Iranian Journal of Obstetrics, Gynecology and Infertility
Year:2018 | Volume:21 | Issue:8 |Papers Count:19

IntroductionDecrease in sperm motility and increase in oxidative stress levels are of the main causes of male infertility. Since the fertility has high value in most cultures، this study was performed with aim to investigate the effect of propolis supplementation on sperm parameters and oxidative stress markers in idiopathic infertile men. MethodsThis double-blind randomized controlled clinical trial study was performed on 60 men with asthenospermia who referred to infertility clinic of Velayat hospital in Qazvin in 2016. The subjects were divided into two groups of intervention and placebo (n=30 in each group). The subjects in both groups received daily 1500 mg (three capsules of 500 mg) propolis and placebo for 12 weeks. The parameters of sperm، total antioxidant capacity (TAC) and malondialdehyde (MDA) concentration were determined at the beginning and the end of the study. Statistical analysis was performed using SPSS software (version 16)، and Paired samples t-test (dependent t-test) and Independent samples t-test. P< 0. 05 was considered statistically significant. ResultsAfter the intervention، the number، concentration and percentage of sperm motility and total antioxidant capacity significantly increased in the intervention group and the concentration of malondialdehyde significantly decreased in the intervention group (p <0. 05). ConclusionReceiving the propolis leads to reduction in oxidative stress and improvement in sperm parameters. Since increased oxidative stress was observed in sperm disorders، receiving antioxidants supplement such as propolis may be one of the methods to deal with sperm oxidative impairments in this group of infertile men.

IntroductionRegular sports exercises and the use of food strategies are always considered as low-risk and healthy approaches for coping and treatment of obesity. In this regard، the present study was performed with aim to determine the effect of concurrent training with Flaxseed supplementation on body mass index، glucose، insulin and insulin resistance in overweight girls. MethodsThis clinical trial was performed on 36 overweight women in Tabriz University in 2017. The subjects were randomly divided into four groups (n=9 in each group)، including training along with supplementation، concurrent training، supplementation Flaxseed and control. Concurrent training included aerobic exercises with an intensity of 65% of heart rate and resistance training with intensity of 60% 1RM. The subjects used the powdered seed one hour before food، at three meals and dissolved in 250 mg of water، during four weeks of supplementation course. Insulin value was measured using an ELISA kit، fasting glucose level by autoanalyzer، and insulin resistance by homoeostasis model (HOMA). Data was analyzed by SPSS software (version 22) and ANOVA، repeated measurements variance analysis، and bonferroni post hoc. P <0. 05 was considered statistically significant. ResultsIn concurrent training group، after four weeks، there was a significant decrease in WHR (P=0. 015)، and supplementation of flax seed alone caused a significant reduction in weight (P=0. 008)، fat percentage (P=0. 041)، WHR (P=0. 015). Meanwhile، interventions could not affect insulin (P=0. 511)، insulin resistance (P=0. 549)، and glucose (P = 0. 600). ConclusionFour weeks of concurrent training and Flaxseed supplementation had no significant effects on glucose and insulin-related indices، and body composition. The use of such independent variables requires more research.

IntroductionPregnancy is a phenomenon which is associated with very important physical and psychological changes. It plays an important role in women’ s sexual function، as sexual relationships are changing due to various physical and psychological changes during pregnancy. This study was performed with aim to evaluate sexual dysfunction and its related factors in pregnant women referred to Mashhad health centers. MethodsThis cross-sectional study was conducted on 241 pregnant women referred to Mashhad health center in 2017. Data collection tools were demographic questionnaire and female sexual function Index. Data analysis was performed by SPSS software (version 16) and multi liner regression model test. P<0. 05 was considered statistically significant. ResultsThe mean of total score of women's sexual performance was 26. 47 ± 5. 64 and 131 women (54. 4%) had sexual dysfunction. Mean scores of sexual desire was 3. 95 ± 0. 98، Arousal 4. 15 ± 1. 19، Lubrication 4. 64 ± 1. 25، orgasm 3. 53 ± 1. 34، sexual satisfaction 4. 89 ± 1. 10 and painful intercourse 4. 31 ± 1. 36، and the most common sexual dysfunction were decreased sexual desire (46. 5%) and Arousal (43. 6%). The results of linear regression showed that previous history of delivery was related to sexual function، so that in the case of previous delivery، the mean of total score of sexual function decreased 1. 86 unit (P = 0. 01). ConclusionSexual dysfunction has high prevalence in pregnant women and history of previous delivery had a negative effect on sexual function. Therefore، it is suggested that sexual counseling programs be merged in prenatal care to improve the quality of pregnant women's care، and sexual counseling programs be designed and implemented especially for multiparous pregnant women.

Introductionpost term pregnancy is associated with maternal and fetal complications، including sudden death of the fetus and low Apgar score after birth. Evening primrose oil has been used for cervical ripening. Despite the effects of evening primrose oil on prostaglandin precursor levels and the well-established role of prostaglandins in the reconstruction of cervical matrix. This study was performed with aim to evaluate the effect of vaginal consumption of evening primrose oil on cervical ripening in nulliparous women with post-term pregnancy. MethodsThis randomized clinical trial study was conducted on 60 pregnant women with post-term pregnancy who referred to the maternity of Ahvaz Sina Hospital in 2017. The study groups consisted of 2 groups: vaginal capsule of 1000 mg of evening primrose oil and placebo. Drug was administered after induction of labor with 10 unit oxytocin. In the intervention group، one vaginal capsule of 1000 mg of evening primrose oil and in the control group، gelatin capsule as similar as the drug were used. Then، the induction of labor was started with oxytocin with similar dose (10 unit in 1000 cc serum ringer) in both groups. Cervical ripening was measured based on regular examination (every one hour). Data were collected by demographic questionnaire، timing، and bishop-score checklist. Data were analyzed by SPSS software (version 22) and independent t-test and Chi-square test. P<0. 05 was considered statistically significant. ResultsThe duration of the latent phase in both groups was 9-10. 5 hour. The duration of latent phase (p=0. 003) and bishop score (p=0. 01) had significant difference between the intervention group and the placebo group; it means more cervical ripening in the intervention group. At second stage of measurement، bishop score ≥ 7 was 90% in the intervention group and 60% in the control group that was significantly more in the intervention group (P=0. 01). However، no significant difference between the two groups in terms of the duration of the active phase، progression rate، severity of pain، and volume of bleeding. ConclusionThe vaginal use of evening primrose oil reduces the duration of the latent phase and has a positive effect on the cervical ripening and Bishop score.

IntroductionAccording to the high prevalence of breast cancer in Iran and the importance of evaluation the attitude، behavior، and knowledge of women in the incidence of cancer screening، this study was performed with aim to evaluate the women's attitude، behavior، and knowledge about breast cancer screening. MethodsThis cross-sectional study was conducted on 400 women aged >15 years who referred to Shiraz Imam Reza clinic in 2016. Data was collected by the questionnaire of individual characteristics and breast cancer screening. The data was described by the mean، standard deviation، and frequency. Data was analyzed by SPSS software (version 19) and Pearson correlation، independent t-test، and ANOVA tests. P<0. 05 was considered statistically significant. ResultsThe mean scores of knowledge، attitude، and behavior were 25± 4. 8، 27± 5. 2، and 18. 9± 3. 7، respectively. According to the results of Pearson correlation coefficient، knowledge had stronger correlation with behavior (r= 0. 24، p<0. 001) than attitude and behavior (r=0. 14، p<0. 001). Knowledge had significant relationship with age، education، history of breast cancer and history of breast self-examination (p <0. 001)، and attitude had significant relationship with the history of breast cancer (p <0. 05)، and behavior had significant relashenship with education and the history of breast self-examination (p <0. 05). ConclusionMean score women's behavior for participation in the breast cancer screening program was lower than expected mean scores (score 20).

IntroductionNausea and vomiting is of the common complain during pregnancy. Herbal medicine is among the traditional treatments. This study was performed with aim to compare the effects of chamomile، Ginger and vitamin B6 on treatment of nausea and vomiting in pregnancy. MethodsThis randomized clinical trial was performed on 105 pregnant women with gestational nausea and vomiting in Qazvin Health Centers in 2016-2017. The subjects were randomly assigned to three groups (intervention 1، 2، 3) (n=35 in each group). The intervention groups received oral capsule of chamomile، ginger and vitamin B6 for four days، three times a day. Rhodes index was used to assess nausea and vomiting before and 1 week after intervention. Data were analyzed by SPSS software (version 23) and t-test، Chi-square، Kruskal– Wallis and Wilcoxon. P<0. 05 was considered statistically significant. ResultsBefore the intervention، no significant difference was observed between three groups in the mean of nausea، vomiting based on Rhodes index (p>0. 05). Whereas، after the intervention، it showed significant decrease in three groups (P=0. 001)، but there was no significant difference between three groups in terms of decreased mean of nausea and vomiting (p>0. 05). ConclusionChamomile، ginger and vitamin B6 are equally effective for decreasing nausea and vomiting in pregnancy and there is no significant superiority in therapeutic effects in any of the three drugs.

IntroductionBacterial Vaginosis is the most common type of vaginitis in women of reproductive age which is diagnosed by Amsel’ s clinical criteria and the Nugent microscopic scoring system (Gram stain). This study was performed with aim to compare Amsel clinical criteria with standard method of Gram stain for diagnosis of bacterial vaginosis. MethodsThe experimental study was conducted to compare Amsel's clinical criteria with standard gram stain method for diagnosis of bacterial vaginosis on 100 married women referred to women clinics of Khorramabad in 2015-2016. Nugent scoring system was considered as the gold standard method for diagnosis of bacterial vaginosis. Sensitivity، specificity، positive predictive value، and negative predictive value of Amsel's criteria was compared with those of the Nugent scoring system. Data was analyzed by SPSS software (version 20). P<0. 05 was considered statistically significant. ResultsThe mean of age، duration of marriage، age of the first menstruation and first pregnancy were 31. 96 ± 8. 93، 18. 96 ± 3. 50، 12. 99± 0. 85، and 20. 03 ± 3. 84 years. In the evaluation of diagnostic value of the Nugent scoring system in comparison with the Amsel's criteria، Amsel's criteria had sensitivity 100%، specificity 46%، positive predictive value 92. 5%، and negative predictive value of 100%. ConclusionAmsel's criteria are not as accurate as the Nugent scoring system in the diagnosis of this infection and Gram staining is needed to correctly diagnose bacterial vaginosis.

IntroductionPrimary dysmenorrhea is referred to painful menstrual cramps without organic cause، which is one of the most common problems in women of reproductive age. Regarding to high incidence of dysmenorrhea and its effect on daily activities and the side effects chemical drugs، this study was performed with aim to evaluate the effect of Teucrium polium capsule on the pain duration of dysmenorrhea. MethodsThis triple-blind controlled randomized clinical trial was conducted on 70 students with primary dysmenorrhea in one of the dormitories of Shahid Beheshti University in 2014. The subjects were randomly divided into intervention and control groups. During the first three days of menstruation، the intervention group was treated with Teucrium polium capsules every 6 hours and the control group with capsules containing starch powder، for two consecutive months. Pain duration was assessed based on the day (one period before the beginning of the study and two periods of intervention). Data analysis was done using SPSS software (version 20) and SAS9. 2 software، and independent t-test، Mann-Whitney، and random effects model. P<0. 05 was considered significant. ResultsThere was no significant difference between the two groups in pain duration before the intervention (P > 0. 05). The menstrual pain duration significantly decreased after the use of Teucrium polium capsule compared to placebo group (P <0. 0001). The pain duration was 4. 3 days before the use of Teucrium polium capsule that reduced to 1. 9 and 1. 4 days after the use of capsule in the first and second periods، respectively. ConclusionTeucrium polium capsule significantly reduces the menstrual pain duration and can be used to treat primary dysmenorrhea.

IntroductionSelf-efficacy is an important motivating factor for success in lactation، so that increasing self-efficacy in the postpartum period leads to continued lactation. Performing lactation self-efficacy promotion interventions based on the sources of practical self-efficacy seems to be reasonable. Therefore، this study was performed with aim to compare the effect of Purslane cream and Lanolin for treatment of breast fissure on lactation self-efficacy. MethodsThis double-blind randomized clinical trial was performed on 86 breastfeeding women with nipple fissure in Mashhad in 2016. The subjects were randomly assigned to two treatment groups of Purslane cream and Lanolin (n=43 in each group). Appropriate method of lactation and drug use were trained to both groups and they were asked to use treatment three times a day and up to one week. The score of nipple fissure was measured and recorded before the intervention، the third and eighth day after the intervention using the Store scale by the researcher. The tool of lactation self-efficacy was completed before the intervention and one day after treatment (8th day) through interview with the research units. Data were analyzed using SPSS software (version 22) and t-test، repeated measures variance analysis، Mann-Whitney، and Chi-square. PResultsAccording to the results of Mann-Whitney test، two groups were homogeneous in terms of mean score of fissure before the intervention، but there was significant difference between two groups on the third and eighth day (P <0. 001). So that، recovery was faster observed in the Purslane creamgroup than Lanolin group. Self-efficacy score increased in both groups and this increase was significant in each group (P<0. 001). However، this difference was not statistically significant when two groups were compared (P=0. 434). ConclusionPurslane cream in comparison with lanolin accelerated the recovery process of breast fissure and increased lactation self-efficacy score، although this difference was not significant.

IntroductionMenopause symptoms severity is different in women، and in addition to the effects on aging process، hormonal changes with inducing the symptoms can affect women's quality of life. There are several tools to assess physical and psychological changes during the climacteric period. The MSSI-38 questioner is one of the new tools for simultaneous assessment of the frequency and intensity of symptoms with five-point Likert scale. This study was performed with aim to assess the validity and reliability of MSSI-38 questionnaire. MethodsThis cross-sectional study was performed on 676 Iranian women who were resident in Mashhad in 2017. The MSSI-38 questioner was translated into Persian and after calcuating CVR، 6 items were eliminated according to the Lawshe formula and 9 factors were extracted by exploratory factor analyses. The content validity was evaluated with Content Validity Ratio (CVR) and Content Validity Index (CVI)، and Construct validity was evaluated with Average Variance Extracted (AVE) and Composite Reliability (CR). Data were analyzed with SPSS software (version 16. 0) and MPlus and Smart PLS. P< 0. 05 was considered statistically significant. ResultsThe value of AVE=0. 562 was favorable. The CVI=0. 87 was obtained and the content reliability was confirmed. The Cronbach alpha and CR in most of the factors were acceptable (>0. 7). KMO=0. 851 indicates the adequacy of the samples. After CFA، the goodness of fit indices were (χ 2/df=1. 53، RMSEA=0. 039، CFI=0. 972، TLI=0. 968). 7 factors were extracted by using CFA and WLSM and factors construct validity was confirmed. ConclusionMSSI-38 is a valid and reliable tool for evaluation of Menopause Severity Symptoms and can be used in research articles on Iranian Persian languages population.

IntroductionPolycystic ovary syndrome (PCOS) is one of the most common disorder of women at reproductive age. Many findings indicate that genetic variations in the vitamin D receptor gene may affect PCOS development. This study was performed with aim to evaluate the associations between TaqI polymorphism in the vitamin D receptor gene (VDR) and PCOS، and the association of TaqI polymorphism with gonadotropins and steroid hormones parameters in two groups of patients and control. MethodsThis case-control study was performed on 77 women who had referred to fertility and infertility center of Isfahan during three months of summer 2016. 38 obese women with PCOS were selected as patient group and 39 healthy obese women as control group. Serum levels of LH، FSH، testosterone and progesterone were measured by ELISA method. The TaqI polymorphism was genotyped by using PCR-RFLP (restriction fragment length polymorphism) technique. Data was analyzed by SPSS software (version 22) and independent t-test، Mann-Whitney، Kruskal-Wallis، and Chi-square test. P<0. 05 was considered statistically significant. ResultsBased on the results of Chi-square test، no difference was found between T and t alleles and TaqI genotypes in PCOS and control women (p> 0. 05). Serum levels of FSH (p = 0. 012) and testosterone (p = 0. 017) was significantly lower in control group than the patient group. There was no significant difference in serum LH and progesterone between patients and control group (P> 0. 05). Also، the level of LH hormone was significantly higher in TT individuals than that of Tt / tt subjects (p = 0. 01). ConclusionAmong the studied population، there was no significant relationship between tt، Tt and TT genotypes with FSH، testosterone and progesterone hormones. Therefore، it can be concluded that TaqI polymorphism was not associated with the risk of polycystic ovary syndrome.

IntroductionSevere perineal tears during delivery decrease maternal health and satisfaction. This is a challenge for promotion and acceptance of normal vaginal birth. Therefore، this study was performed with aim to identify the risk factors associated with severe perineal tears during normal vaginal delivery. MethodsThis was a case-series study which was performed by reviewing medical records and interviewing with women who gave birth from 20th April to 25th December 2016 at Omolbanin Hospital، Mashhad، Iran and had third and fourth degree perineal lacerations. Data extracted from patients’ medical records included demographic and childbirth-related data (number of parity، the length of the first and second stage of labour، frequency and duration of uterine contractions، prescribed medications in labour، birth attendant، mode of delivery، degree of perineal tear، method of perineal repair and neonatal weight) that was recorded in related forms. Interviews were conducted within the first year after childbirth following telephone invitation، focusing on women’ s chief complains. Descriptive statistics were used for data analysis. ResultsOut of the seven Iranian patients studied، four cases (57. 2%) were multiparous and three cases were primiparous. The most risk factors associated with perineal lacerations included 6 cases of induction by oxytocin (85. 7%)، 3 cases of gestational diabetes (42. 8%)، 3 cases of postdate pregnancy (42. 8%) and 2 cases of macrosomia (28. 50%). The delivery of only one case was done by the skilled stuff of labor and the others were accomplished by medical and midwifery students. In 6 cases (%85. 7)، more than one risk factor was seen. The most common postpartum complication was gas incontinence. ConclusionLabor induction with oxytocin، gestational diabetes، and postdate pregnancy are the most common risk factors associated with severe perineal tears during normal delivery. The majority of women suffer of gas incontinence، even after successful repair of perineal lacerations.

IntroductionMirror syndrome is described as mother's generalized edema accompanied with hydrops fetalis، which sometimes leads to preeclampsia. Mirror syndrome is uncommon and its accompaniment with eclampsia is very rare. This report presents a rare case of pregnancy accompanied with mirror syndrome leading to eclampsia. Case Report: The patient was a 21-year-old woman، gravida 2 with history of one abortion and with 33 weeks gestation. The patient was admitted in Mashhad Imam Reza hospital with hydrops fetalis، diagnosed by sonography، generalized edema، hypertension (blood pressure of 140/90 mmHg) without headache، epigastric pain، and blurred vision which caused suspicion of mirror syndrome. The laboratory tests showed normal liver and renal function، normal platelet count، and no proteinuria. Two days after admission، hypertensive crisis occurred، and her blood pressure was 170/110 mmHg، and preeclampsia occurred. Therefore، cesarean section was performed because of prematurity. The neonate died after 48 h due to respiratory distress. After three days، the patient was discharged following 48 h infusion of intravenous magnesium sulfate with a good general condition and normal blood pressure. ConclusionMirror syndrome is a rare complication of pregnancy accompanied with hydrops fetalis. Its symptoms can range from mother's edema to eclampsia. If maternal symptoms increased، emergency pregnancy termination leads to good prognosis and recovery of maternal symptoms.