International Journal of Reproductive BioMedicine
Year:2019 | Volume:17 | Issue:10|Papers Count:8

Background: Pregnant women and newborns are at risk for vitamin D deficiency (VDD). Also, poor health outcomes for pregnant women with VDD are reported in the published literature. Objective: The aim of this systematic review was to estimate the prevalence of hypovitaminosis D and the associated risk factors for hypovitaminosis D in Middle Eastern pregnant women and their newborns. Materials and Methods: The international electronic databases PubMed and Scopus for the years 2000-2017 were utilized to identify studies of vitamin D status for pregnant women and newborns in the Middle East. Of the 1, 785 reports identified, 1, 734 met exclusion criteria and 51 studies were included for this review. Results: The prevalence of circulating 25-hydroxyvitamin D (25(OH)D) < 50 nmol/L as a marker of vitamin D status in pregnant women and their newborns was between 24. 5-98% and 22-100%, respectively. The prevalence of 25(OH) D < 25 nmol/L in pregnant women and their newborns was over a wide range between 16. 7-80% and 22-82%, respectively. Predictors for low maternal and neonatal 25(OH)D concentrations included decreased vitamin D synthesis due to reduced exposure to sunlight and decreased nutritional intake of vitamin D. A predictor of low neonatal 25(OH)D concentrations included maternal vitamin D status and the correlation between vitamin D concentrations in maternal and cord blood. Conclusion: The high prevalence of VDD in the pregnant women of the Middle East underscores the necessity of implementing national prevention and intervention strategies. A clear policy for clinicians and healthcare workers is needed for screening and maintaining sufficient vitamin D status during pregnancy.

Background: The optimal colloid solution for the treatment of ovarian hyperstimulation syndrome (OHSS) remains to be established. Objective: We aimed to compare artificial colloids (AC) with human albumin (HA) for the treatment of OHSS. Materials and Methods: In this retrospective cohort study, data for OHSS participants were collected from a national inpatient database in Japan. The participants received intravenous fluid management with AC (n = 156) or HA (n = 127). We compared the two groups in terms of the length of stay, development of post-treatment complications, and termination surgery. Results: In multivariable linear regression analyses for log-transformed length of stay with reference to the OHSS participants receiving AC, the regression coefficient (95% confidence interval) in participants receiving HA was 0. 03 (-0. 04-0. 09, p = 0. 42). Thromboembolism occurred in two participants in the HA group and three participants in the AC group. Two participants in the HA group suffered renal failure during hospitalization. No participants underwent termination surgery in the two groups. Conclusions: The present results showed comparable efficacy between AC and HA for the treatment of OHSS. There were no significant differences in post-treatment complications between the two groups.

Background: Para-nonylphenol (p-NP), an environmental contaminant, can generate free radicals that disturbs the reproductive properties. Green tea extract (GTE) is an antioxidant which may prevent the adverse effects of free radicals. Objective: The aim was to investigate the effect of GTE on sperm parameters and testis tissue in p-NP-treated rats. Materials and Methods: 24 adult male Wistar rats (215 ± 20 gr) were randomly divided into four groups (n = 6/each) – including control, p-NP (200 mg/kg/day), GTE (200 mg/kg/day), and p-NP + GTE – and orally treated for 56 days. The right testes and left caudal epididymis were used to evaluate selected parameters. In addition, the concentration of serum malondialdehyde was calculated. Results: A significant decrease in the sperm number, motility, viability and morphology (p < 0. 001) was observed in the rats treated with p-NP compared to the control ones. The diameter of seminiferous tubules (p < 0. 001), thickness of germinal epithelium (p = 0. 018), total volume of testis (p = 0. 009), volume of seminiferous tubules (p < 0. 001), and testis weight (p = 0. 017) decreased in the p-NP group in contrast with the other groups. Moreover, a significant increase of the malondialdehyde concentration was seen in the p-NP group when compared with the controls (p = 0. 043). The majority of adverse effects of p-NP could be recovered following the administration of GTE. Conclusion: It seems GTE can be used as a potent antioxidant in the case of p-NP toxication.

Background: Nitrosamines as a carcinogenic agent has unfavorable effects on some of the male reproductive parameters. Pentoxifylline (PX) is a xanthine derivative used as a drug inhibiting the inflammatory factors, reducing blood viscosity, improving peripheral blood flow, and so on. Objective: The aim of the present study is to evaluate the effects of PX against Dimethyl nitrosamine (DMN)-inducing the damage to the reproductive parameter of male rats. Materials and Methods: In this experimental study, 48 male Wistar rats (8 wk, 220-250 gr) were randomly assigned to eight groups (n = 6/each): normal control and DMN control groups (40 mg/kg); PX groups (25, 50, 100 mg/kg), and DMN + PX groups (25, 50, 100 mg/kg). Treatments were administered intraperitoneally and the gavage applied daily for 28 days. The sperm parameters, spermatogenesis index, total antioxidant capacity, testosterone level, and seminiferous tube diameter were assessed. Results: The values of all parameters reduced significantly in the DMN control group compared to the normal control group (p < 0. 001). The PX and PX + DMN treatments at all entirely doses improved all parameters significantly compared to the DMN control group (p < 0. 001). Conclusion: DMN caused detrimental effects on reproductive parameters. Also, no significant modifications were observed in PX treatments at all doses compared to the normal control group. PX compensated the toxic effect of DMN on reproductive parameters.

Background: Concentrations of plasma lipids levels during pregnancy clearly increases. According to some studies, dyslipidemia is effective in the incidence of preeclampsia and insulin resistance. Objective: This study aimed to examine the relationship between hyperlipidemia and maternal and neonatal outcomes in pregnant women. Materials and Methods: This is a cross-sectional study which was conducted on two groups of pregnant women with hyperlipidemia and normal ones to assess maternal and neonatal outcomes. Maternal data including gestational age, mother’ s age, body mass index, and maternal weight gain during pregnancy, gestational diabetes mellitus, preeclampsia, cholestasis, and delivery method. Also, birth weight and Apgar score were gathered as the neonatal outcomes. Results: The results showed that the prevalence of abnormal lipid parameters increased with increasing gestational age. In pregnant women with dyslipidemia in combination with increased triglyceride, cholesterol and Low-density lipoprotein, and decreased High-density lipoprotein, the incidence rates of gestational diabetes (p < 0. 001), preeclampsia (p < 0. 001), cholestasis (p = 0. 041), fetal growth retardation (p < 0. 001), and macrosomia (p < 0. 001) were statistically higher. Conclusion: Dyslipidemia was associated with some adverse effects of pregnancy and harmful fetal outcomes. Therefore, it seems that adding laboratory assessment of lipid profiles before and during pregnancy can be effective in early diagnosis of dyslipidemia.

Background: In about 40% of the couples, the cause of infertility problems is attributed to men because of low sperm production and disturbed motility of sperm. Pieces of evidence show that Myo-inositol has a potential role for the treatment of sperm morphology and male fertility. Objective: This study aimed to determine the effect of Myo-inositol on the sperm parameters and fertility rate in patients with oligoasthenospermia treated by intrauterine insemination (IUI). Materials and Methods: This study was a randomized clinical trial conducted on 37 patients with oligoasthenospermia treated by IUI during 2016-2017. In this study, the patients were randomly divided into two groups of oligoasthenospermia treated with (Case group) and without Myo-inositol (Control group). The case group received 0. 5 ml of Myo-inositol with a concentration of 2 mg/ml and incubated at 37° C incubator for 2 hr, but the control group had no interventions. Results: The results of this study showed that although there was no significant difference in sperm parameters including sperm motility and concentration before processing with Myo-inositol in the case group, but there was a significant increase in sperm motility during the treatment with Myo-inositol. The therapeutic effect of this method was confirmed on induction of pregnancy in 18% of the treated patients, in such a way that was about twice greater than those who did not receive the drug. Conclusion: According to the results of this study, the use of Myo-inositol is efficient enough to change sperm parameters to increase the chance of fertility.

Background: The empowerment of psychological well-being is an important and fundamental issue among infertile females. Objective: The present study investigates the effect of teaching self-compassion on the psychological well-being of initial infertile women. Materials and Methods: In this cross-sectional, quasi-experimental study with pre-test and post-test, 32 infertile women who were referred to the Yazd Reproductive Sciences Institute during 2016-2017 were enrolled. The participants were randomly divided in two groups as control and experiment (n = 16/each). The participants only in the experimental group received 8 sessions of 90 min training (Self-Compassion Training). Ryff’ s psychological well-being questionnaire was applied (reliability coefficient = 0. 82) and covariance analysis statistical test was used to test the research hypothesis. Results: There was a significant difference between the estimated mean scores for improving the psychological well-being of the participants in the experiment and control groups (p = 0. 007), and the difference indicates that 72. 7% of the covariance of the post-test scores is due to self-compassion intervention. Therefore, the intervention of self-compassion training affects the improvement of psychological well-being among infertile women. Also, the pre-test variable is significant with the effect of 94. 2% (p = 0. 006). Conclusion: The findings showed that teaching self-compassion to initial infertile women has an effect on their psychological well-being.

Background: Women with untreated phenylketonuria (PKU) are at an increased risk to have offspring with multiple abnormalities due to teratogenic effects of hyperphenylalaninaemia. Treatment goals include blood phenylalanine concentrations between 120 and 360 μ mol/L, however, there are limited pieces of evidence for the practical management of pregnant PKU patient and prediction of phenylalanine tolerance changes during a course of pregnancy. Case: We report the case of a mother with classical PKU (p. R408W/p. R408W) and the course of her two pregnancies with low phenylalanine tolerance increase (347mg and 227mg) despite the rewarding collaboration with a nutritionist. Conclusion: This case report does not confirm the observation that a very low phenylalanine tolerance increase in pregnancy of PKU patient is a marker of coexisting PKU-affection in fetus.