International Journal Of Fertility and Sterility
Volume:1 Issue: 3, 2008

The aim of this study was to compare prenatal outcome of intra cytoplasmic sperm injection (ICSI) pregnancies with pregnancies obtained through in vitro fertilization (IVF). Retrospectively 532 pregnancies of ART cycles were assessed during 1999-2000. The main outcome measured including abortions, ectopic pregnancies, prematurity, low birth weight, cesarean section, prenatal mortality and malformation compared between IVF and ICSI groups The mean age was similar in both IVF and ICSI groups, as well as treatment protocols, and the number of transferred embryos. There were significant differences in duration of infertility, and times of ART cycles between groups (p<0.05). The total spontaneous abortion rate (19.09% in IVF and 16.42% in ICSI) showed no significant difference between groups. In addition, we could not find significantly differences about the first and second trimester abortion between two groups. ICSI patients experienced similar ectopic pregnancy rate (1.2%) to IVF (0.9%).The rate of cesarean section was 42.5% in ART cycles. ICSI group showed a significant difference with IVF in cesarean section rate (46.9% VS. 35.8%) (p=0.043). The rate of low birth weights and preterm labor at birth demonstrated similarity between ICSI and IVF groups (5.1% versus 6.4% and 5.4% versus 5.5%, respectively). In ICSI, seven congenital anomalies were detected. The rate of congenital anomalies was 2.08% in ICSI and 0.9% in IVF (p>0.05). Prenatal mortality was also similar between groups. In conclusion, perinatal outcome after ICSI showed similarity in the number of pathologies in comparison with IVF.

This novel approach describes a rapid and simple method for identification of necrotic vs. viable cells within a mammalian blastocyst. Hatched bovine blastocysts produced in vitro were first incubated for 30 min in pre-equilibrated culture medium containing propidium iodide (PI; 300µg/ml) and bisbenzimide (Hoechst: H33342; 5µg/ml) fluorescent dyes. Embryos were then freed from residual dyes by thoroughly washing in warm phosphate buffer saline free of calcium and magnesium (PBS-), fixed in 2.5% glutharaldehyde and washed again in PBS-. Stained embryos afterwards were mounted in a drop of glycerol over a microscopic slide. Prepared samples were examined under an epifluorescent microscope using the same excitation wavelength (330-385nm) and barrier filter (400nm) to distinguish necrosed vs. viable blastomers as being appeared in red and blue, respectively. Obtained results showed that in cells with altered cell membrane such as late apoptotic or necrotic cells, PI and H33342 readily enter through the cytoplasmic barriers and so the chromatin materials are stained by both, but since PI quenches bisbenzimide fluorescence, necrotic blastomeres are seen in red to pinky red, while live cells are seen just as blue. Obtained results clearly indicated that this novel approach can be used as a simple, feasible and precise method for every embryology lab and with all the mammalian blastocysts produced either in vitro or in vivo. The basic assay can be completed in 60 min, and valuable and reliable information can be obtained about the quality of the embryos.

Although varicocele can be treated, it is considered as one of the most common causes of infertility. This study was performed in order to estimate prevalence of varicocele in adolescents aging 12-14 years in the city of Isfahan During this descriptive analytic research, 800 secondary school students who were 12 to 14 years old were randomly chosen from all the five areas of the city. Physical examination results were considered absolutely private. Examinations could screen grades I, II, III, unilateral and bilateral varicocele. Finally, recorded data was analyzed. From 800 students examined, 133 individuals had varicocele. 74 students out of 133 individuals with varicocele, had grade I (55.6%) in the left side, 44 students had grade II (33.1%) in the left side, 4 students had grade III (3%) in the left side, and 11 students had bilateral varicocele (8.3%). Considering the significant frequency of varicocele among adolescents more attention must be paid to early treatment of varicocele in order to restore the testicular function and therefore, future fertility. However late treatment may lead to testicular atrophy and irreversible consequences. Thus examination, diagnosis and treatment of possible varicocele in individuals at this range of age is highly recommended. In addition, the results of this study highlight the importance of parents'' education about the consequences of varicocele on the future fertility of their children.

Approximately 2-4% of all women have recurrent spontaneous abortion (RSA); however, the cause is determined in only 50% of cases. Recent studies have shown an association between thyroid autoantibodies as a sign of thyroid autoimmunity and abortion. The aim of the present study was to determine whether circulating anti-thyroid peroxidase (anti-TPO) was associated with RSA. In this observational analytic study, Sera from 58 non-pregnant women with a history of RSA and also 58 healthy, fertile subjects with at least one live birth as control (Aging from 18 to 45 years) were tested for thyroid peroxidase antibodies by means of a standard Anti-TPO ELISA kit. We used data collection forms and SPSS software for data analysis. Of 116 women, 8 (13.8%) of the control subjects and 12 (20.7%) of the women with a history of RSA had positive results for anti-TPO. There was not any significant association between presence of anti-TPO and RSA We did not find any correlation between the presence of TPO antibodies and abortion in women with a history of RSA. On the basis of this study, testing for anti-TPO doesn’t seem to be useful in the evaluation of patients with a history of RSA.

In IVF/ICSI treatment, several attempts have been made to quantify the implantation potential of embryos in order to optimize the pregnancy rate. The objective was to determine the possible factors which might have positive impact on implantation We retrospectively analyzed 110 IVF- ICSI cycles as first trial for ART programs. Maternal and ovulation factors such as female age, body mass index, type of infertility, infertility diagnosis, duration of ovulation stimulation, numbers of aspirated and fertilized oocytes, day of ET, were compared in high (≥2 gestational sacs) and low implantation groups (one or no sac). All analyses were adjusted for age and PCO subgroups in line with the design of the study. Our results showed that there were significant differences in follicle size between high and low implantation groups (19.32±0.37 vs. 18.07±0.32 respectively) (p= 0.014). Mean number of grade (V) oocytes was also statistically greater in high implantation group (p=0.035). Our results were also compared based on age and PCO diagnosis. Women younger than 35 years old in high implantation group had higher number of grade (V) oocytes than the other group (p=0.038). Assessing our results based on PCO diagnosis, we found that the number of oocytes grade (IV) were significantly higher in high implantation group with non PCOs diagnosis (4.82±2.87 vs. 4.25±3.6) (p=0.043). Non PCO women in low implantation group had also greater number of grade II oocytes compared to the other group (p=0.017). The mean follicle size was significantly greater in high implantation group than the other group (19.32±2.17 versus 18.07±1.76) (p=0.014). Follicle size, and oocyte quality have positive effect on high implantation potential.

Endometriosis has been widely implicated as one of the causes of chronic pelvic pain, dysmenorrhea and infertility. The purpose of our study was to define the presumed correlation between visual and histologic diagnostic features of endometriosis based on the peritoneal findings identified in laparoscopy as a diagnostic trial with a standardized technique. So, all the specimens including complete excised lesions suggestive of endometriosis and systematic biopsies of normal appearing pelvic peritoneum were analyzed. This study was performed in Mahdieh hospital and IRHRC1 between 2004 and 2005. A diagnostic study of 30 patients (14 to 45 years) undergoing diagnostic laparoscopy for the evaluation of chronic pelvic pain, infertility, dysmenorrhea and dyspareunia was carried out (average age was 28.6±5.14). All areas suggestive of endometriosis were excised and examined pathologically. Peritoneal biopsy specimens were obtained from areas of normal appearing peritoneum to rule out microscopic endometriosis. The positive predictive value, sensitivity, negative predictive value and specificity were determined for identified endometriosis versus the histological findings. The mean prevalence of abnormalities visually consistent with endometriosis was 63% while 42% confirmed histologically. The positive predictive value was 42.1%, sensitivity 88.8%, negative predictive 90.9% and specificity 47.6% for visual versus histological diagnosis of endometriosis. A diagnosis of endometriosis should be established only after histologic confirmation.

A family traditionally consisted of a married man, his wife, and their children. The new reproductive technologies including use of the third party as egg, sperm and embryo donation and also surrogacy have changed the traditional meanings of lineage, ancestry and family. The increasing number of lesbians and gays in addition to single women requesting fertility treatment from IVF centers in the world has brought a debate: “Can fertility treatment be offered to single persons or homosexuals?” According to ASRM and ESHRE taskforces, there is no such limitation, but as legislations and law, also ethical and social considerations depending on the culture, believes and religion of societies must be considered as limitations in some contexts like Iran. In this study we review the Iran law and also some Islamic resources about offering the fertility treatment to single mothers or homosexuals. Homosexuality is not accepted in Islamic contexts and is considered as a crime. Children should have a family with both mother and father, unless they lose one of them or both. In the latter situation Islamic court will hand over the custody of the child to someone else like uncle or grandfather We concluded that according to Islam and Iran’s law, fertility treatment cannot be offered to single mothers and homosexuals mostly because of welfare of the child.

Prevalence of Polycystic Ovarian Syndrome(PCOS) in Iran is more than 6%. Therefore we encounter with many PCOS patients. In Vitro Maturation (IVM) of oocytes as an attractive method in ART is considered. Studies show that changes in culture conditions should be administered to make IVM protocol more successful. For this purpose in this study we have set up the beneficial cultures for IVM procedure. Fourteen PCOS patients received FSH, 75 IU or 150 IU per day for 3 days initiating on day 3 of menstruation. Oocyte retrieval was performed transvaginally using an ultrasound-guided 17-gauge single lumen needle and filtered through a 70 micron gauge filter. Viable oocytes were put to maturation in TCM-199 supplemented with 10% Patient serum, recombinant FSH, pyruvate, penicillin, streptomycin sulphate and human chorionic gonadotropin..Oocytes were then inseminated by ICSI. The results indicated that 43.4% of oocytes matured to metaphase II. After 48 hours 47.5 % of M II oocytes fertilized by ICSI and cleaved to 2- and 4-cell stage. No pregnancy observed in PCOS patients. The oocytes maturation rate (43.4%) and embryo formation (47.5 %) from immature oocytes obtained in our IVM and ICSI culture system indicate that the present system may be nearly good, even though the number of patients were too small to draw significant conclusions.