International Journal of Reproductive BioMedicine
Volume:7 Issue: 3, Mar 2009

This study assessed emotional adjustment of infertile couples and the psychological outcomes of infertility (depression, anxiety, relationship and sexual problems, and personality disorders) in different phases of treatment. References used include studies which have been performed within the last two decades. The articles were invested on data bases at Pub med, Scholar, Google, Scpous and Amazon and key words include (infertility OR pregnancy OR depression OR anxiety OR psychology disorder OR marital satisfaction OR psychiatric & psychology interventions AND personality disorder or ….). Each one of them was used in abstract and keywords, according to articles selected which were published before 2006. Almost all of accessible articles were obtained, and other inappropriate articles were not considered.

Results derived from most studies show that more than half of infertile people (women, men, and couples) learn to cope with this problem to some extent.

However, a significant percentage of people show clinical signs such as inability to adjust with the problem and inappropriate emotional reactions, which highlights the importance of psychological inventions and psychotherapy.

Endometriosis is the presence of endometrial glandular and stromal cells outside of the uterine cavity. Our previous study showed that in vitro culture of human endometrial tissue in a three-dimensional (3D) fibrin matrix could mimic the early stages of endometriosis with invasion, gland and stroma formation and sprouting of new vessels.

The objective of the present study was to evaluate the expression of aromatase in in vitro cultured endometrial fragments.

Endometrial samples obtained from the fundus of the uterine cavity of ten normal ovulating women on cycle days19-24 that referred to Toronto Center for Advanced Reproductive Technology (T.C.A.R.T) for infertility treatment and cultured in vitro by a three-dimensional fibrin matrix culture system. Cultures were performed in 24-well culture plates.

After 4 weeks, the tissues were fixed and blocked for immunostaining. They were stained by anti-aromatase antibodies. Although a fine anti-glycodelin positive glandular epithelium and anti-cyclooxygenase-2 (COX-2) positive new vessels were detected and reported in our previous study, we were unable to detect any aromatase activity in the cultured fragments.

No aromatase activity was detected in the 3D cultured endometrial tissue. Although it is reported that aromatase is expressed in endometrial disease, it is possibly not expressed in this phase in normal endometrium.

para-nonylphenol (p-NP) is able to induce malformations in male reproductive system.

The aim of this study was to investigate the preventing role of vitamin E (Vit.E) on sperm parameters and reproductive hormones in developing rats.

Pregnant rats were divided into 4 groups: control, p-NP, Vit.E and p-NP+Vit.E. Treatments were performed on day 7 of gestation and continued during weaning. The male pups were then divided into the same groups as the mothers and were treated till 90 days of age. Finally, body and left testis weight were recorded and left epididymis was cut in Ham’s F10. Released sperm were used to analyze number, motility and viability of the sperm. Blood serum was used to assess follicle stimulating hormone (FSH), luteinizing hormone (LH), estrogen and testosterone.

In p-NP-treated rats, a significant decrease was found in body and testis weight, sperm number and sperm motility compared to control and p-NP+Vit.E groups. A significant increase was also found in sperm viability in Vit.E group (83.3±7.6) compared to both p-NP (59.5±7.5) and control (66.3±9.7) groups. Rats treated with p-NP showed a significant decrease in FSH level and a significant increase in estrogen level. However, testosterone and LH level remained constant. In p-NP+Vit.E group, the change of estrogen level but not FSH was significantly reversed compared to p-NP group.

Vit.E not only is able to compensate the toxic effects of p-NP on testis weight, sperm number, sperm motility and estrogen level, but also increases sperm viability in developing rat.

Infertility is defined as one year unprotected intercourse without pregnancy. It greatly affects couples' quality of life, and has great impact on their careers, everyday activities, sexual and non-sexual relationships.

To study the prevalence of both primary and secondary infertility and demographic characteristics of it in Yazd province.

We studied 5200 married defined couples in 260 randomized clusters. These couples were interviewed based on using a structured questionnaire. Then, for etiological evaluation, infertile couples were referred to the Research and Clinical Center for Infertility.

Among these couples, 277 cases of infertility were encountered and the overall prevalence of infertility was 5.52% (95% CI from 4.9% to 6.1%). In total 170 couples (3.48%) had primary and 107 (2.04%) had secondary infertility. The prevalence of infertility in rural and urban areas was 5.3% and 6.8% respectively. Female factors were more common (57.5%) in etiologic assessment of infertility.

Our data showed a lower total prevalence of infertility in our people compared to the other countries. Furthermore, there was significant difference in infertility prevalence between geographic parts of the province. Female factors and among them ovarian disorders were the main cause of infertility in central part of Iran.

One of the main laboratory tests for evaluation of infertility is semen analysis (SA). However, additional tests may be suggested for further diagnosis of male fertility potentials. The seminal fluid contains sperms, non-sperm cells, and various types of lipids and glucose.

The objective of this cross-sectional study was to correlate the sperm parameters with concentrations of cholesterol, triglyceride, LDL, and HDL in serum samples of infertile men with abnormal SA.

A total of 120 infertile men (aged 23-49 years) with abnormal SA were enrolled for this cross-sectional study. Sperm concentration and motility was evaluated using Makler chamber. While, normal morphology was done after Geimsa staining. Following 12 h of fasting, the blood samples were obtained for evaluation of cholesterol, triglyceride, LDL, and HDL levels. The lipid profiles were compared with the rates of normal and abnormal sperm parameters. Chi-square and fisher exact tests were used for data evaluation.

75.5% and 98% of the subjects with normal levels of triglyceride had abnormal sperm morphology and progressive motility, respectively. Also, abnormal levels of triglyceride and cholesterol were related with abnormal sperm morphology and motility. The levels of LDL and HDL were normal in 80% and 89.3% of the cases, respectively. The majority of the patients with normal LDL had abnormal sperm parameters.

The results showed that the concentrations of serum lipids were not generally related with the quality of semen parameters. Further studies on the role of lipid profiles of infertile men with sperm fertilizing potentials are necessary.

Some evidences showed that the secretion of uterine tube, vagina and follicular fluid (FF) affects X and Y-chromosome populations. Sperm selection with X or Y chromosome can added to oocyte for gender desired. The isolation of X, Y sperm have done and all efforts in this field are done to make culture media similar to in vivo condition. The objective of this study was to find if the FF can influence the ratio of X or Y chromosomes, therefore we added human FF to culture media to separate X and Y sperms.

Normal semen sample from 36 healthy men were selected. Then the samples were divided into control and experimental groups: control group sperms have been incubated with conventional culture media (Ham''s F-10) and experimental group with conventional culture media + 10% human FF. For sperm isolation, swim up technique was used. After 24 hours of incubation, slides smear were prepared. Then, we used the Fluorescent in Situ Hybridization (FISH) method to evaluate the effect of follicular fluid on the population ratio of X and Y containing sperms.

Although the incubation of sperm in FF and Ham''s F-10 increased Y sperm (59.44 % in control and 61.42% in experimental groups) in comparison with X sperm (40.56% in control and 38.5 in experimental groups) significantly (p<0.05), but the Y (or X) bearing sperm did not significantly change in experimental group in comparison with Y (or X) bearing sperm in control group.

This study showed that using the swim up method for collecting sperms and adding FF to culture media can improve some sperm parameters, but did not has significant effects on population of X and Y sperm.

Embryo transfer (ET) has traditionally been performed two days after oocyte retrieval. Delaying transfer from day two to day three or four would allow for further development of the embryo, might therefore optimize the selection of viable and best quality embryos for transfer and may be closer to the physiological time of the entry into the uterus than transfer on day two, and might have a positive effect on pregnancy outcomes.

The study aimed to determine whether delayed transfer of embryos from 2 to 3 or 4 days after oocyte retrieval and the pregnancy rate in ICSI (intra cytoplasmic sperm injection) procedure.

In this descriptive study we evaluated infertile couples who were referred to the Mehr Infertility Institute between 2006 and 2008 for ICSI, according to the day of embryo transfer. We compared embryo quality, pregnancy rate and implantation rate among day 2, 3 or 4 of transfers. Pregnancy rate was confirmed by measurement of β-hCG in serum after 14 days. After data collection, analysis was carried out with the t-test and chi squared tests by using the statistical software package, SPSS.16.

The overall clinical pregnancy rate (CPR) reported was 46.6%. The mean age of women and duration of infertility didn''t differ on the day of embryo transfer (p>0.05). Overall CPRs were not statistically different for day 2 (50.3%), day 3 (46.5%) and day 4 (34.8%) transfers respectively, there were no significant differences in the age of transferred embryos between pregnant and nonpregnant women (p>0.05).

From the result of the present study there were no statistically significant differences in pregnancy rates according to the day of embryo transfer.

Sperm preparation is a fundamental step in ART and attempt for developing new methods to be continued.

To evaluate the efficacy of upstream method for separation of human spermatozoa and its effects on sperm parameters including: motility, morphology, and concentration.

Semen samples from 17 men who referred to infertility clinic for evaluating their infertility problems were collected. Semen was placed in floor of the upper container of device, and then media was gently placed on the upper semen portion. During the procedure, semen flowed from upper container and dropped in lower container. When semen flowed, the non-motile sperms, cells, debris and seminal plasma enter the lower container, while only motile sperms separated by swimming upstream and go to the upper part of the medium. Finally, all of the semen flowed from the upper container to the lower one, and merely the medium remained, which contained motile normal sperms.

With application of upstream method, the recovered spermatozoa showed significant improvement with motility and normal morphology. The data showed that mean sperm motility increased from 39% to 90% (p<0.0001) and normal morphology increased from 25% to 32 % (p<0.0001) after processing using new method. In addition, the concentration of round cells decreased to zero in all samples.

The results indicate that upstream method can enrich the sperm population of normal motile sperms. Also, the new method is simple and does not require centrifugation step or any chemicals.