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Showing 26 results for Infertility
Laparoscopic study on 75 cases of secondary infertility in Roointan Arash Hospital, 1993-96
R Behdani ,
Volume 58, Issue 1 (4-2000)
Abstract

Over a period of 4 years 325 infertile women were evaluated by diagnostic by laparoscopy, which included 250 cases of primary and 75 cases of secondary infertility. The aim of the present study was to find out the probable causes of infertility by collecting qualitative and quantitative data from laparoscopy results of the secondary infertility group so as to give precautions for decreasing the predisposing factors. The results of this study showed that pelvic adhesion was the most frequent pathologic findings (57 cases), which could be due to complication of PID or surgical trauma. 14 cases had other problems and only 4 cases showed no apparent pathological anomalies.


Unilateral multifocal testicular biopsies in 320 patients with Germ Cell Aplasia
D Jamali Zavareii. M, Jarrahi. Mr,
Volume 64, Issue 11 (10-2006)
Abstract
Background: Germ cell aplasia (G.C.A) is one of the most important testicular causes of infertility and azospermia.In this condition the seminiferous tubules are only lined by a single layer of sertoli cell. In some cases, there is focal area with spermatogenic activity.
Methods: We studied infertile men with G.C.A referred to Jahade Daneshgahi of Iran during 1381-82, retrospectively. All the cases had more than one biopsy of one testis.
Results: In 11.6٪ of 320 cases, comparison of multiple biopsy sites of a testis revealed: when one site showed G.C.A, another site revealed areas with spermatogenic activity. Considering the cases who showed germ cells in both sites, 15.3٪ of cases multiple biopsy sites appeared to have focal spermatogenesis, better maturation of germ cells or higher scoring area for urologic operation.
Conclusion: According to new techniques in treatment of infertility with ICSI (intra cytoplasmic sperm injection) in which fertility is possible with one spermatozoa or even spermatid (after recovery), biopsy of multiple sites instead of only one site is highly recommended in azospermic patient.
Correlation of H. pylori infection and infertility a survey in Yazd infertility clinic
Khalili M B, Sharifi Yazdi M K, Sadeh M,
Volume 65, Issue 3 (6-2007)
Abstract
Background: Infertility is a worldwide problem. Many different factors may cause infertility. Among them, bacterial infection of the reproductive system is one of the main factors. Recently, some limited investigation has revealed that H. pylori is capable of causing genital inflammation that may lead to infertility. Although known to be a causative agent of gastritis and duodenal ulcers, this species may be transferred orally to the vagina and asymptomatic infection leads to inflammation of the system and finally manifestation of infertility. In addition, infertility may be due to antibodies synthesized against H. pylori cross-reacting with the genital tissue.
Methods: In the present study, 180 women consisting of 90 cases referred to IVF center of Yazd and 90 matched controls were enrolled. Serum was taken from all women for detection of IgG and IgM using the ELISA technique.
Results: A total of 117 (65%) serum samples were positive for Helicobacter, of which 63.3% were from fertile and 66.7% from infertile women. The serum positive population was found to be predominantly in the age range of 25-35, although some 35-42 year olds were also serum positive. When the prevalence of Helicobacter infection status was compared with marriage duration in both groups, it was found that antibody titer in subjects from marriages with durations of greater than five years was significantly higher than those of five-year marriages. In addition, higher antibody titers were found in infertile women with fallopian tube (FT) factor and lower titers in those with polycystic factors.
Conclusion: Although the results were not significant, they nevertheless indicate that the Helicobacter antibody titers in infertile women were higher than those of fertile women (P =0.6). Therefore, further studies are necessary to determine the role that Helicobacter infection plays with regard to infertility among women. Since the antibody titer in infertile cases with FT factor was higher than others, it may indicate that inflammation caused by H. pylori plays an indirect role in the induction of infertility.
Effectiveness of psychiatric and counseling interventions On fertility rate in infertile couples
Ramezanzadeh F, Noorbala Aa, Malak Afzali H, Abedinia N, Rahimi A, Shariet M, Rashidi B, Tehraninajad A, Sohravand F, Bagheri M,
Volume 65, Issue 8 (11-2007)
Abstract

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.


Dimensions of neuroticism and androgeny: fertile versus infertile women
Abolghasemi A, Shibani H, Narimani M, Ganji M,
Volume 66, Issue 7 (10-2008)
Abstract

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 !mso]> ject classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id=ieooui> Background: Infertility influences various aspects of a woman's personality and psyche, and affects her functions within her family and occupation, as well as her ability to communicate. Studies have shown that infertility is associated with depression, stress, anxiety, dissatisfaction with life and other psychological problems. The purpose of the present study was to compare the dimensions of neuroticism and androgyny in fertile, infertile and postmenopausal women.
Methods: This study included of 180 fertile, infertile and postmenopausal women (60 in each group) selected from inpatients at Imam Khomeini and Mirza Koochak Khan Hospitals, Tehran, Iran, during 2004. Data were collected using the NEO Personality Inventory Neuroticism Scale and Bem Sex-Role Inventory and analyzed using the one-way ANOVA technique.
Results: LSD test results show that mean neuroticism scores were significantly different between the three groups, with scores following the trend: infertile women > postmenopausal women > fertile women. The mean androgyny scores were also significantly different between the three groups, following the trend: infertile women < postmenopausal women < fertile women (p<0.01).
Conclusion: The results of this research are congruent with findings from other studies. These results may be useful for infertility counseling and therapy.


GSTM1 and GSTP1 polymorphisms and glutathione S-transferase activity: Iranian infertile men
Mirfeizollahi A, Farivar Sh, Akhondi Mm, Modarresi Mh, Hodjat M, Sadeghi Mr,
Volume 66, Issue 12 (3-2009)
Abstract

Background: Pi-GST and Mu-GST are subclasses of glutathione S-transferase that present on human sperm surface and play an important role against oxidative stress. Therefore, any defects in the enzyme activity may be associated with male infertility.In this study the polymorphisms of GSTM1 and GSTP1 in association with enzyme activity and sperm parameters were studied.

Methods: This case-control study involved 95 men with oligoastenoteratozoospermia and 26 controls with normozoospermia. Semen analyses were carried out according to WHO guidelines. Blood DNA was extracted using salting out procedures. GSTM1 and GSTP1 polymorphisms gene were determined through PCR-RFLP and multiplex PCR, respectively. Finally, Glutathione S-transferase activity was measured.

Results: Frequencies of GSTM1 null genotype in oligoastenoteratospermic and normospermic groups were 52.1% and 53.8% respectively. There were no statistically significant differences in sperm parameters and enzyme activity between GSTM1 null and positive genotypes in two groups. There were no statistically significant differences in glutathione S-transferase activity between oligoastenoteratospermia and normospermic groups (p>0.05). All the 121 men in this study had Ile/Ile genotypes at 105 codon of GSTP1. Frequency of normal homozygote (114Ala/Ala), heterozygote (114Ala/Val) and mutant homozygote (114Val/Val) genotypes in oligoastenoteratospermic group were 81.1%, 17.9% and 1.1% respectively but in the control group they were 88.5%, 11.5% and null.

Conclusions: Total glutathione S-transferase activity and sperm parameters were not affected by deficient Glutathione S-transferase activity in GSTM1 null genotype. Compensate activity of other sperm surface glutathione S-transferase isozymes, like GSTP1, may justify the cause.


Detection of Chlamydia trachomatis and Mycoplasma genitalium in semen samples of infertile men using multiplex PCR
Sadrpour P, Bahador A, Asgari S, Bagheri R, Chamani-Tabriz L,
Volume 70, Issue 10 (1-2013)
Abstract

Background: Chlamydia trachomatis is the most common bacterial sexually transmitted infection in the world, but the effect of this infection on male fertility is still controversial. Despite reports of interaction between Mycoplasma genitalium and sperm, this pathogen in semen samples of infertile men is less studied. We studied, the prevalence of Chlamydia trachomatis and Mycoplasma genitalium infection in infertile men.
Methods: Among attending Avicenna Infertility Center, 120 men who had abnormal semen analysis tests were selected and the samples were taken. After detailed analysis of semen quality, DNA was extracted from each sample by chelex. Samples were evaluated for these two pathogens by multiplex PCR. Results were statistically analyzed.
Results: Chlamydia trachomatis and Mycoplasma genitalium was detected in 23/3% and 12/5% of the samples, respectively. Although, Mycoplasma genitalium infection rises by increasing (P=0.640) and decreasing in age of first sexually activity (P=0.203), and also positive cases of Chlamydia trachomatis infection showed increase regarding age increase (P=0.619) and age decrease in first sexually activity (P=0.511), but these differences were not statistically significant.
Conclusion: All in all, regarding to the increased prevalence of Chlamydia trachomatis infection compared with the only similar study in Iran and high prevalence of Mycoplasma genitalium infection in infertile men, this assessment was done. A multiplex PCR protocol rapidly and simultaneously identify these organisms in comparison with uniplex from clinical samples. Based on our results screening for Chlamydia trachomatis and Mycoplasma genitalium infection among infertile men seems to be valuable.


Predictive value of semen parameters and age of the couple in pregnancy outcome after Intrauterine insemination
Marjan Sabbaghian, Tahereh Modarresi, Hani Hosseinifar, Ali Daliri Hampa, Leila Karimian, Firoozeh Ghaffari, Jalil Hosseini, Mohammad Ali Sadighi Gilani,
Volume 71, Issue 8 (11-2013)
Abstract
Background: Intrauterine insemination (IUI) is one the most common methods in infertility treatment, but its efficiency in infertile couples with male factor is controversial. This study is a retrospective study about correlation between semen parameters and male and female age with successful rate of IUI in patients attending to Royan Institute.
Methods: A total of 998 consecutive couples in a period of 6 months undergoing IUI were included. They were classified into two groups: couples with successful and unsuccessful pregnancy. Main outcome was clinical pregnancy. Data about male and female ages and semen analysis including concentration, total sperm motility, class A motility, class B motility, class A+B motility and normal morphology was extracted from patients’ records. Semen samples were collected by masturbation or coitus after 2 to 7 days of abstinence. Their female partners were reported to have no chronic medi-cal conditions and have normal menstrual cycles.
Results: One hundred and fifty seven of total 998 cycles (15.7%) achieved pregnancy. The average of female age in successful and unsuccessful group was 28.95±4.19 and 30.00±4.56 years, respectively. Mean of male age was 33.97±4.85 years in successful group and 34.44±4.62 years in unsuccessful group. In successful and unsuccessful groups, average of sperm concentration was 53.62±38.45 and 46.26±26.59 (million sperm/ml), normal morphology of sperm was 8.98±4.31 (%) and 8.68±4.81 (%), sperm total motility was 47.24±18.92 (%) and 43.70±20.22 (%) and total motile sperm count was 80.10±63.61 million and 78.57±68.22 million, respectively.
Conclusion: There was no significant difference in mean of females’ age and males’ age between successful and unsuccessful groups (P<0.05). In addition, there was no significant difference in semen parameters including concentration, total sperm motility, class A motility, class B motility, class A+B motility and normal morphology between two groups. It was shown that common semen analysis and male and female ages cannot predict IUI outcome.

Expression analysis of Tsga10 during in vitro differentiation of germ cells from mouse embryonic stem cell
Mohammad Miryounesi , Zeinab Jamali , Masoumeh Razipour , Elahe Alavinejad , Mohammad Hossein Modarressi ,
Volume 72, Issue 11 (2-2015)
Abstract
Background: About 15% of couples have fertility problems and male factor in fertility accounts for half of the cases. In vitro generation of germ cells introduces a novel approach to male infertility and provides an effective system in gene tracking studies, however many aspects of this process have remained unclear. We aimed to promote mouse embryonic stem cells (mESCs) differentiation into germ cells and evaluate its effectiveness with tracking the expression of the Testis specific 10 (Tsga10) during this process. Methods: This is an in vitro study that was performed in department of Medical Genetics in Tehran University of Medical Sciences from February 2012 to March 2013. Mouse embryonic stem cells were cultured on mouse embryonic fibroblast as feeder layer. Then mESCs were differentiated into germ cells in the presence of Retinoic Acid. Based on developmental schedule of the postnatal testis, samples were taken on the 7th, 12th and 25th days of the culture and were subjected to expression analysis of a panel of germ cell specific genes (Stra8 as pre-meiotic, Dazl and Sycp3‌ as meiotic and Protamin1 and Spata19 as Post-meiotic). Expression of Testis Specific Gene 10 (Tsga10) at RNA and protein levels was then analyzed. Results: It was shown that transition of embryonic stem cells from mitosis to meiosis occurred between 7th and 12th days of mESC culture and post-meiotic gene expression did not occur until 25th day of the culture. Results showed low level of Tsga10 expression in undifferentiated stem cells. During transition from meiotic to post-meiotic phase, Tsga10 expression increased in 6.6 folds. This finding is in concordance with in vivo changes during transition from pre-pubertal to pubertal stage. Localization of processed and unprocessed form of the related protein was similar to those in vivo as well. Conclusion: Expression pattern of Tsga10, as a gene with critical function in spermatogenesis, is similar during in vitro and in vivo germ cell generation. The results suggest that in vitro derived germ cells could be a trusted model to study genes behavior during spermatogenesis.
Clinical results of microinjection with long protocol and prednisolone addition
Fariba Nanbakhsh , Behrooz Ilkhanizadeh , Nava Moghadasian Niaki , Sima Oshnouei, Pooya Mazloomi ,
Volume 73, Issue 1 (4-2015)
Abstract
Background: Last decades, we have observed major improvements in treating infertility by using microinjection. However, reduction in abortion or increase in fertility has not been significant. It seems use of corticosteroids improves clinical outcomes during assisted reproductive technology (ART) techniques. Therefore, this study tried to show how corticosteroids therapy improves the results of intracytoplasmic sperm injection (ICSI). Methods: This semi clinical trial study without control group was included infertile women with more than one year’s infertility and were candidate to ICSI which were referred to Kosar Infertility Center, Urmia University of Medical Sciences from April 2011 to September 2013. Patients received prednisolone which was started 20 mg/day from one day before embryo transfer to 7 days, then for 2 days more 1 tablet and stopped. Pregnancy outcomes were chemical and clinical pregnancy, ectopic pregnancy, multiple pregnancy and rate of abortion before 20 weeks. Beta human chorionic gonadotropin (HCG) test was performed. Patients with positive pregnancy test were followed by sonography in 6, 12 weeks and 20 weeks of pregnancy. Results: One hundred and eighty one patients entered to the study. The mean± SD of age and fertility duration were 30.42± 6.07 and 7.69± 5.54 years. The mean± SD of transferred embryo was 4.60± 1.10 and embryo grading was 138 (44.7%) grade A, 124 (40.1%) grade B, 47 (15.2%) grade C, respectively. There were no significant difference between fresh/frozen embryo transfer in pregnancy outcomes (P> 0.05 in all of outcomes comparison). The incidence rate of biochemical pregnancy was 48.1% (87), clinical pregnancy rate with appearance of fetal heart was 44.2% (80), incidence rate of abortion before appearance of fetal heart (6 weeks) in women with intra-uterine pregnancy was 5.9% (5), incidence rate of abortion before 20 weeks was 12.9% (11). Incidence rate of ectopic pregnancy was 2.3% (2) and rate of multiple pregnancies was 32.5% (26). Conclusion: Our study suggests that the infertile patients who receive prednisolone in ICSI cycle, had improved pregnancy outcomes. Additional confirmatory studies are needed.
Relationship between Helicobacter pylori infection and spontaneous abortion
Sariyeh Golmahammadlou, Masomeh Hagishafiha , Tayebeh Karjooyan , Sima Oshnouei , Sarvin Pashapoor ,
Volume 73, Issue 4 (7-2015)
Abstract
Background: Helicobacter pylori (HP) infection may be having no clinical symptoms and if not treated will be persisting. This infection was considered as gastric diseases even during pregnancy. During the last decade its relationship with pregnancy related- disorders has been strongly reported in literature. In this study we evaluated the effect of positive IgG and CagA strains helicobacter pylori on incidence of early spontaneous abortions. Methods: A cross-sectional study was carried out on 100 women were referred to health centers and Motahari Hospital, Urmia, Iran, from October 2012 to March 2013. Fifty women with first miscarriage as cases and 50 women with previous normal delivery as controls were studied. A 2-cc blood sample was taken from each patient to evaluate the specific IgG titer by ELISA method. All results of samples with positive H. pylori IgG, were assayed for anti-CagA, IgG antibodies. A questionnaire was filled for each subject. The associations between CagA positive cases with odds of spontaneous abortion incidence were analyzed by using SPSS software, ver. 19 (Chicago, IL, USA). Results: Mean (±SD) of age were 21.0±5.78 and 30.78±5.10 years for cases and controls group respectively. There was no significant difference in mean of age (P=0.25), and parity (P=1) between two groups. H. pylori IgG antibodies were positive among 23 and 24 (46% vs. 48%) in women with aborted and normal pregnancy respectively. Relationship between IgG status and miscarriage was not significant (OR=0.92, CI95%: 0.39-2.17, P=0.84). In particular anti-CagA antibodies were positive among 18 and 13(78.3% vs. 54.2%) in women with aborted and normal pregnancy respectively. Among women with CagA positive strains had higher odds of miscarriage (OR=3.05, CI95%: 0.73-13.76, P=0.08), but it wasn’t significant. Conclusion: According to the result of this study there was not any association between HP infection and miscarriage. We recommend more studies with larger sample size for determining the effect of CagA positive strains on miscarriage.
The effect of varicocelectomy on serum testosterone level in infertile men with varicocele: an interventional study
Meysam Jangkhah, Faramarz Farrahi , Abdolhossein Shiravi, Mohammad Ali Sadighi Gilani , Seyed Jalil Hosseini , Farid Dadkhah, Reza Salman Yazdi, Mohammad Chehrazi,
Volume 73, Issue 6 (9-2015)
Abstract
Background: Varicocele is recognized as the most common cause of male factor infertility and is found in 15% of the general population. This prevalence increases to 35% in men presenting with primary infertility and between 70 to 80% in men presenting with secondary infertility. The effect of varicocele on Leydig cell function and testosterone production has been always a question. In this study we examined the effect of varicocelectomy on serum testosterone. Methods: This research protocol was approved by the institutional review board at Royan Institute in infertility department and also this study has been done in Royan Institute (Tehran, Iran) during one year since September 2012 till October 2013. In this cross-sectional study, Serum levels of total testosterone in 79 men with clinical varicocele and in 70 fertile men who served as a control group were compared. Men aged 23–46 years with clinically palpable varicoceles as determined by physical examination were studied. Three to 6 months, testosterone levels were measured again after varicocelectomy, then testosterone levels were compared before and after varicocelectomy. Results: The mean of serum testosterone levels before surgery in infertile men with varicocele and fertile men were 590(230) vs. 583(237) ng/dl respectively. No statistically significant changes were noted in serum testosterone levels for any groups. Three month after varicocelectomy mean serum testosterone levels were significantly increased in infertile men with varicocele compared with preoperative levels from 590 (230) to 663 (242) ng/dl (P=0.009). Also the testis volume of patients were examined, which were divided into two groups included the men with testis volume less than 16 ml (<16) and more than 16 ml (≥16). Conclusion: In infertile men affected with clinical varicocele, varicocelectomy seems to have caused positive impact on the level of serum testosterone increase. It is thought that positive effect is probably caused by improvement of the Leydig cell functions which induce the increase of serum testosterone level.
The effect of recombinant follicle-stimulating hormone on semen parameters after varicocelectomy in infertile men
Atoosa Bagheri Behzad, Barzin Bagheri Behzad , Hassan Niroomand , Mahbod Ebrahimi , Gholamreza Poormand , Firoozeh Akbari Asbagh,
Volume 73, Issue 9 (12-2015)
Abstract

Background: Infertility is defined as failure to achieve pregnancy after one year of unprotected sexual intercourse. Infertility can be related to male or female factors. Varicocele is the most common cause of infertility in men that is correctable with surgery. The purpose of this study was to determine the effects of recombinant follicle-stimulating hormone (rFSH) on semen parameters in infertile men.

Methods: This randomized clinical trial was done on 96 infertile men admitted to the Women's General Hospital Mohebe-Yas from September 2014 to September 2015. Inclusion criteria were to include varicocelectomy for unilateral idiopathic varicoceles and consent to participate in the study. Allergy to the drug combination and patient dissatisfaction were exclusion criteria. Patients participating in the study were divided into two groups randomly, one group received recombinant FSH three times a week and the other group received a placebo (normal saline) in the same way. After three months, the improvement of semen parameters, including motility, morphology and sperm count as well as the complications were determined in both groups. The data were analyzed with statistical software SPSS version 13 (Chicago, IL, USA).

Results: A total of 96 patients were enrolled in two groups of 48 men and women both groups were matched in terms of underlying factors. The rate of improvement in the morphology and motility of sperm in the treated group was significantly more than the placebo group (P= 0.0001) but the changes in sperm count were not significantly different between the groups (P= 0.495).

Conclusion: In summary, based on the results obtained in this study, it can be concluded that recombinant FSH is effective on improving semen parameters in infertile men after varicocelectomy compared with a placebo group and its major impact is on the morphology and motility of sperm.


The prognostic value of serum CA-125 level in prediction of outcomes of ICSI among infertile couples with male-factor infertility
Nahideh Pazhohan , Azar Pazhohan , Nasrin Niromand , Mahbod Ebrahimi ,
Volume 73, Issue 10 (1-2016)
Abstract

Background: Receptivity of endometrium has a critical role in the establishment of pregnancy after embryo transfer in the treatment process of infertile couples. As the glycoprotein CA-125 is a product of human endometrium and is measurable in the peripheral circulation, it is investigated whether it might serve as an indicator of endometrial receptivity and predictor of pregnancy following Intracytoplasmic sperm injection (ICSI).

Methods: In an observational diagnostic study, over a twelve-month period (from August 2013 to July 2014), all couples with male-factor infertility who attended to infertility clinic of Moheb Yas Hospital, Tehran and were candidate of performing ICSI, were invited to participate in the study. Based on the inclusion criteria of study, 64 women were eligible to take part in the study. They were assessed for serum CA-125 levels on the day of human chorionic gonadotropin (HCG) administration and also on the day of oocyte retrieval. After ICSI, the possibility of pregnancy was assessed by measuring serum concentration of &beta-HCG on 14 days after embryo transfer and also by visualizing the gestational sac by trans-vaginal ultrasound examination on four to five weeks after transfer. The pregnancy rate was compared between those with normal and high CA-125 levels.

Results: Among the subjects, 15 patients (23.4%) had high CA-125 levels, and totally 19 patients (29.7%) experienced pregnancy. Among those with normal and high CA-125 levels, 16 patients (32.7%) and 3 subjects (20%) experienced pregnancy, respectively, that showed no statistically significant difference according to Chi-square test (P=0.348). Also, according to the Fisher’s exact test, there was no correlation between CA-125 levels and the rate of pregnancy on the basis of body mass index (BMI).

Conclusion: Totally, according to the obtained results in current study, it may be concluded that serum CA-125 levels has no prognostic value in prediction of the outcomes of ICSI among infertile couples with male-factor infertility.


Association study of rs2228570 SNP of the VDR gene with spermatogenesis disorders in infertile men in Iranian population
Mehdi Mohebi, Fateme Karami , Mohammad Hossein Modarressi, Seyed Mohammad Akrami ,
Volume 74, Issue 2 (5-2016)
Abstract

Background: Lots of vitamin D functions are mediated by its steroid family receptor (VDR). Vitamin D role in infertility is reported by significant fertility reduction in many male laboratory animals with vitamin D deficiency. The reason for reduced fertility in male VDR-null mouse model has been reported to be reduced sperm count and sperm motility. Vitamin D has effects on sperm motility, sperm-ovum coupling, and acrosome reaction stimulation. As VDR is expressed in human male reproductive system, the aim of the current study was to investigate the role of rs2228570 polymorphism of VDR gene in male infertility.

Methods: Investigation was done as a case-control study on infertile azoospermic or oligospermic men referring to Avicenna Research Institute from March 2014 to April 2015. Rs2228570 single nucleotide polymorphism (SNP) located in exon 1 of VDR gene was chosen according to its role on protein function. Blood sampling was done on cases and control groups and after DNA extraction the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) reaction was designed and performed on 100 normal cases, 100 azoospermic and 100 oigospermic control samples. Distribution of quantitative age variable was done using Student’s t-test and qualitative variables (genotype and allelic frequencies) was done using SPSS, ver. 22 (Chicago, IL, USA).

Results: Chi-square test didn’t show significant difference between two case groups and controls (Azoosperm and control P=0.5 and oligosperm and control P=0.09). Comparing CC genotype frequency with TT and CT genotypes (azoosperm and control P=0.48 OR=0.77, oligosperm and control, P=0.17 OR=0.77) and in comparing between TT genotype with CT and CC genotypes (azoosperm and control P=0.49 OR=3.03, oligosperm and control P=0.19 OR=7.21) the difference between these groups was not significant and didn’t increase the probability of disease and didn’t show protective role against it.

Conclusion: According to the findings, the association between rs2228570 polymorphism of vitamin D receptor gene and infertility was not significant and investigation of other polymorphisms might show a relationship with male infertility.


Effect of the time in administration of clomiphene on follicular growth, endometrium and pregnancy rates in PCOS patients
Mahtab Zeinalzadeh , Yousefreza Yousefnia Pasha , Zinatossadat Bouzari , Mohadese Mahdavi , Mojgan Naeimi Rad,
Volume 74, Issue 12 (3-2017)
Abstract

Background: Clomiphene citrate is very successful in inducing ovulation; there is usually a discrepancy between ovulation and pregnancy rate. If treatment is started early in the cycle this negative effect is reduced. The aim of this study was to investigate the effect of the time of administration of clomiphene citrate on follicular growth, endometrial thickness and ovulation and pregnancy rates in PCOS (Polycystic ovary syndrome) patients.

Methods: This randomized controlled trial study was performed on 115 PCOS (Polycystic ovary syndrome) women in Fateme Zahra Fertility and Infertility Research Health Center in April 2012. Patients randomly divided into two groups. Patients in the early group (No. 55) received 100 milligrams of clomiphene citrate tablet daily starting the next day after finishing medroxyprogesterone acetate tablet for 5 day, whereas the patient in the late group (No. 60) received 100 milligrams of clomiphene citrate tablet daily for 5 day starting on day 3 of the menstrual cycle. Then on follicular growth, endometrial thickness and ovulation and pregnancy rates by SPSS software, version 16 (Armonk, NY, USA) were compared in two groups.

Results: 36.4% of patients of early administration of clomiphene and 60% of patients in the later administration of Clomiphene were able to build dominant follicle. This difference was statistically significant (P<0.011). There was no statistically significant difference between the two groups on age, body mass index, duration of infertility. Findings showed that in the early group 14 (63.6%) and in the late groups 8 (36.4%) women who made dominant follicle, were pregnant. There was significant difference between these two groups (P<0.001). But, in the number of follicles, endometrial thickness and pregnancy rate, there were no significant difference. In the early administration of clomiphene, the pregnancy rate was 25.5%. However in the later administration of clomiphene it was 13.3% (P=0.882).

Conclusion: According to the results of this study, if the dominant follicle was made, with administration of clomiphene citrate in luteal phase the incidence of successful pregnancy is higher.

Hormonal profiling and clusterin gene expression in non-obstructive azoospermic patients
Azar Mardi Mamaghani, Seyed Jalil Hosseini, Elham Moslemi,
Volume 75, Issue 11 (2-2018)
Abstract
Background: Infertility is clinically defined as failure of a couple to conceive after one year of regular sexual intercourse and occurs in both males and females for various reasons. About half of the infertility causes is due to male factors such as azoospermia and the lack of sperm in the ejaculate. Azoosperima is divided into two types: Non-obstructive azoospermia (NOA) and obstructive azoospermia (OA). NOA is a type of male infertility caused by spermatogenesis defects. Therefore, investigating the factors involved in spermatogenesis, including hormones and genes, is one of the important aspects in understanding the mechanism of infertility in men. To this end, we aimed to investigate the expression of the clusterin gene expression and LH, FSH and testosterone hormone levels in the testicular tissue and blood of NOA patients, respectively.
Methods: The study population included 42 NOA infertile men referred to Royan Institute, Tehran, Iran in June 2016 to February 2017. Their blood samples were collected and testosterone, LH and FSH hormones were measured by ELISA. Afterwards, based on the biopsy results the patients were categorized into TESE+ (positive sperm retrieval) and TESE- groups. The genomic RNA was extracted from testicular tissue samples obtained from TESE surgery. After converting to cDNA, the clusterin gene expression was investigated by Real-time PCR technique. The achieved data was analyzed using SPSS software, version 18 (Armonk, NY, USA).
Results: According to Real-time PCR results, the expression level of clusterin gene in TESE+ group was significantly higher than TESE- group (P= 0.035). The mean of FSH and LH hormone levels in the TESE+ group was relatively lower than the TESE- group (P= 0.07 and P= 0.08), but there was no significant difference in the mean of testosterone hormone levels between the two groups (P= 0.66).
Conclusion: Based on the results of this study, the clusterin gene can have a role in spermatogenesis and by evaluating FSH and LH hormones in a larger non-obstructive azoospermic patient’s population significant statistical results can be achieved.

Metabolomics: a bird’s eye view of infertile men: review article
Niloofar Agharezaee , Rezvan Marzbani , Hassan Rezadoost , Saeideh Zamani Koukhaloo, Babak Arjmand , Kambiz Gilany ,
Volume 75, Issue 12 (3-2018)
Abstract
Infertility influences an estimated 20% of couples worldwide. The factors that can affect the fertility potential are equally distributed between men and women. Despite extensive research in male infertility, the etiology in majority of infertile men is unknown. In 2010, there was an opinion published in Nature asking a selection of leading researchers and policy-makers about what their future focuses will be in 2020. Metabolomics was mentioned as the leading omics technology by them. The word metabolomics has been defined almost 20 years ago. However, the clinical metabolomics history goes back to more than 1,000 years ago. The great Persian physician and philosopher Avicenna observed an individual urine changes during illness. Today, the color or smell changes are known to be caused by metabolites deregulation indicating metabolic diseases. Metabolomics approach is a systematic analysis of the unique pattern followed by a specific biochemical pathway that uses a biological material, e.g. spermatozoa or human seminal plasma. For the diagnosis of infertile men, the typical parameters of semen analysis are: sperm motility, sperm morphology, concentration and count. Human seminal plasma is a valuable biological source which was not used in the diagnosis of infertile men, unfortunately. To the best of our knowledge, there is no parameter for analysis of the human seminal plasma. Thus, the need for a novel parameter to diagnose infertile men is urgently needed. We recommend the use of seminal plasma in order to diagnose infertile men according to our previous research. Only a handful studies have used metabolomics approaches in the male infertility. In this study, we summarize the current research and our contribution to the field of male infertility and metabolomics. One of our main contributions has been to use metabolic profiling of seminal plasma from non-obstructive azoospermia to find 36 potentials biomarkers for detection of spermatogenesis. A search in the PubMed using keywords “metabolomics” and “infertility” shows only 59 publications. This demonstrates how newborn the metabolomics in its application for male infertility is. In this review article we have tried to have a comprehensive and specific approach to male infertility from a metabolomics perspective and related techniques.

Evaluation of gene expression of three adrenergic receptors in infertile women with poor ovarian response, candidate for IVF
Farideh Zafari Zangeneh , Mohammad Mehdi Naghizadeh , Maryam Bagheri , Masoumeh Dehghan ,
Volume 78, Issue 3 (6-2020)
Abstract
Background: Most studies show that 9 to 24% of people who are in in vitro fertilization (IVF) cycles are women who respond poorly to ovarian stimulation. Women with poor ovarian response (POR) are a group of infertile patients whose ovarian reserve, ovarian response to medication, and the quality of ovum are declining. Therefore, the number of female cycles, the number of fetuses from the oocyte and the rate of pregnancy in these women is reduced. The purpose of this study was to investigate the expression of three adrenoceptor receptor genes in the cumulus cells of women with poor ovarian response in culture medium.
Methods: This case-control study was conducted in two groups: study (POR) and control (oocyte donor's women) groups. POR diagnosis was performed by ESHRE Bologna criteria. After puncture of the follicles, cumulus-oocyte complex was collected and the cumulus cells (CCs) were isolated by enzyme and are counted with Neobar lamella and then were added in the culture medium. After completing the culture, RNA was extracted from cumulus cells and the RNA concentration was read by the Spectrophotometer (NanoDrop Technologies, Wilmington, DE, USA). Then cDNA synthesized and primers designed for ADR-α1, 2 and ADR-B2 or gene expression by real-time polymerase chain reaction (PCR) technique. The research was done in Reproductive Health Research Center of Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran, from April to December 2017.
Results: Comparison of the results of ADR-α1, 2 gene expressions in cumulus cells showed a significant decrease, but ADR-B2 was not significant in two groups. Correlation coefficients also showed that there are relationship between three adrenoceptors and their effects on each other.
Conclusion: Our results showed that the decreased expressions of ADR-α1, 2 probably related to activation of the sympathetic system and release of the more neurotransmitter that lead to down-regulation of ADR-α1, 2 in the cell membrane of cumulus in culture medium.

The role of MMP9 C-1562T and MMP2 G1575A genetic variants in male infertility: review article
Rezvan Asgari, Mitra Bakhtiari,
Volume 78, Issue 6 (9-2020)
Abstract
Infertility as a vital process in human reproduction involves many couples worldwide. Although many genetic causes of infertility are known, the genetic basis of infertility in men is largely unknown. Therefore, the identification of genetic biomarkers in this field is important and genetic polymorphisms in key genes of the spermatogenesis pathway can be valuable biomarkers in this field. Gene's polymorphisms with specific genetic background and/or environmental factors can lead to the dysfunction in testicular function or the process of sperm production. Matrix metalloproteinases (MMPs) are a family of zinc-dependent enzymes that play an important role in extracellular matrix remodeling by activating gelatinases, collagenases, and proteolytic enzymes. These enzymes are essential for the regulation of cellular connections in the testis. Extracellular matrix degradation and connective tissue remodeling are important structural changes in germ cell migration that are controlled through important genes, including MMPs and their biological inhibitors. Given the important role of MMPs in the structural and functional characteristics of reproductive organs, genetic polymorphisms in MMP genes are significant because they can influence gene transcription and the biological function of proteins. Studies have shown that matrix metalloproteinases are involved in the degradation of extracellular matrix and play an important role in the process of spermatogenesis and sperm quality. This review article aims to evaluate the role of two common, functional MMP2 G1575A and MMP9 C-1562T polymorphisms in male infertility. The findings indicate that polymorphisms of MMP2 G1575A and MMP9 C-1562T can affect gene transcription, protein level, and enzymatic activity, and also, these variants can be as one of the genetic causes in male infertility among different ethnic populations. Therefore, identifying these molecular changes can help to adopt appropriates therapeutic and diagnostic measures as well as guide therapeutic approaches to intelligent therapies. To achieve a definitive conclusion and confirm the association of these polymorphisms with male infertility, evaluations of gene-gene and gene-environment interactions can be important for larger sample sizes of different ethnicities.
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