International Journal of Reproductive BioMedicine
Volume:18 Issue: 3, Mar 2020

A considerable evidence suggests that maternal inflammation dysregulation may play as a risk factor for both maternal and neonatal outcomes.

The study's objectives were designed to evaluate the correlation between serum C-reactive protein (CRP) levels, as an inflammation factor, preterm delivery, and small for gestational age (SGA) births.

This prospective cohort study was conducted on 120 singleton pregnant women with gestational age less than 20 wk. Maternal CRP serum concentration was measured before 20 wk gestation. Patients were followed-up until the delivery and final outcomes of pregnancy were recorded in terms of preterm delivery and SGA births.

Serum CRP levels in participants with normal fetuses and SGA births were 4.09 ± 1.35 mg/l and 6.04 ± 3.29 mg/l, respectively (p =0.19), while in cases of preterm delivery, it was 9.63 ± 5.78 mg/l (p <0.001). By using receiver operating characteristic (ROC) curve, serum CRP levels (cut-off point 5.27 mg/l, area 0.836) had acceptable diagnostic accuracy value in distinguishing preterm delivery (sensitivity (75%), specificity (86.1%), positive predictive value (37.5%), negative predictive value (96.87%), accuracy (85 %)) and serum CRP levels (cut-off point 6.67 mg/l, area 0.673) in distinguishing SGA births (sensitivity (50%), specificity (91.2%), positive predictive value (23.07%), and negative predictive value (97.19%), and accuracy (89.16 %)).

Higher maternal serum CRP levels measured early in pregnancy may associate with higher risk of preterm delivery and SGA.

Polycystic ovary syndrome (PCOS) is a multifactorial and heterogeneous disease that has a potent inheritable component based on familial clustering. Despite many studies in the genetic field of PCOS, the genes that are involved in the causes of this syndrome have not been thoroughly investigated.

The purpose of this study was to establish the occurrence of the Trp64Arg polymorphism of beta3 adrenergic receptor in non-obese women with PCOS.

This cross-sectional study was performed on 100 women with PCOS and normal women as the control group in Imam Khomeini Hospital of Tehran in 2016-2017. Peripheral blood sample (2 cc) was obtained from two groups for genomic DNA based on the gene bank. Polymorphisms were genotyped by of using ADRB3 Trp64Arg. Then the DNA was extracted by genomic kiagen kit. The primer was analyzed for PCR based on gene bank by using Primer3 software and then confirmed by primer Blast tool at NCBI site to conformity to the beta-3 adrenergic receptor gene. The protein changes were assessment by the Clastal W software.

The sequence analysis presented in NCBI, transcript variant 1, with the code NM_000025.2, shows changes in the amino acid sequence of exon 1 in women with PCOS. Polymorphism in the codon 64 encoding the amino acid tryptophan (W) occurred in the nucleotide c.T190C, which changed the nucleotide T to C and then the amino acid sequence of the tryptophan was altered to arginine pW64R.

T-C polymorphism is evident in the codon 64 of the adrenergic β3 receptor in patients with PCOS. Therefore, Beta3 adrenergic receptor gene polymorphism (Thr164Ile) associates with this syndrome in nonobese women.

Various treatment methods are used to deal with sexual problems.

This study was applied to answer the question of whether psychosexual therapy (PST) can be a reliable alternative to bupropion extended-release (BUP ER) to promote sexual function in infertile women.

In this randomized clinical trial, 105 infertile women with sexual dysfunction were randomly allocated to three groups: PST, BUP ER, and a control group. The PST group participated in a total of eight 2-hr group sessions. In BUP ER group, 150 mg/day Bupropion ER was administered for eight weeks. The control group did not receive any interventions.  The female sexual function index (FSFI) and a clinical interview were used to assess their sexual dysfunction.

The mean pre-to-post treatment scores of FSFI and its subscales increased significantly in PST and BUP ER groups (except in the subscale of sexual pain) (p= 0.0001, p= 0.0001). The changes in the subjects were not significant in the control group. After adjusting for the baseline values, the results remained significant for the mean FSFI (p= 0.0001), and its subscales between the groups. Compared to the control group, a significant increase was observed in the mean FSFI (p= 0.0001, p= 0.002) and its subscales in the PST group and in the BUP ER group (except in the subscale of sexual pain). Comparison of two intervention methods showed that PST had the better effect on the sexual function improving (p= 0.0001) and its subscales (exempting the subscale of orgasm) than BUP ER.  

PST can be considered not only a reliable alternative to pharmacotherapy; it also produces better results in terms of improving sexual function in infertile women.

Various endocrine disorders have been reported in women of reproductive age, 10% of which is affected by polycystic ovary syndrome (PCOS).

This study aimed to evaluate the correlation of anti-Müllerian hormone (AMH) levels with the metabolic syndrome in patients with PCOS.

This cross-sectional study employed a consecutive sampling method using medical records from January 2013 to December 2017 at Dr. Cipto Mangunkusumo General Hospital polyclinic and Yasmin in vitro fertilization Clinic (Kencana), Jakarta, Indonesia. The primary outcome of the study was the AMH levels as independent variable correlated with metabolic syndrome. The secondary outcome was also the AMH levels correlated with each PCOS phenotype. The tertiary outcome was each PCOS phenotype as independent variable correlated with metabolic syndrome.

Women with phenotype 1 of PCOS had a median AMH level of 13.92 (range: 3.88-34.06) ng/ml. 21% patients had metabolic syndrome, with a median AMH level 7.65 (3.77-20.20) ng/ml, higher than the women without metabolic syndrome (p = 0.38). The most frequent phenotype in women with PCOS was phenotype 4, oligo- or anovulation and polycystic ovary morphology (OA/PCOM) in 41.3%. The most frequent phenotype in women with metabolic syndrome was phenotype 1, OA + PCOM + hyperandrogenism in 56.5%.

All PCOS phenotypes exhibited significant correlations with the AMH level. Phenotype 1 (OA + PCOM + hyperandrogenism) was associated with the highest AMH level and was significantly associated with metabolic syndrome.

Divorce is a social issue, which challenges not only the structure of family but also of a society. Studies have shown that infertility affects the marital boredom. In addition, resilience training and emphasizing on increasing piety (religiousness) can help to decrease this boredom.

This study aimed to evaluate the resilience training effects on the compromising of infertile couples' applicant for divorce.

In this cross-sectional study, 100 infertile couples who had requested for divorce and referred to the Center for consolidation of the family foundation were enrolled. Participants were randomly divided in two categories (n= 50/each): the case group received some consultation classes on social services as well as resilience training by a consultant in 5 sessions lasting 2 hr. In total, 10 hr of treatment; while the control group just received the consultation and social services. Canner and Davidson questionnaires were utilized as pre- and posttest in both groups. Groups answered the resilience's criterion of Canner and Davidson.

The resilience training significantly increased the compromises made by couples in the case group compared to the control (p < 0.01). The results showed that 26% of members of the case group relinquished divorce, while 10% of control group members did the same; this difference was statistically significant (p < 0.01).

The resilience training leads to increased psychological well-being elements and compromises in infertile couples.

Pinopods concentrations in endometrial surface is a marker of implantation. estradiol valerate (EV) was used for change the adverse effects of Clomiphene Citrate (CC) on the endometrium. Endometrial morphology was less examined in this fields.

Objective (s): 

To assess whether there is a significant difference in endometrial pinopods concentrations and other parameters after adding estradiol valerate (EV) and progesterone to higher doses of clomiphene citrate (CC).

Study design: In this prospective randomized clinical trial, a total of 30 women, who did not respond to 100 mg CC from February 2016 until June 2016 were evaluated. They received 150 mg CC alone or CC with EV or CC plus progesterone. On day 21 of the menstrual cycle, endometrial biopsy and a blood sampling and scanning by electron microscopy were performed.

On day 21 of the menstrual cycle there was no significant difference regarding pinopods concentrations (P=0.641) and serum estrogen levels (P=0.276) between groups. Serum progesterone levels on day 21 of the menstrual cycle among patients treated with CC, was higher than the other two groups (P=0.007).

The addition of EV and progesterone to higher dosages of CC, did not changes the pinopods concentration and serum estrogen levels on day 21 of the menstrual cycle. It can be concluded that the anti- estrogenic effects of CC just appear on the endometrium. In this study, there were higher levels of serum progesterone on day 21 of the menstrual cycles in the CC alone compared to other two groups.

Acupuncture is an adjunct therapy to support infertile women received in vitro fertilization (IVF) treatment; however, the efficacy of this approach needs more evaluation.

This randomized clinical trial (RCT) study aimed to evaluate the influence of acupuncture on reproductive outcomes in women undergoing IVF treatment.

The study was carried out on 186 participants who had undergone IVF treatment in the Mother and Child Hospital between September 2015 and February 2016. Subjects were randomly divided into three groups: Acupuncture 25 min before embryo transfer (ET) (ACU1 group, n = 62), acupuncture 25 min before and after ET (ACU2 group, n = 62), and ET without acupuncture (control group, n = 62). Pregnancy rates (biochemical, clinical, and ongoing) were evaluated and compared between groups.

There were significant differences between the ACU1 group and the control group regarding biochemical (p = 0.005), clinical (p = 0.006), and ongoing (p = 0.007) pregnancies. Also, our results showed that two-session acupuncture (ACU2) lead to a significant reduction in frequency of biochemical (p = 0.002), clinical (p = 0.003), and ongoing (p = 0.01) pregnancy rates when compared to the one-session acupuncture (ACU1). No significant difference was found between the ACU2 and control groups regarding the aforementioned terms (p = 0.50).

Acupuncture 25 min before ET significantly increased the IVF outcomes in women undergoing IVF compared with no acupuncture. Repeating acupuncture 25 min after ET did not improve the IVF outcome.

Synthetic prednisolone (PRED) is a widely used over-the-counter glucocorticoid. Glucocorticoids have inhibitory effects on the immune system and are often used as immunosuppressive agents. Suppressed immunity may impact fertility via the hypothalamic-pituitary-adrenal axis. Bitter leaf (BL) has been shown to improve sperm parameters, but its effects on immunosuppression-associated infertility have not yet been documented.

To determine the fertility effects of bitter leaf on immunosuppressed Wistar rats.

A total of 30 male adult Wistar rats were randomly assigned to 6 groups(n= 5/each). Group A served as a control and were given distilled water in addition to normal feeds, group B received 2 mg/kg PRED for 14 days and served as the standard immunosuppressed group, and groups C-F were immunosuppressed as in B but in addition received 50 mg/kg levamisole, low-dose (250 mg/kg) BL, high-dose (375 mg/kg) BL, and low-dose BL + levamisole, respectively. The CD4 counts, hematological parameters, and sperm parameters were analyzed and compared.

There were significant decreases in sperm motility, progressive motility, morphology, and life/death ratio in the animals given PRED only compared to the controls (p = 0.002, 0.001, 0.001, and 0.01, respectively). These were significantly increased in the treated groups, and animals given levamisole and 250 mg/kg BL showed significantly increased sperm counts compared to the controls (p = 0.04 and p = 0.04, respectively).

Low-dose BL (250 mg/kg) restored the sperm parameters altered by prednisolone administration.