International Journal of Fertility & Sterility
Year:2010 | Volume:4 | Issue:3|Papers Count:8

Background: The pattern of Islamic fasting differs from other forms of fasting; therefore its effect on health also differs. This research studies the effect of Islamic fasting on gonadotropin hormones around the time of the ovulatory cycle and ovulation.Materials and Methods: This self-controlled study was performed on 24 adult females. Blood sampling was performed during Ramadan and two months later to determine the levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), estrogen and progesterone. Ultrasonography was done in order to detect ovulation and the results were compared. Results: The mean values of FSH, LH and estrogen during the 14th day of menstruation were comparable with non-fasting values. There was no significant difference in ovulation.Conclusion: Islamic fasting causes neither significant variation in hormone secretion around ovulation nor does it influence the occurrence of ovulation.

Background: Oocyte cryopreservation is potentially the best way to preserve female fertility for unmarried women or young girls at risk of losing ovarian function. The aim of this study was to compare fertilization and embryo development in frozen-thawed oocytes to their fresh siblings in women undergoing in vitro fertilization (IVF) and embryo transfer (ET).Materials and Methods: Eleven infertile women undergoing infertility treatment, between the ages of 24 to 37 years (mean ± SD = 31.6 ± 3.5), were included in this study. Mature oocytes from each patient were randomized into cryopreserved and fresh groups prior to intracytoplasmic sperm injection (ICSI). One hundred and thirty nine oocytes were retrieved, of which 105 were at metaphase II (MII). Forty- five fresh MII oocytes were kept in culture whereas their sibling 60 MII oocytes were cryopreserved using a slow cooling protocol. The frozen oocytes remained in LN2 for 2 hours before thawing. ICSI was performed 1-2 hours after thawing for frozen oocytes and 4-5 hours after retrieval for fresh oocytes. Fertilization and embryo development were compared.Results: Following thawing, 31 oocytes (51.6 %) survived and 22 fertilized (79%) while 32 fresh oocytes fertilized upon ICSI (71%). The mean ± SE scores for embryos developing from frozenthawed oocytes were significantly lower at 48 and 72 hours post-ICSI than for embryos resulting from fresh oocytes (p<0.05).Conclusion: Our data demonstrated that oocyte freezing resulted in acceptable survival rates following cryopreservation, and similar fertilization rates following ICSI as compared to the fresh sibling oocytes. However the number of blastomeres and the embryo quality on day three was superior in embryos from fresh oocytes when compared to the frozen oocytes.

Background: Heat shock protein A2 (HSPA2) is correlated with sperm maturity and function. Therefore, dysfunctional expression of this gene results in abnormal spermatogenesis. On the other hand, DNA damage in spermatozoa is considered to be an important cause of male infertility, and the presence of sperm with DNA fragmentation and chromatin abnormalities in human ejaculates is well documented, in particular in men with poor semen quality. Therefore, the aim of this study is to evaluate HSPA2 expression and its relation with DNA fragmentation, protamine deficiency involved in DNA packaging and semen parameters in varicocele patients in comparison to fertile men before and after varicocelectomy.Materials and Methods: This study included 52 fertile individuals as the control group and 70 infertile individuals with varicocele as the experimental group. Sperm DNA fragmentation, protamine deficiency and relative HSPA2 expression were evaluated by the sperm chromatin dispersion test, chromomycin A3 staining and RT-PCR, respectively.Results: The mean values of abnormal morphology, protamine deficiency and DNA fragmentation were significantly lower in varicocele individuals following varicocelectomy when compared to fertile individuals. The correlation between these parameters were studied and discussed in the text. Conclusion: There is a decrease in relative HSPA2 expression which is possibly due to chronic induced hyperthermia in varicocele individuals. Removal of this stress increases HSPA2 expression and results in the proper folding of proteins involved in spermatogenesis; therefore resulting in improved DNA packaging, as well as better sperm morphology and motility which may indirectly reduce sperm DNA fragmentation.

Background: Although spermatozoa deliver its RNA to oocytes at fertilization, its biological role is not well characterized. Our purpose was to identify the genes differentially and exclusively expressed in sperm samples both before and after the swim-up process in control donors and infertile males with the purpose to identify their functional significance in male fertility. Materials and Methods: This was a nested case-control study. Ten sperm samples were obtained from infertile patients [n=5 (two aliquots each from five samples; one before the swim-up process and one after)] and donors [n=5 (two aliquots from five samples, one before the swim-up process and one after)]. Oligonucleotide microarrays were employed to study the genome-wide expression of pooled samples from infertile patients vs. donors. A total of four microarrays were perfomed: two with sperm sample aliquots before swim-up and two with sperm samples aliquots after swim-up, from both the case and control groups. The results were evaluated to detect which genes expressed differentially [fold change (FC)>5 and p<0.05] and which genes were exclusive to each of the groups, both before and after swim-up.Results: Profound differences were detected between the fresh sperm samples of donors vs. infertile patients with respect to both differentially and exclusively expressed genes. Nevertheless these differences seemed to decrease after the swim-up selection process.Conclusion: There are important differences between the expression profiles of sperm samples of fertile donors vs. infertile patients who require assisted reproduction techniques (ART). These differences are potential forecasters of fertility success, although their reliability needs to be explored further.

Background: Polycystic ovarian syndrome (PCOS) was first introduced by Leventhal and Stein in 1935. It has a wide range of manifestations such as hyperandrogenism, irregular menstruation and central body obesity. The lack of definite diagnostic criteria has made the diagnosis a difficult task. Moreover, the disturbing aspects of the syndrome range from hirsutism in an adolescent girl to infertility in a young woman. Based on the Rotterdam 2003 Criteria, current diagnostic criteria must include two of the following three symptoms:1. Either oligo-ovulation or anovulation,2. Clinical or laboratory manifestations of hyperandrogenism,3. Polycystic ovaries on sonographic examination (more than 12 follicles of less than 10 mm in diameter in each ovary).In this study, we have focused on the enrollment of a large sample size to assess the prevalence and clinical features of PCOS such that a wide range of basic information can be utilized for further investigations.Materials and Methods: This was a cross-sectional study with multi-stage random sampling. Subjects were selected from 15-18 years old girls from a number of high schools in Tehran. After interview and clinical examination, those individuals with either menstrual irregularities, hirsutism or obesity were referred for further laboratory evaluations and abdominal sonography in order to diagnose PCOS and estimate its prevalence. We also aimed to assess the predominant features of this disorder among adolescents.Results: The overall prevalence of the syndrome was 3.42%. Out of the 1430 girls, 49 were diagnosed with PCOS.Conclusion: Despite its high prevalence, this syndrome has not been widely studied. Most of the conducted studies have enrolled small samples within a short time period. Thus, more accurate policy making in this regard can be achieved through definition of the prevalence of PCOS and accurate estimation of its burden.

Background: Chlamydia trachomatis (CT) is a common cause of sexually transmitted infections (STI) and a prevalent microorganism found in the vaginal discharge of sexually active women. The infection usually has no symptoms; although it may cause chronic complications such as pelvic inflammatory disease (PID), ectopic pregnancy, chronic pelvic pain, tubal infertility and cervical cancer. This study was done, for the first time, in Shiraz (southern Iran) to determine the prevalence of genital C.T in women. Materials and Methods: A total of 402 women who referred for routine pap smears to randomly selected health centers in Shiraz were tested with the IMAGEN Chlamydia test, a direct immunofluorescence test for the detection of Chlamydia in human urogenital specimens. The results of this test were compared to the socio-demographic condition of each participant as well as their sexually transmitted disease (STD) symptoms, both present and past. Results: The prevalence rate of Chlamydia infection was 8% (32/402). No correlation was found between this infection and age, marital age, number of children, education and occupational status of the participants. On the other hand, the correlation between the presence of infection and a positive history of STD symptoms, both present and past was significant.Conclusion: Chlamydia infection is quite frequent in our society, where knowledge about STD infections is scant. Considering the sequelae of this infection and the fact that this is a quiet disease, it seems rational to screen sexually active women and inform them more about this issue.

Background: To assess whether the C677T and A1298C mutations in the methylenetetrahydrofolate reductase (MTHER) gene are associated with recurrent abortion (RA), we determined the frequencies of the T677 and C1298 mutations in patients and controls.Materials and Methods: Mutations were determined by a RFLP-PCR method in 53 patients and 61 matched controls.Results: The frequencies of T alleles were 0.26 in patients and 0.29 in controls. The frequencies of C/C, T/C and T/T genotypes were 34 (55.7%), 22 (36.1%) and 5 (8.2%) in patients, and 27 (50.9%), 21 (39.6%) and 5 (9.43%) in controls. The C allele frequencies were 0.38 in patients and controls. C/C, A/C and A/A genotype distributions were 9 (14.8%), 28 (45.9%) and 24 (39.3%) in patients, and 8 (15.1%), 24 (45.3%) and 21 (39.6%) in controls.Conclusion: There were no significant differences between patients and controls concerning the T677 and C1298 mutations.

Pregnancy implantation within the scar of a previous cesarean delivery is one of the rarest locations for an ectopic pregnancy. Early diagnosis of this condition with the use of ultrasound imaging allows for preserving the uterus and subsequent fertility. However, a delay in either diagnosis or treatment can lead to uterine rupture, hysterectomy and significant maternal morbidity.With increasing incidence of cesarean sections (CS) worldwide and more liberal use of transvaginal sonography (TVS) in early pregnancy, more cases of cesarean scar pregnancy (CSP) are diagnosed. Thus every woman with a previous CS presenting to the early pregnancy unit should have a routine check for the cesarean scar appearance.We present the case of a 34 year-old multigravid woman who was found to have an ectopic pregnancy in a cesarean scar at six weeks gestation, with significantly elevated beta-human chorionic gonadotrophin (Beta-hCG) level.