International Journal of Reproductive BioMedicine
Year:2018 | Volume:16 | Issue:4|Papers Count:8

Background: Uncontrolled increase of C-section is one of the major problems in Iranian health system, such that C-section is the most common surgical procedure in the entire country’ s hospitals in Obstetrics and Gynecology sections. A variety of complications also come along with cesarean. Objective: The aim of this study was to evaluate the prevalence, causes, and complications of cesarean in Iran. Materials and Methods: forty-one articles were considered with respect to certain criteria and were included in a systematic review to perform a meta-analysis study. The systematic review’ s search was conducted on SID, Iranmedx, Magiran, Medlib, PubMed, and Science Direct databases published between1999-2016. The weight of each included study was calculated according to its sample size and the reported prevalence of binomial distribution. A random-effects model using R and STATA (Version 11. 2) software was utilized for analyzing data Results: The total number of the sample was 197514 pregnant women with a mean age of 26. 72 yr. The prevalence of cesarean in Iran was estimated at 48%. The main reasons for the prevalence of cesarean in this study were mothers’ higher education, previous cesarean, and doctor recommendation. The most frequent complication in women undergoing cesarean was the muscular pain, and the most common fetal complications in newborns by caesarean delivery was transient tachypnea. Conclusion: The prevalence of C-section in Iran is much higher than what WHO recommends. It is essential, to decrease such a phenomenon, making the mothers aware of the risks of cesarean delivery, and establishing counselling sessions as well to eliminate the mothers’ fear of vaginal delivery.

Background: The streptozotocin (STZ)-induced diabetic model is widely used to evaluate the adverse effects of diabetes mellitus (DM) on spermatogenesis and testicular steroidogenesis. However, the actual mechanism of sub/infertility in DM males needs to be elucidated. Objective: To conduct a detailed examination of the testicular histopathology, sperm acrosome reaction (AR) status, and tyrosine-phosphorylated protein expression in the testis of male mice induced with STZ. Materials and Methods: Ten ICR mice were divided into two groups (n=5/each): control and diabetes induced by multiple low doses of streptozotocin (MLD-STZ). The control mice were intraperitoneally injected with citrate buffer, whereas MLDSTZ mice were injected with STZ at 40 mg/kg body weight for five consecutive days. At the end of the experiment (day 40), reproductive parameters, AR status, and the histopathology of the testis and epididymis were evaluated. The expression of testicular tyrosine phosphorylated proteins was examined. Results: Blood glucose levels, AR percentages, and sperm abnormality of STZ group were significantly higher (p=0. 003, 0. 001, 0. 000), while sperm concentration was significantly lower (p=0. 001) compared to control. Histopathology of the seminiferous tubule was classified into 7 types. Additionally, abundant round cells were found in the epididymal lumen of the MLD-STZ mice. Moreover, the intensities of testicular phosphorylated proteins (170, 70, 36, 30, and 25 kDas) were markedly higher and a 120 kDa protein band was noticeably lower in the MLD-STZ mice. Conclusion: MLD-STZ-induced DM causes many testicular histopathologies, precocious sperm AR, and increased expression of testicular phosphorylated proteins. These findings may clarify some mechanisms of sub/infertility in DM males.

Background: A notable proportion of idiopathic male infertility cases is accompanied by oligozoospermia; and yet, the molecular mechanisms of fertilization problem underlying this defect are still unclear. Epithelial cadherin has been involved in several calcium-dependent cell-to-cell adhesion events; however, its participation in gamete interaction has also not been fully investigated. Objective: The aim was to investigate the changes in the expression of E-cadherin, based on the frequency of Single nucleotide polymorphisms in Nuclear Factor Kappa-B 1 and pre-mir-146a in oligospermic men. Materials and Methods: In this case-control study, semen and blood samples of 131 oligospermic men as the case group and 239 fertile healthy men as the control group were analyzed. Variants single nucleotide polymorphisms rs28362491 and rs2910164 were performed using polymerase chain reaction-restriction fragment length polymorphism method and E-cadherin expression were determined by immunoprecipitation studies. Results: ins/ins genotype of rs28362491 was determined as a risk factor for idiopathic oligospermia by 1. 73 times (p=0. 0218), whereas no significant differences were found between the groups concerning pre-mir-146a rs2910164 polymorphism (p=0. 2274 in case of GC genotype and p=0. 9052 in case of GG genotype). Combined genotype analysis results did not show any notable differences between the multiple comparisons of 28362491-rs2910164 in oligospermic men and control groups. In addition, E-cadherin expression of oligospermic men with ins/ins genotype was significantly lower than patients with del/ins genotype (p=0. 0221). Ecadherin expression level was low in oligospermic men with respect to the control group in presence of ins/ins genotype of NFKB1 gene. Conclusion: These results suggest that ins allele prevents binding of surface proteins to spermatozoa, leading to a low affinity of sperm-oocyte interaction in oligospermic men.

Background: Over the years, many article on different aspects of pathogenesis and management of poor ovarian responders have been published but there is no clear guideline for treating themyet. Objective: This study was designated to compare the effectiveness of a delayed start protocol with gonadotropin-releasing hormone (GnRH) antagonist and microdose flare-up GnRH agonist protocol in poor ovarian responders. Materials and Methods: This randomized clinical trial consisted of 100 poor ovarian responder women in assisted reproductive technologies cycles. They were divided randomly in delayed-start antagonist protocol (with estrogen priming followed by early follicular-phase GnRH antagonist treatment for 7 days before ovarian stimulation) and microdose flare-up GnRH agonist protocol. The main outcome was clinical pregnancy rate and second outcome was the number of retrieved oocytes, mature oocytes, 2PN number, fertilization rate, and implantation rate. Results: Fertilization rate, clinical pregnancy rate, and ongoing pregnancy rates were not significantly different between the two studied protocols. Number of retrieved oocytes (5. 10± 3. 41 vs. 3. 08± 2. 51) with p=0. 002, mature oocytes (4. 32± 2. 69 vs. 2. 34± 1. 80) with p=0. 003, number of 2PN (3. 94± 1. 80 vs. 2. 20± 1. 01) with p=0. 001 and implantation rate (19. 40% vs. 10. 30%) with p=0. 022 were significantly higher in delayed antagonist group. Conclusion: The delayed-start protocol can improve ovarian response in poor responders by stimulating and synchronizing follicle development.

Background: Malathion is an organophosphorus pesticide that commonly used in many agricultural and non-agricultural processes. Previous studies have reported the effects of melatonin on the reproductive system. Cerium dioxide nanoparticles (CeNPs) due to their antioxidative properties are promising to impact on the development of male infertility. Objective: The aim of this study was to evaluate the effect of CeNPs on oxidative stress and sperm parameters after malathion exposure of male rats. Materials and Methods: 36 adult male Wistar rats were divided into 6 groups (n=6/each): Control, CeNPs-treated control (15 and 30 mg/kg/day), malathion (100 mg/ kg/day), and CeNPs-treated malathion groups (15 and 30 mg/ kg/day). At the end of the study (4 wk), the sperm counts, motility, and viability in the testis of rats were measured, also lipid peroxidation, total antioxidant capacity, and total thiol groups in homogenate testis were investigated. Results: Malathion significantly reduced sperm count, viability, and motility than the control rats (p<0. 001). Co-treatment of malathion with CeNPs 30 mg/kg had a protective effect on sperm counts (p=0. 03), motility (p=0. 01), and viability (p<0. 001) compare to malathion group. Also, the results showed that malathion reduced testis total anti-oxidant capacity, the total thiol group, and increased testis malondialdehyde than the control rats (p<0. 001). CeNPs 30 mg/kg are increased total antioxidant capacity (p<0. 001) and total thiol group (p=0. 03) compared to malathion group. CeNPs at both doses (15 and 30 mg/kg) improved malondialdehyde than the malathion group (p<0. 001 and p=0. 01 respectively). Conclusion: CeNPs 30 mg/kg administered considerably restored testicular changes induced by malathion. The improvement of oxidative stress by CeNPs may be associated with increased sperm counts, motility and viability in the testis.

Background: Polycystic ovary syndrome (PCOS) is an endocrine disorder featured by insulin resistance and hyperandrogenism. Testosterone enanthate can induce PCOS in mice models. Objective: We investigated the ovary stereological features along with the oxidative stress and inflammatory factors in mice following PCOS induction using testosterone enanthate. Materials and Methods: Twelve female NMRI mice (3 wk old) were divided into 2 groups (n=6/each): Control and PCOS. PCOS was induced through daily injections of testosterone enanthate (1 mg/100g subcutaneous s. c for 5 wk). Finally, ovaries were studied stereologically. The serum levels of the follicle-stimulating hormone, luteinizing hormone, testosterone, interleukin-6, and tumor necrosis factor-α were measured using ELISA kit. Serum levels of Malondialdehyde and the antioxidant capacity were measured relatively using thiobarbituric acid and ferric reducing antioxidant power assay. Results: The mean total volume of ovary and the mean volume of cortex (p<0. 001), volume of oocyte in the preantral (p=0. 011) and antral follicle (p=0. 015), thickness of zona pellucida (p=0. 016), the number of antral follicles (p=0. 012), the serum levels of follicle-stimulating hormone (p<0. 001) and the antioxidant capacity (p=0. 020) reduced significantly in the PCOS group compared to the control. The number of primary (p=0. 017) and preantral (p=0. 006) follicles and the serum levels of testosterone (p<0. 001), Luteinizing hormone (p=0. 002), Malondialdehyde, Interleukin 6 and Tumor necrosis factor-α (p<0. 001) showed a significant increase in the PCOS group compared to the control. Conclusion: Testosterone enanthate induced PCOS causes stereological features in the ovary, increases the oxidative stress and inflammatory markers in mice.

Background: Polycystic ovary syndrome (PCOS) is a common form of the endocrine disease which is associated with metabolic dysfunction. PCOS and type 2 diabetes mellitus are related in multiple aspects and are similar in many pathological features. Anti-diabetic effects of Nigella sativa and protective effects of it on reproductive system have been suggested in some reports. Objective: The aim of current study was to evaluate the effects of thymoquinone, the main components of Nigella sativa, on PCOS model of rats. Materials and Methods: Intraperitoneal injection of estradiol valerate for 25 days was used to induce PCOS in Wistar rats, followed by intraperitoneal administration of 8 and 16 mg/kg thymoquinone for 30 days. Rats were divided into 5 groups; control, sham or PCOS, experiment-1 (PCOS and 8 mg/kg thymoquinone), experiment-2 (PCOS and 16 mg/kg thymoquinone), and metformin (PCOS and metformin administration, 100 mg/kg) groups. All of the animals were subjected to serum biochemical analysis of blood and histopathological study of ovaries. Results: Estradiol valerate induced PCOS while administration of thymoquinone recovered it. The body weight, ovarian morphology, and ovulation had been improved and the serum biochemical parameters including glucose, triglyceride, total cholesterol, low-density lipoprotein, high-density lipoprotein, luteinizing hormone, and follicle stimulating hormone were reversed after thymoquinone intervention. Conclusion: Our data suggest that thymoquinone has improvement effects on an ovarian function and ovulation in the PCOS rat model. Therefore, thymoquinone and Nagilla sativa could be used as a protective agent and as an adjunct treatment in PCOS patients.

Background: Infertility as well as obesity are risng global concern. Whilst there is an established association between female obesity and infertility, a similar link is yet to be proven in men. Objective: To determine the effects of elevated body mass index (BMI) on semen quality among male partners of infertile couples attending an infertility clinic. Materials and Methods: In this cross-sectional study, 206 men who met the inclusion criteria were recruited for the study. Selected participants were grouped according to their BMI (kg/m2): normal BMI (18. 5-24. 9 kg/m2) and elevated BMI (≥ 25 kg/m2). The effect of weight on semen quality was assessed based on sperm count, percentage motility, and morphology. Results: The number of participants with normal BMI was 110 (53. 4%) while those with elevated BMI were 96 (46. 6%). Of the participants in elevated BMI group, 52 (25. 2%) were overweight and 44 (21. 4%) were obese. There was no statistically significant difference in the semen quality as well as the pattern of semen parameter abnormalities between males with normal and elevated BMI (overweight or obese) (p=0. 813). Conclusion: Elevated BMI did not significantly influence semen quality.