سپیده پیوندی

Urinary incontinence (UI) is a widespread public health issue predominantly affecting adult women. This study was conducted with aim to investigate the impact of urinary incontinence on sexual satisfaction in postmenopausal women.

This systematic review study was conducted based on the PRISMA checklist. A comprehensive search was carried out in various national and international databases using standard keywords, including MESH terms and their Persian equivalents. The keywords included Urinary Incontinence, Urge, Incontinence, Stress Incontinence, Orgasm, Sexual Arousal, Sexual Function, Sexual Satisfaction, Menopause, and Postmenopause. All relevant descriptive-cross-sectional studies were selected for this research.

Out of a total of 754 studies, 12 articles involving 4132 postmenopausal women were included in the investigation. The studies were predominantly descriptive-cross-sectional, with only one study classified as a clinical trial. The mean age of the participants was 56.48 ± 4.73 years. The studies examined three types of urinary incontinence: stress, urge, and mixed incontinence. All studies emphasized that postmenopausal women with urinary incontinence experienced lower sexual function and satisfaction. Some studies indicated that the type of urinary incontinence could have a greater impact on sexual function and satisfaction. Three studies stated that stress incontinence reduced sexual desire, while four studies linked mixed incontinence to the most significant impact on sexual dysfunction. One study found that only stress incontinence had a significant relationship with sexual function.

The most prevalent types of incontinence were urge, stress, and mixed incontinence, respectively. Most articles (four studies) indicated that mixed incontinence has a more significant effect on sexual dysfunction. However, one study found no correlation between mixed incontinence and sexual dysfunction. Further research in this area is recommended.

Infertility has been raised as a reproductive health problem all over the world. Based on the other studies the prevalence of infertility in different regions of the world is different, and its prevalence in Iran is higher than the global average. There are various methods for treating infertility, one of the most important of which is the IVF microinjection method, which is considered one of the last treatment methods for infertile couples. Because various factors play a role in the success of this treatment, many of which may not be known yet, so this study was conducted to investigate the paraclinical and demographic factors affecting infertility treatment by IVF microinjection method in the infertility treatment center of Imam Khomeini Hospital in Sari.

The data of this cross-sectional study were extracted using information from the files of infertile women who are being treated at the Infertility Treatment Center of Imam Khomeini Hospital in Sari. Information was collected on cases that were Iranian couples, married women whose diagnosis of infertility was definite, and the problem of infertility was related to the woman. Paraclinical and demographic factors affecting the success of infertility treatment by IVF microinjection method were investigated using a logistic regression model. First, using a univariate model, important variables were identified, and a multivariate model was fitted. SPSS21 software was used for data analysis.

64 people (19.9%) were successfully treated using the IVF microinjection method. Women who were successfully treated had a lower average age at the time of diagnosis of infertility than women who were not treated successfully (P= 0.015). Also, the treatment success rate in women who had a history of psychiatric diseases is higher than in women who did not have (P= 0.005). Also, less than one year after the diagnosis of infertility, an increase in the age of the woman at the time of diagnosis of infertility, reduces the chances of successful IVF microinjection treatment. The success rate of treatment for women who were treated for less than one year was 17/5% (13/3% - 22.4%), and for women who were treated for more than one year was 31.5% (20/3% - 44.6%).

The overall success rate of microinjection IVF treatment in this study was lower than in similar studies, although, in women who had been treated for less than one year, this rate was lower than in women who had been treated for more than one year. So, continuing infertility treatment by IVF microinjection method for a longer period after the start of treatment increases the chance of treatment success. A woman's age when infertility is diagnosed is one of the most important factors in the treatment of infertility, and the younger the infertility is diagnosed and the sooner treatments are started, the higher the chance of success in treatment and fertility. Therefore, early referral to a specialist can affect the success of the treatment. The success of treatment was higher in women with a history of psychiatric diseases than other women, which could be due to their insistence on treatment.

Background and

Infertility is defined as the inability to conceive after 12 months of regular coitus. Anovulatory processes are the most common cause of infertility in women. The aim of this study was to compare the efficacy of combination treatment of clomiphene citrate (CC) and letrozole versus letrozole alone for ovulation induction and pregnancy rate in infertile women with polycystic ovarian syndrome (PCOS).

This is a single-blind, controlled trial study. A total of 102 infertile PCOS women were randomly divided into two groups. Group one (n=51) received 100 mg CC plus 5 mg letrozole daily on cycle days 3-7 for a single treatment cycle and group two (n=51) received 5 mg letrozole daily on cycle days 3-7 for a single treatment cycle. When at least one follicle reached a diameter of 18-19 mm, the patients received human gonadotropin hormone (5000 U-IV injection). The couples had regular intercourse, 2-3 times a week, as they had been instructed.

The number of follicles with a diameter of 14 mm was significantly higher in women who received the combination treatment of letrozole and clomiphene compared to the ones who received letrozole treatment (P=0.04). There were no statisticaly significant differences in the number of 18 mm follicles (P=0.07), mean endometrial thickening (P=0.37), clinical pregnancy rate (P=0.99), ongoing pregnancy rate (P=0.59), multiple pregnancy rate (P=0.99), and live birth (P= 0.99) between the two groups.

According to our study, the combination treatment of letrozole and CC is more effective than letrozole and can be used as the first-line therapy for infertility in women with PCOS. Moreover, the cost and risk of this treatment may be lower than other induction ovulation treatments.

Recurrent implantation failure is one of the problems associated with in vitro fertilization cycles. The aim of this study was to evaluate the results of pregnancy using intralipid infusion in infertile women with history of two implantation failures.

A clinical trial was conducted in 80 infertile women in the infertility center in Sari Imam Khomeini Hospital, Iran 2020. In all samples, the level of peripheral blood natural killer (NK) cells was measured two weeks before the intervention using flow cytometry. The participants were divided into an intervention group (n=40) and a control group (n=40) by SAS statistical software. Two days before embryo transfer, patients in intervention group underwent intra lipid infusion (2 ml of 20% solution in 250 ml sterile saline) for two hours and the control group received normal saline (250 ml) infusion. Clinical pregnancy (detection of fetal heart rate by ultrasound) rate was compared between the two groups. Data were analyzed using Chi-square, Mann-whitney, and t-test.

Clinical pregnancy rate was higher in intervention group after intralipid infusion (30%) compared with the control group (10%) (P=0.025). There were no significant differences between the two groups in the level of NK cells and peripheral blood lymphocytes (P<0.05).

Intralipid infusion improved clinical pregnancy rate in women with history of recurrent implantation failure. However, further studies are required on the possible mechanism of immunological effects of interlaipid in NK cells.

Complementary medicine plays a major role in treatment of infertility. The aim of this study was to evaluate the effect of royal jelly on sperm parameters and testosterone levels in infertile men.

In this quasi-experimental study, 100 infertile men attending the infertility treatment center in Sari Imam Khomeini Hospital were monitored for two months and then underwent a spermogram test. Afterwards, they were treated with royal jelly (100 mg/daily) for two months and spermograms were performed again. Statistical analysis was performed in SPSS V21.

Royal jelly significantly increased sperm motility, improved morphology, and increased testosterone levels (P≤0.001), but, no significant difference was seen in sperm count before and after consumption of royal jelly (47.76 ± 23.59 and 50.28 ± 29.44, respectively, P≥ 0.2).

According to current study, royal jelly could be used as a supplement along with other medications to boost fertility and treat male infertility.
 
(Clinical Trials Registry Number: IRCT20180609040028N2)

One of the problems of in vitro fertilization (IVF) cycles is recurrent failure of implantation. The present study aimed to investigate the effect of intrauterine saline infusion in luteal phase of previous menstrual cycle on occurrence of pregnancy in infertile patients undergoing frozen-thawed embryo transfer.

This clinical trial was conducted in 70 infertile women attending the infertility center in Sari Imam Khomeini Hospital who were undergoing frozen-thawed embryo transfer in 2020. The participants were randomly divided into an intervention group and a control group (n= 35 per group) using random number table. In intervention group, intrauterine injection of saline with ultrasound guidance was performed on day 21 of previous menstrual cycle, while the control group received no intervention. Pregnancy outcomes were compared between the two groups. Data analysis was performed using Chi-square and t-test.

The intervention group and control group were found to be significantly different in rate of clinical pregnancy (6.5%, 28.1%) (P=0.003) and live birth (6.5%, 28.1%), respectively (P=0.02).

In this study, saline infusion sonohysterography did not have positive effect on clinical pregnancy and live birth, which could be due to small sample size, performing the procedure on day 21 of cycle, or ineffectiveness of this method in causing inflammation following scratches compared to conventional methods. Further molecular and cellular studies are needed to compare the effect of these methods on increasing the level of inflammatory factors.

Androgens play a key role in growth of ovarian follicles and female fertility in the process of in vitro fertilization. This study was performed to determine the relationship between androgen levels and success rate in Intracytoplasmic sperm injection (ICSI).

A nested case-control study was carried out in 60 infertile women attending the Infertility Treatment Center in Sari Imam Khomeini Hospital. They underwent agonist protocol and their levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, and dehydro epiandrosterone-sulfate (DHEA-S) were measured on days three of menstrual cycle and ICSI cycle, day six of gonadotropin injection, and the day of human chorionic gonadotropin (HCG) injection. Data were analyzed in SPSS V18 applying independent T-test.

The mean age of participants was 30.1± 6.1 years. Among the subjects, 16 (26.7%) became pregnant and 44 (73.3%) did not become pregnant. On day three of ICSI cycle and before the onset of HCG injection, testosterone level was 0.88 ± 0.68 ng/ml in pregnant women and 0.53 ± 0.25 ng/ml in non-pregnant women (P= 0.012). The levels of DHEA-S were 2.79 ± 1.87 µg/l and 1.62 ± 1.45 µg/l in pregnant and non-pregnant women, respectively (P= 0.02).

Androgen levels can play a significant role in the success of ICSI cycle, so, androgen therapy can be an attractive hypothesis for improving ovarian response and used as a treatment option to increase the success of in vitro fertilization.

Human health and disease are as old as human history. Today, the concept of health is tied to the components of social capital which can act as a shield against stress, depression, anxiety, accident, aging, and various diseases. The present study aimed to review the effect of social capital on women's health.

A scoping review was carried out in five stages: 1-Designing a research question, 2- Searching and extracting research-dependent studies, 3- Selecting related studies, 4- Organizing and summarizing information and data, and 5. Reporting the results. Data collection was done in electronic databases, including MagIran, SID, Iran Doc, IranMedex, Scopus, Google scholar, PubMed, Science Direct, and Embase. The search keywords were women, female, feminine, lady, wife, Iran, Persian, Social capital, health, physical health, mental health, and social health in both Persian and English.

Overall, 15 related articles were included in this review study. These studies were reviewed to organize the findings into three categories: the relationship between social capital with physical health, mental health, and social health.

According to current findings, women's health improves by increasing their social capital which is also increased by more health and education facilities, social participation, trust, and communication with family and friends.

This study was conducted to determine the clinical patterns and major causes of infertility in mazandaran province in north of Iran.

The medical records of 3734 consecutive couples attending two infertility clinics in Mazandaran province north of Iran from 2003 to 2008 were recorded. The couples had not had a viable birth after at least 1 year of unprotected intercourse and were investigated fully.

Of the entire sample 78.7% had primary infertility and 21.3% had secondary infertility. The mean duration of infertility of couples was 5.7 ± 4 years. The etiology of infertility in couples revealed a male factor in 38.9% a female factor in 34.7% combined factors in 14.6% and an undetermined cause in 11.8%.

In this study delayed attendance of infertile couples to the infertility clinic was found. Therefore there is a need to revise public health program on infertility to focus on the education and prevention of infertility and its risk factors.

Male infertility is one of the most challenging problems in andrology. The common cause of male infertility is related to disorders in sperm production and its improvement is synonymous with better treatment outcomes. Although, the etiology of infertility is not clear in most cases but different treatment options have been suggested to increase sperm count and motility. L-carnitine, which is found in different food items and it is derived from lysine and methionine, is a substance essential for the oxidation of long-chain fatty acids in the mitochondria and protection of cell membranes from damages caused by free oxygen radicals. This study was done to evaluate the efficacy of L-carnitine in improving sperm quality in infertile men

This double blind randomized cross-over, clinical trial was conducted on 30 infertile men attending Sari Imam Khomeini Hospital’s Infertility Clinic during 2005- 2006. Subjects that had at least two abnormal spermograms, based on WHO criteria, with a two-week interval during four weeks and their gonadotropins, testosterone an prolactin concentrations were within normal range were recruited for the study. The exclusion criteria were composed of individuals with medical conditions other than infertility such as grade 3 or 4 varicocele, testicular atrophy, ejaculatory disorders, use of any medications in the past two months prior to the study, azoospermia, endocrinological disorders, ICSI candidacy for severe spermogram abnormalities or other causes of infertility.The patients were randomly allocated to two groups of A and B. Group A and B received L-carnitine and placebo 2g/day for 8 weeks respectively. After a washout period of 8 weeks, the two groups, changed place and received placebo and L-carnitine (2g/day×8w). Sperm analyses were done in four stages: Before and after the first intervention, at the end of washout period and after the second intervention.

There were significant improvements in mean sperm concentration and progressive sperm motility upon two months of L-carnitine intake (p<0.05) but no significant changes were found in sperm volume or morphology. The aforementioned changes retracted to the primary status after two months. No changes were seen following the intake of placebos in the cases.

L-carnitine intake effectively improved the mean sperm count and progressive sperm motility. However, confirmation of these results warrants more thorough clinical trials.

Background and

Anterior knee pain is one of the most common symptoms for referral reasons to orthopedic clinics specially knee clinic. This type of pain is one of the most common complaints in adolescents and adults, for various. The most common cause is patellar chondromalasia, but in many cases, no definitive cause is found through clinical examinations, paraclinic and imaging procedures. This type of pain has no detectable pathologic factor and is called anterior knee pain syndrome. The aim of this study was to access the relationship between the anterior knee pain and patellar index in patients who were referred to the orthopedic clinic.

This case-control study was performed analytically on 44 patients that were selected randomly and were divided equally in two case and control groups. Patients in case group had anterior knee pain and patients in control group had come to the clinic for another reason. In all patients, lateral knee radiography was used to calculate patellar index.

In this study, after analyzing the data, we found that there was no significant difference in age factor between the two groups. We found this syndrome to be common in female housekeepers, than in others group. Other notable findings showed there was no significant correlation between BMI and patellar index in females and males. Lastly, we found there is a significant difference regarding patellar index in case group.

Presently, despite several studies regarding knee pains, many authors have no common agreement in this field. Many diseases were not detectable in the past and even their etiology was unknown, however, today we know their etiology and even their mechanism in detail. We now understand the pathologic factor of Anterior Knee Pain Syndrome and even its etiology for the future. In this study, we found the relationship between Patellat Index and Anterior Knee Pain Syndrome and a significant difference between the case and control groups.