مجله زنان مامائی و نازائی ایران
سال پانزدهم شماره 29 (هفته سوم آذر 1391)

Infertility is one of the common problems of human societies. According to the outcome of some studies, the prevalence of infertility due to various factors have been changing in recent years.The aim of this study was to estimate the prevalence of various rates of infertility and provide necessary information for planning in the future.

In this community-based descriptive study, 2400 women aged 18-49 years were selected by using randomized cluster sampling method from four provinces of Iran as a representative of the couple's population living there. Data were collected by using a valid questionnaire made by the researchers. Gathered data were analyzed by the means of SPSS statistical software version 17, descriptive statistics concepts, analytical statistical methods including chi-square and spearman tests. P value less than 0.05 was considered statistically significant.

In this study, 72 subjects (3.2%) of the population was current primary infertile and 26.1% of the population (599 persons) had experienced lifetime primary infertility. Also, 1.7% of subjects despite having at least one child were secondary infertile. Estimation of prevalence of current primary infertility in Isfahan, Hormozgan, Golestan and Kermanshah provinces was respectively 2.3%, 6.8%, 3.4% and 2.2%.

Based on the definition of one year infertility, the estimated prevalence of current primary infertility in investigated population (except in Isfahan) was significantly higher in this study than other studies over the past years. As well, other various rates of infertility were severely influenced by current age and marital age.

Nuchal translucency (NT) refers to the clear space at the back of a fetus’s neck which is measured in a mid-sagittal plan sonography. Typically screening fetal chromosome abnormalities and NT, as a part of this plan, is recommended to all pregnant women. Despite the widespread use, there are many controversial in the value of NT as a predictor of adverse pregnancy outcomes. In this study the relation between NT and some adverse pregnancy outcomes including abortion, preterm delivery, low birth weight and preeclampsia was assessed. In this cohort analytical study, pregnant women were screened for NT at gestational age of 11-13w±6d. They were divided in two groups: 748 cases with NT less than 2 and 360 cases with NT equal or greater than 2. Pregnancy adverse outcomes include abortion, Intra uterine fetal death, preeclampsia and low birth weight were surveyed in both groups. Gathered data were analyzed by chi-square test, calculating the relative risk (RR) and 95% Confidence Interval. P value less than 0.05 was considered statistically significant. Relation betweenNT≥2 and risks of preeclampsia (p<0.001), preterm labor (p=0.039), abortion (p=0.026) and low birth weight (p<0.001) were significant but with intrauterine death and threaten abortion was not significant (p>0.05). Routine NT screening in gestational age (11-13w±6d) is valuable in predicting of adverse pregnancy outcomes.

Health-promoting behaviors of lifestyle during pregnancy preserve women health in order to deliver healthy infant and reduce the risk of low birth weight. The present study was designed to determine the relationship between mother's lifestyle during pregnancy and low birth weight term neonates. Subjects of this historical cohort study included 1177 mother who referred to the health-care centers for postpartum care or child's vaccinations in two months and also had health records. A three-part questionnaire was used as a data-collection tool which included: newborns characteristics, mothers’ demographic characteristics and maternal lifestyle during pregnancy that was completed from maternal health records and organized interview of mothers. The data were analyzed by SPSS statistical software version16, statistic-descriptive, chi-square, Fisher, Lemeshow, Mann Whitney tests, multiple logistic regressions in WaldBackward method. P value less than 0.05 was considered statistically significant. Results showed that the relationship between lifestyle of the mother during pregnancy with newborn’s birth weight was statistically significant (p<0.004). In each of the domains of lifestyle, the chance of low birth weight increased in mothers who had lower activity, rest and social relation during pregnancy than mothers who were in good condition respectively 8.87 time (p<0.039, OR=8.87) and 4.73 times (p<0.002, OR=4.73). Also, the correlation between low birth weight and nutritional status during pregnancy was statistically significant (p<0.008). According to the results of this study, mothers can be trained about proper lifestyle during pregnancy to prevent low birth weight and its complication in infants.

In treatment of infertility, widespread efforts of medical specialists and embryologists have brought innovative methods to solve this problem. One of these methods is artificial fertility by embryo donation. In this process, due to the couple's infertility, another couple's sperm and ovum are taken and fertilized through in vitro fertilization. By specialists control and supervision, ovum get fertilized (Zygote) and in a time about 72 hours, Cell proliferation gets started. Finally, when the fructuous ovum is turned into about 6 to 8 cells (considering that the uterus is fertilizable), the embryo is transferred to the woman's uterus for natural growth. From the perspective of Islamic jurisprudence, this is a controversial method that prompted some reactions from jurisprudents. In this context the following questions are raised: whether Embryo Donation is legitimate or not? In what circumstances the decree is supposed to be permitted? In the condition of legitimacy of Embryo Donation, isn’t it an intervention in god creation? Citing jurisprudential evidences and documents, the present study is intended to prove the relative legitimacy of Embryo Donation and respond some ambiguities related to this area. This is a documentary research and a descriptive study with the help and relying on leading books if jurisprudence and rights of Shiites and other Islamic religions and also by referring to the legal and adjustment with jurists vote try to prove the theory. Couples donate embryos due to distress and hardship. These are the factors that can replace the primary verdict issue with a secondary issue. Therefore, embryo donation is not exempt from this provision. Embryo donation process is not absolutely forbidden.