Journal of Reproduction & Infertility
Volume:15 Issue: 3, Jul-Sep 2014

Fibroblast growth factor (FGF) signaling is thought to play diverse roles in the male reproductive system. However, its role in testicular cells for spermatogenesis and fertility remains unclear. In this study, the expression and localization of Fgfr 1 (FGF Receptor) and Fgfr 2 in the postnatal mouse testes were examined by RT-PCR, Western blotting and immunohistochemistry. The in vivo function of each receptor in testicular germ cells was determined using germ cell-specific Fgfr mutant animals, Tex101-iCre;Fgfr flox/flox and Tex101-iCre;Fgfrflox/flox mice. The results were analyzed by Kruskal-Wallis test and Dunn's Post-test. Both Fgfr1 and Fgfr2 were expressed in the testis throughout the entire postnatal development. Prominent immunostaining of these FGFRs was observed in interstitial and peritubular cells with little or no changes in all phases during postnatal development. Positive staining of these receptors was also detected in germ cells including elongated spermatids and spermatozoa. Germ cell-specific Fgfr1 or Fgfr2 mutant mice were viable with no developmental abnormalities in the testes and accessory sex organs. Fertility studies showed that the fecundity of both mutant mouse lines did not significantly differ from wild-type siblings (n=4, p>0.05). Further analysis indicated the presence of other Fgfrs in testicular germ cells including Fgfr 3, 4 and 5. The results demonstrated that Fgfr1 and 2 are expressed in all testicular cell types and that neither Fgfr1 nor Fgfr2 in testicular germ cells is essential for spermatogenesis and fertility. Future studies are needed to investigate the potential functional redundancy among five Fgfrs in male germ cells for spermatogenesis and fertility.

Dysmorphology and dysfunction caused by prenatal ethanol consumption in different organs of the offspring are wellknown phenomena. The objective of the present study was to explore the antioxidant effect of vitamin E supplementation on testis damage induced by maternal ethanol consumption during pregnancy and early postnatal days. Pregnant Wistar rats on gestation day 7 were assigned to 3 groups, namely, control, ethanol and ethanol-vitamin E groups. Ethanol-treated rats received 4.5 g/kg BW ethanol once per day from day 7 and the procedure continued through postnatal day 21. Vitamin E group received 300 mg of vitamin E and the same amount of ethanol. The male offspring from each group were anesthetized by 10% chloral hydrate (0.5 ml/kg body weight) on day 21 and 90 (n=8 offspring form each group on day 21 and day 90). The results were analyzed by one-way ANOVA. A p<0.05 was considered significant. The results revealed significant (p<0.05) changes in oxidative stress parameters, luteinizing hormone and follicle-stimulating hormone, as well as testis structural alteration in offspring of ethanol group after 21 and 90 days of birth as compared to the control. Significant amelioration of changes in testis structure, along with restoration of the elevated level of oxidative stress parameters were found in vitamin E-treated animals. The findings revealed that prenatal and postnatal ethanol-induced toxicity in testis was exerted through oxidative stress and implied that these effects could be alleviated by vitamin E as an antioxidant.

Nitric oxide plays a major role in increasing uterine blood flow during the luteal phase and early pregnancy. This study was done to compare uterine artery and sub-endometrial blood flow indices during the luteal phase between patients with unexplained recurrent abortion and fertile women and also to evaluate the effects of nitric oxide donors on blood flow indices in the abortion group. The study included a control group of 30 primiparae who had normal vaginal delivery and no history of abortion and an abortion group of 30 nulliparous women with history of two or more unexplained recurrent abortions. Transvaginal three-dimensional pulsed color Doppler ultrasound was done on days 21-23 of the cycle to measure uterine artery resistance and pulsation indices and the subendometrial vascular, flow and vascular-flow indices. Isosorbide mononitrate 20 mg tablet was administered vaginally in the abortion group and blood flow indices were measured again after two hours. The Student t-test and the paired t-test were used for analysis of results and a p-value of ≤0.05 was considered significant. Patients with unexplained recurrent abortion had significantly higher uterine artery resistance and pulsation indices and lower sub-endometrial vascular, flow and vascular-flow index (p<0.01-0.0001). Isosorbide mononitrite significantly decreased uterine artery and increased sub-endometrial blood flow indices (p<0.001). Uterine artery and sub-endometrial blood flow decreased during the luteal phase in patients with unexplained recurrent abortion. Nitric oxide donors increased blood flow and may be of a therapeutic value.

Threatened abortion is a common complication of pregnancy. In order to prevent miscarriage in the cases with threatened abortion, this study was conducted to determine whether progesterone suppository is effective in allowing pregnancy to proceed beyond week 20 in women with threatened abortion. This single-blind clinical trial study was done on 60 pregnant women with threatened abortion. Pregnant women, who had vaginal bleeding until 20 weeks of their pregnancy, were assessed for inclusion. Participants were divided into two groups by random allocation; the control group, which did not undergo any treatment and the case group. The case group was given 400 mg of vaginal progesterone suppository (Cyclogest) each day until their bleeding stopped in less than one week. Participants were followed up until the end of their pregnancy. The treatment was considered successful if pregnancy continued beyond 20 weeks of gestation. Qualitative and quantitative variables were analyzed statistically by Chi Square and T- test respectively. The p-values of less than 0.05 were considered significant. There was no statistically significant difference between the case and the control groups in terms of background variables. The number of abortions in the case group (6 cases, 20%) was lower than the control group which had 10 abortions (33.3%). The study demonstrated that the rate of abortion was reduced in women treated with progesterone suppositories. However, the difference was not statistically significant.

The study aimed to investigate the effectiveness of a single versus double dose of prostaglandin E2 "misoprostol, 400 microgram" prior to myomectomy for multiple uterine fibroids. This was a prospective randomized controlled trial comprised of 69 patients with multiple myomas undergoing myomectomy. Patients received either an intra-vaginal single dose of 400 microgram misoprostol 1 hr pre-operatively (group A, 34 cases) or 2 doses, 3 and 1 hr prior to surgery (group B, 35 cases). Operation time, intra and post-operative blood loss, hemoglobin concentration, blood pressure and body's temperature were estimated and compared in both groups. The data were statistically analyzed using chi-square test. The p<0.05 was considered significant. In group B, the mean operative time was significantly (p<0.001) shorter than in group A (25.8±4.14 vs. 35.4±5.6 min respectively). The mean value for operative blood loss was significantly (p<0.001) smaller in group B (101.4±25.5 vs. 200.16±18.8 ml). There was a significant (p<0.01) rise of the body temperature in group B (38.5±0.7 vs. 37.18±0.84 C). There were no differences between the two groups regarding hemoglobin levels, post-operative febrile morbidity or length of hospital stay. In this study, two doses of pre-operative intra-vaginal misoprostol were more effective than one dose in reducing intra and post-operative blood loss and shortening of operation time during abdominal myomectomy.

Hydatidiform mole is an important obstetric problem which can result in harmful and serious outcomes. In this study, an attempt was made to determine the proportion of hydatidiform mole in prenatal clinics of Iran University of Medical Sciences (IUMS) to find the precise frequency of this disease. Between January 2012 and January 2013, all women who immediately after positive pregnancy test or after retarded menstruation came to prenatal clinics in health care centers of IUMS were included in the study. The women were followed until 8-10 weeks of pregnancy and at this time abdominal sonography was used for confirmation or exclusion of molar pregnancy. In this descriptive study between January 2012 and January 2013, 8614 pregnant women with mentioned criteria were included and 61 cases of hydatidiform mole were diagnosed (0.7% or 7 per 1000 pregnancy). Ten cases (16.4%) were patients with partial moles. There was no significant difference in blood types in molar and non-molar pregnancies, but molar group differed significantly from non-molar group in terms of history of molar pregnancy, abortion, OCP use and ovulation induction. Proportion of hydatidiform mole in this study was more than the reported European and American statistics.

Previous studies suggest that adenylate kinase locus 1 (AK1) has an important role in the control of blood glucose level and in the glycation of structural and functional proteins in type 2 diabetes and in the balanced development of feto-placental unit in healthy puerperae (HP). In this study, an attempt was made to investigate the relationship of AK1 with maternal and neonatal parameters in puerperae with gestational diabetes (GDP) and with preexisting type 1 diabetes (T1DP). This study was carried on 402 HP, 347 consecutive healthy newborns, 102 GDP and 111 T1DP with their newborn infants. AK1 phenotype was determined by starch gel electrophoresis. Chi-square test of independence was carried out by SPSS program. The analysis of three way contingency table was carried out by a loglinear model. Significant level was 0.05. In T1DP, the frequency of AK1*2 allele was higher than in GDP and in HP. Serum glucose level was higher in T1DP than in GDP with higher values in carriers of AK1*2 allele. Neonatal hypoglycemia was more frequent in T1DP than in GDP with a positive association with AK1*2 allele. The correlation between birth weight (BW) and placental weight (PW) was lower in infants from T1DP than HP. In healthy puerperae the correlation is higher in AK1 2-1 than in AK11 phenotype while in diabetic puerperae the pattern is reversed with lower values in AK12-1 than in AK11 phenotype. The lowest value of correlation is observed in infants from T1D mothers carrying the AK1*2 allele. The data confirmed the involvement of AK1 in glucose metabolism and showed a disturbance of the balance between placental and fetal growth which was more marked in T1DP.

Cellular angiofibroma, first described in 1997, is known to occur in both genders with equal predilection occurring in middle aged females and older males. In this study, a case of vaginal cellular angiofibroma was reported in a 30 year old female presenting with secondary infertility. The case was diagnosed based on morphology and immunohistochemistry and was treated surgically. The interesting feature of the case was the rarity of its incidence at the vagina and its resemblance to other benign and more aggressive tumours in the same site. Cellular angiofibromas are benign tumours, which rarely occur in vagina. Although middle aged females are affected more, cellular angiofibromas can affect females of reproductive age group and can cause secondary infertility. These tumours need to be distinguished from other benign tumours and aggressive tumours occurring in the same site.

Pregnancies with early onset fetal growth restriction have poor perinatal outcome. Sildenafil citrate (PDE -5 inhibitor) as a vasodilator increases uteroplacental blood flow and potentiates fetal growth. In this study, a case was examined and Sildenafil was administered for her. It was found that Sildenafil improved the uterine blood flow with a favorable fetal outcome at delivery. Sildenafil, as a vasodilator has emerged as a potential management option in the treatment of Intra Uterine Growth Retardation (IUGR) and preeclampsia by later normalization in velocimetric profile.