SAREM JOURNAL OF MEDICAL RESEARCH (SAREM JOURNAL OF REPRODUCTIVE MEDICINE)
Year:2020 | Volume:5 | Issue:2|Papers Count:7

Commentary: In late 2019, a respiratory illness caused by the Corona virus was identified as the cause of several cases of pneumonia in Wuhan, China. Coronavirus (COVID-19), declared by the World Health Organization (WHO), is responsible for hundreds of thousands of medical records worldwide [1]. This disease has put a lot of costs on the health care system of countries around the world. Although scientists are increasingly monitoring the disease, a look at the diary statistics of the disease in Iran also shows that despite the measures taken, the disease has not yet been managed and controlled, and the statistics are increasing, if What successes have been achieved in the discussion of treatment and prevention of this disease. In the early stages of the disease, most countries used quarantine [2] and this quarantine was also implemented in Iran. The aim of this study was to look at the effects of the first stage of home quarantine for a week during the Covid 19 pandemic in Tehran. 414 people (64% female and 36% male) with a mean age of A35. 21 9 9. 52 years participated in this study. Table 1 shows the demographic and psychosocial characteristics of quarantine. The study questionnaire was distributed using an electronic link https: //docs. google. com/forms/d/13fnHSLAGq74Nlv9l4lGfcOa2fia8zBC_PEWt6BDVsAY This questionnaire was distributed through social media for one week in Tehran province from 2020 April 8. The questionnaire included a form related to demographic characteristics and a form related to psychological indicators related to quarantine and coronation.

Backgrounds and aims: The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may have men at a risk of infertility. The direct influence of this virus on the male urogenital organs should be evaluated. As well as SARS-CoV, SARS CoV-2 uses the ‘ Angiotensin Converting Enzyme-2’ (ACE2) as a receptor to enter human cells. It was found that ACE2, Angiotensin (1-7) and its MAS receptors are present, over in the lung, also in the testicles, in particular in Leydig and Sertoli cells. Also, the presence of proteases such as: TMPRSS2, TMPRSS11B, TMPRSS12 and furin are capable to promote viral fusion. Since the exact mechanism of the COVID-19 has not been fully elucidated and no specific drug or vaccine has been developed for it, control is mainly based on the interruption of the transmission cycle. There are symptoms of COVID-19 (e. g. fever) with the known andrological impacts that should be highlighted. Conclusion: As the SARS-COV-2 may have the potential to infect the testis via ACE2 and adversely affect male reproductive system, it is essential to commence with targeted finding and studies to learn from this disease. The aim of this study was to evaluate the effect of COVID-19 disease on sperm parameters and male fertility.

Background and Purpose: Vaginismus is an involuntary muscle spasm of the outer third of the vagina that makes it impossible to penetrate the vagina and causes discomfort. Based on the Lamont rating, it has 4 degrees, which are 3 and 4 degrees of severity. The aim of this study was to determine the effectiveness of functional electrical stimulation-biofeedback combined with cognitive-behavioral therapy in the treatment of grade 3 and 4 vaginismus based on the Lamont scale and pregnancy success of treated individuals. Method: 113 women with grade 3 and 4 Lamont vaginismus referred to Nejat Sexual Disorders Clinic and Sarem Hospital participated in this study. The patients enrolled in this study had primary severe vaginismus sexual dysfunction according to diagnostic and statistical criteria and the Lamont questionnaire (Grade 3 and 4). Patients underwent gynecological examinations and clinical interviews related to sexual function before and after treatment. After diagnosis of vaginismus, women underwent biofeedback, neuromuscular inhibitory stimulation, and sexual cognitive-behavioral therapy twice a week for 4 weeks. After treatment, the grade of the disease was calculated based on the Lamont scale and the progress of treatment was considered. Findings: After 8 sessions of treatment, there was a significant difference in the improvement of vaginismus and 77. 9% of the subjects were reduced to grade zero and 8% of the subjects were reduced to grade one of Lamont scale. 52. 8% of people who planned to become pregnant became success after two months. Conclusion: Biofeedback and muscular inhibitory stimulation along with cognitive-behavioral therapy are effective and short-term therapies for patients with vaginismus.

Aims: Ovarian factor is one of the most common causes of infertility in couples and various treatment methods have been adopted to treat it. Clomiphene drug is one of the safest, least expensive and most effective methods in these people. The drug is used with or without gonadotropins and IUI (Intra uterine insemination) method in infertile and subfertile couples with ovarian factors and health in the hypothalamic-pituitary-ovarian axis. The aim of this study was to evaluate the success rate of this drug in infertile women with ovarian factor that leads to a positive result. Positive results include pregnancies with a confirmed β hCG test, vaginal ultrasound, and a pregnancy sac seen inside the uterine cavity. Therefore, the results of this study can be effective and useful in the physician's decision to continue treatment. Methods: This study is a retrospective cross-sectional study that the results of treatment with clomiphene with or without IUI in 785 patients referred to the IVF clinic of Sarem subspecialty hospital with ovarian factor during 2015 to 1396 has been reviewed. Hormones level such as thyroid-stimulating hormone (TSH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), prolactin (PRL), and antimalarial hormone (AMH) were measured on the third day of menstruation and then clomiphene was prescribed. In all patients, spermogram test were performed twice, which was normal after the spermation process (Capacitation). Findings: The results showed that there was no significant relationship between the type of menstruation and treatment protocol used for the patients (P=0. 109). Also, there was no significant relationship between the presence of acne and hirsutism in patients and the type of treatment protocol (P=0. 281 and P=0. 232, respectively). In this study, there was no significant relationship between the type of clomiphene treatment or clomiphene with IUI and the levels of LH (P=0. 783), FSH (P=0. 516), AMH (P=0. 679) and PRL (P=0. 345) and also there was no significant relationship between body mass index (BMI) with the type of patient treatment (P=0. 584). Clomiphene treatment alone did not have a significant effect on the success of pregnancy outcomes, but in the clomiphene and IUI treatment protocol, there were 127 positive pregnancies, which 3% of them were ectopic pregnancies, and 5% of them was led to abortion. Finally, 124 cases resulted in the birth of a live baby, which based on the results of statistical analysis showed a significant relationship (P=0. 036). Conclusion: Clomiphene as a drug with low complication, low cost and available can be used as a suitable option in the treatment of infertile patients with ovarian factor in combination with IUI treatment method.

Introduction: Endometriosis is a common gynecologic disease which diagnosis and treatment is an obstacle among gynecologists. This disease depends on estrogen and is seen during the fertility period. On some occasions, endometriosis in the ovary presents as cysts called endometrioma that causes excruciating pain and requires excisional surgery. A dermoid cyst is the most common benign tumor of the ovary and is bilateral in 10% of cases. Sometimes, the patient is a candidate for surgery due to torsion or when the cysts are too large. The simultaneous appearance of these diseases is rare in an ovary and has reported as limited. This study aims to evaluate the simultaneous appearance of dermoid cyst and endometrioma in an ovary as a case study. Case Presentation: The case was a 30-year-old virgin woman who underwent laparoscopic surgery at Sarem Hospital, due to abdominal and pelvic pain for several months as diagnosed with bilateral ovarian endometriosis (based on ultrasound and MRI). In addition to endometrioma during surgery, there was a dermoid cyst in an ovary that removed. In imaging of the patient (sonography and MRI) was not pointed to the dermoid cyst. Conclusion: During each surgery, the possibility of another pathology must be considered simultaneously with the pathology that caused the surgery, and each disease must be treated in the best way that is appropriate.

Background: Ovarian hyperstimulation syndrome (OHSS) is potentially lifethreatening complication including pleural effusion, acute renal insufficiency, and venous thromboembolism associated with controlled ovarian stimulation during assisted reproductive technology. A number of clinical studies have reported on the use of plasma expanders such as albumin, hydroxyethyl starch (HES), mannitol, polygeline and dextran as a possible intervention for the prevention of OHSS. Objective: The purpose of this study was to compare the efficacy and costeffectiveness of mannitol rather than albumin for the treatment of severe OHSS. Materials and Methods: We conducted a single-center and comparative randomized clinical trial with two parallel patient groups. 47 patients with severe OHSS were selected with inclusion criteria. In albumin group (n=26), patients received 100 g/day intravenous albumin. Mannitol therapy (n=21) started twice a day using 100 gr mannitol infusion over 4 hours. Patients were monitored according to the standard protocol. Statistical analysis will be performed to analyze and compare the data between two groups in order to determine the efficacy (based on vital sign, abdominal circumference, weight, intake/output of fluid, correction of hemoconcentration), side effects and cost of drug therapy between the two treatment modalities. Results: The efficacy of drug therapy was evaluated by examining the results of daily urine output, serum biochemistry analytes, weight and abdominal circumference in both group. There were no significant differences between the two study groups in terms of patient age, clinical signs and symptoms, and laboratory findings such as hematocrit, creatinine, oliguria, weight, and abdominal size. Significant improvement of OHSS syndrome was observed in patients using mannitol which no patient was reported any side effects such as respiratory distress syndrome, renal failure, or thromboembolism. In the albumin group, 15. 38 % of patients presented with acute respiratory distress syndrome (ARDS). Another outcome of this study was the significant economic difference between the two managements of severe ovarian hyperstimulation syndrome. Mannitol therapy was obviously cost-effective versus albumin therapy. Conclusion: The use of mannitol is comparable and superior to albumin for the treatment of severe OHSS with regard to the protective effect against the occurrence of acute respiratory distress syndrome. Base on this study, its costeffectiveness makes mannitol an ideal drug for OHSS treatment. This study suggests that mannitol can be first-line therapy for the treatment of severe OHSS, therefore, the addition of mannitol as a treatment of ovarian hyperstimulation syndrome is recommended in the drug pharmacopeia.

Introduction: Ectopic pregnancy and ovarian torsion are both gynecological emergencies. The diagnosis of ovarian torsion is based on clinical signs, and ultrasound is helpful in only 50 to 75% of cases. The incidence of ovarian torsion during pregnancy and due to luteal cysts of pregnancy is 25-30%. The presence of these cysts during ectopic pregnancy can cause torsion, and the coexistence of ectopic pregnancy and torsion makes diagnosis difficult. Case Presentation: The reported case is a 32-year-old woman who was referred to Sarem's Women Hospital (Tehran, Iran) with acute abdominal pain and was admitted to suspicion of ectopic pregnancy due to a positive pregnancy test. Hours after admission, the patient developed severe nausea and vomiting and exacerbated intermittent abdominal pain, and underwent emergency laparoscopic surgery with a diagnosis of ovarian torsion. During the laparoscopic evaluation, in addition to left ovarian torsion, an ectopic pregnancy was seen in the right fallopian tube and the patient underwent the necessary treatments. Conclusion: In medicine, the diagnosis of diseases is based on the patient's clinical signs and symptoms, and paraclinical methods can only help in the diagnosis. Also, the treating physician and especially the surgeon must be aware of the presence of concomitant pathologies in the patient in order to be able to completely treat her/him. Simultaneous ectopic pregnancy and ovarian torsion are rare but do occur. Therefore, early diagnosis is important to maintain future fertility and the ovaries, which can prevent unwanted complications in these patients with appropriate treatment.