International Journal Of Fertility and Sterility
Volume:16 Issue: 3, Jul-Sep 2022

Infertility is a complex multifactorial problem that affects about 7% of men and 15% of couples worldwide. Many molecularmechanisms involved in male infertility. Destructive effects of infertility on the next generations are not wellunderstood. Approximately 60-75% of male infertility cases have idiopathic causes, and there is a need for additionalinvestigations other than routine examinations. Molecular factors that surround DNA, which are mitotically stable andindependently regulate genome activity of DNA sequences, are known as epigenetics. The known epigenetic mechanismsare DNA methylation, histone modifications and non-coding RNAs. Prevalence of metabolic diseases has beenincreased dramatically because of changes in lifestyle and the current levels of inactivity. Metabolic disorders, suchas obesity and diabetes, are prevalent reasons for male infertility; despite the association between metabolic diseasesand male infertility, few studies have been conducted on the effects of epigenetic alterations associated with thesediseases and sperm abnormalities. Diabetes can affect the reproductive system and testicular function at multiple levels;however, there are very few molecular and epigenetic studies related to sperm from males with diabetes. On theother hand, obesity has similar conditions, while male obesity is linked to notable alterations in the sperm moleculararchitecture affecting both function and embryo quality. Therefore, in this review article, we presented new and developedtechnologies to study different patterns of epigenetic changes, and explained the exact mechanisms of epigeneticchanges linked to metabolic diseases and their relationship with male infertility.

This study aimed at comparing a comprehensive set of functional and structural sperm characteristics betweensperm motility fractions and correlating results to the standard semen parameters. By grouping related variables,our objective was to establish the predictive power of semen parameters and whether they accurately reflect the functionalityof sperm motility fractions or merely a small set of parameters within individual fractions. In this non-invasive experimental study, donor semen samples (n=55) were separated viadouble density gradient centrifugation, isolating a high (HM) and low motile (LM) sperm fraction. Fractions wereevaluated for percentage vitality, chromatin integrity, mature spermatozoa, motility and kinematic parameters, hyperactivation,positive reactive oxygen species, intact mitochondrial membrane potential (MMP) and acrosome reaction. HM fractions had significantly (P<0.001) enhanced percentages of induced acrosome reaction (HM, 55.6 ±14.3%, LM, 25.0 ± 16.5%), motility and kinematic parameters, hyperactivation, vitality (HM, 70.4 ± 9.7%, LM, 47.9± 10.3%), mitochondrial membrane intactness (HM, 67.2 ± 10.4%, LM, 44.7 ± 15.0%) and mature spermatozoa (HM,83.4 ± 10.0%, LM, 64.6 ± 8.2%) with intact chromatin (HM, 80.5 ± 8.1%, LM, 71.3 ± 8.0%). Various sperm morphologyabnormalities correlated with LM fractions’ grouped motility parameters (range, 0.46 to 0.51; range -0.4 to-0.75), whereas combined semen traits of total motility, progressive motility, viscosity and mucus penetration (MPT)correlated with HM fractions’ grouped motility parameters (range, 0.44 to 0.84). Collectively, total and progressive motility, viscosity and MPT may represent a reliable grouping of semenparameters for predicting the quality of HM sperm fractions. Separating the same donor semen samples into two significantlydiverse motility sperm fractions could be a potential model in mimicking the qualities of fertile and sub-fertilemales’ sperm populations and used for future research on the improvement of sperm subpopulations from males withdifferent fertility statuses.

We aim to determine the prevalence of renal anomalies in patients with congenital vas deferens agenesisreferred for infertility assessment. This cross-sectional study was carried out on eligible infertile men from 2016 to 2019.Infertile men who were suspected of obstructive azoospermia were referred to the Ultrasound ward and they wereexamined by abdominal ultrasound for detecting the genital and kidney anomalies. An informed consent form wasfilled out by patients. Data was entered into SPSS software 21. Patients were divided into two groups in termsof congenital bilateral absence of vas deferens (CBAVD) or congenital unilateral absence of the vas deferens(CUAVD). Using the Chi-square test kidney anomalies between groups were compared. The P<0.05 was consideredsignificant. The mean age of participants was 33.05 ± 6.35. The frequency of CBAVD was 66 and the frequency of leftside VD and right side VD were 23 and 21, respectively. The percentage of other comorbidities was calculated. Outof 110 cases, 12 (11%) men had coexistence of vas deferens and kidney agenesis. Other studies are in agreement withour findings. Although the percentage of CBAVD and CUAVD were 9.1% and 1.8% respectively, the difference wasnot significant (P=0.07). Considering the fact that kidney agenesis is a remarkable congenital anomaly that coexists with themajority of vas deferens agenesis cases and could not be detected by routine laboratory tests or transrectal ultrasoundexamination, it should be ruled out with transabdominal ultrasound examination after detection of vas deferensagenesis.

Accurate etiology of azoospermia is required for optimal management of patients. The aim of thisstudy was the determination of serum hormonal levels and testicular long axis cut off points to distinguish obstructiveazoospermia (OA) from non-OA (NOA) in Iranian patients as well as the evaluation of the necessity of diagnostictestis biopsy in azoospermic patients. In this retrospective study, data of 471 azoospermic patients such as history and physicalexamination, serum hormonal level, semen fluid parameter, and testicular long axis based on ultrasound wereevaluated from 2016 to 2020. All patients were examined by a single urologist and underwent a diagnostic testisbiopsy for a definite diagnosis. The diagnostic parameters were analyzed using Statistical Package for the SocialSciences (SPSS) version 16 with t test and chi-square test and receiver operating characteristic (ROC) curves todistinguish NOA from OA. A total of 127 patients with OA and 284 with NOA were included in this study. The mean serum testosteronelevel was significantly higher in OA than NOA (4.2 vs. 3.4 ng/ml), whereas the mean serum follicular stimulating hormone(FSH, 5.3 vs. 19.1 mIU/ml) and luteinizing hormone (LH, 5.3 vs. 11 mIU/ml) were lower in OA. ROC curve analysisshowed that FSH and testicular long axis were the best diagnostic predictors. Using a combination of serum FSH (8.9mIU/ml) and testicular long axis (39 mm), the positive predictive value for NOA was 97.02% and for OA was 78.8%. Combination of serum FSH higher than 8.9 mIU/ml and testicular long axis lower than 39 mm werestrong predictors to distinguish NOA from OA in Iranian participants in this study. In addition, diagnostic testicularbiopsy seems to be necessary for patients with OA and NOA characteristics.

Few studies have so far been done about the role of follicle stimulating hormone (FSH) in final oocytematuration. However, none of these studies have been performed solely on normoresponder patients. This study aimedto determine whether oocyte maturation, as well as fertilization and pregnancy rates, could be improved in normoresponderwomen with concomitant FSH and human chorionic gonadotropin (hCG) trigger compared to those with thehCG trigger alone.

In this prospective randomized clinical trial, 117 normoresponder women, aged 19-40 yearswho were candidates for the gonadotropin-releasing hormone (GnRH) antagonist protocol at Avicenna Infertilitytreatment Center, were enrolled and claasified in two groups. Final oocyte maturation was triggered using 10000 IU ofhCG plus 450 IU of FSH in the first group (59 subjects) and 10000 IU of hCG alone in the second group (58 subjects).The primary outcome was clinical pregnancy rate.

Mean age of the patients was 33.21 ± 4.41 years. There was no difference in clinical pregnancy among thetwo groups (30.9% vs. 25.5%, P=0.525). There was no statistically significant difference in fertilization rate (80.0%vs. 74.1%, P=0.106), implantation rates (18.9% vs. 16.7%, P=0.352), and chemical pregnancy rates (38.2% vs. 32.7%,P=0.550). Oocyte maturation rate (84.2% vs. 73.6%, P<0.001), 2 pronuclei (2PNs) (6.53 ± 2.54 vs. 5.36 ± 2.85,P=0.021) and total embryos (5.85 ± 2.43 vs. 4.91 ± 2.58, P=0.046) were significantly higher in the first group.

Adding FSH to hCG for oocyte triggering, significantly improved oocyte maturation rates and total embryos.While there was no significant difference in the clinical and chemical pregnancy rates, between these two groups(registration number: IRCT20190108042285N1).

Laparoscopic excision of ovarian endometrioma is believed to decrease the ovarian reserve, but the riskfactors of declining ovarian reserve are not well studied. This study aimed to determine the risk factors of anti mullerianhormone (AMH) decline after laparoscopic surgery of endometrioma. This prospective study was recruited in Yas and Arash Hospitals affiliated to Tehran Universityof Medical Sciences from 2020 to 2021. Women between 18-45 years with ovarian endometriomas with a diametergreater than 3 centimeters who were candidates for laparoscopy were included. AMH, luteinizing hormone (LH),and follicular stimulating hormone (FSH) as well as cancer antigen 125 (CA125) and cancer antigen 19-9 (CA19-9)were obtained and compared pre and postoperatively. Indeed, the relation of AMH decline rate and the demographic,symptoms and endometrioma characteristics were investigated either. In this study, 100 women were recruited. The mean ± SD age of the participants was 29.08 ± 4.6. AMH(P<0.000) and LH (P=0.013) declined significantly postoperatively. Whereas, no significant difference was observedbetween pre and postoperative FSH (P=0.520). AMH decline rate was 30.07 ± 2.30% and didn’t have significant relationwith the demographic characteristics, preoperative AMH, and the amount of CA125. Otherwise in the multivariateanalysys, CA125 (P=0.160) and the grade of endometriosis (P=0.05) had significant correlation with AMH decline rate. Ovarian reserve decline after laparoscopic excision of endometrioma. Otherwise, there may no specificrisk factor to predict the degree of ovarian reserve decline. Therefore, the selection of patients for laparoscopic excisionof endometrioma should be taken more cautiously as the ovarian reserve diminishes even in the patients with thelowest risks.

This study aimed to determine the prevalence of postpartum metabolic syndrome (MetS), glucose intolerance,and the determinants, 6-12 weeks postpartum in women with assisted reproduction technology conceptiongestational diabetes mellitus diagnosis (ART-GDM) compared to women with spontaneous conception and GDMdiagnosis (SC-GDM).

In this prospective cohort study, two groups consisting of 62 ART-GDM and 64 SC-GDMsingleton pregnant women were followed 6-12 weeks after delivery for postpartum MetS. Fasting glucose, 75-g 2-hOGTT, and lipid profile were assessed. Waist and hip circumference, and systolic and diastolic blood pressures (BP)were measured at postpartum. Clinical, paraclinical, and obstetric data were recorded from registry offices. The prevalenceof MetS and glucose intolerance were determined. Predictors of MetS and glucose intolerance were evaluatedby logistic regression.

The prevalence of postpartum MetS was 20.8% in ART-GDM women and 10.9% in SC-GDM (P=0.123).Mean postpartum BMI and systolic BP were significantly higher in the ART-GDM group (P=0.016 and P=0.027respectively). Adverse pregnancy outcomes were significantly higher in the ART-GDM group. Postpartum glucoseintolerance prevalence did not vary significantly between the groups. Family history of diabetes was a predictive factorfor postpartum MetS and glucose intolerance 6-12 weeks after delivery.

Early postpartum MetS and glucose intolerance prevalence after assisted conception did not vary significantly;however, postpartum body mass index (BMI) and systolic BP were significantly higher in the ART-GDM group.Lifestyle modification programs and long-term health care of ART women with GDM diagnosis can be recommended.Further studies with larger sample size and longer follow-up are necessary to verify our findings.

Polycystic ovary syndrome (PCOS) is known as the most common endocrine and metabolic disorder inthe reproductive-age women. Due to the effects of PCOS on the physical and mental health, the investigation of the factorsaffecting the development of PCOS is crucial. Hexose-6-phosphate dehydrogenase (H6PD) is a microsomal enzymethat catalyzes the first two reactions of the oxidative chain of the pentose phosphate pathway. The present study examinedthe polymorphisms of the H6PD gene (R453Q and D151A) in PCOS patients of Iranian Kurdish women. In this case-control study, a total, of 200 female volunteers in two equal groups participatedin our study. The PCOS patients were selected based on the Rotterdam diagnostic criteria. The association of H6PDgene polymorphisms, D151A and R453Q, with the development of PCOS were investigated. The polymerase chainreaction-restriction fragment length polymorphism (PCR-RFLP) method was used for genotyping. Statistical analysiswas applied by the SPSS (version 16) software. Statistically significant lower frequencies of AA+AG genotype (37% vs. 55%, P=0.01) and A allele (22.5%vs. 34%, P=0.01) of R453Q were observed in the patients compared to the controls. In the case of D151A, no significantdifferences were observed in the frequency of genotypes and alleles between the two groups. The findings of this study suggest that variants of H6PD R453Q affect the risk of PCOS.

Polycystic ovary syndrome (PCOS) is a common type of endocrinopathy in women which is accompaniedby androgens elevation, insulin resistance, and metabolic dysfunction. Eugenol is a phenolic component of clove oil thathas an antioxidant, anti-inflammatory, and anti-diabetic activity. The present study aimed to evaluate the therapeutic effectsof eugenol on the PCOS models of rats. In this experimental study, thirty adults female Wistar rats weighing between 180 and 200g were used. Estradiol valerate-induced PCOS rats (4 mg/rat) were treated with eugenol (12 and 24 mg/kg) for 28days. The effects of eugenol were studied on levels of glucose, lipid profile, liver enzymes, reproductive hormones,oxidative stress, and the expression of cyclooxygenase-2 (Cox-2) and peroxisome proliferator-activated receptor alpha(Ppar-α) genes, using biochemical analysis of blood and histopathological evaluation of ovaries. Estradiol valerate-induced PCOS resulted in the formation of cystic follicles in the ovaries, hyperinsulinemia,hyperglycemia, hyperlipidemia, hyperandrogenism, and anovulation. It altered the Cox-2 and Ppar-α gene expressionand increased oxidative stress and activities of liver enzymes. Eugenol treatment improved the PCOS-associatedendocrine and metabolic disorder and histopathological alterations, mostly through antioxidant, anti-diabetic,anti-hyperlipidemic, and anti-androgenic properties. It showed beneficial effects on serum glucose, serum insulin,fat profile, reproductive hormones, liver activity, oxidative stress, expression of Cox-2 and Ppar-α genes, as well asrestoration of normal ovulation in the PCOS animals. Eugenol could represent a promising natural product to prevent PCOS or reduce its symptoms.

Aim of the study was to evaluate the protective effects of trans-anethole, against polycystic ovary syndrome(PCOS) induced histopathological and biochemical changes in female Wister rats. In this experimental study, forty-eight animals were randomly assigned into 6 groups: control;PCOS; PCOS+trans-anethole (20, 40, 80 mg/kg); and PCOS+metformin (300 mg/kg). Testosterone (1 mg/kg/day) was injected intraperitoneally for 35 days to induce PCOS. After PCOS induction, animals were treated by transanetholeand metformin (30 days oral gavage). Finally, serum oxidative stress and insulin levels as well as histologicalchanges in ovaries, kidneys and liver were evaluated. In PCOS group, the serum level of malondialdehyde (MDA) was 1.391 ± 0.18 mmol/L and significantlyincreased (P=0.000) compared to the control group with the MDA level of 0.35 ± 0.08. Meanwhile the activity ofsuperoxide dismutase (SOD) and catalase (CAT), and total thiol levels were significantly decreased (P=0.000 for allgroups), compared to the control group. In the trans-anethole (80 mg/kg) treated group, insulin (P=0.000) and MDA(P=0.000) levels were significantly decreased while total thiol (P=0.001) and activity of SOD (P=0.000) and CAT(P=0.007) were significantly increased compared to the PCOS group. In the metformin treated group the insulin level(P=0.03) decreased compared to the PCOS group. Histological evaluation showed multiple cysts in the ovarian tissue,an increase in inflammatory cells in the liver, and a loss of order in the structure of the tubules and glomeruli of thekidney in the PCOS group. Tissue damage was reduced in the trans-anethole treated group. Tarns-anethole at a dose of 80 mg/kg improved metabolic status, oxidative stress, liver and kidney damageas well as the cystic mass of ovarian tissue. To understand the exact protective effects of trans-anethole in PCOS,more experimental or clinical studies are suggested.

Among multiple factors that affect the etiology of polycystic ovary syndrome (PCOS), diet hasan important contribution. Chronic oxidative stress has also been implicated in the development of PCOS. Thepresent study is an attempt to evaluate dietary total antioxidant capacity (TAC) and its relationship with odds ofPCOS in Iran. The study was carried out as a case-control study in hospital outpatient clinics, Tehran,Iran. Totally, 310 female participants with a history of PCOS and 602 age-matched controls took part in thisstudy between June 2015 and December 2018. A reproducible and valid 168-item semi-quantitative food frequencyinventory was utilized to determine the entire antioxidants of the usual diet in order to calculate dietaryTAC. The relationship of dietary TAC with odds of PCOS were assessed adjusting for potential confoundersthrough an estimation of two multivariable conditional regression models. The first tertile was presented as areference category. In a fully adjusted model, the highest tertile of dietary TAC was associated with a reduced odds ofPCOS [odds ratio (OR): 0.81, 95% confidence interval (95% CI): 0.59, 0.96, P for trend: 0.038). In addition,PCOS odds decreased in the highest tertile of α-tocopherol intake (OR: 0.73, 95% CI: 0.56, 0.88, P for trend:0.023). The adjusted ORs in the highest tertile of vitamin C, β-carotene and magnesium were 0.79 (95% CI:0.83-0.97), 0.81 (95% CI: 0.67-0.98) and 0.91 (95% CI: 0.55-0.9 8) respectively, with a significant trend. Our results provide evidence that there was a relationship between high TAC diets and lower odds ofPCOS.

The purpose of this prospective study was to compare the ovarian response and pregnancy outcomesin the infertile women with endometrioma undergoing assisted reproductive technologies (ART) in twogroups, who were underwent laparoscopic cystectomy and received gonadotropin releasing hormone-agonist(GnRH-agonist) and who only received GnRH-agonist without any surgery. In this prospective clinical trial study, 79 infertile women with asymptomatic endometriomascyst (2-6 cm) were enrolled and randomly assigned to two groups. First group underwent laparoscopiccystectomy and received GnRH-agonist. Second group only received GnRH-agonist without any surgery. Followingovulation induction, all patients underwent intracytoplasmic sperm injection (ICSI). Different parameterssuch as the number of retrieved oocytes and embryos; were made our outcomes that analyzed using SPSS. The pregnancy rate, chemical and clinical, and live birth rate were higher in the combined group,although these differences were not statistically significant (48.48% vs. 30.8%, P=0.12, 36.36% vs. 25.6%,P=0.32, 36.36% vs. 23.1%, P=0.29). The number of injections, antral follicles, retrieved oocytes, mature oocytes,total embryos, transferred embryos and duration of stimulation were similar in two groups. Laparoscopic cystectomy followed by receiving GnRH-agonist improves pregnancy outcomes in endometriomaprior to treatment with ART (registration number: IRCT201106116689N2).

Recurrent pregnancy loss (RPL) and infertility are associated with significant psychiatric complications.The study aimed to investigate the effectiveness of cognitive behavioral therapy (CBT) and sertralinein the treatment of in depression, anxiety, and infertility stress of depressed infertile women with RPL in comparisonwith usual care. A triple-arm randomized controlled trial was carried out on the 60 depressed infertilewomen with RPL, a population of Infertility Center of Babol city, Iran, who were randomly assigned into threegroups: pharmacotherapy with sertraline (n=20), psychotherapy with CBT (n=20), and a usual care as controlgroup (n=20). The participants of psychotherapy received CBT sessions (90 minutes each) over 10 weeks. Theparticipants in the pharmacotherapy group took 50 mg/day sertraline daily for 22 weeks. Outcomes were assessedusing the Beck Depression Inventory (BDI-II), fertility problem inventory (FPI), and State-Trait AnxietyInventory Form Y (STAI-Y) at the beginning of the trial, 10-weeks post-trial, and three months of follow-up.Using statistical package for the social sciences (SPSS) software, data were analyzed. CBT considerably reduced the depression symptoms more than sertraline with a moderate effect sizeat the post-trial (g=0.11, 95% CI: -0.03 to -0.50). Sertraline showed reduced the scores of state-anxiety moreconsiderably in comparison with control group by a large effect size of post-trial (g=-1.04, 95% CI: -1.70 to-0.38). CBT reduced the total scores of FPI more considerably than sertraline, with a large, small size at followup-trial [95% CI=-0.03(-0.65, -0.58)]. Both CBT and sertraline were superior to the control group in reducingdepression and infertility stress. Depression and infertility stress diminished under CBT and sertraline in depressed infertile women withRPL, with a significant advantage of CBT. Sertraline was superior to CBT in reduction of anxiety (registration number:IRCT201304045931N3).

One of the most common endocrine disorders in women during reproductive age is polycystic ovarysyndrome (PCOS). This study aimed to evaluate sexual functioning among women with PCOS in a sample of a region’spopulation in the west of Iran. This study was a cross-sectional study that was conducted on 130 women with PCOS whoreferred to three clinics of gynecology, infertility, and dermatology affiliated with Hamadan University of MedicalSciences, Iran, from September to November 2020. The measurement tools included demographic characteristics,hirsutism score, and sexual function was assessed using the female sexual function index (FSFI) questionnaire. In total, 60% of patients had reported sexual dysfunction related to lubrication, satisfaction, and pain as domainsof sexual dysfunction. The number 109 (83.85%) of them had hirsutism and these patients had a lower score forlubrication (3.7 ± 1.47 vs. 4.47 ± 1.71, P=0.03), orgasm (3.2 ± 1.34 vs. 3.95 ± 1.37, P=0.02), satisfaction (3.4 ± 1.29vs. 3.71 ± 1.33, P=0.03), and FSFI score (22.56 ± 5.78 vs. 25.42 ± 5.51, P=0.04). Women with higher education hadreported higher scores of FSFI and its domains. Rural participants had a higher arousal score (3.93 ± 1.4 vs. 3.37 ±1.28, P=0.04). Moreover, housekeeper women had higher scores regarding desire, pain, and total FSFI score. Our results showed that there was a significant association between hirsutism and FSFI scores, differentdomains, including lubrication, orgasm, and satisfaction.

Primary dysmenorrhea is the usual medical status in medical students that are defined as painduring the menstrual period. This study was done to evaluate the psychological problems associated with dysmenorrhea. Three hundred forty students aged 18 to 20 years participated in this cross‑sectionalstudy (194 with dysmenorrhea and 150 without dysmenorrhea). In this cross‑sectional study, data were collectedthrough the sociodemographic checklist, the verbal multidimensional scoring system (VMS), and the revisedversion of the Symptom Checklist-90 (SCL-90-R) questionnaire using the convenience sampling method. Thisquestionnaire includes 9 Subscale and a GSI index. We considered psychological distress to be equivalent tothe Global Severity İndex (GSI), which is obtained by dividing 90 questions by 90. The significance level of thetests was considered 0.05. The GSI of the SCL-90 score in the 194 students with dysmenorrhea and 150 students without dysmenorrheawas 1.02 ± 0.42 and 0.34 ± 0.15 respectively (P<0.001). In the group with dysmenorrhea, the severityof dysmenorrhea was significantly associated with a family history of dysmenorrhea and mother's education(P=0.012 and P=0.037, respectively). The strongest predictors of GSI>1 were a family history of dysmenorrheaand mother’s education [odds ratio (OR)=2.33, 95% confidence interval (CI), 1.43-4.15 and OR=0.45, 95% CI,0.24-0.87, respectively]. According to the result, dysmenorrhea is associated with psychological distress. Psychological interventionsand counseling in addition to drug treatment are suggested for treatment of primary dysmenorrhea.Therefore, it is necessary to formulate strategies and health policies to recover psychological issues of menstrualhealth.

Previous studies have shown that embryo donation can be a successful treatment for infertile couples,however the willingness of Dutch couples to donate or accept embryos was unknown. The aim of this article is todescribe the protocol and results for altruistic embryo donation of the only embryo bank in the Netherlands. This is a descriptive study. Since 2011, donated cryo-embryos from couples that have undergonein vitro-fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatments, are being stored in our embryobank. The majority of the donated embryos were frozen on day 3 or 4 by slow freezing techniques. We perform athorough medical and psychological screening of donor couples and recipients, according to the protocol drawn up inclose collaboration with the Dutch Ministry of Health. Up to June 2021, 54 women have received embryos from our embryo bank, all single embryo transfers.While the clinical pregnancy rate in ‘unknown’ embryo donations was relatively high (25.3%), the live birth rateshows limited success (12.6%), partly due to high pregnancy loss through miscarriage. In known donation procedures,the recipients tend to undergo more procedures, depending on the number of donated cryo-embryos. Twentyeightwomen received embryos from known donors, with a clinical pregnancy rate per embryo transfer of 24%, andlive birth rate of 14%. In total, 82 recipients were granted donated cryo-embryos, twenty had an ongoing pregnancy(24.4%), nineteen of whom have given birth to a healthy child (23%). Altruistic embryo donation of embryos appears to be satisfying for the donors, as they are not obliged to destroytheir embryos, but instead help others build a family. Although success rates are still limited, partly due to the relatively highmiscarriage rates and inferior freezing techniques, to this date nineteen out of 82 recipients have given birth to a healthy child.

Present study assessed whether Sinopharm, AstraZeneca, Sputnik V, and Covaxin’s vaccinated womenreveal a distinct incidence of menstruation disturbances, hirsutism, and metrorrhagia. Data collection was performed from June to August 2021, and 427 women working in sevenselected hospitals in Tehran were studied in this descriptive-analytical cross-sectional study. All of these women hadreceived one or both doses of the vaccines with one of the assessed vaccines. Required data was collected via questionnaireand imported to SPSS 16 for further assessment and analysis. Fisher’s Exact Test and Chi-Squared test weremain statistical tests used to understand whether any significant relation exists or not. The participant’s mean age and body mass index (BMI) were 29.78 ± 10.55 and 23.27 ± 3.82, respectively.Three hundred ninety-five cases (92.4%) had received both doses of the vaccines. Also, 154 cases (36.1%) had a historyof COVID-19. A total of 38 cases (8.8%) of menstruation disturbances, 20 cases (4.6%) of metrorrhagia, and 7cases (1.6%) of hirsutism were reported after receiving the vaccines. There was a significant difference among thevaccinated groups with the vaccines as mentioned earlier in terms of menstruation disturbances (hypermenorrhea,dysmenorrhea, Amenorrhea) (P=0.01). The highest and the lowest incidence of menstruation disturbances were recordedin the group vaccinated with Covaxin (17.6%) and Sputnik V (5%), respectively. There was also no significantdifference amongst the vaccinated groups with the four vaccines regarding the incidence of metrorrhagia andhirsutism (P=0.10 and P=0.12, respectively). There was no significant relationship between all three complicationsincidence with the previous infection concerning all vaccines (coefficient=0.46, 1.27, -0.15 respectively for menstruationdisturbances, metrorrhagia, and, hirsutism). Seemingly, Covaxin revealed the most side effects in terms of menstruation disturbances. As a result, professionalsmust carry out several studies with reasonable samples to recommend the vaccine to those women confidently.

Over the past two years, COVID-19 pandemic is an unprecedented health emergency. All countries have taken theirown measures to mitigate the spread of the virus in the first and subsequent mini-outbreaks of infection. In view of thecurrent situation of small outbreaks of COVID-19, guidelines on epidemic prevention should be developed specificallyfor reproductive medical centers. It is necessary to establish a dynamic patient assessment and management systemto identify patients who need priority fertility treatment during epidemic control. Female Patients were assignedas grade A and required hospitalization in the inpatient ward after egg retrieval. Patients who underwent controlledovarian stimulation were classified as grade B, and they can choose to be hospitalizedat home according to their ownconvenience. Patients undergoing frozen embryo transfer (FET) cycle or planned downregulation with gonadotropinreleasinghormone agonists were defined as grade C, who could continue the assisted reproductive technology (ART)treatment cycle with negative COVID-19 nucleic acid test and there was no fever or respiratory symptoms. This briefcomment summarizes the working procedure of the reproductive medical center in the first hospital of Lanzhou Universityin China to minimize the probability of hospital infection and ensure the safe conduct of assisted reproductivetechnology therapy.

Recurrent pregnancy loss (RPL) complication is a challenge of reproductive medicine due to its often unknown etiology.A case-control study was carried out between June 2019 and April 2020 to examine the correlation between RPLand inherited thrombophilia (IT), namely mutations in factor V Leiden (FVL G1691A), prothrombin (FII G20210A),and methylenetetrahydrofolate reductase (MTHFR C677T). A total of 120 Lebanese women with RPL was studiedand compared, for the frequency of these mutations, to 100 healthy reproductive Lebanese women. The associationbetween the zygosity status of the three tested mutations, the existence of more than one prothrombotic single nucleotidepolymorphisms (SNPs), and the increased risk of RPL were examined using Chi-square or two-tailed fisher exacttest, and the student t test. The predictive factors of RPL were analyzed using a multiple logistic regression model.P<0.05 was considered to be statistically significant. Our results showed statistically significant higher frequenciesof FVL G1691A and FII G20210A mutations among the cases with RPL compared to the control group. Thus, RPL isassociated with FVL G1691A and FII G20210A mutations. These mutations seem to increase the risk of RPL in theLebanese women. Therefore, we suggest thrombophilia screening and adequate genetic counseling for women withRPL and at high-risk to plan for primary prevention, avoiding thromboembolic or obstetric accidents, and reducingthe associated morbidity and mortality among Lebanese women.