Journal of Reproduction & Infertility
Volume:11 Issue: 1, 2010

In recent years, preservation of fertility in women has been of great importance, especially in patients exposed to deleterious conditions on fertility. Thus, cryopre-servation of human gametes, embryos and ovarian tissue has become an essential part of assisted reproduction. This approach limits the number of embryos transferred, while supernumerary oocytes and/ or embryos can be used in subsequent treatment cycles. Furthermore, cryopreservation reduces the potential risk of hyperstimulation syndrome. Cryopreservation is carried out by two techniques; the slow freezing method, and the more recent rapid procedure called vitrification technology. Recently due the success and simplicity of vitrification, the balance between those two methods has been changed in advantage of vitrification. The use of slow freezing method has become controversial due to its difficulties, expense and respective low success rates in artificial reproduction. Therefore, vitrification seems to win the battle and will be the cryopreservation method of the future.

Anemia, particularly Iron Deficiency Anemia (IDA), is the most common hematological disorder during pregnancy with considerable complications in both mothers and fetuses. The estimation of anemia prevalence is an important step for health policy makers. Despite being considered a hot topic in epidemiological studies in Iran for the last twenty years, lack of a comprehensive overview on the findings encouraged the authors to carry out this study. All published papers in main national and international databases were systematically searched for some specific keywords to find the related studies between the years 1993 and 2007. All published studies which had reported the prevalence of anemia were included in the study except studies on refugees, patients undergoing hemodialysis, patients with thalassemia or cancer or other selective subpopulations. Two trained reviewers independently assessed the inclusion/exclusion criteria and the quality of the selected papers, summarized them and eventually analyzed the data. Ten eligible papers including 11,037 participants were entered into the analysis. The maximum and minimum reported prevalence rates of anemia during pregnancy were 4.3% and 21.5%, respectively. The overall estimate of anemia prevalence in Iranian pregnant women was 13.6 (95% CI: 8.3 - 18.9). Excluding the only out-layer from the meta-analysis, the overall estimated prevalence was 12.4% (95% CI: 9.6% - 17.9%). The prevalence of anemia in Iranian women during pregnancy is considerably lower than that of most EMRO countries or the one reported by WHO for Iran (> 40%) which had been performed on a small group 16 years ago. The lower prevalence rate of anemia in pregnant women versus the regional rates could be due to the improvements of the national health system and prenatal programs in recent years.

Embryo biopsy has potential applications in molecular research processes in domestic animals, besides its application in sex determination in embryo transfer programs. The objective of the present study was to assess the in vitro development of bovine embryos biopsied on different days of precompacted morula stage. Slaughterhouse-derived oocytes were matured in vitro, fertilized (Day-0) by frozen-thawed, Percol-separated spermatozoa and cultured on oviductal cell monolayer. The embryos were subjected to cell biopsy on Days 2, 3, and 4 postinsemination at 4-16-cell stages. The data were analyzed using ANOVA and Chi-squared tests (SigmaStat, version 2). A p-value < 0.05 was considered significant. Biopsies carried out at 16-cell stage (Day-4) resulted in 94% of embryos developing to the blastocyst stage, which was significantly higher (p < 0.05) than the ones biopsied at 8-cell stage on Day-4 (64%), and those undergoing the procedure on Day-3 (49% and 46% at 4-cell and 8-cell stages, respectively) and Day-2 (39% and 33% at 4-cell and 8-cell stages, respectively). No significant differences were observed between biopsied and non-biopsied embryos on a given day. The total cell number in biopsy-derived blastocysts ranged between 103 and 135. The difference in the number of total cells, dead cells and cell allocation to trophectoderm and inner cell mass between non-biopsied and biopsy-derived blastocysts was insignificant. Biopsy of bovine embryos at 4-16-cell stages had no adverse effects on in vitro developmental potentials and the 16-cell stage embryos, biopsied on Day-4 was the best stage for blastomere removal.

Angiogenesis, growth of new blood vessels from pre-existing vessels, is a crucial physiological process for tissue regeneration. This state is also seen in pathological processes such as malignancies and endometriosis. Vascular endothelial growth factor (VEGF) is a major mediator of angiogenesis and vascular permeability which is known to play an important role in the development of endometriosis. The aim of this study was to investigate the relationship between 405 G>C VEGF polymorphism and endometriosis in an Iranian population. The study population was comprised of 105 women with and 150 women without laparoscopic evidence of endometriosis. Genomic DNA from blood cells was extracted using salting out method. Genotype and allele frequency of 405 G>C polymorphism was compared between women with endometriosis and the controls using PCR-RFLP. Statistical analysis was performed using SPSS 13.0 software. Chi-squared test and odds ratio plus 95% confidence interval were determined. A p-value less than 0.05 was considered statistically significant. While the 405 VEGF genotype frequencies in the case group were 41.3% G/G, 46.2% C/G and .5 C/C, they were 32% GG, S.3 GC and 14.7% CC in the control group. The distribution of three genotypes and allele frequencies of 405 G>C VEGF polymorphism between the case and control groups did not demonstrate any significant difference. In contrast to previous studies, no significant correlation was found between 405 G>C VEGF polymorphism and endometriosis. Since this was the first study in an Iranian population, further investigation with bigger sample sizes may be indicated to be able to generalize the findings.

Azoospermia affects more than 10% - 15% of infertile male subjects attending infertilty clinics. At present, testicular biopsy is the golden standard procedure for evaluating spermatogenesis status in men with azoospermia. Semen collection and analysis is a non-invasive method and has proven to be valuable in the evaluation of spermatogenesis. Identification of seminal plasma markers with testicular or extra-testicular origins have a great value in predicting the prescence of sperm in testicular tissue and presumptive cause of azoospermia. The aim of this study was to find such markers by comparing the content of seminal plasma using different methods in normospermic and azoospermic men.Matherials and

Semen samples were collected from 200 men attending Avicenna Infertility Clinic (AIC) in Tehran, Iran. Semen samples were analysed according to WHO guidlines. The subjects were divided into two groups: normospermic (n = 100; group one) and azoospermic men (n = 100; group two) according to semen analysis results. Seminal plasma was separated by high speed centrifuagation and stored in -20° C. Four markers including fructose, neutral alpha glucosidase (NαG), inhibin B and anti-Müllerian hormone (AMH) were measured in seminal plasma. Fructose and NαG were evaluated by spectrophotometry, while inhibin B and AMH were assessed by ELISA method. The spermatogenesis status in the azoospermic group was evaluated by histopathological method following testicular biopsy.

Fructose concentration showed no difference between the two groups. However, it was significantly correlated with sperm count (p < 0.01, r = -0.408). Seminal plasma inhibin B (OR: 1.01; 95%: CI: 1.005 - 1.016), AMH (OR: 1.63; 95% CI: 1.17 - 2.28) and NαG, (OR: 1.07; 95% CI: 1.04 - 1.1) levels were higher in normospermic subjects compared to azoospermic men. There were significant differences in inhibin B and AMH concentrations between the two groups based on the presence or absence of mature sperm in testicular biopsies (p < 0.01). Inhibin B concentration was positively correlated with sperm count in the normospermic group, however, NαG concentration correlated with sperm count of normospermic men (p < 0.01, r = 0.345) and the subjects’age in both groups.

Inhibin B and AMH were correlated with the presence of sperm in testicular tissue samples. According to non-specific changes in inhibin B and AMH concentrations, identification of more specific molecular markers in seminal plasma to definitely evaluate the status of spermatogenesis is recommended.

Recurrent abortion (RA) may be a consequence of aberrant expression of immunological factors during pregnancy. Although the relative importance of immunological factors in human reproduction remains controversial, substantial evidence suggests that autoantibodies contribute to reproductive failure. Production of such antibodies is under the control of cytokines; and leptin, besides its role in reproductive success, has a profound effect on directing the cytokine profile toward Th1 (cellular) pattern. Therefore, the present study was performed to assess serum leptin levels in women with immunological recurrent abortion. In this prospective study, 250 women who attended Avicenna Infertility Clinic with RA were screened for known causes of abortion from July to December 2008 in Tehran, Iran. Eighty-one patients with normal karyotypes and hormonal profile with normal ovaries and uterus and no signs of infection were categorized as patients with immunological (IRA, n = 39) or unexplained (URA, n = 42) recurrent abortion based on presence or absence of autoantibodies. After blood sampling, levels of anti-nuclear antibody (ANA), anti-double stranded DNA antibody (anti-dsDNA), lupus anti-coagulant antibody (LACAb), anti-phospholipid antibody (APA), anti-cardiolipin antibody (ACA), anti-thyroglobulin antibody (TgAb), anti-thyroperoxidase antibody (TPOAb) and anti-thrombin III antibody (ATIIIAb) were measured by enzyme-linked immunosorbent assay (ELISA) or chemiluminescent enzyme immunoassay (CLEIA). In IRA group, 9 (23.1%), 24 (61.5%), 25(64.1%) and 1 (2.6%) women were above the normal cut-off point for ANA, TgAbs, TPOAbs and AT-III Abs, respectively. IRA patients had normal values of LACAbs, APA and ACA. With normal level of fasting blood sugar (FBS), IRA and URA groups had similar serum leptin levels (23.7 13.2 ng/ml vs. 22.7 12.5 ng/ml, respectively). Serum leptin concentrations showed a positive correlation with weight and BMI in both groups. This study suggests that serum leptin levels are higher in IRA and URA patients than normal women. The findings of this study suggest the need for a more comprehensive study and comparison of leptin levels in IRA and URA patients to women with no history of miscarriages.

Nowadays, HIV is mostly spreading in Asian countries. One of the important routes for HIV transmission in these countries is the vertical route which infects 35% to 45% of newborns. Mother’s education, drug prophylaxis and Cesarean section, accompanied by banning breastfeeding will decrease this rate to 2%. Therefore, mothers’ knowledge about Prevention of Mother to Child Transmission (PMTCT) has a great role in HIV/AIDS prevention. This study was designed to evaluate knowledge of pregnant women about HIV, its vertical transmission and prevention in Tehran, Iran. This cross-sectional study was conducted on 1577 pregnant women aged 15 - 46 years who were attending prenatal care clinics in Tehran, Iran. The research material was a questionnaire which was completed daily by trained midwives. The data were statistically analyzed by ANOVA, independent sample t-test, Pearson correlation and linear regression with a significance level of p = 0.05. About 16.5% of the participants had good knowledge about HIV/AIDS and 54.1% about its transmission routes but awareness about its prevention was only 5.7%. Fifty-seven percent of the participant had not been tested for HIV earlier and 20.2% were not willing to undergo such tests. About 86.2% of the participants had no idea about the availability of drug prophylaxis in Iran for PMTCT. The fact that 28.2% of the participants were not willing to undergo HIV testing reflects negative attitude about HIV infection. Although the overall awareness about the infection and its transmission was good but knowledge about its prevention especially by PMTCT and its availability in Iran was low. Educational programs through mass media or prenatal care programs by focusing on HIV/AIDS prevention maybe useful.

Primary ovarian failure (POF) is a syndrome composed of amenorrhea, estrogen deficiency and Follicular Stimulating Hormone (FSH) of menopausal ranges in young women. In this article, we report a case of primary amenorrhea that presented with full term pregnancy. A 29-year old woman with a history of primary amenorrhea attended hospital with full term pregnancy. She had experienced a few episodes of withdrawal bleeding on hormonal treatment initially and she had conceived spontaneously. Subsequently, she had uneventful pregnancy and caesarean delivery on maternal request. This case was presented to emphasize the real chances of spontaneous conceptions due to intermittent and unpredictable ovarian function in patients with POI. Nevertheless, egg donation is still considered the best option for infertility in such women.