International Journal of Women’s Health and Reproduction Sciences
Volume:6 Issue: 4, Autumn 2018

Over the last years, maternal nutrition and its effect on the fetal health have been much focused on and different aspects of it have been widely investigated. However, the impact of diet on the child sex has not been well understood; it has been considered by the parents from past until now. According to hypotheses indicating that maternal nutrition status was associated with the child gender, this study was conducted to find out whether maternal nutrition would affect the child’s sex in humans. A systematic literature search in English was performed with pre-determined keywords on preconception maternal diet, maternal nutritional status, fetal sex, and sex ratio in international electronic databases (i.e., ISI Web of Knowledge, PubMed, Cochrane Library, and Scopus) with no time limitation. Reviews, letters to the editors, commentaries, editorials, experts’ opinions, and publications without available electronic full texts were excluded. Fifteen studies fulfilled the criteria and were categorized into 2 groups; the first group included publications on maternal nutritional status. Despite the heterogeneity of the articles, it was assumed that the nutritional status did not affect the sex ratio at birth except for malnutrition. In the second group which included publications on the maternal diet, results illustrated a relation between a diet with high sodium and potassium intake and male gender. Besides, high magnesium and calcium intake were found to be related to female foetus. Based on the results obtained, it can be concluded that there are not enough publications regarding the effect of maternal nutrition on the sex of child in the literature. Accordingly, more researches are warranted.

The present study aimed to measure the protamines P1 and P2 concentrations, standard sperm parameters, and also DNA fragmentation and condensation. In addition, the correlations between the above-mentioned variables and the P1/P2 ratio were explored in order to find out whether the ratio could be used as a biomarker for semen quality. A total of 272 semen samples were divided into 3 P1/P2 ratio groups: G1 as low (<0.8), G2 as normal (0.8-1.2), and G3 as high (>1.2) ratios. DNA fragmentation and condensation were evaluated by TUNEL and CMA3 (chromomycinA3) assays and protamine levels (P1 and P2) were measured using acid urea polyacrylamide gel (AU-PAGE) electrophoresis and western blot (WB). In G1, CMA3 positive and DNA fragmentation index (DFI) were negatively correlated (r = -0.371, P = 0.001). In addition, P1/P2 ratio had a positive correlation with DFI (r = 0.652, P = 0.001);however it had a negative association with CMA3 (r = -0.623, P = 0.001). Moreover, G2 demonstrated positive correlations between sperm concentration and P1(r = 0.257, P = 0.011) and P2 (r = 0.277, P = 0.006), progressive motility, and P1 (r = 0.352, P = 0.001). The P2 was positively correlated with progressive motility (r = 0.380, P < 0.01). Besides, a positive relationship was found between P1/P2 ratio and CMA3 (r = 0.333, P = 0.001). In contrast, normal morphology showed a negative association (P < 0.05) with P1 (r = -0.206) and P2 (r = -0.208).Meanwhile, there was a negative correlation between P1 and DFI (r = -0.207, P = 0.041) as well. Finally, in G3, negative correlations were also observed between P1 and normal morphology (r = -.283, P = .027) and also P1/P2 ratio and P2 (r = -0.372, P = 0.003) while DFI showed a positive correlation with CMA3 (r = 0.299, P = 0.019). The results revealed that P1/P2 ratio affected DNA integrity. Therefore, it was found that it could play a crucial role in human sperm quality and function and thus might be used as a predictor of fertility in assisted reproductive technology (ART) treatments.

The aim of this study was to assess the utilization of epidural analgesia, its determinants and deterrents among Obstetricians. A questionnaire-based cross-sectional study was conducted among obstetricians who attended the Annual Scientific Conference of the Society of Gynecology and Obstetrics of Nigeria in 2016. A total of 324 questionnaires were analyzed using Epi-info statistical software. Knowledge of epidural analgesia was high (100%), while availability was 77.8%, however only about 25.9% routinely prescribed it. The majority (96.2%) of the respondents practiced in tertiary health facilities in urban locations (94.1%). Almost three quarter (237/324; 73.1%) of respondents were males while 87(26.9%) were females. Female obstetricians were more likely to prescribe epidural analgesia for pain management in labor (68.9% vs 63.3%, P value = 0.001). The greatest impediment to its use was the cost (69.4%), lack of skill (27.8%), client’s refusal (13.9%) and fear of complications (10.2%). Over 95% of obstetricians whose patients had used epidural analgesia expressed satisfaction and good fetomaternal outcome of labor. There is a huge disparity between knowledge of epidural analgesia and actual practice among obstetrician. In closing this gap, obstetricians must do more to adequately educate patients on the options of pain relief and routinely offer it for a satisfying birth experience.

Sixteen percent of Nigerian women have an unmet need for family planning (FP) as a result of the fear of contraceptive side effects and religious beliefs. Increasing the range of accessible contraceptives, especially addition of fertility awareness options is likely to reduce unmet need. This study sought to assess the factors influencing the use of the Creighton model system (CrMS) of natural family planning (NFP) and its effectiveness in a subpopulation of women in Enugu, Southeast Nigeria. This was a cross-sectional descriptive study involving all consenting women attending the family planning clinic (FPC) of a private hospital, through a structured questionnaire and information from follow-up (FU) form of each consenting client. Data analysis was done using SPSS version 17.0 and results were expressed in descriptive statistics of frequency and percentage. Forty-five couples consented to the study. The age range of the women was 22-47 years, with a mean of 32 years. Forty-seven percent of the women had a tertiary education. Two-thirds (67%) of the couples were using the system to temporarily space their pregnancies and 60% of them were Roman Catholics. One “unplanned” pregnancy occurred during the period of review (October 2010-October 2016). The major reason for discontinuance was the tension created between the spouses during periods of avoiding pregnancy. The major advantage was being rid of the fear of side effects of artificial contraceptive methods. Roman Catholicism and high motivation were factors influencing the use of this FP model. For couples who can learn the method, the CrMS of FP is an effective option for regulating family size

The purpose of this study was to compare the effects of letrozole plus recombinant follicle stimulating hormone (R-FSH) and human menopausal gonadotropin (HMG) on ovarian stimulation in intrauterine insemination (IUI) cycle. This randomized clinical trial was conducted on 130 women with polycystic ovary syndrome (PCOS) resistant to clomiphene and letrozole who were divided into A and B groups. Both groups received 5 mg of letrozole daily from the third to seventh day of the cycle and then group A (n = 59) received 75 units of HMG intramuscularly per day and group B received 75 units of R-FSH subcutaneously per day. Follicular maturation was triggered with 250 μg of recombinant human chorionic gonadotrophin (R-hCG) and IUI was performed 36 hours later. Main results under study were the number of matured follicles, endometrial thickness on the day of hCG injection, and the rate of chemical and clinical pregnancy. The 2 groups were not significantly different in demographic information. The rate of pregnancy was significantly higher in the letrozole + R-FSH group than in the letrozole+HMG group (20% and 5.8% respectively, P = 0.04). There was no significant difference between the 2 groups in the number of mature follicles (≤18 mm) and endometrial thickness at the time of hCG injection (P > 0.05). Letrozole plus R-FSH is a recommended regimen for ovarian stimulation in PCOS patients.

Due to the importance of marriage in providing the society structure, foundation for family formation, and continuity of the generation, as well as considering the decline of marriage rate in Iran, this study was designed to explore desire and attitude to marriage among Iranian youth. Participants were 22 unmarried Iranian youth who were selected by purposive and snowball sampling from the capital of Iran, Tehran. Interviews were carefully recorded and concurrent with data collection, analysis was done using directed content analysis technique. After securing the data saturation, interviews were finished and data were categorized. A total of 4 main categories and 12 sub-categories were derived from the results of the current study in terms of attitude to marriage among Iranian youth. Main categories included sense of excellence, achievement of calm, achieving stability, and the necessity of marriage. The concept of marriage from the viewpoint of Iranian youth is an essential element that can help to create a sense of stability, achieve calm in life, and ultimately achieve excellence. On the whole, the attitude to marriage was positive among unmarried Iranian youth, but marriage rate was definitely falling in Iran. Identification of the factors affecting marriage rate can be addressed in future national research.

According to previous researches marital satisfaction has various patterns during family life cycle; meanwhile, there are only few studies showing a correlation between sexual and marital satisfaction in different stages of family life cycle. Therefore, the current study was designed to assess long-term female marital and sexual satisfaction in intimate relationships In this cross-sectional study, 266 married women in different stages of their life family cycle recruited in the study through cluster random sampling technique. Outcomes measurement was carried out using three questionnaires: demographic, ENRICH marital satisfaction, and Larson sexual satisfaction. In this study, 24.4% of the women reported a high level of marital satisfaction while about 21.8% of them mentioned high levels of sexual satisfaction. Positive and highly significant correlation was observed between sexual and marital satisfaction in the first three stages of family life cycle (beginning a family (r=0.5, P = 0.001), childbearing family (r=0.46, P = 0.004), and families with preschool children (r=0.24, P = 0.036). That is, both of the above-mentioned factors decreased slightly, however, such a correlation was not observed in the following stages (P > 0.05). In addition, it was found that, in the last 3 stages (i.e., teenage, empty nest, and retirement), despite a decrease in sexual satisfaction, marital satisfaction increased. In general, the findings revealed that the correlation between sexual satisfaction and marital satisfaction reduced across the stages of life cycle. It seems that through deepening the relationship between the couples, other factors that are more important than sexual satisfaction would contribute to marital satisfaction as well.

Low back pain (LBP) is one of the most prevalent complications of pregnancy, which can cause significant disabilities. However, data on the intensity of and disability caused by LBP during pregnancy are rare. The purpose of this study was to evaluate the severity of and disability caused by LBP, and compare them in different trimesters, and identify risk factors. This cross-sectional study was conducted in 2013 on 514 pregnant women. A questionnaire on demographic information, severity of LBP (based on VAS), and the Oswestry disability scale was filled out by the participants. Data were analysed by Mann-Whitney, one-way ANOVA, and linear regression using SPSS software. P value below 0.05 was considered to be statistically significant. In total, 69.09% of participants had LBP. The mean severity of visual scale pain was 38.2 ± 10.88 and mean disability due to LBP was 35.38 ± 18.30. The highest severity of pain, attributed to the second trimester, was 40.8 ± 21.7 and the highest disability score, 37.13 ± 18.81, was observed in the third trimester. In total, 77.1% of pregnant women studied with LBP had moderate to severe disability. There were meaningful associations of gestational age, parity, and previous chronic LBP with disability due to LBP (P value < 0.05). LBP during pregnancy is very prevalent and causes moderate to severe disability in the majority of pregnant women.

In this experiment, possible effect of superovulation on important molecular profiles of oocytes and embryos were examined in mice regarding their development. A total of 120 metaphase II oocytes were produced by super or spontaneous ovulation. Blastocyst-stage embryos were produced after in vitro fertilization (IVF) and in vivo fertilization. Blastocysts that have been obtained from naturally mated female without gonadotrophin treatment were also used as controls. Using real-time polymerase chain reaction (PCR), the mRNA expression patterns of Bone morphogenesis protein (Bmp 15(, hepatoma-derived growth factor (Hdgf), DNA methyl transpherase-1 (Dnmt-1), developmental pluripotency associated 3 (Dppa3), and zinc finger protein 57 (Zfp57) genes were compared between superovulated and spontaneously ovulated oocytes; the expression patterns of H19 and small nuclear ribonucleoprotein N) Snrpn( imprinting genes between embryos produced from these oocytes were also compared. The results of the study showed that expression of five maternal effect genes (Bmp15, Hdgf, Dnmt-1, Dppa3, and Zfp57) in superovulated oocytes were significantly reduced (P<0.05). However, the rates of cleavage to the blastocyst stages were not significantly different (P<0.05) between superovulated and naturally ovulated oocytes in cultured embryos. Moreover, superovulation disturbed the expression patterns of imprinting genes (H19 and Snrpn) in single blastocysts obtained by different assisted reproductive techniques (ARTs). The findings indicated that superovulation affected the molecular characteristics of ART conceived embryos.

Fetomaternal immune tolerance induced by natural killer cells (NKs) is a necessary phenomenon associated with maternal killer-cell immunoglobulin-like receptors (KIRs) and fetal human leukocyte antigens (HLAs). We aimed to investigate maternal KIR, parental HLA-C, and maternal-parental KIR-HLA combination in 2 preeclampsia and control groups. A total of 200 couples participated in this case-control study. DNA samples were assayed through polymerase chain reaction with sequence specific primers (PCR-SSP). No significant difference was observed between the cases and the controls regarding the maternal KIR genes and genotypes and paternal HLA-C genes. A significant relation was found for maternal KIR and paternal HLA-C combination. The relation was for the inhibitory combination KIR2DL1+HLA-C2 in the preeclampsia group (P < 0.05; odds ratio [OR] = 2.02; sensitivity = 79%). In addition, maternal AA genotype of KIR in combination with paternal HLA-C1C2 was a risk factor (P < 00.05; OR = 3.24; specificity = 92%). The inhibitory maternal-paternal combinations KIR2DL1+HLA-C2 and AA+HLA-C1C2 seem to be more associated with risk of preeclampsia. Prediction of the risk of preeclampsia with the help of maternal KIR typing and paternal HLA-C typing can be possible in future.

Premenstrual syndrome (PMS) is among the most widely recognized conditions affecting the women of childbearing age and includes a set of physical and mental symptoms. It can also affect the relationship between couples. The purpose of this study was to determine awareness, attitude, and performance of men regarding PMS. As a cross-sectional study, it targeted a sample of 150 men from Urmia. To gather data, awareness and performance questionnaire (Morowati Sharifabad, 2013) and a researcher-made attitude questionnaire were employed. The collected data were analyzed using SPSS version 19.0. Descriptive statistics, t-test, and Pearson correlation coefficient were used to analyze the data. Twenty-two percent of the wives of the surveyed men had PMS and during the premenstrual stage, they had experienced most of the emotional symptoms (84%) and fluid retention (60.7%). The mean scores of awareness, attitude, and performance of men regarding PMS were 24.2 ± 4.45, 23.93 ± 5.35, and 43.10 ± 5.23, respectively. Men whose partners had PMS recorded a higher awareness and performance scores while getting lower than average scores regarding attitude. Thus, the difference in attitude between the 2 groups was statistically significant (P = 0.04). Besides, there was a significant relationship among awareness, attitude and the performance of men compared to each other (P < 0.001). Men with wives who had PMS recorded a higher awareness and performance scores while they got lower than average scores regarding attitude in comparison with the ones whose wives did not suffer from PMS. In addition, there was a significant relationship between and among awareness, attitude, and performance of men concerning PMS of their wives.

Considering the increasing morbidity and mortality in high-risk pregnancies, it is essential to identify the mental health status of women during their pregnancy since this type of pregnancy is associated with the stress for the women and also their spouses. The present study was designed to determine the mental health status of the couples in high-risk pregnancies and its respective characteristics. This cross-sectional study was conducted on couples faced with high-risk pregnancy situations in hospitals and public health centers of Gorgan during 2016-2017. The sample size included 375 couples who were selected by cluster random sampling technique based on the inclusion criteria. Four questionnaires were used to collect the required data. Descriptive and analytical statistics were employed to analyze the obtained data. The results of the study showed that 31.7% of mothers and 25.6% of fathers had mental disorders in high-risk pregnancy situations. Examining the mental health relevant characteristics, the findings indicated an inverse relationship among the following variables: duration of marriage (P = 0.041), number of children (P = 0.050), maternal age (P = 0.018), number of previous pregnancies (P = 0.032), age of the spouse (P = 0.013), gestational age (P = 0.12), social support (P = 0.001), and the mean score of pregnant women’ mental health. It was found that the above-mentioned factors were associated with an improved mental health. The mean scores for the spouse’s mental health (P = 0.000), the need for counseling (P = 0.12), opening the pregnancy file before the first trimester (P = 0.015), and concern (P = 0.000) were found to have a direct relationship with the mean score of the pregnant women’ mental health. Checking mental health during prenatal care is recommended to promote the mental health status of the couples encountered with high-risk pregnancy.

Dysmenorrhea or painful menstruation is a frequently observed fertility and femininity abnormality in women of childbearing age. Dysmenorrhea is treated by medical, complementary or surgical treatments. The aim of the present randomized clinical trial (RCT) study was to compare the effectiveness of electroacupuncture and acupressure treatment methods in reducing symptoms of primary dysmenorrhea. In this double-blinded RCT, 64 female students who met the criteria were assigned into 2 groups (Intervention group: electroacupuncture and Control group: acupressure) using random allocation software (RAS). Pain according to visual analogue scale (VAS), menstrual distress severity according to Moos Menstrual Distress Questionnaire (MMDQ) and the frequency of drug use during menstruation were measured 3 times before and after treatment cycle and follow up cycle. Electroacupuncture and acupressure were done by applying electrical stimulation (ES) to needles or pressure at SP6 and SP4 points for 10 minutes on each side. The MMDQ (P = 0.000) and VAS (P = 0.000) showed a significant decrease in both groups but the rate of decline was higher in the electroacupuncture group. According to the results, it was revealed that treatment with electroacupuncture can also be suggested as a treatment in complementary medicine for treatment of primary dysmenorrhea which has no reported side effects.

Sexual dysfunction is highly prevalent nowadays and is a threat to healthy marital life. The aim of the present study was to determine the factors associated with sexual dysfunction in newly married women referred to the urban health comprehensive services centers of Zanjan, Iran in 2015-2016. This descriptive-analytical cross-sectional study was conducted on 300 women married in the last 5 years who referred to the health centers in Zanjan. The participants were selected through cluster sampling method. Data were collected using a socio-demographic characteristics questionnaire and the Female Sexual Function Index. Descriptive and analytical statistics including independent t test, one-way ANOVA, and the general linear model were used to analyze the data. Sexual dysfunction was found in 66% of the women. The frequency of sexual dysfunction was 33% for arousal, 31% for pain, 28.7% for desire, 23% for satisfaction, 3% for vaginal lubrication, and 16.3% for orgasm dimensions. According to the general linear model, breastfeeding and contraceptive method had a significant relationship with the mean score of sexual function. About two-thirds of women in their early years of marriage had sexual dysfunction, and given its impact on all aspects of marital life, it seems necessary to include sexual counseling in the pre-marital counseling program.

Many women experience unplanned pregnancies in their life and have to make a critical decision whether to abort or continue with the pregnancy. The present study aimed to assess the factors affecting the decision about unplanned pregnancies. The present prospective study was conducted on 230 women with unplanned pregnancy who were selected through sequential sampling, including 80 women who had decided to abort and 150 who had decided to continue with their unplanned pregnancy, and referred to health complexes and centers, and obstetrics and midwifery offices in Tabriz, Iran, in 2017. Data were collected through perceived threats, support, and beliefs and values questionnaires and analyzed using the t-test and the logistic regression with a hierarchical modeling strategy. According to the results, the mean scores of perceived threats (40.02±5.5), perceived support (23.09±2.8), and beliefs and values (18.12±3.2) were significantly higher in the abortion group compared to the continuation group (19±3.3, 21.04±3.05 and 11.2±4.3; P < 0.001). The results of the hierarchical modeling strategy showed that the perceived threats of the continuation of pregnancy had the greatest predictive power over the decision to abort (β=1.12; 95% CI: 1.08-1.17; P < 0.001). The results of this study showed that women’s decision about the outcome of unplanned pregnancy is potentially affected by three groups of reasons, including perceived threats, support, and beliefs and values. Indeed, understanding these factors provides a broad picture of the situations affecting women’s decision-making. The findings of this study suggest the need for planning and implementing counseling interventions based on the abovementioned factors, especially identifying perceived threats and providing appropriate strategies to remove these threats in women who have to make such critical decision in their life.

The present study aimed to assess the prevalence of intimate partner violence (IPV) in the first post¬partum year and its predictive factors in an urban area of Iran. In this cross-sectional study, 398 women with a healthy infant aged 12 months were examined using revised Conflict Tactics Scale (the CTS2) to determine the prevalence of IPV. The data were collected at the public health centers in Tabriz (from October 2015 to April 2016). The predictors were determined using multivariate binary logistic regression. More than half of the women (58%) reported experience of one or more instances of any form of IPV, namely, psychological, physical, sexual, and/or injury and one-third of them reported physical and/or sexual IPV in the first postpartum year. Reported prevalence of each form of IPV were as follows: psychological aggression (54%), physical assault (21%), sexual coercion (21%), and injury (13%). Predictor factors of overall IPV were: woman aged less than 30 years (adjusted odds ratio 2.0 [95% CI: 1.3 to 3.3]), unplanned pregnancy (1.6 [1.03 to 2.6]), husband disappointment about their baby’s gender [1.9 (1.1 to 3.2)], and inability to fully meet the husband’s sexual expectations (1.6 [1.03 to 2.4]). The IPV during postpartum is very common. Therefore, it is recommended to implement IPV screening programs and effective strategies for IPV prevention in the health care settings for newly delivered women emphasizing on the high risk for the women

In this experimental study, a testicular torsion/detorsion model was used in male rats to investigate the effect of onion juice on male fertility factors and rate of pregnancy by intrauterine insemination (IUI). A total of 56 Wistar rats (28 males vs. 28 females) were included in this study. Male rats were randomly divided into 4 groups including sham, testicular torsion/detorsion, testicular torsion/detorsion treated with onion juice (40 mg/kg, orally) 30 minutes before detorsion, and those rats that were only treated with onion juice. Treatment with onion juice was continued for 14 days after detorsion. At the end of the study, following anesthesia with ketamine/xylazine (5/1 mg/kg), levels of testosterone hormone as well as some oxidative stress markers in the blood serum of the male rats were analyzed. Furthermore, sperm parameters were assayed, and then fertility power of the male rats was investigated in the adult female rats using IUI method. The results of the study showed that there was a significantly negative change in TD group in terms of histological parameters while they were decreased in treated groups. On the one hand, although serum level of malondialdehyde (MDA) significantly increased in TD group, other oxidative markers’ (i.e., glutathione peroxidase and superoxide dismutase) serum levels and also testosterone hormone significantly decreased, on the other as compared to the other groups. In addition, the rate of sperm parameters and pregnancy presence were lower in TD group than those of other groups. However, onion juice as a treatment factor could improve the sperm quality and fertility power. The obtained results revealed that using onion juice could enhance the quality of sperm and fertility power after testicular torsion/detorsion.

Endometriosis is a prevalent inflammatory gynecologic disease in women of reproductive age that affects up to 15% of the women. It has been reported that majority of the malignant tumors are associated with endometriosis along with clear cell and invasive endometrioid ovarian malignancy. However, in this case presentation, we have identified an association of endometriosis and sex cord tumor with annular tubules. It was considered as a disease with some conditions which make it appear not malignant for sharing some properties related to cancer and some other malignant tumors are associated with the endometriotic type and clear cell ovarian cancer. However, in this case report, we have identified coincidence of endometriosis and sex cord tumor with annular tubules. The ultimate goal of this study was to draw the attention of the readers to the point that endometrioma could be accompanied not only by clear cell and endometrioid ovarian cancer but also by other ovarian cancers. This case was considered in the study to conduct further research if similar cases are observed.