International Journal of Reproductive BioMedicine
Volume:10 Issue: 6, Nov 2012

Male infertility accounts for 30-50% of all infertilities among couples. Iranian traditional medicine (ITM) stressed the importance of nutrition in the prevention and treatment of male infertility. Many Iranian traditional physicians have described the traits of specific foods for prevention and treatment of male infertility. To explore the principles and roles of foods recommended by ITM scientists in prevention and treatment of male infertility as well as enlisting all the recommended foods for treating this problem addressed through the ITM original resources written between 815 and 1901. In this review study specific data related to the subject among all referral ITM texts was extracted firstly, and then the collected data were analyzed using inductive content analysis. The analysis of data revealed that foods that enhance sexual performance must have 3 properties; they should be warm in nature, very nutritious, and flatulent. Foods that are warm in nature and nutritious affect the quality and quantity of semen. A food having the third trait of being flatulent is required to complete sexual performance by creating an erection. Foods with only one of these traits must be consumed with another food that has the other trait. This study also provided a list of foods that can enhance the quality and increase the quantity of semen. Foods that can enhance sexual performance and the quality and quantity of semen can be recommended to male patients who suffer from infertility in medical centers.

Given the paucity of data on possible testis changes in opioid dependents, we sought to compare the testis volumes between a group of opium dependents and a group of healthy controls. Comparison of testis volume between opium dependents and healthy controls. This case-control study recruited 100 men with opium dependency (cases) and 100 healthy men (controls) in Iran, in 2008. A checklist containing questions about age, height, weight, daily amount of cigarette use, and duration of cigarette use for all the participants as well as daily amount of opium use (grams) and duration of opium use (years) for the case group was completed. Additionally, the dimensions of each testis were measured by a single person using calipers, and the mean of the left and right testes volume was compared between these two groups. The mean of the testis volumes in the case group was significantly lower than that of the case group (11.2±2.2 and 25.1±2.7cm³, p<0.001). The results of the ANCOVA test showed that even after the omission of the cigarette smoking effect (p=0.454), the testis volume remained lower in the opium dependents (R2=0.884, p<0.001). In the case group, there were significant reverse correlations between testis volume and age (r=-0.404, p<0.001), daily amount of opium use (r=-0/207, p=0.039) and duration of opium use (r=-0.421, p<0.001). We found that the testis volume in the male opium dependents was lower than that of the healthy controls. We would recommend that future studies into the impact of drugs on the testis dimensions pay heed to possible histological changes in the testes owing to opium dependency.

Fetal DNA in maternal plasma and serum has been shown to be a useful material for prenatal fetal sex determination during early gestational ages. Non-invasive prenatal diagnosis is now possible at 8th week of pregnancy, by maternal blood sample testing. The purpose of this study was to evaluate two DNA extraction methods from mother plasma and its routine clinical application in bovine fetus gender determination with non-invasive method. Maternal blood samples were taken from 40 pregnant cows during the 8th-38th weeks of gestation. DNA was extracted from 350 µl of maternal plasma with two salting-out and phenol-chloroform methods. The absorption in A260 and purity (A260/A280) of extracted DNA were detected by ultraviolet spectrophotometer. Three µl of the extracted DNA with phenol-chloroform method was used as a template. The PCR reaction was carried out to amplify the fragments of X and Y chromosomes of amelogenin, TSPY and BC1.2 genes. The difference between the mean absorption of DNA extracted by phenol-chloroform method and salting-out method was not significant in A260 (p>0.05, p=0.3549), but the difference between mean purity (A260/A280) of DNA extracted by phenol-chloroform method and salting-out method was significant (p<0.001). X chromosome fragment was detected in all 40 samples and Y chromosome fragments were detected in 25 plasma samples which were delivered a male calf. The sensitivity and specificity of test was 100% with no false negative and false positive results. The results showed that phenol-chloroform method is a simple and sensitive method for isolation of fetal DNA in maternal plasma.

Unovulation is the most common cause of infertility. The first line oral treatment has been clomiphene citrate. Another anti-estrogen used for ovulation induction is tamoxifen. Many unovulatory infertile women are resistance to anti-estrogens and need another treatment. Alternative treatments are aromatas inhibitors. This study was designed to compare the effectiveness of clomiphene, tamoxifen and letrozole in ovulation induction outcomes in isolated non PCOS unovulatory patients. 150 unovulatory infertile women who had isolated non- polycystic ovarian syndrome (PCOS), randomized to 3 groups. Group A received clomiphene 50 mg to maximum 150 mg for 5 days, Group B received tamoxifen 10mg to maximum 30 mg for 5 days, Group C received letrozole 2.5 mg for 5 days, to maximum 7.5 mg until ovulation was induced. If ovulation failed to occur with 5 days treatments, drug continued for 7 days. Treatment has been stopped if they became pregnant or if patient didn’t ovulate with maximum dose for 7 days (resistant to treatment) or failed to concept after six months despite ovulation (failure of treatment). Main outcome measures were: number of mature follicles, endometrial thickness, pregnancy rate, multiple pregnancy rate, live birth and miscarriage. Overall ovulation rate was 60 (73.4%), this rate in group A was 39 (78%), in group B it was 24 (68%) and in group C was 37 (74%). Pregnancy rate in groups A, B and C were, 32 (64%), 20 (40%), and 25 (50%) respectively, and live birth rate was 22 (44%) in A, 17 (34%) in B and 21 (42%) in C. Miscarriage rate with clomiphene was 10 (20%) while this was 3 (6%) in tamoxifen and 4 (8%) in letrozole group (p=0.05). One twin pregnancy was occurred with clomiphene and one with tamoxifen, while all pregnancies with letrozole were singleton. Because of higher pregnancy rate with clomiphene citrate than tamoxifen and letrozole, Clomiphene citrate is still the first-line therapy for ovulation induction. Surprisingly, pregnancies after tamoxifen and letrozole have lower miscarriage rate than clomiphene.

Muslim women tend to postpone their menstrual period using short course oral contraceptives (OC) during Ramadan, Muslims fasting month. Recently, many cases of stroke, particularly cerebral vein thrombosis (CVT), have been reported in Ramadan. This work studies the incidence of CVT and its relation to Ramadan. This is a cohort study conducted from October 2006 to October 2009 and included 4 consecutive Ramadan’s. All patients with definite diagnosis of CVT who were referred to the neurology department of Ghaem Hospital, Mashhad, Iran in this four-year period were included in the study. During the study period, 70 cases with CVT (11 males and 59 females) were recruited. Twenty five cases were admitted during Ramadan months which was significantly higher than all the other 32 months (p=1.9×10-7). The higher frequency of females (6 times more) among CVT cases probed by investigating possible risk factors and short term OC consumption was revealed as the major risk factor (p=0.00071). Higher incidence of CVT in females during Ramadan suggests the presence of specific risk factors in this group. Our study revealed that short-term use of OCs may be a major risk factor for CVT.

Human chorionic gonadotropin (HCG) has been used as a replacement for the mid-cycle luteinizing hormone (LH) surge for several years. The recent arrival of recombinant DNA technology has made recombinant HCG (rHCG) accessible. To assess efficacy of rHCG compared to urinary HCG (uHCG) for triggering of ovulation and induction of final oocyte maturation in assisted reproductive cycles. 200 patients who were candidate for ICSI were randomly divided in two groups. In group I (rHCG), patients received 250µg of rHCG for final oocyte maturation, and in group II (uHCG) the patients received 10000 IU of uHCG. Measured outcomes were number of retrieved oocyte and mature oocyte, maturation rate of oocyte, fertilization rate and clinical pregnancy rate. The rates of oocyte maturity were similar in both groups. Fertilization rate was similar in two groups (58.58% in rHCG group versus 60.58% in uHCG group p=0.666). The clinical pregnancy rate per cycle was similar in both group 34.0% in rHCG group versus 39% in uHCG group (p=0.310). We demonstrated that rHCG is as effective as uHCG, when it is used for final oocyte maturation in ICSI cycles. The numbers of retrieved oocyte and maturation rates were similar in both groups; also fertilization and clinical pregnancy rates were similar.

Central nervous system malformations are the second most common congenital malformations after congenital heart diseases. These malformations are associated with many instances of morbidity and mortality which underline the importance of prevention and their early diagnosis. The objective of this study is the diagnosis of neural tube defect (NTDs) in the first trimester and its comparison to second trimester diagnoses in order to reduce the complications associated with late pregnancy terminations and its costs. This study was a trans-sectional study. A total number of 1074 patients who referred to Imam Khomeini Hospital were enrolled in this study. During the 11th-13th (+6 days) gestational week the patients were screened sonographically; subsequently they were re-scanned for fetal anomalies during 18th-20th gestational week, and we followed the babies after birth. Considering that Intracranial Translucency (IT) was introduced in the newer researches, it was, too, measured in 125 of the cases. In a total number of 1074 patients we had one patient with an anencephalous fetus whom was diagnosed in the first trimester of pregnancy. In the second trimester, we detected one case of myelomenigocele; when we referred to this patient’s first trimester sonography, there was no visible IT. In the 125 cases in whom the IT length was measured, it was normal; the 2nd trimester sonographies in these patients were also normal. It must be noted that the diagnosis of NTD is more accurate in the second trimester of pregnancy. Consequently it is recommended that in high risk patients, the second trimester sonography be performed transvaginally, and in an earlier gestational age (14th-16th gestational weeks).

Indisputable population exposure to widespread electromagnetic fields, has grown concerns over the probable health effects of these fields. The present study was aimed to examine the possible effects of 50 Hz extremely low frequency electromagnetic field (ELF-EMF) exposure on the number and quality of mice blastocysts. In present study, 66 NMRI pregnant females divided into two treated and non-treated groups. The treated group exposed to ELF-EMF (50 Hz and 6×10-3 T). Subsequently, embryos were collected by flushing the uterine horn and Fallopian tubes on the day 3 of gestation. Number of trophoectoderm (TE) and Inner Cell Mass (ICM) cells in blastocysts were determined after differential nuclei staining using a modified method. Furthermore, number of all flushed blastocysts calculated in each group. There was no significant difference in mean number of blastocysts in treated (6.64±1.34) and none treated (8.22±1.59) groups. In treated group, there were significant decreased in total cell number of blastocysts (p=0.000), number of ICM cells (p=0.000), and number of TE cells (p=0.001) whereas the ratio of ICM/TE cells increased (p=0.002). The data indicate that ELF-EMF is able to affect cellular composition of blastocysts, but it can''t omit total volume of blastocysts.

Since preterm delivery is an important problem in obstetrics, it is necessary to know the risk factors. Periodontal disease is an infectious disease and infection is risk factor for preterm delivery. Respecting to the mechanisms of preterm delivery and because involved mediators in this procedure are synthesized in periodontal disease, gum disease is investigated as risk factor for preterm delivery. The aim of this study was to determine the association between preterm, low birth weight with periodontal diseases to improve the mothers’ and the children’s health. This cases-control study was done on 70 women (mean age 25.01 yrs.) 35 women with preterm delivery, gestational age <37 weeks and birth weight <2500 gr as case group and 35 women with term delivery, gestational age >37 weeks and birth weight >2500 gr as control group referring to Imam Reza Hospital. Mean Probing Depth (MPD), percent of sites with more than 3 mm in probing, bleeding Index (BI), Plaque Index (PI), and Extent and Severity Index (Ext. and Sev.) were measured using a mirror and a standard William''s periodontal probe. Significant difference was found in Mean Probing Deep (MPD), percentage of sites with more than 3 mm in probing, BI, PI, Ext. and Sev. indices in case and control groups. There was no significant difference in patient’s job, age, education, and husband’s job and education. No difference was observed between two groups in monthly income and gravidity. Gum disease can be a risk factor for preterm delivery.

The latest studies reported that local endometrial injury is a useful method to improve the success of IVF-ICSI outcome. To assess whether local endometrial injury occurred by Pipelle in the spontaneous cycle could improve implantation rate، cleavage rate، and pregnancy outcome in the subsequent IVF-ICSI cycle in patients who had recurrent IVF failure. An endometrial biopsy was performed on day 21st in 41 patients as intervention group in this retrospective cross-sectional study. The control group contained 42 women. Implantation rate was 22. 5% and 10. 5% in intervention and control group، respectively and this difference was found to be statistically significant (p=001). Pregnancy rate was 43. 9% in the intervention group and this parameter was significantly lower in control group (21. 4%) (p=0. 03). Local endometrial injury in the nontransfer cycle increases the implantation rate and pregnancy rate in the subsequent IVF-ICSI cycle in patients who had previous failed IVF-ICSI outcome.

Vitamin E is an effective antioxidant, protecting cells against oxidative stress. In this investigation the protective effect of vitamin E on the testis during development and spermatogenesis in rats exposed to sodium arsenite was evaluated. Pregnant Wistar rats were divided into 4 groups (n=8) control, sodium arsenite (8 mg/kg/day), sodium arsenite+vitamin E (100 mg/kg/day) and vitamin E. Treatment was carried out from day seven of pregnancy till 90 days. Finally the right testis was stereologically studied. The obtained data was analyzed using one way ANOVA and Tukey''s test and the means difference was considered significant at p<0.05. The weight and volume of testis, volume of seminiferous tubules and its diameter, volume of interstitial tissue, height of germinal epithelium and the total number of types A and B spermatogonia, spermatocyte, spermatid and sertoli cells reduced significantly in sodium arsenite group compared to the control. Co-administration of vitamin E and sodium arsenite compensated the adverse effects of sodium arsenite on the above parameters. We concluded co-treatment of rats with sodium arsenite and vitamin E could prevent the adverse effects of sodium arsenite exposure on the testicular tissue during the prenatal stage till sex maturity.

Genital tuberculosis is a common entity in gynecological practice particularly among infertile patients. It is rare in developed countries but is an important cause of infertility in developing countries. The present study has investigated the prevalence of female genital tract tuberculosis (FGT) among infertile patients, which was conducted at the Obstetrics and Gynecology Unit-I, Allied Hospital, affiliated with Punjab Medical College, Faisalabad, Pakistan. 150 infertile women who were referred to infertility clinic were selected randomly and enrolled in our study. Patients were scanned for possible presence of FGT by examination and relevant investigation. We evaluated various aspects (age, symptoms, signs, and socio-economic factors) of the patients having tuberculosis. Very high frequency of FGT (20%) was found among infertile patients. While, a total of 25 patients out of 30 (83.33%) showed primary infertility and the remaining 5 cases (16.67%) had secondary infertility. Among secondary infertility patients, the parity ranged between 1 and 2. A total of 40% of patients (12 cases) were asymptomatic but infertile. Evidence of family history was found in 4 out of a total of 30 patients (13.3%), respectively. According to histopathological and bacteriological examination of endometrial biopsy and laparotomy, tuberculous endometritis was found in 20 out of a total of 25 (80%) cases, while tuberculous salpingitis and tuberculous oophoritis were found both in 2 (8%) of the cases, respectively. Only one case (4%) of tuberculosis cervicitis was found in the present study. Although infertility is not a disease in classical sense, but it is an extremely important personal concern for many couples and a significant health problem for our profession. So, it is worthwhile to identify and evaluate the factors contributing to infertility.

Ovarian hyperstimulation syndrome (OHSS) is a recognized complication of ovulation induction, occurring in 1-10% of IVF and embryo transfer cycles. While mild OHSS is of no clinical relevance, severe OHSS is a life threatening complication. However, the efficacy of prevalent treatments appeared to be limited. We developed a continuous autotransfusion system with an ultrafiltration instrument for reinfusion the protein of concentrated ascites for the treatment of severe OHSS. To study the efficacy and safety of using a continuous autotransfusion system for the treatment of severe OHSS. 69 patients with severe OHSS who were treated with controlled ovarian hyperstimulation due to infertility from February 2002 to August 2010 in our reproductive center were divided into two groups. One group treated with continuous autotransfusion system with an ultrafiltration instrument which infused the protein of concentrated ascites, called ultrafiltration group, another group were treated with simple-albumin supplement, called albumin group. Several examinational results and adverse effect were compared between the two groups. The volume of urine output after 72h in ultrafiltration group was more than that in albumin group, the waist circumference and body weight in ultrafiltration group were lower than those in albumin group after 72h. The serum creatinine levels after 72h in ultrafiltration group was still significantly lower than that in albumin group (p<0.05). The ultrafiltration group rarely showed adverse effect compared with albumin group. Autotransfusion of protein in concentrated ascites for the treatment of severe ovarian hyperstimulation syndrome was effective and safe.

Balloon bionic midwifery has been applied in clinical obstetrics in China for 10 years, although played a certain role in controlling and improving the quality of obstetrics and caesarean section rate, but some questions have not been resolved. The aim of this study was to investigate the efficacy and safety of airbag midwifery. Primiparas (2410 cases) with various medical conditions were randomly divided into airbag and control groups undergoing the same obstetrical treatments, but airbag midwifery as a birthing option was chosen twice when the cervix was dilated to 2-4 cm during labor. The duration of the first and second stages, as well as the total delivery process, of the airbag group was shorter than that for the controls. The natural delivery rate of the airbag group was higher than that of the control group. The forcep delivery rate, cesarean section rate, amount of vaginal bleeding within 2 h after delivery, rate of postpartum hemorrhage, fetal distress, and pitocin use in the airbag group were all lower than those in the control group. No significant difference in the rate of maternal and fetal complications was observed in the two groups. The bionic airbag midwifery approach did not contribute to the incidence rate of urine retention, leukocyte count, neutrophil proportion, and level of creactive protein and IL-6 24 h after delivery. Airbag midwifery skill is a simple, effective, and safe procedure.

Infertility affects various aspects of personality and psychology, familial and career performances, and relationships. Studies show that stress, anxiety, life dissatisfaction, and other psychological problems follow infertility. Infertility issue, its tests and remedy are stressful and may lead to anxiety and depression and have destructive effects on couple relationships. The present study was done in order to comparison general health and coping strategies in fertile and infertile women. This is an analytic cross-sectional study and was done through random sampling on 70 fertile women and 70 infertile women who visited Yazd’s clinics. The age range of participants was between 20-40 years. General Health Questionnaire (GHQ) and Ways of coping questionnaire (WOCQ) were filled by women who were agreed to participate in the study, following some explanations about aims and ways of doing the study. In the next step, data were analyzed through statistic methods and independent t-test. We considered a significant level p<0.05 in all tests. The results indicated a significant difference (p<0.05) with respect to general health in two groups, but no significant difference was found in problem-centered and emotion centered coping strategies and depression anxiety. This study shows that general health in both groups is below average which means women are not sensitive about their general health. So planning on improving women’s general health by providing consultation and training courses is suggested.