نرگس مسلمی زاده

The Genital self-image is one of the important components of sexual health, which means women's attitude, feelings and beliefs about their genital organs, which is associated with sexual satisfaction and all aspects of women's sexual performance. Therefore, considering the importance of genital self-image in women's sexual health, this study was conducted with the aim of reviewing effective interventions on women's genital self-image.
To conduct this scoping  review, search was done in the databases Scopus, SID, PubMed, Magiran, Library of Cochrane, Web of Science and Google scholar search engine with keywords Genital Body image, genital self-image, Genital appearance, genital self-perception, Women, Female, Intervention and Method. Data were extracted from studies that were consistent with the objectives of the study. The quality of the articles was evaluated based on the Cochrane Risk of bias assessment tool.
Out of a total of 418 searched studies, 11 studies matched the study criteria. Based on the results, the effective interventions on genital self-image of women are divided into three categories. The first class  includes educational interventions (Psychosexual Education, Sexual Assertiveness Training, Brief Educational Video, Sex Education, sexual skills training, Self-Encouragement Skills Training, effects of exposure to pictures of natural vulvas), the second class includes exercise interventions (Qigong exercise, water Pilates), and the third class includes counseling interventions (Acceptance and Commitment Therapy).
By using appropriate approaches in different ways, such as educational, exercise and counseling interventions, it is possible to improve women's genital self-image and sexual skills and correct their sexual beliefs and attitudes. It is suggested that in order to improve sexual health, special attention should be given to improving the genital self-image of women. However, more culture-based research is still needed to adopt the best interventions and drive policy change.

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.