سال:1396 | دوره: | شماره: |تعداد مقالات:7

Background: Waiting period of fertility treatment is stressful, therefore it is necessary to use effective coping strategies to cope with waiting period of intrauterine insemination (IUI) treatment. Objective: The aim of this study was comparing the effect of the positive reappraisal coping intervention (PRCI) with the problem-solving skills training (PSS) on the coping strategies of IUI waiting period, in infertile women referred to Milad Infertility Center in Mashhad. Materials and Methods: In this randomized clinical trial, 108 women were evaluated into three groups. The control group received the routine care, but in PRCI group, two training sessions were held and they were asked to review the coping thoughts cards and fill out the daily monitoring forms during the waiting period, and in PSS group problem-solving skill were taught during 3 sessions. The coping strategies were compared between three groups on the 10th day of IUI waiting period. Results: Results showed that the mean score for problem-focused were significantly different between the control (28. 54± 9. 70), PSS (33. 71± 9. 31), and PRCI (30. 74± 10. 96) (p=0. 025) groups. There were significant differences between the PSS group and others groups, and mean emotion-focused were significantly different between the control (32. 09± 11. 65), PSS (29. 20± 9. 88), and PRCI (28. 74± 7. 96) (p=0. 036) groups. There were significant differences between the PRCI and the control group (p=0. 047). Conclusion: PSS was more effective to increase problem-focused coping strategies than PRCI, therefore it is recommended that this intervention should be used in infertility treatment centers.

Background: Preterm labor and birth are associated with several neonatal complications including respiratory distress syndrome and intraventricular hemorrhage. Differentiating true and false labor pain is a dilemma to obstetricians. Objective: To elucidate the role of cervical length measurement in prediction of birth in pregnant women with threatened preterm labor. Materials and Methods: In this double blind randomized clinical trial, 120 women with gestational age <34 wk who presented painful uterine contractions randomly assigned to undergo measurement of cervical length. Patients were registered in the hospital and a unit number was given. Based on the unit numbers, patients were randomly assigned to two groups using a computerized random digit generator. All participants were managed accordingly (n=65) or to receive tocolysis as planned (n=55). Tocolysis was prescribed when cervical length was <15 mm while those with cervical length ≥ 15 mm were managed expectantly. Delivery within 7 days of the presentation was the primary outcome. Results: This RCT showed in case group, 78. 9% of patient with cervical length <15 mm were delivered within 7 days and only 21. 1% of them maintained their pregnancy. Of those with cervical length ≥ 15 mm, only 15. 2% were delivered within the study period and the rest (84. 8%) maintained their pregnancy (p<0. 001). Conclusion: “ Our results indicate that in women who presented preterm labor symptoms, cervical length measurement will result in decreased unnecessary tocolytic treatment. Women with cervical length ≥ 15mm should not receive tocolysis, however, withholding corticosteroid therapy in these patients needs further evidence.

Background: Genetic factors are candidates for about 30% of male infertility with sperm production-related abnormalities. Y chromosome microdeletions are responsible for around 10% of male infertility. These microdeletions generally occur in azoospermia factor on the Yq. That is often associated with the quantitative reduction of sperm. Objective: The aim of this cross-sectional study was to determine the frequency of Yq microdeletions among idiopathic azoospermic, oligoasthenozoospermic, and oligospermic men in Shohada infertility center, Chaharmahal va Bakhtiari province. Materials and Methods: A total of 81 idiopathic azoospermic, oligoasthenozoospermic, and oligospermic infertile men were selected as cases and 81 fertile men assigned to control group. For molecular investigations, 13 sequencetagged site markers were chosen from azoospermia factor (AZF) region for detection of Y chromosome microdeletions and amplified by two separate multiplex-polymerase chain reaction. The relationship between the AZF microdeletions and incidence of male infertility in the family, consanguineous parents, smoking, and the levels of reproductive hormones among infertile men were investigated. Results: The total frequency of the microdeletions was 6. 17% (2 cases in azoospermic, 3 cases in oligoasthenozoospermic subgroups, and none in the oligospermic participants and the control group). Most deletions (3. 7%) were seen in the AZFb followed by the AZFc (2. 46%) and none in AZFa. No significant association was seen between the microdeletions and clinical characteristics. Conclusion: Although the frequency of Yq chromosome microdeletions in Chaharmahal va Bakhtiari province is lower than the mean frequency of Iran, the frequency is comparable to those reported by some studies in Iran.

Background: Chlamydia trachomatis (C. trachomatis) is the main cause of bacterial sexually transmitted infections. In women, this infection can lead to tubal infertility. Objective: In this study we investigated C. trachomatis among infertile and fertile women with both polymerase chain reaction (PCR) and ELISA methods in Ahvaz, Iran. Materials and Methods: This case-control study was conducted at the Infertility Clinic of University Jahad, Ahvaz, Iran from January to August 2017. A total of 225 vaginal swabs and blood samples (100 infertile and 125 fertile women) were collected. Detection of C. trachomatis DNA was performed from vaginal swabs by amplification of MOMP gene. Also, anti C. trachomatis immunoglobulin M (IgM) and immunoglobulin G antibodies in the serum samples were recognized by enzyme-linked immunosorbent assay (ELISA). Results: Results showed that, 6 (6%) infertile and 2 (1. 6%) fertile women were positive for IgM (p=0. 21). Also, PCR was positive for C. trachomatis infection in 5 infertile (5%) and 2 fertile women (1. 6%) (p=0. 35). We did not find any seropositive immunoglobulin G in both groups. Conclusion: In this study, no significant difference was found between fertile and infertile groups for C. trachomatis infection. Also, the correlation between IgM and PCR results revealed a relatively strong agreement and seems both PCR and IgM assays are appropriate for the accurate diagnosis of C. trachomatis infections.

Background: Infertility is a disease that results in the abnormal functioning of the male or female reproductive system. Systematic research planning on any subject, including infertility is in need of solid data regarding previous efforts in this field and to identify the gaps in the research. Objective: The aim of this research is to study the thematic structure of articles related to infertility. Materials and Methods: In this descriptive-analytical study with a scientometric approach, the PubMed database was searched for research publications indexed under "Infertility" over the period 2011-2015. Specific parameters were retrieved from the PubMed. Articles about infertility were analyzed regarding the journal of publication, topics, and countries using Net draw, Ucinet and RavarPreMap software. Also, the most influential topics were analyzed by indicators in the analysis of the network: closeness centrality, and between centrality Results: The growth in scientific productions the area of infertility over the mentioned period shows an upward trend with the highest growths seen in countries like the United States, the UK, Netherlands, China, and Germany. Moreover, the contents such as fertilization in vitro, adverse effects, spermatozoa, pregnancy rate, and treatment outcome were among the most frequently-used topics in the sphere. Conclusion: Thematic analysis can provide us the research topics, important expressions, and the relationships between them. Users and policymakers can also have a better understanding of the research status in the sphere and consequently, they can plan to increase the quantity and quality of scientific productions in a more efficient way.

Background: Preterm labor is a major cause of perinatal morbidity and mortality and it might be predicted by assessing the cervical change. Objective: To assess the association between absence of cervical gland area (CGA) and spontaneous preterm labor (SPTL). Materials and Methods: This prospective cohort study was performed on 200 singleton pregnant women with a history of SPTL, second-trimester abortion in the previous pregnancy or lower abdominal pain in current pregnancy. Each patient underwent one transvaginal ultrasound examination between 14-28 wk of gestation. Cervical length was measured and CGA was identified and their relationship with SPTL before 35 and 37 wk gestation was evaluated using STATA software version 10. Results: The mean of cervical length was 36. 5 mm (SD=8. 4), the shortest measurement was 9 mm, and the longest one was 61 mm. Short cervical length (≤ 18mm) was significantly associated with SPTL before 35 and 37 wk gestation. Cervical gland area (the hypoechogenic or echogenic area around the cervical canal) was present in 189 (94. 5%) patients. Absent of CGA had a significant relationship with SPTL before 35 and 37 wk gestation (p=0. 01 and p<0. 001, respectively). Cervical length was shorter in women with absent CGA in comparison with subjects with present CGA: 37± 10 mm in CGA present group and 23± 9 mm in CGA absent group (p<0. 001). Conclusion: Our study showed that cervical gland area might be an important predictor of SPTL which should be confirmed with further researches.

Background: Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication, which can cause high morbidity and mortality. Use of gonadotropin releasing hormone (GnRH) agonist instead of human chorionic gonadotropin (hCG) in GnRH antagonist cycles causes luteinizing hormone surge by GnRH stimulation which reduces the risk of OHSS by reducing the total amount of gonadotropin; however, there is no possibility of transferring fresh embryos. Objective: The current study aimed to evaluate the effect of hCG along with GnRH agonist administration in the occurrence of OHSS and pregnancy rate in females undergoing in vitro fertilization. Materials and Methods: The current randomized clinical trial was conducted on 80 cases in 2 groups. Gonal-F was used to stimulate the oocyte from the second day of menstruation. When follicle size was 12-14 mm, GnRH antagonist was added to the protocol till the detection of more than two follicles greater than 18 mm. Then, GnRH agonist was added to the protocol as a trigger. In group A, 35 hr after the administration of GnRH agonist, the low-dose human hCG, 1500 IU, was used. In group B, low-dose hCG, 1500 IU, was used at the same time by GnRH agonist administration. The rate of pregnancy, OHSS, and its severity were compared between 2 groups within 2 wk. Results: There was no significant difference regarding chemical and clinical pregnancies between the 2 groups. Severe OHSS was significantly higher in group B (p= 0. 03). Conclusion: Administration of hCG 35 hr after GnRH agonist administration results in lower rate of severe OHSS.