مجله زنان مامائی و نازائی ایران
سال هفدهم شماره 98 (هفته چهارم اردیبهشت 1393)

Poor and low fertility in IVF cycles can be due to hormonal status and hormonal levels results from induced ovulation protocols. In cases of decreased ovarian reserve، follicular response to gonadotropin stimulation also decreases and the small number of oocytes will be resulted. This article measured the predictive effects of anti-mullerian hormone (AMH) and follicle-stimulating hormone (FSH) levels and antral follicle count (AFC) in infertile women prior to IVF and ICSI on ovarian response and the success rate of pregnancy.

This prospective observational study was conducted during 2011 to 2013 on 60 patients referred to Montaserie infertility center of Mashhad، Iran for IVF or ICSI. Serum levels of AMH، FSH، CBC، LFT، TFT، Ur، Cr and Prolactin were measured and vaginal ultrasound was performed to determine AFC. Required number of gonadotropin ampoules were determined and recorded. At days 20 and 21 of menstrual cycle patients underwent imitated transfer and GnRH was injected. At the 2nd day of menstruation، gonadotropin was injected. 6 days after injection، the ultrasound was performed every other day until at least two follicles up to 17-18mm were observed. Based on the number of follicles، 5000 to 10000 units of hCG was administered. After 36 to 40 hours، IVF or ICSI was performed. Finally bHCG was measured as an index of pregnancy. Data were analyzed by SPSS software version 11andt-test and chi-square tests. P value less than 0. 05 was considered significant.

The mean number of antral follicular and oocytes before and after treatment was 4. 43±4. 17 and 3. 09±3. 71، respectively. Mean of bHCG after treatment was 94. 79±265±86 Pmol/dl. Adequate ovarian response occurred in 52 cases (86. 7%) and the incidence of pregnancy was 30% (18 cases). In all patients، AMH was 1. 34±2. 66 Pmol/dl and FSH was 6. 81±4. 54 Pmol/dl. Comparison of hormone levels in women with positive and negative ovarian response showed no significant differences (p>0. 05)، but the differences of these hormones were significant in terms of pregnancy and pregnancy outcomes (p<0. 05). In pre-treatment، the level of AFC in these groups showed no significant difference (p>0. 05)، .

AMH and FSH hormones are predictive factor for positive pregnancy in infertile women after IVF and ICSI.

Infertility is defined as the absence of pregnancy without using contraception methods after one year of regular intercourse. Considering the importance of childbearing in terms of religion and general culture community، infertility is one of the reasons for divorce. This study was performed aimed to determine prevalence and causes of infertility among couples in Ilam province in 2013. This cross sectional study was conducted on 1013 married women living in urban and rural areas of Ilam who referred to private centers of gynecology. Data were gathered based on a self-made questionnaire and interview. The content validity was used in order to confirm the questionnaire validity. Data were analyzed by SPSS software version 16andKolmogrov smirnov and Kruskal wallis tests. P value less than 0. 05 was considered significant. 896 (88. 4%) women of 1013 participants had no problem in Fertility. Present primary infertility and history of primary infertility were reported in 37 (3. 6%) and 17 (1. 7%) of all participants respectively. There are a significant relationship between the married age and infertility (P<0. 001). But there was any significant relationship between the Menarche age and infertility (P=0. 956). The estimated prevalence of infertility among study population in Ilam province was higher in compared with other studies. This difference will require further investigation of the etiology and risk factors.

Menopause is a period of life that a permanent cessation of menstruation occurs due to loss of ovarian follicular activity. This study was done to determine the level of physical activity and its relationship with the severity of menopausal symptoms. This cross sectional study was conducted on 600 menopause women in 2013. Cases were selected randomly through cluster sampling method. Data were gathered based on a self-made questionnaire on demographic characteristics (Age، education، occupation، socioeconomic status، marital status، and number of pregnancies)، international physical activity questionnaire and menopausal symptoms. Data were analyzed by SPSS software version 21andKolmogorov-Smirnovand Spearman correlation coefficient tests. P value less than 0. 01 was considered significant and p value less than 0. 05 was also synchronous. Most women complained of menopausal symptoms in moderate، severe and very severe scales were sleep disorders (39%)، myalgia (42. 5%) and flushing (23. 2%). Daily work، transportation and leisure showed inverse association with hot flashes، heart problems، sleep disorders، depression، decreased libido، incontinence، vaginal dryness and muscle pain and working at home was also showed significant inverse association with heart problems and muscle pain (p<0. 05). Exercise is very important to stabilize the natural circulation and other physiological activities in postmenopausal women.