International Journal of Reproductive BioMedicine
Year:2018 | Volume:16 | Issue:11|Papers Count:8

Background: Understanding the prevalence of menstrual disorders has important implications for both health service planning and risk factor epidemiology. Objective: The aim of this review is to identify and collate studies describing the prevalence of menstrual disorders in Iran. Materials and Methods: Studies with original data related to the prevalence of menstrual disorders were identified via searching six electronic databases and reviewing citations. All abstracts or titles found by the electronic searches were independently scrutinized by two reviewers. The Meta-analysis was performed with a random effects model, considering the remarkable heterogeneity among studies. A total of 35 eligible epidemiological studies were included in this review. Results: Overall, the pooled prevalence of primary dysmenorrhea was 73. 27% (95% CI=65. 12-81. 42). The mean proportion of women with oligomenorrhea was 13. 11% (95. 5%, 95% CI: 10. 04-16. 19). We identified 16 studies that reported polymenorrhoea with a random effect of pooled prevalence estimate of 9. 94% (95% CI 7. 33%-12. 56%). The prevalence estimate of hypermenorrhea was 12. 94% (95% CI 9. 31%-16. 57%). Overall prevalence of hypomenorrhea was 5. 25% (95% CI 3. 20%-7. 30%), ranging from 0. 9-12. 90%. Pooling six studies that reported estimates for menorrhagia, the overall prevalence was 19. 24% (95% CI 12. 78-25. 69). Overall, 6. 04% (95% CI: 1. 99-10. 08) of the women were shown to have metrorrhagia. Conclusion: This systematic review suggests that the average prevalence of menstrual disorders in Iran is substantial. It has been neglected as a fundamental problem of women's reproductive health. Diagnosis and treatment of these disorders should be included in the primary health care system of reproductive health.

Background: The underlying etiology of polycystic ovarian syndrome (PCOS) is unknown and assumed to have a strong correlation with insulin resistance. Homeostasis Model Assessment of insulin resistance (HOMA-IR) is a good tool to assess insulin resistance. Low levels of serum Insulin-like Growth Factor-Binding Protein-1 (IGFBP-1) in PCOS women led to the hypothesis that hyperinsulinemia in PCOS inhibits the production of IGFBP-1, which in turn stimulates excessive androgen production. Objective: The study is aimed to analyze the correlation between the levels of IGFBP-1 and HOMA-IR on insulin resistance in PCOS. Materials and Methods: A cross-sectional study among 105 PCOS women, including 60 women with insulin resistance were recruited. The mean of IGFBP-1 and HOMA-IR were 6. 507± 4. 7821 μ g/l and 3. 633± 1. 666 respectively. Results: Low levels of IGFBP-1 were detected in all insulin resistance women. There was a correlation between HOMA-IR and overweight (p=0. 045), while IGFBP-1 showed no correlation with overweight (p=0. 106). In addition, no correlation between IGFBP-1 with HOMA-IR as a marker of insulin resistance was detected. Conclusion: Despite the decrease in IGFBP-1, it seems that there is no correlation between IGFBP-1 with HOMA-IR as a marker of insulin resistance.

Background: Infertility is a serious health problem that affects the individual, her/his family, and the community. Infertility is defined as failure to achieve clinical pregnancy after at least 12 months of unprotected coitus. Objective: The purpose of this study was to investigate the prevalence of primary and secondary infertility and the associated factors in Yazd Greater Area during 2014-2015. Materials and Methods: This is a cross-sectional analytic study using Yazd Health Study data which was conducted on 10, 000 people. We studied 2611 women between 20-49 yr old who lived in Yazd Greater Area. Data were collected using a validated questionnaire. Anthropometrics were collected using standardized instruments. Results: Among women participating in the study, 135 cases of infertility were documented and the overall prevalence of infertility was 4. 73% (95% CI: 3. 94%-5. 59%), among them 2. 6% (95% CI: 2. 4-3. 8%) had primary and 2. 1% (95% CI: 1. 8-3. 4%) had secondary infertility. In this study, infertility was significantly correlated with age (r=0. 051, p=0. 032), educational level (r=-0. 41, p=0. 001), body mass index (r=-0. 012, p=0. 018), waist circumference (r=0. 027, p=0. 022), history of abortion (r=0. 099, p=0. 026), and family history of infertility (r=0. 121, p=0. 001). Conclusion: The results of our study showed that the prevalence of infertility among women living in Yazd was lower compared to the other regions in Iran. Female factors were the main cause of infertility in central part of Iran.

Background: Vitamin D has multifaceted function in human reproductive physiology. It has been revealed that vitamin D is involved in spermatogenesis, and semen quality can be linked to vitamin D status in men. Objective: Evaluating the correlation of 25-hydroxy vitamin D (25-OHD) levels in serum with basic and advanced semen parameters and essential determinants of spermatozoa function. Materials and Methods: Participants were categorized, based on semen parameters, into normozoospermic (NS) and oligoasthenoteratozoospermic (OAT) men. Serum level of 25-OHD was measured. Apoptotic status of spermatozoa, mitochondrial membrane potential and reactive oxygen species content of semen were assessed. Results: Difference of 25-OHD concentration in serum of NS men versus OAT ones did not meet significance threshold. DNA fragmentation, reactive oxygen species content of semen and mitochondrial membrane potential state revealed significant difference between NS and OAT subjects. There were no significant differences in basic and functional semen parameters when men were stratified based on serum 25-OHD level. Taking both 25-OHD and semen categories (NS and OAT) into consideration did not indicate any significant difference in studied parameters. Total motility of spermatozoa was positively correlated with serum concentration of 25-OHD in all studied subjects. In addition, normal morphology of spermatozoa in NS men revealed a positive and significant correlation with levels of 25-OHD in serum. Conclusion: Vitamin D may affect motility and morphology of spermatozoa. Lower content of serum vitamin D may affect fertility of men and should be considered in examination of men with abnormal spermogram.

Background: Sexually transmitted infections play a great role in formation of inflammatory diseases of female urogenital system. These diseases can cause a decrease in the level of female sex hormones, as well as the ratio of estrogens and androgens. Objective: To determine changes in the state of sex hormones in women with inflammatory diseases of ovaries associated with opportunistic urogenital flora. Materials and Methods: 136 women aged 18-39 yr participated in this crosssectional clinical study. They were examined with the use of a complex of clinical, laboratory and instrumental methods of examination. The patients with confirmed diagnosis of inflammatory disease of reproductive system associated with opportunistic urogenital infection have been under blood analysis to reveal the concentration of follicle-stimulating hormone, luteinizing hormone, and estrogens. Results: After the treatment the functional capacity of ovary significantly increased, proved by a corresponding increase in the concentration of estradiol hormone in blood serum in all phases of menstrual cycle. According to estradiol in follicular phase its concentration was increased from 421. 8± 10. 8 nmol/L to 581. 3± 10. 2 nmol/L. The elevation in the ratio of estradiol/testosterone hormones in blood serum also is demonstrated. Conclusion: Inflammatory diseases associated with opportunistic urogenital infection is responsible for a decrease of female sex hormones and the ratio of estrogens and androgens.

Background: Acyclovir (ACV) is known to be toxic to gonads, inducing apoptosis in the reproductive system. The beneficial effects of vitamin C (Vit C) and menthone, both as antioxidant agents on various organs has been reported. Objective: This study evaluated the potential role of the Vit C and menthone on the DNA damage in rat spermatozoa induced by the ACV. Materials and Methods: In this experimental study, adult male albino Wistar rats with average weight of 250± 10 gr, were divided into six groups (n=18/each), as: ACV (15 mg/kg/day), ACV+Vit C (20 mg/kg/day), ACV+ menthone (100 μ l/d), ACV+ menthone (250 μ l/d), ACV+ menthone (400 μ l/day) and control group without any treatment. At the end of experiment, the animals were sacrificed and sperm samples were collected and isolated in phosphate-buffered saline and examined by TUNEL staining process. The percentage of TUNEL positive spermatozoa was evaluated by fluorescence microscopy. Each experiment was performed in three repeats. Results: Male rats exposed to ACV had significant increase in DNA damages in comparison to other groups. The percentage of TUNEL positive sperm cells was 90. 83 (p<0. 001) in ACV group. The protective role of both antioxidants used in high dose, compensate the adverse effects of the ACV. The results showed that the percentage of apoptotic sperm in the ACV+Vit C group was 16. 38 (p<0. 001) and in the ACV+ menthone (400 μ l/d) group was 16. 05 (p<0. 001). Conclusion: The present results showed that Vit C and menthone at higher dose have a good compensatory effect with significant reduction in DNA damages in sperm cells by reversing the adverse effect of ACV on the reproductive system in male rat.

Background: Cyclophosphamide (CP) is one of the most invasive chemotherapeutic agents, which used commonly despite of its wide spectrum toxicity. Clinical evidence showed toxic side effects of CP in multiple organ systems. Objective: The objective of the present study was to evaluate the effects of American ginseng on CP-induced testicular toxicity in rats. Materials and Methods: Adult male Wistar rats (220± 30 gr) were randomly divided into four groups (n=7 in each). Group 1 as control received normal saline by gavage, group 2 received CP (6. 1 mg/kg/day, i. p. ) for a period of 50 days. Group 3 received American ginseng (500 mg/kg/day) by gavage. Group 4 received American ginseng (500 mg/kg/day) 1h prior to the administration of CP in the equal dose of group 2. The animals scarified one day after the last treatment and the effects of American ginseng on the sperm vital parameters, testicular functions, biochemical factors, and structural malformations evaluated. Results: Serum testosterone concentration was significantly decreased whereas the level of malondialdehyde and DNA damage were significantly increased in animals of CP group (p<0. 01). Co-administration of American ginseng reversed these parameters and improved recovery in CP+ginseng group. In addition, seminiferous tubules of testis severely damaged in the CP group but ginseng improved histologic changes in CP+ginseng group. Conclusion: The findings confirmed the protective effects of American ginseng on toxicity induced by CP in the reproductive system of male rats.

Background: Endometriosis, can cause ovarian conflict and reduced ovarian reserve that could lead to lower response to assisted reproductive techniques Objective: Current study was conducted to determine the association between level of anti-mullerian hormone (AMH) and the infertility treatment outcomes in infertile females with endometriosis versus the non-endometriosis infertile subject. Materials and Methods: In this case-control study, 64 infertile females who referred to Shariati Hospital from April 2015 to November 2017 were enrolled. They were divided in two groups of 32 patients (endometriosis and non-endometriosis women). The anti-mullerian hormone level among all subjects was determined, treatment outcomes were evaluated and association between these factors was assessed. Results: It was seen that the anti-mullerian hormone (p=0. 06), the number of retrieved oocytes (p=0. 7) and embryos (p=0. 7), implantation rate (p=0. 6) and clinical pregnancy rate (p=0. 9) were similar between two groups. In patients with stage 3 or 4 endometriosis who had lower serum AMH level significantly (p=0. 001) less oocytes were retrieved (p=0. 001) and less transferrable embryos (p=0. 03) were achieved. However, implantation and pregnancy rates did not differ (p=0. 7) (p=0. 6). Conclusion: Totally, according to the obtained results, it may be concluded that ovarian reserve has more significant role in predicting infertility treatment outcome rather than receptive endometrium.