Journal of Reproduction & Infertility
Volume:8 Issue: 2, 2007

Gonadotropin hormones control spermatogenesis and any alteration in their level can influence the process and subsequently the number of germ cells. Gonadotropin-releasing hormone (GnRH) agonists suppress the pituitary-gonadal axis. The objective of this study was to investigate the ultrastructural and histological alterations in spermatogenic and spermiogenic cells following administration of a single dose of leuprolide acetate, an analogue of gonadotropin-releasing hormones. This study was done on 24 adult male 8-old week mice were used. The animals were divided in to 3 groups. The control group received no drugs but to the animals in the second and third groups 0.2ml of carboxymethyl cellulose and 7.6mg/kg of leuprolide acetate were administered respectively. All the animals were dissected five weeks after the administrations and their testes were processed for the study of germ cells and morphometric studies of seminiferous tubule parameters using transmission electron (TEM) and light microscopes (LM). The results from the five groups were compared morphologically and the data were statistically analyzed by ANOVA tests. The ultrastructural study revealed that most alterations were in spermiogenic cells. The nuclei and acrosomes had been deformed in most spermatids. In some developing spermatids, there were acrosomal vesicles inside the nucleus and ectoplasmic specialization had been partially deleted in some areas. The flagella were deformed in elongated spermatids and their fibrous sheaths were discontinuous. In light microscopy, the maturity of spermatogenetic cells, based on Johnson’s testicular biopsy score, in the control, sham and experimental groups were 8.1±0.53, 8.04±0.82 and 7.01±0.57 respectively and maturation had been significantly reduced in the third group (p<0.01). In addition, all histometric parameters in seminiferous tubules had been decreased compared to the sham and control groups (p< 0.01). Administration of a single dose of leuprolide acetate during a spermatogenetic cycle in mice is associated with adverse effects on spermatogenesis and it is mostly associated with alterations in spermiogenesis or transformation of round spermatids into elongated spermatids.

Finasteride, a synthetic 4-azasteroid compound, is a competitive and specific inhibi-tor of type II 5--reductase, an intracellular enzyme that converts testosterone into dihydrotestos-terone (DHT). Finasteride is prescribed for nearly all disturbances related to DHT concentration such as benign prostatic hyperplasia, male-pattern androgenetic alopecia, hirsutism, acne and seborrhea. Since finasteride is frequently prescribed in men, the effects of different doses of finas-teride on the number of spermatogonia, Sertoli and Leydig cells have been investigated in the present study. Forty mature male Sprague-Dawley rats were divided into five groups of eight. The first group was kept as the control group and received nothing. The second or the sham group, only received distilled water orally, but the last three experimental groups respectively received 25, 50 and 100mg/kg of BW/d doses of finasteride orally for a 32-day period. Then photo-micrographs of testis tissues were studied and the results of the five groups were statistically analyzed by ANOVA, t, Tukey and Duncan tests. P<0.05 was considered significant. Administration of 50 and 100mg/kg per BW doses of finasteride significantly decreased the number of spermatogonia and 50mg/kg doses reduced the number of primary spermatocytes (p0.05). The number of Sertoli cells had no significant difference in the experimental groups in comparison with the control group but there was a significant increase in the number of Leydig cells in all of the experimental groups (p0.05). This drug did not have any significant effects on the density of different kinds of cells, and nuclear or cytoplasmic staining properties of spermato-gonia. Finasteride causes a significant decrease in the number of spermatogonia and primary spermatocytes. It also causes a significant increase in the number of Leydig cells but it does not have any significant histological effects on the testis or any effects on spermatogenesis. Therefore, it seems that short-term uses of the medication may not have harmful effects on male fertility.

Prolactin exists in three different molecular forms, i.e., monomeric, big and big big (macroprolactin) in human serum. Macroprolactin is a complex of prolactin and IgG and may account for a significant proportion of idiopathic hyperprolactinemia. Its biological activity is considered low or absent, but it is measured alongside free prolactin in common immunoassay methods, thus can wrongly lead to high prolactin detection, expensive explorations and ineffec-tive treatments. Conventionally, the diagnosis of macroprolactinemia has been done by gel filtra-tion chromatography, which could not be used routinely. Recently polyethylene glycol (PEG) has been employed to precipitate macroprolactin, allowing its detection rapidly, trustworthily and inexpensively. The objectives of the present study have been to evaluate the prevalence of macroprolactinemia in infertile women with hyperprolactinemia through identification with PEG and to compare the clinical (Galactorrhea and oligomenorrhea) and radiological findings (Sella turcica MRI). 17 infertile women with hyperprolactinemia were investigated for macro-prolactin by using PEG. Prolactin was measured before and after precipitation of macroprolactin by PEG. A prolactin recovery >60% after precipitation was an indicator of macroprolactinemia. The results were analyzed by SPSS software and p<0.05 was considered significant. Macroprolactinemia was diagnosed in six (35%) women. In true hyperprolactinemic women (11women), galactorrhea occurred in 81.8% and oligomenorrhea in 90.9% of them, but in macroprolactinemic women galactorrhea occurred in 33.3% and oligomenorrhea in 16.6%. In addition, normal pituitary images were found in 45.5% of the patients who had true hyperpro-lactinemia; however, 100% of the women with macroprolactinemia had normal pituitary images. Macroprolactinemia evaluation by PEG in infertile women with hyperprolactinemia is recommended before extensive diagnostic and therapeutic procedures.

Metabolisms of vitamin D, calcium and parathormone change during normal preg-nancies. Evaluating these changes and factors affecting them, especially consumption of vitamin D containing foods by mothers and its bioavailability to the fetus, are essential. The primary aim of this study was to determine the relationship between bone turnover and maternal nutritional status of vitamin D during normal pregnancies.

This cross-sectional study was done on 449 healthy pregnant women and their newborns who had attended educational hospitals of Tehran University of Medical Sciences in 2003. Average intakes of vitamin D and calcium were studied by a food frequency question-naire and measurements of serum calcium, vitamin D, PTH, cross-laps and osteocalcin of the mothers and their infants through cord vein. Statistical analysis was done by SPSS software, version 11.5 and p<0.05 was considered significant.

Serum concentrations of vitamin D in cord blood samples from newborns, whose mothers had adequate vitamin D intake (200IU/Day of vitamin D for pregnant women), were higher. There was a positive correlation between maternal serum calcium and calcium in the cord blood of the newborns (r=0.35). There were significant differences in concentration between PTH, osteocalcin and cross-laps of the mothers and their newborns (p<0.001). The serum concentrations of vitamin D and calcium in the cases and their infants had a correlation with adequate intake of the two (p<0.05). There was a reverse association between bone turnover markers and calcium with vitamin D intake in mothers.

The nutritional status of vitamin D in human fetus and neonates is completely dependent on vitamin D stores of their mothers and adequate intakes of these elements can influ-ence bone metabolism in mothers and newborns. Therefore, programs aimed at improving vitamin D and calcium intake through educational materials and classes, which focus on the consumption of rich sources of vitamin D, should be considered. Fortification and supplementation of these elements to those at risk has to be nationally regarded.

Premature ovarian failure (POF) or premature menopause is one of the stressful problems in women younger than 40, which may cause numerous early or late psychological and physical complications. Failure of germ cell development is associated with complete ovarian failure, while their decreased number is more likely associated with partial ovarian failure, which leads to secondary amenorrhea. Literature review shows almost no study has been done on chromosomal factors involved in POF in Iran. The purpose of this study was to study chromo-somal abnormalities in women with premature ovarian failure referred to the Fertility Health Research Center at Taleghani Hospital. Thirty-four patients experiencing menopause before the age of 40 and resultant infertility, attended the gynecology and obstetrics ward of Taleghani Hospital of Shahid Beheshti University of Medical Sciences, from the spring of 2005 to the summer of 2006, and underwent physical exam, sonography and hormonal tests (FSH, LH and PRL). The FSH level of the cases was ≥40 IU/lit. Then, the patients were referred to a genetic counselor for undergoing cytogenetic tests and counseling. Most of the cases (81.8%) were younger than 40 years of age and 18.2% were 40 or older. Definite abnormal X chromosomes − mosaic karyotypes 45, X/46, XX or 47, XXY (Klinefelter’s syndrome) and mosaic 46, XX or 47, XXX − were diagnosed in 17.6% of the patients (6 cases) with a mean age of 32.1±7.6. Although, there were no significant correlations between POF and chromosomal abnormalities, the results from the chromosomal analysis in this study and in a limited number of cases who had been affected by early menopause due to premature ovarian failure, it is suggested that chromosomal studies be considered as one of the first steps to understand the reasons for amenorrhea. The information obtained from cytogenic tests such as chromosomal analysis could be useful for patient management, genetic counseling, and future family planning.

Finding the most suitable method for cervical ripening in patients with all the indications for terminating their pregnancy, is a considerable problem in obstetrics. The objective of this study was to compare intravaginal misoprostol, traction on the cervix with a Foley catheter and a combination of the two methods for the induction of labor. This randomized clinical trial was performed at Shahid Akbar-Abadi teaching Hospital from March 2004 to February 2005, on 300 pregnant women with a gestational age of 28 weeks, who had the indications for terminating their pregnancy. All of the cases had a Bishop score of 5 and were singletons. In 100 patients (Group 1), misoprostol (25g every 3 hours up to a maximum dose of 6) was used intravaginally. In the next 100 patients (Group 2), a No. 16 Foley’s catheter was introduced into the intracervical canal, its bulb being filled with 30 ml of distilled water, to exert traction on the cervix. In the last 100 patients (Group 3), a combination of the two methods was used. The time interval between the start of the methods to delivery, duration of the active phase of labor, the interval between the beginning of the methods to beginning of the active phase, cesarean section rates and neonatal Apgar scores were compared in the three groups. The obtained data were statistically analyzed by SPSS software employing χ2, one-way ANOVA and Kruskal Wallis tests. There were no statistically significant differences between the three groups according to age, gestational age, parity and Bishop scores. The interval between the beginning of the methods and delivery was shorter in the misoprostol group (p0.001)_10.53 hours in misoprostol group, 12.32.4 hours in the Foley catheter group and 11.72.5 hours in the combination group. The duration of active phase in the misoprostol group was less than the Foley catheter group (p0.001)_ 5.51.9 hours in the misoprostol group, 6.61.6 hours in the Foley catheter group and 6.11.5 hours in the combination group. There was no statistically significant difference between the three groups regarding the interval between the beginning of the methods and the beginning of the active phase, neonatal Apgar score or cesarean section rates. Misoprostol and Foley catheters are good methods for cervical ripening and the induction of labor, but the combination of the two methods does not increase their effectiveness and there seems to be no synergistic effects.

Induced abortion is a medical or surgical termination of pregnancy before the time of fetal viability with maternal or fetal indications. Regarding abundant complications of surgery, anesthesia, need for hospitalization, risk of uterine perforation and other early or late complications, the necessity to terminate pregnancy by medical methods is seriously felt. The aim of this study was to evaluate the efficacy of medical abortion with methotrexate and misoprostol (prosta-glandin E1) at the first trimester of pregnancy. This descriptive study was done on 100 women that had been referred at their first trimester of pregnancy to the hospitals of Mashad University of Medical Sciences during 2004 to terminate their pregnancies due to maternal or fetal indications. The data were gathered according to patient's answers to questions and observation of outcomes as the patients went through labor stages. At first, 50mg of methotrexate per unit of body surface area was injected intramuscularly and after 72 hours, the first dose of misoprostol (800µg) was admi-nistered intravaginally. The second dose of misoprostol was repeated 24 hours after the first dose if abortion did not occur. Sonography was performed 7 days after the last dose of misoprostol, to determine the size of probable residue of pregnancy. The gathered data were descriptively analyzed and frequency distributions were assessed by SPSS software. P0.05 was considered significant. Eighty-one women (81%) had successful complete abortions, among whom pregnancy was terminated in 60 cases (74.1%) following the first dose of misoprostol. 40 patients (25.9%) needed a second dose of misoprostol. 21 women had complete abortion, but 19 required curettage. In this study, failure rate was higher in cases with missed abortions (p<0.05). Duration of uterine content expulsion (p<0.001) were higher in this medically induced abortion. No important side-effects or complications were noted due to methotrexate or misoprostol administration. Medical abortion in the first trimester of pregnancy with methotrexate and miso-prostol is safe and cost-effective.

Women with perfect physical, emotional and mental health are bases of healthy families. The suppression of these divine needs will leave unfavorable effects on the cordiality and joys of couples. In assessing these needs, sex is not only a physiological need but also spiritual and gnostic as well. World Health Organization (WHO) contended that sexual health is the integrity and coordination of the mind, emotions and the body, and any disorder leading to dis-coordination and therefore dissatisfaction, can be associated with sexual dysfunction. Statistics have indicated that about 50% of couples may experience some forms of sexual disorders at some stages in their conjugal life but only a few are consulted and receive treatment. This research has been conducted to study sexual dysfunction and some related factors in women. This analytical-descriptive study was cross-sectionally conducted on 366 women referring to Sabzevar Health Care Centers in 2003. The sample population was selected through convenient non-probability methods. The data were collected by interviews consisting of demographic data, sexual patterns and an evaluation for sexual dysfunction. Data analysis was performed by SPSS software by using descriptive and non-parametric statistics such as Kruskal Wallis and Chi-squared with a confidences interval of 95%. The findings indicated that 63.2% had experienced problems in their sexual relationships. Statistically significant correlations were observed between a history of conjugal life and sexual disorders where fewer disorders were reported for those with longer conjugal life (p=0.05). Higher sexual disorders were observed in women who had reported their libido low or high in comparison with the subjects with moderate sexual desire. Similar results were shown in the subjects’ spouses (p=0.001). Women dissatisfied with their coital relations, 3.90%, suffered from sexual dysfunction (p=0.003). A small number of women suffering from sexual dysfunction, 5.83%, had done nothing to solve their problems. One of the essential topics of premarriage counseling is to educate young couples to get a right understanding of their personal characteristics and tendencies, to direct their attitudes and beliefs and to train them to achieve correct skills and concepts of how to respond to their own physical and emotional needs. In fact, discovering and solving sexual problems by couples and getting a clear understanding of their concerns and helping themselves to build up and improve conjugal relationships, will have significant effects on increasing sexual satisfaction and will con-siderably prevent family disputes and problems.

Parvovirus B19, Toxoplasma gondii and Chlamydia trachomatis are the most common microorganisms which cause different sequela during pregnancy such as congenital aplasia, hydrops fetalis, abortion and other congenital anomalies in fetus (Such as neuro-ophthalmic complications). The purpose of this study was to determine the prevalence of these agents in pregnant women attending the Obs & Gyn ward of Imam Khomeini Hospital in Ahwaz, Iran. In this cross-sectional study, IgG against the mentioned microorganisms was assessed by ELISA method in the sera of 79 pregnant women attending Imam Khomeini Hospital in Ahwaz during a period of one month. In addition, a questionnaire was filled for each case and clinical data were entered. Finally, χ2 was calculated and the data were analyzed by SPSS (Version 11.5). P<0.05 was considered significant. 44 specimens (55.7%) from the 79 serum samples had IgG against Parvovirus B19, 28 samples (35.4%) against Toxoplasma gondii and 8 samples (10%) against Chlamydia tracho-matis. The results demonstrated that >40% of the pregnant women did not have IgG against the mentioned agents, so they were vulnerable to infection by those microorganisms in ensuing pregnancies. Therefore, health education for pregnant women and screening for the mentioned microorganisms to prevent abortions and birth of newborns with congenital anoma-lies should be addressed more attentively.