International Journal of Reproductive BioMedicine
Volume:15 Issue: 2, Feb 2017

Conducting research on the stem cell lines might bring some worthy good to public. Human Stem Cells (hSCs) research has provided opportunities for scientific progresses and new therapies, but some complex ethical matters should be noticed to ensure that stem cell research is carried out in an ethically appropriate manner. The aim of this review article is to discuss the importance of stem cell research, code of ethics for stem cell research in Iran and ethical recommendation. Generation of stem cells for research from human embryo or adult stem cells, saving, maintenance and using of them are the main ethical, legal and jurisprudence concerns in Iran. Concerns regarding human reproduction or human cloning, breach of human dignity, genetic manipulation and probability of tumorogenisity are observed in adult/somatic stem cells. Destruction of embryo to generate stem cell is an important matter in Iran. In this regards, obtaining stem cell from donated frozen embryos through infertility treatment that would be discarded is an acceptable solution in Iran for generation of embryo for research. Ethical, legal, and jurisprudence strategies for using adult/somatic stem cells are determination of ownership of stem cells, trade prohibition of human body, supervision on bio banks and information of Oversight Committee on Stem Cell Research. Recommendations to handle ethical issues for conducting stem cell research are well-designed studies, compliance codes of ethics in biomedical research (specifically codes of ethics on stem cell research, codes of ethics on clinical trials studies and codes of ethics on animals studies), appropriate collaboration with ethics committees and respecting of rights of participants (including both of human and animal rights) in research. In addition, there is a necessity for extending global networks of bioethics for strengthening communications within organizations at both the regional and international level, strengthening legislation systems, designing and establishing convenient collaborative educational courses at ifferent levels.

Chlamydia trachomatis and Neisseria gonorrhoeae are the most prevalent bacterial sexually transmitted diseases in women.

The purpose of this study was to investigate the prevalence of gonorrheal and chlamydial infections and determination of related risk factors in married women with vaginal discharge attending gynecological outpatient department (OPD) in Zanjan in 2013-2014.

In this cross sectional study, 100 married women aged 18-49 years with vaginal discharge were evaluated for signs and symptoms of gonococcal and chlamydial infections. Then cervical discharge samples and blood samples were collected from each subject for the detection of Nisseria gonorrhea and Chlamydia trachomatis by bacterial culture and serological tests, respectively.

The overall prevalence of Chlamydia trachomatis and Nisseria gonorrhoeae were 16% and 4%, respectively. There was no significant relationship between the contraception methods, previous history of vaginal infections, previous history of urinary tract infections, number of coitus per week and self-reported symptoms (itching, burning, abdominal pain) with prevalence of Nisseria gonorrhoeae and Chlamydia trachomatis.

According to our results, the prevalence of gonococci infection in Zanjan was remarkable and relatively was higher than other parts of Iran, therefore it is necessary to put emphasis on education and further preventive and therapeutic programs.

There are different methods in endometrial preparation for frozen-thawed embryo transfer (FET).

The purpose of this study was to compare the live birth rate in the artificial FET protocol (estradiol/ progesterone with GnRH-agonist) with stimulated cycle FET protocol (letrozole plus HMG).

This randomized clinical trial included 100 women (18-42 years) randomly assigned to two groups based on Bernoulli distribution. Group I received GnRH agonist [Bucerelin, 500μg subcutaneously] from the previous midlutea lcycle, Then estradiol valerat [2 mg/ daily orally] was started on the second day and was increased until the observation of 8mm endometrial thickness. Finally progesterone [Cyclogest, 800 mg, vaginally] was started. Group II received letrozole on the second day of the cycle for five days, then HMG 75 IU was injected on the7th day. After observing [18 mm folliclhCG10000 IU was injected for ovulation induction. Trans cervical embryo transfer was performed in two groups. The main outcome was the live birth rate. The rate of live birth, implantation, chemical, and clinical pregnancy, abortion, cancellation and endometrial thickness were compared between two groups.

Implantation rate was significantly higher in group I. Live birth rate was slightly increased in group I without significant difference (30% vs. 26%). The rate of chemical and clinical pregnancy was similar in two groups. The abortion rate was lower in letrozole protocol but the difference was not statistically significant. The mean endometrial thickness was not different between two groups.

Letrozole plus HMG method cannot improve pregnancy outcomes in frozen-thawed embryo transfer but it has only one injection compare to daily injections in artificial method.

Ovarian hyperstimulation syndrome (OHSS) is one of the most important complications of assisted reproduction treatment. Many substances are involved in the regulation of the vascular permeability, which have been concerned to cause OHSS. Vascular endothelial growth factor (VEGF) has emerged as one of the main angiogenic factors, which could be responsible for increased vascular permeability.

In this study the association of vascular endothelial growth factor -460C/T and  G/C polymorphisms and susceptibility to ovarian hyperstimulation syndrome was evaluated.

In this cross sectional study, VEGF gene polymorphisms were amplified by Polymerase chain reaction- Restriction Fragment Length Polymorphism in 75 women with established OHSS (case group) and 85 normoresponder (control group) which received conventional ovarian stimulation regimen.

There was no significant difference in the frequency of -460 C/T polymorphism between cases and controls (p=0.85). The frequency of  G/C polymorphism was significantly higher in the OHSS women (p=0.03, OR=2.44; 95% CI=1.23-4.82).

In women who developed OHSS, VEGF gene polymorphism  could be effective. Two of the polymorphisms -460 C/T and  G/C were reported to be associated with increased VEGF basal promoter activity. However, only  G/C gene polymorphisms were more frequent in cases than controls.

Based on different studies it was shown that exercise training is an important factor in preconception and prenatal care.

The aim of this study was to determine whether regular preconception exercise training with or without exercise training during pregnancy decreases detrimental effects of maternal high fat diet on female offspring bone health.

Twenty-four C57BL/6 female mice were fed high-fat diet (35%) and were randomly divided into four groups: trained in preconception period and exercised during pregnancy (TE); trained in preconception periods but unexercised during pregnancy (TC); untrained in preconception periods but exercised during pregnancy (CE); untrained and unexercised (CC). Trained mice were subjected to a protocol of moderate endurance exercise training over a period of 4 weeks before pregnancy. TE and CE Dams groups had access to wheels throughout pregnancy until delivery. Analyses were performed on the female offspring that did not have access to running wheels or exercise training during any portion of their lives. The relative expression levels of β-catenin, Peroxisome proliferator-activated receptor ƴ (PPARƴ), osteoprotegerin (OPG), and Receptor activator of nuclear factor NF-kB ligand (RANKL) were determined by Quantitative RT-PCR (qPCR).

Exercise during pregnancy in isolation had no effect on any measure genes but exercise both before and during pregnancy affected all genes. Exercise only before pregnancy increased β-catenin and OPG and decreased PPARƴ, RANKL, and RANKL/OPG ratio (p

This study demonstrated that maternal exercise training before and during pregnancy may modulate the risk of bone disorders in offspring of mothers fed a high-fat diet.

Gonadotropin-releasing hormone (GnRH) antagonist protocol has been proposed as a potentially proper option for the patients with limited ovarian reserve. Nevertheless, there is no significant difference in terms of clinical pregnancy between the GnRH antagonist and agonist cycles. The use of aromatase inhibitors such as letrozole was suggested by some studies.

The object of this study was to evaluate the efficacy of letrozole co-treatment with GnRH-antagonist protocol in ovarian stimulation of poor responder patients undergoing intracytoplasmic sperm injection.

A double-blinded randomized control trial was conducted on 70 infertile women with poor ovarian response based on Bologna criteria in two groups: letrozoleᩴantagonist (LA) group and placeboᩴantagonist (PA) group (n=35/each). The LA group involved at letrozole 2.5 mg daily over 5 days and recombinant human follicle stimulating hormone 225 IU/daily. The PA group received placebo over 5 days and recombinant human follicle stimulating hormone at the same starting day and dose, similar to LA group. GnRH-antagonist was introduced once one or more follicle reached ≥14 mm. The main outcome measures were the number of oocytes retrieved, fertilization rate, implantation rate, cycle cancellation rate, and clinical pregnancy rate.

There were no significant differences in demographic characteristics between groups. There were no significant differences between groups regarding the number of oocytes retrieved (p=0.81), number of embryos transferred (p=0.82), fertilization rate (p=0.225), implantation rate (p=0.72), total cycle cancelation rate (p=0.08), and clinical pregnancy rate (p=0.12).

The use of letrozole in GnRH-antagonist cycles does not improve clinical outcomes in poor responder patients undergoing intracytoplasmic sperm injection.

The outbreak of gestational diabetes has a significant increase during recent years. This disease has complications for mother and her baby. Screening is an opportunity for preventing of gestational diabetes complications.

The aim of this research was to determine the most important risk factors for Gestational Diabetes Mellitus (GDM) in Iran according to the expert's views by Group Analytical Hierarchy Process.

In this cross-sectional study, papers related to the prevalence and risk factors of GDM in Iran from 1992-2015 were reviewed. By studying texts and Up to Date databases, 10 risk factors for gestational diabetes were collected. Among these 10 items, the risk factors that have become significant based on studying literature in Iran were selected for analysis. Group Analytical Hierarchy Process (GAHP) questionnaire distributed among all experts.

8 risk factors of gestational diabetes were significant in Iran. The analysis of expert's views showed that "History of GDM or disorder in glucose tolerance in pregnancy" is the most important risk factor for developing GDM (40.7%). The second and third most important risk factors were "History of macrosomia (infant birth weight > 4.1 Kg)" (20.2%) and" History of diabetes in first degree relatives" (10.7%).

Suggesting screening based on the determined order of these risk factors can reduce the cost and stress in pregnant women. Also, it makes patient identifying faster. The healthcare sector can consider these priorities determined in expert's views to prevent gestational diabetes.