Background and Aims: A significant part of infertility has been related to environmental conditions as well as acquired risk factors. Different environmental conditions emphasize the necessity of studying different etiologies of infertility in each region. The present study aimed to determine the etiologies of infertility in infertile couples. Materials and Methods: In this cross-sectional study, 583 infertile men and women referred to the infertility clinic from 2021 to 2022 were examined. In addition, sampling was performed using the census method. Information about patients was obtained from medical tests and laboratory findings. It is noteworthy that descriptive statistics, such as frequency and mean, were used to analyze the data. Results: According to the results, oligospermia was the most common cause of male infertility (44.72%), and ovulation disorder was the most prevalent reason for female infertility (66.17%). In general, ovulation disorder and sperm motility were the most common causes of infertility (36.73%). There was no significant relationship between women's underlying diseases and the causes of infertility (P>0.05). Conclusion: The etiology pattern of infertility is closely similar to that of many other regions reported by the World Health Organization (WHO). Despite this, the rate of ovarian disorders is higher than that in many other studies, which needs further studies.

Epidemiological studies link ovulation and epithelial ovarian cancer, which frequently develops from the ovarian surface epithelium (OSE). Ovulation can be likened to an inflammatory reaction initiated by the mid-cycle luteinizing hormone surge. Each ovulation involves proteolytic breakdown of the follicle wall and ovarian surface to allow shedding of the oocyte. Serial injury and repair of the OSE thereby creates the potential for inflammation-associated genetic damage leading to neoplasia. Since ovulation is normally so regular and frequent, natural mechanisms must exist to localize and limit ovarian inflammation and minimize emergent disease. Our research suggests a role for cytokine up-regulation of HSD11B1 gene expression in this process. HSD11B1 encodes the steroidogenic enzyme 11bhydroxysteroid dehydrogenase type 1 (11bHSD1) that metabolizes substrate cortisone to anti-inflammatory cortisol. We find 11bHSD1 mRNA and enzymatic activity strongly up-regulated by the ovulation-associated cytokine interleukin-1a (IL-1 a) in cultured human OSE cells. Moreover, cortisol enhances IL1a-induced up-regulation of 11bHSD1 mRNA, providing feed-forward amplification of local anti-inflammatory signaling in these cells. We therefore propose that cytokine activation of cortisol regeneration via 11bHSD1 can provide a mechanism for anti-inflammatory ‘protection’ of ovary during ovulation. In support of this concept, we find that IL1a up-regulates matrix metalloproteinase (MMP) 9 (gelatinase B) activities in OSE cells and this is suppressed by glucocorticoid receptor-mediated cortisol action in vitro. Suppression of MMP9 gene expression through locally regenerated glucocorticoids has implications both for normal ovulation and ovarian cancer spread. Many ovarian cancer cell lines are unable to respond normally to IL- a in terms of 11bHSD1 mRNA. Likewise, many primary epithelial ovarian cancer cells show a deficient 11bHSD1 mRNA response to IL- 1a relative to normal OSE. If this translates into deficient glucocorticoid suppression of MMP9 in primary ovarian cancer, this could be a mechanism of promoting metastatic tumour spread in vivo.

History and Objective: Ovarian hyper stimulation syndrome (OHSS) is a dangerous iatrogenic complication of ovulation induction cycles. Considering HCC injection complications, reports of GnRH agonist effectiveness and safety in other countries and no report in Iran, in order to determine GnRH agonist effect on ovulation induction cycles in OHSS risk, this study was performed in Mirza Koochak Khan Hospital in 5004-2000. Considering HCC's essential role in OHSS, in ovulation induction cycles with many follicle number and estradiol level elevation, HCC injection is not recommended. GnRH agonist was used for final oocyte maturation and ovulation stimulation; in order to inhibit OHSS risk and Material and Methods: A clinical trial was performed on women in ovulation induction cycle combined with IUI that were in OHSS risk. Patients were randomized in case and control group. Case group received GnRH agonist and the control group didn't. Progesterone level was measured on 21 st or 23rd day of period cycle and was followed for ovulation, pregnancy and OHSS.Results: 34 patients of total 70 that had suitable conditions were studied. Patients were matched for age and estradiol level. Ovulation rate in case and control group was 50% and 74/1%, respectively that was not statistically significant. There was no case of OHSS in both groups.Conclusions and Recommendations: Results have revealed that GnRH agonist injection in hyper stimulated cycles will be successful and prevent OHSS. Therefore its application is recommended.