Royan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X1220070701The Pregnancy Outcomes of Day 2 versus Day 3 Embryo Transfer: A Cross-Sectional Study47544562010.22074/ijfs.2007.45620ENMahnaz AshrafiEndocrinology and Female Infertility Department, Royan InstituteObstetrics and Gynecology Department, Iran University of Medical SciencesKiandokht KianiEndocrinology and Female Infertility Department, Royan InstituteElahe MirzaaghaEndocrinology and Female Infertility Department, Royan InstituteFatemeh ShabaniEpidemiology Department, Royan InstituteJournal Article20200929Background: The objective was to evaluate whether extending the embryo culture period from 2 to 3 days would yield a more optimal selection of viable embryos, thereby increasing the pregnancy rate.<br />Materials and Methods: We have retrospectively analyzed pregnancy rates in the patients who had embryo transfer either on day 2 (582 patients) or on day 3 (387 patients) post-insemination over a 10-month period. The relationship between the quality score of day 2 and day 3 embryos and their respective pregnancy rates was also analyzed.<br />Results: The demographic and clinical characteristics were similar in both groups. Embryos transferred on day 2 or day 3, were similar morphologically& we found no difference in the distribution of grades between patients who became pregnant and those who failed to become pregnant. Pregnancy rates were slightly higher in patients who had embryo transfer on day 3 (40.72%) than patients who had transferred on day 2 (38.96%), but this difference was not significant.<br />proportion of embryos with 2-3 cells, four cells, and 5-7 cells, which selected for transfer, showed significant difference between day 2 and day 3 (p <0.05). There was also significant difference between pregnant and non-pregnant women based on embryo cell numbers on day two (p <0.011).<br />Conclusion: Extending the embryo culture period from 2 to 3 days had no adverse effect on pregnancy rate. Embryo transfer could be done on days 2 or 3 according to the convenience of the patient and the medical team.https://www.ijfs.ir/article_45620_acf4889ec661630f8a38776f2f3206d6.pdfRoyan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X1220070701Correlation between Seminal Fluid Analysis and Levels of Gonadotropins in Serum and Seminal Plasma of Normozoospermic Men and Infertile Patients55624562210.22074/ijfs.2007.45622ENMuhammad Baqir FakhrildinClinical Reproductive Physiology Department, IVF Institute of Embryo Research and Infertility Treatment, Al-Nahrain University, Baghdad, IRAQJournal Article20200929Background: Levels of serum gonadotropins have direct effects on testicular functions and spermatogenesis. Assessment of levels of serum gonadotropins from fathered subjects and infertile patients indicates wide range diversity. In this study, we tried to find out whether the levels of seminal FSH and LH affect the parameters of seminal fluid analysis (SFA) and if there is any correlation between levels of serum FSH and LH in healthy men and infertile patients.<br />Materials and Methods: Levels of FSH and LH in serum and seminal plasma were assessed randomly, in addition to examination of seminal fluid analysis from 12 normozoospermic subjects (age range: 33-56 years) and 66 infertile patients (age range: 20-62 years) with duration of infertility (15-201 months). Macroscopic and microscopic parameters of semen specimens were determined. Data were statistically analyzed using multiple correlation and regression, and MANOVA tests.<br />Results: Result of the present study observed significant positive correlation between FSH levels in serum and seminal plasma (r=0.984; p <0.001) of normozoospermic subjects as compared to other groups of infertile patients. No correlations were noticed between LH levels in serum and seminal plasma of normozoospermic subjects and groups of infertile patients. Significant and positive correlation was assessed between sperm concentration and levels of seminal FSH (r=0.822; p Conclusion: This study shows a strong association and effect between seminal FSH and serum FSH and parameters of SFA for normozoospermic men and different groups of infertile patients. These finding may call for large cohorts being executed with larger population of patients that is required for this analysis to be more accurate.https://www.ijfs.ir/article_45622_19a1bdc218b76668cdbca3785e43ec74.pdfRoyan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X1220070701Correlation between Endometrial Parameters in Doppler Sonography and Success Rate of Implantation in Assisted Reproductive Programs63684563010.22074/ijfs.2007.45630ENFiroozeh AhmadiDiagnostic Imaging Division, Endocrinology and Female Infertility Department, Royan InstituteAhmad VosoughAndrology Department, Royan Institute0000-0001-7567-1122Shohreh IraniDiagnostic Imaging Division, Endocrinology and Female Infertility Department, Royan Institute0000-0002-7170-1424Fatemeh ZafaraniDiagnostic Imaging Division, Endocrinology and Female Infertility Department, Royan InstituteJournal Article20200929Background: A good blood supply towards the endometrium is usually considered to be an essential requirement for implantation. Evaluating the role of endometrial and sub-endometrial blood flows detected by color Doppler sonography at the day of embryo transfer, as a predictor of pregnancy rate during IVF/ICSI programs was our main goal in this study.<br />Materials and Methods: Seventy three infertile patients aged Results: Pregnancy occurred in 28 patients. Mean age, duration and etiology of infertility, baseline mean FSH and estradiol level at the day of Human chorionic gonadotropin (HCG) injection, amount of drug administered, number of retrieved oocytes and embryos, also number and quality of transferred embryos in the pregnant and non-pregnant groups showed no statistically significant difference .On the other hand, none of the sonographic parameters reported in two groups indicated a statistically significant difference.<br />Conclusion: Doppler ultrasonographic indices at the day of embryo transfer are not considered appropriate criteria for prediction of success rate or failure of embryo implantation.https://www.ijfs.ir/article_45630_ae6ff18ee03340efef2b56f0224c35bb.pdfRoyan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X1220070701Dexamethasone As a Supplement for Exogenous Gonadotropin to Improve Ovarian Response of Women over 35 Years Undergoing IVF/ICSI Cycles69744563510.22074/ijfs.2007.45635ENMahnaz AshrafiEndocrinology and Female Infertility Department, Royan InstituteObstetrics and Gynecology Department, Shaheed Akbarabadi Hospital, Faculty of Medicine, Iran University of Medical ScienceFatemeh ZafaraniEndocrinology and Female Infertility Department, Royan InstituteEnsieh Shahrokh TehraninejadEndocrinology and Female Infertility Department, Royan InstituteObstetrics and Gynecology Department, Imam Khomeini Hospital, Faculty of Medicine, Tehran University of Medical ScienceAhmad Reza BaghestaniEpidemiology Department, Royan InstituteElham AmirchaghmaghiEndocrinology and Female Infertility Department, Royan InstituteJournal Article20200929Background: With aging, the ovarian reserve is decreased and that is a major contributor to poor ovarian response to exogenous gonadotropins. The aim of the present study is to evaluate the role of Dexamethasone on ovarian response in infertile patients aged over 35 years undergoing IVF/ICSI cycles.<br />Materials and Methods: In this triple blind placbo-control clinical trial study, a total of 72 infertile women over age 35, undergoing IVF/ICSI cycles, referred to Royan Institute from May 2000 to May 2002 were selected. Dexamethasone co-treatment (1mg/d) was started on the 21st of their preceding menstrual cycle and it was continued until oocyte aspiration. The main outcome measures were number of retrieved oocytes, number of fertilized and transferred embryos, number of used HMG, serum E2 level on HCG injection day, and pregnancy rate.<br />Results: There was no significant statistical difference in age, duration of infertility, Body mass index, hormonal tests, number of retrieved oocytes and transferred embryos. However, the number of used HMG was significantly lower in Dexamethasone group compared to placebo group (30.6±13.39 versus 41.64 ± 18.34) (p <0.05).<br />Conclusion: The addition of dexamethasone 1mg/d to standard long protocol decreased the number of HMG used in patients over 35 years who hold known risk of low ovarian response.https://www.ijfs.ir/article_45635_165a42e2ab18d781d350973d3fee60d8.pdfRoyan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X1220070701Chromosomal Abnormalities in Iranian Infertile Males who are Candidates for Assisted Reproductive Techniques75784564610.22074/ijfs.2007.45646ENIman SalahshourifarReproductive Genetics Department, Reproductive Biomedicine Research Center, Royan InstituteMohammad Ali Sadighi GilaniMale Infertility Department, Reproductive Biomedicine Research Center, Royan InstituteNajmeh Sadat MasoudiReproductive Genetics Department, Reproductive Biomedicine Research Center, Royan InstituteHamid GourabiReproductive Genetics Department, Reproductive Biomedicine Research Center, Royan InstituteJournal Article20200929Background: The present study offers our contribution on the topic by a retrospective analysis of the prevalence of chromosomal abnormalities in a population of Iranian infertile men attending assisted reproduction programs.<br />Materials and Methods: Cytogenetic analysis was performed according to standard methods on cultured cells obtained from the patient peripheral blood. In all, 874 files belonging to male partner of each couple were classified as follows: azoospermic, oligozoospermic and patients with low sperm quality in respect of morphology and motility.<br />Results: Chromosomal abnormalities were observed in 136(15.5%) individuals of the whole population studied including 12.0 %, 1.2 % and 2.0% of azoospermic, oligozoospermic and patients with low sperm quality, respectively. Of those, 116 (13.2%) had sex chromosome abnormalities and 20(2.3%) had autosomal chromosome abnormalities.<br />Conclusion: We observed high frequency of aneuploidy and sex chromosomal mosaicism in azoospermic men and high structural aberrations in males with low sperm quality. We suggested that type of chromosomal abnormalities had an inverse relation to sperm count. So that, high chromosomal aneuploidy was detected in males with lower sperm count and high structural aberration was detected in males with low sperm quality. Chromosomal abnormalities are a major cause of male infertility. Consequently, Genetic testing and counselling is indicated for infertile men with abnormal semen parameters with either abnormal karyotype or normal karyotype before applying assisted reproductive techniques.https://www.ijfs.ir/article_45646_7243c8a4513269fb82bdf3d4c87e0d72.pdfRoyan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X1220070701Detection of Chlamydia Trachomatis Infection in Female Partners of Infertile Couples79844564710.22074/ijfs.2007.45647ENSeyyed Mehdi KalantarResearch and Clinical Center for Infertility, Yazd Medical Sciences UniversityIslamic Azad University, JahromMohammad Javad KazemiIslamic Azad University, JahromMohammad Hassan SheikhhaResearch and Clinical Center for Infertility, Yazd Medical Sciences UniversityAbbas AflatoonianResearch and Clinical Center for Infertility, Yazd Medical Sciences UniversityFarzad KafilzadehIslamic Azad University, JahromJournal Article20200929Background: The prevalence of infertility is about 10-15% among the couples overally. Several factors can affect fertility ability of men and women. Chlamydia is a non-motile gram negative obligatory interacellular pathogenic organism. It can cause infections in females as cervicitis, urethritis, endometritis, pelvic inflammatory disease also prostatitis and epidydidimitis in male as well. The aim of this survey is to mention the frequency of infection with Chlamydia in infertile female who were treated in Yazd Research & Clinical Center for Infertility.<br />Materials and Methods: A questionnaire containing some demographic information and clinical features related to the infection was completed for each infertile woman. Specimen of vaginal discharge was collected by well trained nurses using sterile cotton swap from 91 women. Elisa test was done on blood serum. DNA extraction for Chlamydia was carried out using low salt method and PCR was done using MOMP and plasmid primers. DNA sequencing was performed on two PCR products using Chromas LITE ver.2.01 and analyzed by BLAST.<br />Results: Of 91 blood samples collected in this survey, none of them was positive by ELISA. Also there was no positive PCR result. Four PCR products showed a questionable band which was not in the range of Chlamydia. The products underwent DNA sequencing and there were not any finding related to any other micro-organism.<br />Conclusion: However, it is well known that Chlamydia as an infection plays a role in infertility. Nevertheless, there was not evidence of this organism in these infertile patients. It is necessary to design such a survey in larger populations of infertile patients especially on infertile women with tubal infertility and their husbands as well.https://www.ijfs.ir/article_45647_dd1b126621e220e4823f152b62779324.pdfRoyan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X1220070701Evaluation of Protamine Deficiency and DNA Fragmentation in Two Globozoospermia Patients Undergoing ICSI85884564810.22074/ijfs.2007.45648ENMohammad Reza DeemehIsfahan Fertility and Infertility CenterMarziyeh TavalaeeEmbryology and Andrology Department, Royan InstituteShahnaz RazaviAnatomy Department, School of Medicine, Isfahan University of Medical ScienceMohammad Hossein Nasr-EsfahaniIsfahan Fertility and Infertility CenterEmbryology and Andrology Department, Royan InstituteJournal Article20200929The aim of this report has been evaluating protamine content and DNA integrity of two patients with globozoospermia undergoing Intra Cytoplasmic Sperm Injection (ICSI).<br />Semen analysis was carried out according to WHO criteria. Protamine deficiency and DNA fragmentation was assessed using Chromomycin A3 and sperm chromatin dispersion assay respectively. ICSI and chemical activation were carried out on inseminated oocyte.<br />Both cases demonstrated high degrees of protamine deficiency, while one of the cases indicated high level of DNA fragmentation, too. High fertilization rates were achieved in both cases. However, embryo transfer did not lead to implantation or pregnancy.<br />Artificial oocyte activation overcomes low fertilization rate reported in cases with high level of protamine deficiency. In the present study, failed implantation in one of the cases may be caused by high DNA fragmentation.https://www.ijfs.ir/article_45648_17bcb09e9f2d47747dca011269e44f8d.pdfRoyan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X1220070701Pregnancy Outcome with Intracytoplasmic Sperm Injection Method in a Woman with Prosthetic Heart Valves89914564910.22074/ijfs.2007.45649ENFahimeh KashfiEpidemiology Department, Royan InstituteCardiac Surgery Department, Shaheed Rajaei Heart CenterAmir Jamshid KhamooshiCardiac Surgery Department, Shaheed Rajaei Heart CenterTahereh MadaniReproductive Health & Infertility Research Center, Shaheed Beheshti University of Medical SciencesSaeed HosseiniCardiac Surgery Department, Shaheed Rajaei Heart CenterRobabeh TaheripanahReproductive Health & Infertility Research Center, Shaheed Beheshti University of Medical SciencesAlireza Alizadeh GhavidelCardiac Surgery Department, Shaheed Rajaei Heart CenterJournal Article20200929There is an increased risk of thromboembolism, anticoagulant-related hemorrhage, fetal-wastage and congestive cardiac failure in pregnant women with mechanical heart valves. In order to have a good outcome, the care of such patients must necessarily be multidisciplinary and in a well- equipped centre with adequate support services .One such patient who had mechanical mitral and aortic valves replacement in 2000 receiving warfarin anticoagulant therapy, presented with a first trimester pregnancy by ICSI method in 2006. She remained in stable homodynamic state and went through pregnancy without event. Delivery was done by caesarian section at 37 weeks gestation age.<br />With considering use of warfarin during pregnancy, use of stimulation protocol during ICSI and delivering normal neonate ultimately, this interesting case is presented herein.https://www.ijfs.ir/article_45649_fc4b48f60416c7d398bb34018417ebe5.pdfRoyan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X1220070701Comparative Histerosalpangographic and 3D Images of Septate and Unicotnuate Uterus92924565010.22074/ijfs.2007.45650ENFiroozeh AhmadiReproductive Imaging Division, Endocrinology and Female Infertility Department, Royan InstituteJournal Article20200929https://www.ijfs.ir/article_45650_1fe2ec11ba04fc95d7f813eb4380bde6.pdf