Editor, The problem of congenital hemoglobin disorder is common in tropical Asia. In tropical Southeast Asian countries, very high prevalence of thalassemia disorder especially for beta thalassemia is observed. This tropical hematological problem affects millions of population and cause several health disorders. Of interest, the issue of reproductive health impairment of the population with beta thalassemia disorder is not well mentioned.Here, the author tried to summarize some important information on the semen problem in beta-thalassemia. In beta-thalassemia major, poor semen quality is observed. It is noted that most patients have "hypogonadotropic hypogonadism state, impairment fertility and growth retardation." Jensenet al proposed that "The causation is multi-factorial, with iron deposition in the pituitary gland resulting from life-long dependence on blood transfusions being a major factor."