International Journal of Reproductive BioMedicine
Volume:2 Issue: 2, Nov 2004

Fetal alcohol syndrome is associated with numerous problems in the developmentand function of the brain. Learning and memory deficits are among well known effects of prenatalexposure to alcohol.

This study aimed to examine the spatial working memory of 60-day old rats who wereexposed to alcohol during their fetal life and to find the relation between the possible alcoholimpairedspatial memory and gestational period of exposure to alcohol.

Pregnant rats in different stages of gestation period were administeredwith ethanol. Using a radial arm maze, the offspring were subjected to spatial working memorytraining at 60 days of postnatal age.

The rats exposed to ethanol during the first 10 days of fetal life indicated lowerperformances compared to the controls. Those receiving alcohol during the second half ofpregnancy period had no problem in maze navigation. Behavior of the animals exposed to alcoholduring the first and the second quarter of the gestation period demonstrated that only the latter wereweak in solving maze tasks. The groups related to the third and the forth quarter of gestation periodhad a similar behavior with the control group. Comparison of the animals'' performances in allgroups revealed that only the second quarter group was the most disadvantaged.

Our data indicates that the second quarter of the gestation period is more sensitive toharmful effects of alcohol on the areas of brain involved in learning and memory. Since thehippocampus is central in cognitive functions and this part of brain is highly vulnerable to alcoholeffects it can be concluded that the hippocampus is mostly affected in the second quarter of prenatallife.

Pentoxifylline (PX) prevents cAMP breakdown by inhibiting the activity of thecAMP-phosphatase and presumably, stimulates sperm motion. Incubation with PX causeshyperactivation of sperm, an important step in achieving fertilization, and leads to changes inmembranes associated with sperm capacitation.

The purpose of this study was to examine the effects of pentoxifylline on spermviability, motility and fertilization rate after mouse sperm preservation.

Epididymal spermatozoa from adult NMRI mice were collected in T6medium supplemented with 5% BSA and divided into four control and four experimental groups.The control groups included: (1) Fresh sperm sample (2) Preserved sperm sample at roomtemperature for 18 hours. (3) Preserved sperm sample at incubator 37°C for 18 hours. (4) Preservedsperm sample at 4°C for 18 hours. Experimental groups were the same groups after treatment with3mmol/L PX. All the samples were assessed according to World Health Organization Criteria.Oocytes from superovulated NMRI female mice were inseminated in-vitro incubated sperm of allthe control and experimental groups. After insemination and washing, the fertilization rate andcleavage rate were assessed by the presence of two pronucleus (2PN) and 2-cell stage embryos. Tostudy the acrosomal reaction of control and treated spermatozoa transmission electron microscopy(TEM) technique was used.

The results showed that addition of 3mmol PX to preserved mouse spermatozoa at 4 ºCand 37 ºC could increase the motility rate significantly (P<0.05) and also it could enhance abnormalmorphology rate. Significant increase of fertilization rate was seen after preservation of treatedsperm at 4 ºC (P<0.05), but there was not seen significant difference regarding cleavage ratecomparing treated and non-treated spermatozoa (P>0.05). Studies with electron microscopy showedthat addition of PX to the preserved spermatozoa prevent early acrosomal reaction.

The results of this study demonstrated that addition of pentoxifylline in mouse spermsamples after short time preservation can enhance the motility and fertilization rate, although it canenhance the abnormal morphology. It also can increase the number of intact sperm afterpreservation.

There is growing evidence that damage to spermatozoa by reactive oxygen species(ROS) play a key role in male infertility.

The aim of the present study was to assess the antioxidant status of seminal plasma bymeasuring total antioxidant capacity (TAC) and activities of catalase and superoxide dismutase(SOD) in men with asthenozoospermia, asthenoteratozoospermia and oligoasthenoteratozoospermiacompared to normozoospermic males, and their correlations with seminal parameters.

46 men with seminal parameters abnormalities divided in threecategories: asthenozoospermic (n=15), asthenoteratozoospermic (n=16) andoligoasthenoteratozoospermic (n=15), according WHO criteria, participated in the study. Thecontrol group consisted of 25 males with normozoospermia. Catalase activity was measured byAebi spectrophotometeric method. Commercially available colorimetric assays were used formeasuring SOD activity and TAC.

TAC evaluation showed significantly lower values in the total case group (n=46) versuscontrol group (1.05±0.04 mmmol/ml vs. 1.51±0.07 mmol/ml, p<0.05). Catalase activity alsoshowed significantly lower values in the total case group (n=46) versus control group (14.40± 0.93U/ml vs. 21.33±1.50 U/ml). But this difference was not significant for SOD activity (5.31±0.56U/ml vs. 6.19±0.83 U/ml). Both catalase activity and TAC in asthenozoospermic,asthenoteratozoospermic, oligoasthenoteratozoospermic subjects were significantly lower thannormozoospermic males, but SOD activity did not show a significant difference between thesegroups. Both catalase activity and TAC showed a positively significant correlation withprogressively motile sperms and normal sperm morphology, but these correlations with SODactivity were not significant.

Decreasing seminal plasma antioxidant status especially catalase activity and TACmay have significant role in etiology of sperm abnormality.

The etiologic cause in near one third of male factor infertility is unknown. Thepercentage of men with idiopathic infertility who have been successfully treated by the empiricaltherapeutic modalities is not high.

The aim of this study was to assay the effect of L-carnitine on sperm parameters inpatients who needs intracytoplasmic sperm injection (ICSI) as a method for infertility treatment.

The study population consisted of 65 men (mean age± SD: 34.4 ± 6.07)presenting with primary infertility due to idiopathic oligoasthenoteratozoospermia. L-carnitine wasprescribed 1gram orally every 8 hours for 3 months. Before and after the ending of the L-carnitinetreatment, semen analysis was performed.

The proportion of patients who had motile and grade C sperms rose significantly aftertreatment. Percentile of abnormal shaped sperms decreased significantly after treatment. Inapproximately 22%, complete asthenozoospermia changed to relative asthenozoospermia.

Appearing motile sperms will potentially improve the technique of ICSI. Themagnitude of the elevation in normal morphology is not clinically obvious, but it seems that it canbe important in obtaining normal-shaped sperms for intracytoplasmic injection.Designing a study on selected patients with complete asthenozoospermia who have not otherabnormalities in semen parameters can reveal the real effect of carnitine therapy in this category.

Embryo transfer has received little clinical attention and has been the most inefficientstep in in-vitro fertilization (IVF). Recent reports have suggested that an awareness of the positionand length of the uterus during embryo transfer might be helpful in improving pregnancy rate.

The main objective of the present study was to determine the relation between thelength and position of the uterus during embryo transfer and pregnancy rate.

Patients were randomly allocated to two groups. In case group A (n=40)length of uterus was measured at the day of oocytes collection and the position of uterus wasdetermined. In the control group, Group B, (n=40) the length and position of uterus were notinvestigated. The embryo transfer catheter was advanced to 5 mm from uterine fondues based onthe previously determined cavity length in group A. The embryo transfer procedures (IVF/ICSI) at48 hours after oocytes collection was done. The outcome of the treatment cycle in two groups wasinvestigated. Data analysis was performed by using chi-square, fisher-exact and ANOVA tests. Thestatistical significant was defined (P≤0.05).

There were no significant differences in the mean age (28.5+4.4, 27.8+6.2), and durationof infertility (7+3.4, 8.7+5.4). The pregnancy rate was not significantly different with respect toposition and length of uterus. The pregnancy rate in case groups was 25% and in control group was22.5%, the difference was not significant (P= 0.792). In both groups, there were ectopic peregnancyand in fact he incidence of ectopic pregnancy, per reported clinical pregnancy, was highest in groupA (14.9%) in comparison with group B (1.8%).

The pregnancy rate was not significantly different in the two groups. Misdirecting theembryo transfer can not be avoided by an accurate knowledge of the position or length of uterine atthe time of oocytes retrieval. Further studies are required to evaluate the role of length and positionof uterus related to the pregnancy rate.

Infertility affects about 10-15% of reproductive-age couples. About half the causes ofinfertility are female related and approximately 40% of the cases are caused by anovulation, mostlyin PCO women.

This study was conducted to determine and compare the effects of two drug treatmentregimens: higher dose of clomiphene and a combination of lower dose of clomiphene and tamoxifenin treating infertile women with PCO.

The study was a randomized clinical trial conducted on 100 infertilepatients who referred to Yazd-Iran Infertility Clinic between the years 2001-2003. The patientswere selected who had received at least 3 periods of clomiphene, but no pregnancy had occurred.They were randomly divided into two groups. In the first group, clomiphene was increased to 100mg and the second group 20 mg of tamoxifen was added to 50 mg of clomiphene from day 5-9 ofmenstruation cycle. Infertility duration, duration of medicine used, PCT score, endometrialthickness, ovulation, and pregnancy rate were studied in both groups.

Ovulation rate in clomiphene group was 54.9%; Tamoxifen + clomiphene group was73.5% without significant differences in both groups. (PV = 0.053). Positive pregnancy rate inclomiphene group was 39.2%; clomiphene + tamoxifen group was 61.2% (P value < 0.05), whichcould be concluded that pregnancy rate was higher in clomiphene/tamoxifen group than in theclomiphene group. The presence of a dominant follicle in the two treatment groups in womenbetween 18-24 was not significant, but in women between 25-39 years was significant (PV= 0.049)(Table III).

The recommendation is to add Tamoxifen to Clomiphene in 35-39 women with 20≤BMI ≤26.99 before the use of gonadotropins treatment in PCOS with or without IUI, because theseoptions have higher risk of multiple pregnancy and ovarian hyperstimulation syndrome.

In patients with anovulatory infertility the first choice of treatment for ovulationinduction is an antiestrogen, most commonly clomiphene citrate (CC). However, 20-25% of thewomen are resistant to CC and do not ovulate perhaps due to antiestrogenic mechanism of the CCaction, which involves long-lasting estrogen receptor (ER) depletion.

The objective of the study was to mimic the action of CC without depletion of ERs bythe administration of an aromatase inhibitor letrozole in a selected group of Poly Cystic Ovary(PCO) patients who demonstrated failure to ovulate after treatment with CC.

20 patients with anovulation due to polycystic ovary syndrome (PCOS),who had previously inadequately responded to CC were selected for study. The aromatase inhibitorletrozole was administered orally in a dose of 2.5 mg on days 3-7 of the menstrual cycle. Then,occurrence of ovulation, endometrial thickness, and pregnancy rates were determined.

Only one patient had one dominant follicle (1.8 cm diameter) on day 14 of the cycle(estradiol = 200 pg/ml). IUI was done; however, no pregnancy took place. In the remaining cases,several sonographies were done between days 9 to 15 of the cycle; however, all cycles werecancelled due to absence of a dominant follicle (>1.4 cm).

Our study did not confirm the favorable effect of letrozole for induction ofovulation in patients with clomiphene resistant PCO.

Studies in regions with seasonal climatic variations have revealed a correlationbetween human natural conception and birth rates. Holidays and other cultural activities probablyhave influence on conception, but the ambient temperature and emotional influences on the femalehormones related to fertility may play an important part in the seasonal variation in conception.

The aim of study was to determine the relationship between the success rate ofAssisted Reproductive Technique (ART) treatment cycles and temperature in different seasons.

A retrospective study on all individuals undergoing assisted ART at ourinstitution was performed during June 2000 to June 2001. The study population represented 258IVF-ET cycles and 821 ICSI treatment cycles. Different variables were analyzed using χ2 test.

In IVF treatment cycles, conception was more common from early spring (March to June).This decreased from spring, with the minimum in fall, 22% and 14%, respectably. A significantseasonal variability in the number of eggs, embryo transferred and sperm motility was notdemonstrated (p>0.05), but sperm count was significantly higher in spring than any other season(72+4 x106 and 52+7x106, respectively).

The seasonal changes should be taken into account together with other factors whenevaluating infertility data.