Journal of Reproduction & Infertility
Volume:18 Issue: 1, Jan-Mar 2017

Fertility and childbearing, in addition to the biological aspects, has always been regarded as a social phenomenon and, therefore, to understand the incident, values and beliefs, norms, and in short, the culture of any society should be scrutinized. Since the concept, condition, and value of childbearing is associated with cultural, social, political and economic dimensions, it has undergone various transformations during passage of time from past to present. The sociological approach of the current study investigated the evolution of the concept and value of fertility and childbearing in light of historical, social, cultural and economic upheavals. This study shows that the methods of rationalizing and legitimizing decisions about fertility and childbearing are defined and specified in the context of society. The rational for selecting the decisions is intermingled with social, cultural, economic, and political evolutions of the society like modernization, urbanization and the level of development in human communities. Today, fertility, childbearing and the number of children are not only connected with the interpretations of the individuals about the conditions and micro and macro subjective and objective factors surrounding them, but they are also linked with factors such as family income, the amount of time parents allocate to their children, quality of child nurturing and other family variables.

The aim of the present study was to evaluate the effectiveness of human ovarian vitrification protocol followed with in vitro culture at the morphological and molecular levels.
Ovarian tissues were obtained from 10 normal transsexual women and cut into small pieces and were divided into non-vitrified and vitrified groups and some of the tissues fragments in both groups were randomly cultured for two weeks. The morphological study using hematoxylin and eosin and Masson's trichrome staining was done. The analysis of mean follicular density, 17-β estradiol (E2) and anti mullerian hormone (AMH), and real-time RT-PCR was down for the evaluation of expression of genes related to folliculogenesis. Data were compared by paired-samples and independent-samples T test. Values of p The proportion of normal follicles did not show significant difference between vitrified and non-vitrified groups before and after culture but these rates and the mean follicle density significantly decreased in both cultured tissues (p In conclusion, the present study indicated that the follicular development and gene expression in vitrified ovarian tissue was not altered before and after in vitro culture, thus this method could be useful for fertility preservation; however, additional studies are needed to improve the culture condition.

Leptin and its receptor are present in spermatozoa; however, the role of leptin in sperm function is still controversial. Our present study aimed at demonstrating the effect of cryopreservation on sperm DNA fragmentation (DNAf) and investigating the possible effects of sperm capacitation techniques and leptin in vitro incubation on frozen-thawed sperm DNAf and oxidative stress.
Samples of 45 normospermic men attending for infertility investigation at Vida Centro de Fertilidade, Rio de Janeiro, Brazil, were frozen and thawed with or without capacitation and leptin incubation prior to freezing. Sperm DNA fragmentation was evaluated by Sperm Chromatin Dispersion Assay before and after cryopreservation and oxidative stress parameters were measured by spectrophotometry with and without leptin incubation. Statistical analysis was performed using paired t test to compare DNAf between groups before and after freeze-thaw cycle, to compare groups before and after capacitation and leptin incubation and oxidative measurements before and after leptin incubation. Statistical significance was considered when p≤0.05.
Our results revealed a significant post-thaw rise in sperm DNAf compared with fresh samples (p=0.0003). Sperm DNAf was significantly reduced when sperm capacitation was performed before freezing, when compared to those frozen with no previous capacitation (p=0.01). The addition of leptin to capacitated sperm before freezing reduced DNAf (p The addition of leptin to capacitated sperm can improve sperm DNA quality following cryopreservation, possibly by inducing the activity of certain antioxidant enzymes.

Singleton pregnancy with a live birth beyond 37 weeks of gestation is the ultimate goal of any assisted reproductive technology. However, singletons conceived after ART are found to have a poor perinatal outcome in comparison to naturally conceived singletons. It was hypothesized that the outcome of singleton conceived after transfer of two or more embryos may be dependent on the sharing of uterine space with other embryos.
Patients who had single gestational sac visualized at 6 weeks after transfer of 4, 3 or 2 embryos were considered for the study. 195 singleton pregnancies were selected for final evaluation such that as per implantation rates of 25%, 33%, and 50%, they were divided into 3 groups of 50, 82 and 63 cases, respectively. The basic characteristics of pregnancy (gestational age, birth weight) were compared using analysis of variance (continuous variables), and categorical variables were evaluated with chi-squared test. The p Among the various variables including maternal age, conception, type of infertility, type of abortion, total live birth, gestational age in live birth, birth weight, kind of embryo transfer and gestational age, there was not significant statistical differences between groups except gestational age that it was higher in group with 50% (p There is higher chance of missed abortion in patients with singleton pregnancies conceived after multiple embryo transfer. Gestational age at delivery and birth weight were correlated with number of embryo transfered.

Premature ovarian failure (POF) is an ovarian defect characterized by the premature depletion of ovarian follicles before the age of 40, representing one major cause of female infertility. Mutations in bone morphogenetic protein 15 (BMP15) and growth differentiation factor 9 (GDF9) have been shown to be associated with POF.
Genomic DNA was isolated from 52 idiopathic premature ovarian failure patients and 100 normal control individuals. Exons of BMP15 and GDF9 gene were amplified using PCR method and subjected to directed sequencing. Variants were identified by comparing the sequences obtained with normal sequences from NCBI database.
Four BMP15 gene variants were identified in 6 patients in heterozygous condition. Out of these 4 variants, 3 variants namely, c.165A>T (p.Glu55Asp), c.538 G>T (p.Aln180 Ser) and c. 510_512 delT were novel variants. In silico analysis using SIFT, Provean and Polyphen 2 score predicted the non-deleterious effect of c.165A>T and c.538 G>T variant. 788insTCT variant was identified in 3 patients. No variant was identified in GDF9 gene in any patients and controls.
Although the variant has been identified in BMP15 gene but it may not be associated with the premature ovarian failure.

Research supports that in vitro fertilization causes anxiety and that anxiety can continue into the resulting pregnancy. Most women who have IVF will have a less invasive treatment for infertility prior to IVF; however, it is unclear if specific less invasive treatment cycles impact anxiety that is experienced in the pregnancy resulting from IVF.
A prospective study was conducted for women who became pregnant via IVF, and data was collected about reported previous non-IVF treatment cycles as well as Pregnancy Related Anxiety Measure. Latent Class Analysis was conducted A p-value of ≤0.05 was considered significant.
144 subjects participated and were highly educated, affluent, married, and primarily white. The LCA process yielded two groups that on average had similar levels on most items except for use of intra uterine insemination and/or ovarian stimulation. This information was used to generate four exhaustive and mutually exclusive groups: Stimulation Only (stim-only), Stimulation and Intra uterine Insemination (stim-IUI), Intra uterine Insemination only (IUI only), or No Treatment (No Tx). ANOVA found that those in the Stim Only group had statistically significantly higher PRAM scores than the Stim IUI (p=0.0036), the IUI only group (p=0.05), and the No Tx group (p=0.0013).
Women who become pregnant via IVF and had a history of non-in vitro fertilization cycles that only involved ovarian stimulation experienced more pregnancy-specific anxiety in the pregnancy that results from in vitro fertilization.

In human, SRY (sex-determining region of the Y chromosome) is the major gene for the testis-determining factor which is found in normal XY males and in the rare XX males, and it is absent in normal XX females and many XY females. There are several methods which can indicate a male genotype by the presence of the amplified product of SRY gene. The aim of this study was to identify the SRY gene for embryo sex determination in human during pregnancy using loop mediated isothermal amplification (LAMP) method.
A total of 15 blood samples from pregnant women at eight weeks of pregnancy were collected, and Plasma DNA was extracted. LAMP assay was performed using DNA obtained for detection of SRY gene. Furthermore, colorimetric LAMP assay for rapid and easy detection of SRY gene was developed.
LAMP results revealed that the positive reaction was highly specific only with samples containing XY chromosomes, while no amplification was found in samples containing XX chromosomes. A total of 15 blood samples from pregnant women were seven male embryos (46.6%) and eight female embryos (53.4%). All used visual components in the colorimetric assay could successfully make a clear distinction between positive and negative ones.
The LAMP assay developed in this study is a valuable tool capable of monitoring the purity and detection of SRY gene for sex determination.

Invasive mole is responsible for most cases of localized gestational trophoblastic neoplasia. Gestational trophoblastic disease describes a number of gynecologic tumors that originate in trophoblastic layer including hydatidiform mole (complete or partial), invasive mole, choriocarcinoma, placental site trophoblastic tumor and epitheloid trophoblastic tumor. Invasive mole may arise from any pregnancy event although in most cases is diagnosed after molar pregnancy. Overall cure rate in low risk patients is nearly 100% and in high-risk patient 90%. In rare cases, molar tissue traverses thickness of myometrium and leads to perforation and acute abdomen and invasive mole infrequently metastasis. The best treatment option is chemotherapy (according to stage and score with single or multiple agent) and in patients that fertility is not the matter, hysterectomy can be done.
A 41 years old G3P2ab1 woman referred to Firouzgar hospital 2 months after curettage of molar pregnancy with vaginal bleeding and acute abdomen. In workup, HCG 224000 mIU/ml and evidence of metastasis was detected. Chemotherapy due to stage 3 and score 9 and surgery due to acute abdomen was done. This case was reported for its rarity.
This case reported about ovarian metastasis and uterine rupture with acute abdomen and involvement of omentum in metastatic invasive mole. Lack of surveillance led to extensive morbidity. Management of this patient was successful. In follow up, she was free of disease without sequel of any kind for five years now.