International Journal of Reproductive BioMedicine
Year:2017 | Volume:15 | Issue:6|Papers Count:8

This paper summarizes the proceedings of the stem cell session of the “ 7th Yazd International Congress and Student Award in Reproductive Medicine” held at Shahid Sadoughi University of Medical Sciences, Yazd, Iran, on 28-30 April 2017. Here, we collected the papers of the session entitled: “ Stem Cells, Good manufacturing practice, and tissue engineering” , that presented and discussed at this meeting by the international and national experts of the overlaps of the fields of stem cells and reproductive medicine, and the translation of these efforts towards practical application in regenerative medicine.

Children and young adults, who suffer from cancer, receive gonadotoxic therapy, which destroys their fertile abilities after survival. Ovarian cryopreservation and transplantation provide the promising solution to this problem, where the ovary can be removed before the gonadotoxic therapy and reimplanted after patient's survival, where the ovary is to be cryopreserved during the period of the therapy. However, cryopreservation of the whole ovary is still facing great obstacles, namely the ischemic reperfusion injury and the defective cryopreservation related to the defective ability to universally deliver the cryopreservation/warming solutions through the ovarian vascular bed. Meanwhile, the currently applied technique of ovarian tissue cryopreservation provides limited follicular recovery because many follicles are lost until the establishment of revascularization post-transplantation. To solve the problems, an innovative system has been developed to insure immediate and universal delivery of the cryopreservation/warming solutions to the graft, in addition to keeping the graft under continuous perfusion before and after cryopreservation, minimizing any chance for microthrombi formation or ischemia-reperfusion. This innovative system can be applied in the following surgical and clinical interventions: 1) Allogeneic ovarian transplantation; 2) Preservation of fertility after systemic chemotherapy or bone marrow transplantation in young females, where the ovaries could be removed before the therapy and exposed to the adequate cryopreservation provided by the system till re-implantation after the patient's survival; 3) The system is also suitable for the corresponding applications on the testicles.

The sperm DNA damage may occur in testis, genital ducts, and also after ejaculation. Mechanisms altering chromatin remodeling are abortive apoptosis and oxidative stress resulting from reactive oxygen species. Three classifications of intratesticular, post-testicular, and external factors have been correlated with increased levels of sperm DNA damage which can affect the potential of fertility. Alcohol consumption may not increase the rate of sperm residual histones and protamine deficiency; however, it causes an increase in the percentage of spermatozoa with DNA fragmentation and apoptosis. In a medical problem as spinal cord injury, poor semen parameters and sperm DNA damage were reported. Infection induces reactive oxygen species production, decreases the total antioxidant capacity and sperm DNA fragmentation or antigen production that lead to sperm dysfunctions and DNA fragmentation. While reactive oxygen species generation increases with age, oxidative stress may be responsible for the age-dependent sperm DNA damage. The exposing of reproductive organs in older men to oxidative stress for a long time may produce more DNA-damaged spermatozoa than youngers. Examining the sperm chromatin quality in testicular cancer and Hodgkin’ s lymphoma patients prior to chemotherapy demonstrated the high incidence of DNA damage and low compaction in spermatozoa at the time of diagnosis. In chemotherapy cycles with genotoxic agents in cancer patients, an increase in sperm DNA damage was shown after treatment. In overall, those factors occurring during the prenatal or the adult life alter the distribution of proteins associated with sperm chromatin induce changes in germ cells which can be detected in infertile patients.

Background: There is little evidence about antioxidant properties of vitamin D. Recent studies suggest that oxidative stress may play a major role in the pathophysiology of polycystic ovary syndrome (PCOS), but the association of vitamin D with oxidative stress is still not known in PCOS. Objective: The goal of the present study was to evaluate the correlation between serum 25-hydroxy vitamin D and oxidative stress markers in PCOS group compared to control group. Materials and Methods: 60 PCOS women (20-40 yr old) and 90 healthy women as control group were participated in this case-control study. Fasting serum level of 25-hydroxy vitamin D 25(OH) D, glucose, insulin, calcium, malondialdehyde (MDA), protein carbonyl (PC), also homeostasis model assessment for insulin resistance (HOMA-IR) and fasting glucose to insulin ratio (FGIR) were measured. Results: It was found that the mean of serum 25(OH)D was lower in the PCOS group (10. 76± 4. 17) than in the control group (12. 07± 6. 26) but this difference was not statistically significant (p=0. 125). Fasting insulin, HOMA-IR and MDA were significantly higher in the PCOS patients as compared to the controls, whereas PC level did not differ for the two groups (p=0. 156). No significant correlations were found between 25(OH) D levels and oxidative stress markers (MDA and PC). Conclusion: The findings indicated no significant differences in the serum 25(OH) D levels between the PCOS patients and the matched controls. Also, no correlation was found between the serum vitamin D levels and oxidative stress markers in both groups.

Background: The purpose of triggering in ovulation induction is to induce the final maturation of oocytes and their release from the ovary for fertilization. Objective: The aim of the present study was to compare the effectiveness of gonadotropin-releasing hormone (GnRH) agonist and human chorionic gonadotropin (HCG) on the final maturation of oocytes and pregnancy rates in intrauterine insemination (IUI) cycles. Materials and Methods: In this randomized clinical trial, 110 infertile women who were selected for IUI entered the study. Ovulation induction was performed. Group I received 0. 1 mg GnRH agonist as triggering and group II received 10, 000 IU of HCG. The serum Estradiol (E2), Luteinizing Hormone (LH), and Follicle-Stimulating Hormone (FSH) levels were measured at 12 and 36 hr after injection. Results: LH surge was detected in all patients. LH levels at 12 and 36 hr after triggering was higher in Group I and it washed out earlier than group II (p=0. 00). The pregnancy rate was higher in Group I, but the difference was not statistically significant (26. 9% vs. 20. 8%, respectively p=0. 46). Also, the incidence of ovarian hyperstimulation syndrome was not different between the two groups (p=0. 11). There was a significant difference regarding the estradiol levels at 36 hours after triggering (p=0. 00). Conclusion: Effects of GnRH on endogenous LH surge is sufficient for oocyte releasing and final follicular maturation. Pregnancy rates and ovarian hyperstimulation syndrome incidence were not different between the groups. We suggest that GnRH agonists might be used as an alternative option instead of HCG in IUI cycles.

Background: Trichomonas vaginalis (T. vaginalis) and Neisseria gonorrhoeae (N. gonorrhoeae) are two most common non-viral sexually transmitted infections in the world. No data are available regarding the epidemiology of genital infections in women of Qom, central Iran. Objective: Epidemiological investigation of sexually transmitted infections in genital specimens of women referred to the referral gynecology hospital in Qom, central Iran. Materials and Methods: Genital swab specimens were collected from women volunteers and used for identification of bacterial and protozoal infections by conventional microbial diagnostics, porA pseudo gene LightCycler® real-time PCR (for N. gonorrhoeae) and ITS-PCR (for T. vaginalis). Results: Of 420 volunteers, 277 (65. 9%) had genital signs/symptoms, including 38. 3% malodorous discharge, 37. 9% dyspareunia, and 54. 8% abdominal pain. Totally, 2 isolates of Streptococcus agalactiae were identified. Five specimens (1. 2%) in Thayer-Martin culture and 17 (4. 1%) in real-time PCR were identified as N. gonorrhoeae. Fifty-four specimens (12. 9%) in wet mount, 64 (15. 2%) in Dorset’ s culture, and 81 (19. 3%) in ITS-PCR showed positive results for T. vaginalis. Five mixed infections of T. vaginalis+ N. gonorrhoeae were found. The risk of T. vaginalis infection was increased in women with low-birth-weight (p=0. 00; OR=43. 29), history of abortion (p=0. 00; OR=91. 84), and premature rupture of membranes (PROM) (p=0. 00; OR=21. 75). The probability of finding nuclear leukocytes (p=0. 00; OR=43. 34) in vaginal smear was higher in T. vaginalis infection. Conclusion: The significant prevalence of trichomoniasis and gonorrhea emphasizes the need for accurate diagnosis and effective surveillance to prevent serious reproductive complications in women.

Background: Improving women’ s health through modern contraceptive methods utilization is the key strategy to prevent unwanted pregnancy and its complication. However, there was limited evidence on utilization of modern contraceptive methods in the study area. Objective: This study identified factors affecting utilization of modern contraceptive methods among women at reproductive age group in rural areas of Dembia district, 2015. Materials and Methods: Community based cross sectional study was conducted in 2015 in Dembia District. Multi-stage sampling technique was used to select a total of 616 study participants. Bivariate and multivariable logistic regression model was fitted to identify factors associated with modern contraceptive utilization. Odds ratio with 95% confidence interval (CI) was computed to determine the level of significance. Results: Modern contraceptive methods utilization was found to be 31. 7% 95%CI (28. 0-35. 3). Age [Adjusted odds ratio (AOR): 1. 94, (95%CI: 1. 170-3. 216)], women who has educated husband [AOR: 0. 28, (95%CI: 0. 117-0. 666)], Marital status [AOR: 2. 81, (95%CI: 1. 344-5. 855)] and Spousal announcement about family planning issues [AOR: 2. 58, (95%CI: (1. 276-5. 202)] were factors associated with modern contraceptive methods utilization. Conclusion: Modern contraceptive methods utilization was found to be low. Providing educational opportunities, creating awareness about contraception and effective counseling would increase modern contraceptive methods utilization.

Background: Human and experimental studies suggest that the sympathetic regulatory drive in the ovary may be unbalanced (hyperactivity) in polycystic ovary syndrome (PCOS). Dysfunctional secretion of interleukin (IL)-1 (α & β ) or related cytokines may thus be related to abnormal ovulation and luteinization. Objective: The aim of this study was the evaluation of cytokines’ pattern in PCOS women and discussion about the explanation of cross-talk between two super systems: sympathetic and immune systems and explanation sympatho-excitation and relationship with interleukins. Materials and Methods: In this study, 171 PCOS women aged between 20-40 years were studied. Their body mass index was <28. The patients were divided into two groups: study group (n=85, PCOS women) and control group (n=86 normal women). The blood sample was obtained on the 3rd day of menstruation cycle. IL-17, IL-1α , IL-1β , and Tumor necrosis factor-alpha (TNF-α ) concentrations were determined in both groups. Results: The median serum level of IL-1α in the PCOS group was higher than the control group (293. 3 and 8. 0, respectively, p<0. 001). Also, the median serum level of IL-1β was higher than the control group (5. 9 and 3. 1 respectively). But the median serum of level IL-17 in women with PCOS was significantly lower than the control group (p<0. 001). Conclusion: Our results confirm that PCOS is a low-level chronic inflammation.