International Journal of Reproductive BioMedicine
Year:2018 | Volume:16 | Issue:1|Papers Count:8

Background: Preeclampsia, a severe complication of human pregnancy is one of the main causes of maternal, fetal, and neonatal morbidity and mortality with unclear pathogenesis. Heat shock protein 70 (HSP70) is one of the factors that can mediate cytoprotective, antiapoptotic, and immune regulatory effects. Objective: This meta-analysis was performed with aim to evaluate HSP70 in preeclampsia and normal pregnancy. Materials and Methods: The original publications reporting the serum HSP70 levels in preeclampsia and normal pregnancies published before November 2015 were identified by searching PubMed Central, Scopus, and ISI Web of Knowledge databases by two researchers, separately. The keywords were” preeclampsia” and “ HSP70” or “ Heat shock protein 70” Statistical analyses were performed using STATA software (version 11). Results: Out of 127 studies, seven eligible case-control studies were identified which consists of 350 preeclampsia and 429 normal pregnancies. Our pooled analysis of data from 7 studies which met the inclusion criteria, provides evidence that there is a significant association between HSP70 and preeclampsia. Cochran's test results showed the heterogeneity of the studies (p<0. 001) and the I2 index was 91%. The standardized mean differences (SMD) based on a random effect model with trim and fill method was 0. 92 (95% CI: 0. 33-1. 51); also there was a significant association between HSP70 and preeclampsia (Z=3. 07, p=0. 002). Conclusion: The results showed that serum HSP70 concentration was significantly higher in preeclamptic patients than the control group. Therefore HSP70 may be identified as a diagnostic factor.

Background: The use of embryo cryopreservation excludes the possible detrimental effects of ovarian stimulation on the endometrium, and higher reproductive outcomes following this policy have been reported. Moreover, gonadotropinreleasing hormone agonist trigger in gonadotropin-releasing hormone (GnRH) antagonist cycles as a substitute for standard human chorionic gonadotropin trigger, minimizes the risk of ovarian hyperstimulation syndrome (OHSS) in fresh as well as frozen embryo transfer cycles (FET). Objective: To compare the reproductive outcomes and risk of OHSS in fresh vs frozen embryo transfer in high responder patients, undergoing in vitro fertilization triggered with a bolus of GnRH agonist. Materials and Methods: In this randomized, multi-centre study, 121 women undergoing FET and 119 women undergoing fresh ET were investigated as regards clinical pregnancy as the primary outcome and the chemical pregnancy, live birth, OHSS development, and perinatal data as secondary outcomes. Results: There were no significant differences between FET and fresh groups regarding chemical (46. 4% vs. 40. 2%, p=0. 352), clinical (35. 8% vs. 38. 3%, p=0. 699), and ongoing (30. 3% vs. 32. 7%, p=0. 700) pregnancy rates, also live birth (30. 3% vs. 29. 9%, p=0. 953), perinatal outcomes, and OHSS development (35. 6% vs. 42. 9%, p=0. 337). No woman developed severe OHSS and no one required admission to hospital. Conclusion: Our findings suggest that GnRHa trigger followed by fresh transfer with modified luteal phase support in terms of a small human chorionic gonadotropin bolus is a good strategy to secure good live birth rates and a low risk of clinically relevant OHSS development in in vitro fertilization patients at risk of OHSS.

Background: Cisplatin is a potent antineoplastic agent for many cancers but causes several levels of gonadal damage. Ovarian toxicity is a major concern of young cancer patients undergoing chemotherapy. Objective: This study sought to examine the effect of Cisplatin and Resveratrol supplementation on ovarian function in Sprague-Dawley rats. Materials and Methods: In this experimental study, 45 cyclic Sprague-Dawley rats with an average weight of 160 gr were divided into 9 groups (n=5/group). Group 1 was used as control and received distilled water. Groups 2 and 9 received Cisplatin only. Groups 3, 4, and 5 received different doses of Resveratrol after a single dose of Cisplatin. Groups 6, 7, and 8 received Resveratrol before Cisplatin. At sacrifice, the ovary was analyzed for histopathology, biochemical indices of oxidation and hormonal assay. Results: Relative and absolute organ weights were notably increased (p=0. 001, 0. 01) in the prophylactic groups relative to the groups that received Resveratrol after Cisplatin. Also, glutathione, superoxide dismutase and catalase were significantly increased (p=0. 047, 0. 01, 0. 023) in a dose-dependent manner when compared to Cisplatin group only. Malondialdehyde decreased significantly (p=0. 001) in the groups that received high dose Resveratrol compared with the control and Cisplatin alone groups. Although oestrogen showed no significant difference within the groups (p=0. 48), Resveratrol significantly increased progesterone, follicle stimulating hormone and luteinizing hormone levels (p=0. 007, 0. 001, 0. 006) at high doses when compared with Cisplatin alone groups. Ovarian histoarchitecture was best preserved in the prophylactic groups in a dose-dependent manner. Conclusion: Resveratrol supplementation confers protection and preserves ovarian follicles from Cisplatin toxicity in Sprague-Dawley rats.

Background: Various treatments have been proposed to treat ectopic pregnancy, but their impact on future pregnancies is still the subject of controversy. Objective: The aim of this study is to compare the medical and surgical treatment methods and their impact on the subsequent fertility results and complications in women with a history of ectopic pregnancy. Materials and Methods: In this analytical, cross-sectional study, 370 women with the history of ectopic pregnancy, (treared with single dose of methotrexate or salpingectomy by laparotomy), that referred to Al-Zahra Hospital, Rasht, Guilan between 2009 to 2013 were enrolled. 147 women responded to the phone call. The age, the number of women that needed to drug for pregnancy, fertility rate and the fertility outcomes were studied. Result: 147 women responded to the call and between them, 114 women tried to get pregnant again after the ectopic pregnancy treatment. They were agreed to the participate in the study. The mean age of the patients was 28. 56± 5. 63 yr. The fertility rates in the medical and the surgical groups were 56. 6% and 47. 61%, respectively (p=0. 141). There were no significant differences in the poor consequences of pregnancy among the two groups; ectopic pregnancy (p=0. 605), miscarriage (p=0. 605), and prematuredelivery (p=0. 648). 15. 1% in the medicinal group and two patients 12. 5% in the surgical group had received fertility treatment in order to get pregnant (p=0. 135). There was no significant difference in two groups. Conclusion: It seems that surgical treatment depending on the underlying variables of each patient, can be used such as medical treatment, without worrying about its effect on fertility.

Background: Granulocyte colony-in stimulating factor (G-CSF) gene can be a potential candidate gene implicated recurrent pregnancy loss (RPL), a common complication of pregnancy with the prevalence of 1-5% among women of reproductive age. Objective: To investigate the association between rs1042658 polymorphism in the 3' untranslated region (3'UTR) of G-CSF gene and the risk of unexplained RPL among Iranian women. Materials and Methods: In total, 122 women with unexplained RPL and 140 healthy postmenopausal women as a control group were enrolled in this case-control study. Tetra-primer amplification refractory mutation system-polymerase chain reaction was performed to determine the rs1042658 genotypes in all subjects. Results: Statistically significant differences were detected between the distribution frequencies of both heterozygote CT, and carriage of T allele (TT+CT) genotypes of the rs1042658 between case and control groups. Allelic association was not observed with RPL. Conclusion: Regarding the results of the present study, G-CSF rs1042658 gene polymorphism could be considered as a probable risk factor for unexplained RPL among Iranian women.

Background: Designing a valid and reliable questionnaire that allows a fair evaluation of sexual knowledge and attitudes and develop a proper sexual educational program is necessary. Objective: The present study was designed to develop and psychometric evaluation of the sexual knowledge and attitudes scale for premarital couples. Materials and Methods: An exploratory mixed method study was conducted in two phases; in the first, in order to develop a questionnaire an item pool was generated on sexual knowledge and attitudes through focus group discussions and individual interviews. In the second phase, the psychometric properties of the questionnaire were examined. For this purpose, face validity, content validity as well as construct validity were conducted. Reliability was assessed by the Cronbach’ s alpha coefficient to assess internal consistency and test-retest reliability. Results: In the first phase an item pool with 88 questions was generated (sexual knowledge 45 items and sexual attitudes 43 items). In the second phase, the number of final items reduced to 33 and 34 items of sexual knowledge and sexual attitudes respectively, through exploratory factor analysis (EFA). Five factors for sexual knowledge and six factors for sexual attitudes identified by EFA. The Cronbach’ s alpha coefficient for two sections was 0. 84 and 0. 81 respectively. The test-retest correlations for sexual knowledge and sexual attitude was 0. 74 and 0. 82 respectively. Conclusion: The findings suggest that the Sexual Knowledge and Attitudes Scale for Premarital Couples is a valid and reliable instrument. Further studies are needed to establish stronger psychometric properties for the questionnaire.

Background: Estrogen and progesterone are two crucial factors for endometrial preparation in frozen embryo transfer (FET) cycles. Studies assessing different forms of estradiol in FET have published already but literature lacks enough surveys on transdermal estrogen application in reproductive medicine. Objective: To investigate the effects of trans dermal estrogen (Oestrogel) on pregnancy rates in patients that candidate for FET cycle. Materials and Methods: In this randomized clinical trial, 100 women undergoing FET cycles referred to Imam Khomeeini Hospital were enrolled in two groups, randomly. Group I received 8 mg/day estradiol valerate (E2 tablet) orally and group II were treated with 6 mg/day transdermal oestrogel gel after suppression with gonadotropin releasing hormone agonist. In both groups medication were started in the first day of menstruation cycle and continued until endometrial thickness reached 8 mm. Pregnancy rates (chemical, clinical, and ongoing), abortion rate, live birth rate, and frequency of complications were compared between two groups. Results: Chemical and clinical pregnancy rates were not significantly different between two groups (p=0. 384). The abortion rate was significantly lower in group II than group I (p=0. 035). Ongoing pregnancy and the live birth rates were significantly higher in group II (p=0. 035). The rate of complication was not different in two groups. Conclusion: Oestrogel seems to enhance ongoing pregnancy and live birth rates in comparison to estradiol valerate tablet.

Background: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. Genital TB (GTB) is a form of extrapulmonary TB that occurs more frequently in women, in whom it classically presents in association with menstrual irregularity, pregnancy loss and short and long-term sequelae especially infertility in infected women. Patients with GTB are usually young women diagnosed during workup for infertility. GTB is rare in postmenopausal women and responsible for only approximately 1% of postmenopausal bleeding. In this study, we aimed to evaluate the laboratory, clinical and demographic characteristics of female GTB cases. Case: We presented four female GTB cases with distinct clinical symptoms. All patients have no history of TB, and no acid-fast bacilli were seen in smears prepared from the clinical materials of the patients. Histopathological examinations revealed granulomatous inflammation in all patients. Conclusion: In the light of the clinical features of these cases we aimed to emphasize that, female GTB must be taken into account in the patients with different clinical symptoms like postmenopausal bleeding, menometrorrhagia, infertility, and menstrual irregularities. We believe that these symptoms will be helpful for the diagnosis and treatment of female GTB.