Tehran University Medical Journal

Lithium is a immunomodulator that can increase immunoglobulins to confront infectious desese. It is also able to increase the production of interleukins, interferon gamma and prostaglandins. We conducted this study to evaluate the correlation between lithium consumption and humoral immunity. Blood samples were obtained from 76 patients under lithium treatment. We classified the patients according to their serum lithium level in to five categories. Using single radial immuno diffusion technique, we measured IgG, IgA, IgM, C3 and C4 levels in the blood samples of our patients and a group of 100 controls as well. Analysis of variance method was used for comparison of groups. We found significant differences between groups in level of IgG, IgA, IgM and C3 (P<0.05). This findings show that lithium has many effects on humoral immunity.

Background: Considering the psycho-social model of diseases, the aim of this study was to evaluate the effect of psychiatric intervention on the pregnancy rate of infertile couples.

Methods: In a randomized clinical trial, 638 infertile patients referred to a university infertility clinic were evaluated. Among them, 140 couples with different levels of depression in at least one of the spouses were included in this substudy. These couples were divided randomly into two groups. The patients in the case group received 6-8 sessions of psychotherapy before starting infertility treatment and were given fluoxetine 20-60 mg per day during the same period. The control group did not receive any intervention. Three questionnaires including the Beck Depression Inventory (BDI), Holmes-Rahe stress scale and a socio-demographic questionnaire were applied for all patients. The clinical pregnancy rates of the two groups, based on sonographic detection of the gestational sac six weeks after LMP, were compared. The data were analyzed by paired-T test, T-test, χ² and the logistic regression method.

Results: The pregnancy rate was 47.1% in the case group and 7.1% in the control group. The pregnancy rate was significantly related to the duration and cause of infertility and the level of stress in both groups (p< 0.001). The pregnancy rate was shown to be higher in couples in which the male has a secondary level of education (p< 0.001).

Conclusions: Psychiatric interventions greatly improve pregnancy rates, and it is therefore crucial to mandate psychiatric counseling in all fertility centers in order to diagnose and treat infertile patients with psychiatric disorders and help couples deal with stress.