Royan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X11420180101Revisiting The Relationship between The Ejaculatory Abstinence Period and Semen Characteristics2382464544110.22074/ijfs.2018.5192ENBashir M AyadDivision of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South AfricaGerhard Van Der HorstDivision of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South AfricaStefan S Du PlessisDivision of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South AfricaJournal Article19700101Variation in the ejaculatory abstinence period suggested by different guidance bodies have resulted in a growing concern among researchers and clinicians over what the precise period of ejaculatory abstinence ought to be for an optimal semen sample. Several studies have thus been undertaken to examine the association between the length of sexual abstinence and semen characteristics. Not all studies, however, have arrived at the same conclusions. This study aims to review all existing literature published during the past few decades pertaining to the influence of ejaculatory abstinence on semen quality. For the purpose of this systematic review, all data related to sexual abstinence duration and seminal parameters were re-analysed to homogenize the current data. Thorough PubMed, MEDLINE and Google Scholar, a literature search was conducted using the keywords “sexual abstinence”, “ejaculatory abstinence”, “semen”, “spermatozoa”, “semen analysis”, “sperm parameters”, “motility”, “reactive oxygen species (ROS)” and “DNA fragmentation”. After carefully reviewing all the literature, 30 relevant papers, both written in English and published between January 1979 and December 2016, were included in this review. The weight of the evidence suggests that the decline in semen volume and sperm concentration with shorter abstinence periods is accompanied by a substantial improvement in sperm motility characteristics, especially progressive motility and velocity. Nevertheless, available data are insufficient to support definitive conclusions regarding the influence of the ejaculatory abstinence period on advanced semen parameters (ROS, DNA fragmentation and seminal plasma antioxidant capacity) and pregnancy rates. In conclusion, taking all data into account, shortening of the abstinence period may be beneficial to sperm quality. Furthermore, we recommend that the current guidelines regarding the prescribed abstinence period should be revisited.Royan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X11420180101Gene Polymorphism of Matrix Metalloproteinase 9 in Asthenozoospermic Male Subjects2472524544210.22074/ijfs.2018.5038ENSina Mohagheghi.Student Research Center, Hamadan University of Medical Sciences, Hamadan, IranIraj Khodadadi.Department of Biochemistry, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, IranManoochehr Karami.Modeling of Non-Communicable Diseases Research Center, Department of Biostatistics and Epidemiology, School of
Public Health, Hamadan University of Medical Sciences, Hamadan, IranIraj Amiri4.Endometrium and Endometriosis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran0000-0003-4587-736XHeidar Tavilani5.Urology and Nephrology Research Center, Hamadan University of Medical Sciences, Hamadan, IranJournal Article19700101Background: Matrix metalloproteinase (MMPs) play important roles in the structural and functional properties of reproductive organs. The aim of this study is to determine the prevalence of C-1562T MMP-9 (rs3918242) gene polymorphism in fertile and infertile men. In addition, we aim to determine the association between C-1562T MMP-9 and G-1575A MMP-2 gene polymorphisms. Materials and Methods: A total of 400 subjects, including 200 fertile and 200 infertile men, were recruited for this casecontrol study. The allele frequencies and genotype distributions of single nucleotide polymorphism in the promoter regions of MMP-9 (C-1562T) were determined using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. The chi-square (χ2) test was used to assess the distribution of genotype frequencies. Results: There were no significant differences found in the genotype distributions or allele frequencies between fertile and infertile men for the C-1562T MMP-9 gene polymorphism. The percent of immotile sperm in infertile men with the CC and CT genotypes of C-1562T MMP-9 gene polymorphism significantly differed compared with that of subjects with the TT genotype. The frequency of CC/GA-combined genotypes of C-1562T MMP-9 and G-1575A MMP-2 gene polymorphisms significantly differed in fertile and infertile men (P=0.031). Conclusion: Our results suggest that genetic polymorphisms in MMP may impact male fertility.Royan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X11420180101Multiplex-Polymerase Chain Reaction for Detecting Microdeletions in The Azoospermia Factor Region of Y Chromosome in Iranian Couples with Non-Obstructive Infertility and Recurrent Pregnancy Loss2532574544310.22074/ijfs.2018.5162ENAfsaneh Mojtabanezhad ShariatpanahiDepartment of Biology, University of Sistan and Baluchestan, Zahedan, Iran;Medical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, IranHassan AhmadniaDepartment of Urology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, IranAdam TorkamanzehiDepartment of Biology, University of Sistan and Baluchestan, Zahedan, IranMahnaz Mansouri Torshizi4Novin Infertility Center, Mashhad, IranMohammad Amin KerachianMedical Genetics Research Center, Mashhad University of Medical Sciences, Mashhad, Iran;5Department of Medical Genetics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranJournal Article19700101<strong>Background</strong><br /> Approximately 15% of couples are infertile with the male factor explaining approximately 50% of the cases. One of the main genetic factors playing a role in male infertility is Y chromosomal microdeletions within the proximal long arm of the Y chromosome (Yq11), named the azoospermia factor (AZF) region. Recent studies have shown there is a potential connection between deletions of the AZF region and recurrent pregnancy loss (RPL). The aim of this study is to examine this association by characterizing AZF microdeletions in two infertile groups: in men with non-obstructive infertility and in men with wives displaying RPL. <br /><strong>Materials and Methods</strong><br /> In this is a case-control study, genomic DNA was extracted from 80 male samples including 40 non-obstructive infertile men, 20 males from couples with RPL and 20 fertile males as controls. Multiplex polymerase chain reaction was used to amplify 19 sequence tagged sites (STS) to detect AZF microdeletions. Differences between the case and control groups were evaluated by two-tailed unpaired t test. P < 0.05 were considered statistically significant. <br /><strong>Results</strong><br /> Only one subject was detected to have Y chromosome microdeletions in SY254, SY157 and SY255 among the 40 men with non-obstructive infertility. No microdeletion was detected in the males with wives displaying RPL and in 20 control males. Y chromosome microdeletion was neither significantly associated with non-obstructive infertility (P=0.48) nor with recurrent pregnancy loss. <br /><strong>Conclusion</strong><br /> Performing Testing for Y chromosome microdeletions in men with non-obstructive infertility and couples with RPL remains inconclusive in this study.Royan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X11420180101Body Mass Index Effects Kruger’s Criteria in Infertile Men2582624544410.22074/ijfs.2018.4888ENYaprak Engin-UstunZekai Tahir Burak Education and Research Hospital, Reproductive Endocrinology Unit, Ankara, TurkeyNafiye YılmazZekai Tahir Burak Education and Research Hospital, Reproductive Endocrinology Unit, Ankara, TurkeyNilufer AkgunZekai Tahir Burak Education and Research Hospital, Reproductive Endocrinology Unit, Ankara, TurkeyAyla AktulayZekai Tahir Burak Education and Research Hospital, Reproductive Endocrinology Unit, Ankara, TurkeyAhmet Deniz TuzluoğluZekai Tahir Burak Education and Research Hospital, Urology Unit, Ankara, TurkeyBatuhan BakırararDepartment of Biostatistics, Faculty of Medicine, Ankara University, Ankara, TurkeyJournal Article19700101<strong>Background</strong><br /> The aim of this study is to evaluate the relationship between sperm parameters and body mass index (BMI) in the male spouses with infertility complaints, who had reffered to our clinic. <br /><strong>Materials and Methods</strong><br /> The male spouses from 159 couples reffering to our clinic because of infertility, during a six-month period, were included in the study. In this prospective case control study, the included men were catego- rized as non-obese (BMIRoyan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X11420180101Royal Jelly Promotes Ovarian Follicles Growth and Increases Steroid Hormones in Immature Rats2632694544510.22074/ijfs.2018.5156ENElham GhanbariFertility and Infertility Research Center, Kermanshah University of Medical Sciences, Kermanshah, IranMohammad Rasool KhazaeiFertility and Infertility Research Center, Kermanshah University of Medical Sciences, Kermanshah, IranMozafar KhazaeiFertility and Infertility Research Center, Kermanshah University of Medical Sciences, Kermanshah, IranVahid NejatiDepartment of Histology and Embryology, Faculty of Science, Urmia University, Urmia, IranJournal Article19700101<strong>Background</strong><br /> Royal jelly (RJ) is a complementary diet widely prescribed by traditional medicine specialists for treatment of in- fertility. The aim of present study was to evaluate the effects of RJ on a set of reproductive parameters in immature female rats. <br /><strong>Materials and Methods</strong><br /> In this experimental study, thirty two immature female rats (30-35 g) were divided into four groups (n=8/group): three experimental groups and one control. The experimental groups received 100, 200 and 400 mg/kg/body weight doses of RJ daily for 14 days, and the control group received 0.5 ml distilled water interaperito- nealy (i.p). The treated rats were sacrificed and their ovaries were dissected for histological examination. The serum levels of ovarian hormones, nitric oxide (NO) and ferric reducing antioxidant power (FRAP) were evaluated, and the ratios of the ovarian and uterine weight to body weight were calculated. One-way ANOVA was used for data analysis. <br /><strong>Results</strong><br /> The body weights were significantly different (P=0.002) among the rat groups, with an increase in all RJ treated animals. Uterine and ovarian weights and the serum levels of progesterone (P=0.013) and estradiol (P=0.004) were significantly increased in experimental groups compared to the control group. In addition, a significant increase in the number of mature follicles and corpora lutea (P=0.007) was seen in RJ recipients compared to the controls. A significant increase in the serum levels of FRAP (P=0.009) and a significant decrease in NO level (P=0.013) were also observed. <br /><strong>Conclusion</strong><br /> RJ promotes folliculogensis and increases ovarian hormones. This product can be considered as a natural growth stimulator for immature female animals.Royan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X11420180101N-Acetylcysteine Compared to Metformin, Improves The Expression Profile of Growth Differentiation Factor-9 and Receptor Tyrosine Kinase c-Kit in The Oocytes of Patients with Polycystic Ovarian Syndrome2702784544610.22074/ijfs.2018.5142ENEbrahim CheraghiDepartment of Biology, Faculty of Sciences, University of Qom, Qom, Iran0000-0001-7433-6090Malek Soleimani MehranjaniDepartment of Biology, Faculty of Science, Arak University, Arak, Iran0000-0003-4822-2617Seyed Mohammad Ali ShariatzadehDepartment of Biology, Faculty of Science, Arak University, Arak, IranMohammad Hossein Nasr EsfahaniDepartment of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute, ACECR,
Isfahan, IranBehrang Alani4Department of Applied Cell Science, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, IranJournal Article19700101<strong>Background</strong><br /> Paracrine disruption of growth factors in women with polycystic ovarian syndrome (PCOS) results in production of low quality oocyte, especially following ovulation induction. The aim of this study was to investigate the effects of metformin (MET), N-acetylcysteine (NAC) and their combination on the hormonal levels and expres- sion profile of GDF-9, BMP-15 and c-kit, as hallmarks of oocyte quality, in PCOS patients. <br /><strong>Materials and Methods</strong><br /> This prospective randomized, double-blind, placebo controlled trial aims to study the effects of MET, NAC and their combination (MET+NAC) on expression of GDF-9, BMP-15 and c-kit mRNA in oocytes [10 at the germinal vesicle (GV) stage, 10 at the MI stage, and 10 at the MII stage from per group] derived following ovulation induction in PCOS. Treatment was carried out for six weeks, starting on the third day of previous cycle until oocyte aspiration. The expression of GDF9, BMP15 and c-kit were determined by quantitative real time polymerase chain reaction (RT-qPCR) and western blot analysis. Data were analyzed with one-way ANOVA. <br /><strong>Results</strong><br /> The follicular fluid (FF) level of c-kit protein significantly decreased in the NAC group compared to the other groups. Significant correlations were observed between the FF soluble c-kit protein with FF volume, androstenedione and estradiol. The GDF-9 expression in unfertilized mature oocytes were significantly higher in the NAC group com- pared to the other groups (P < 0.001). Similar difference was not observed between the MET, NAC+MET and control groups. The c-kit expression in unfertilized mature oocytes were significantly lower in the NAC group compared to the other groups (P < 0.001). Similar difference was not observed between the MET, NAC+MET and control groups (Registration number: IRCT201204159476N1). <br /><strong>Conclusion</strong><br /> We concluded that NAC can improve the quality of oocytes in PCOS.Royan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X11420180101The Effects of Dienogest on Macrophage and Natural Killer Cells in Adenomyosis: A Randomized Controlled Study2792864544710.22074/ijfs.2018.5137ENSaowapak PrathoomthongDepartment of Obstetrics and Gynecology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandYada TingthanatikulReproductive Endocrinology and Infertility Unit, Department of Obstetrics and Gynecology, Faculty of Medicine,
Ramathibodi Hospital, Mahidol University, Bangkok, Thailand000-0001-6103-1001Srithean LertvikoolReproductive Endocrinology and Infertility Unit, Department of Obstetrics and Gynecology, Faculty of Medicine,
Ramathibodi Hospital, Mahidol University, Bangkok, ThailandNittaya RodratnReproductive Endocrinology and Infertility Unit, Department of Obstetrics and Gynecology, Faculty of Medicine,
Ramathibodi Hospital, Mahidol University, Bangkok, ThailandWanwisa WaiyaputOffice of Research Academic and Innovation, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand0000-0001-6462-4996Kanthanadon DittharotOffice of Research Academic and Innovation, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandMorakot Sroyraya4Department of Anatomy, Faculty of Science, Mahidol University, Bangkok, Thailand;5Mahidol University Nakhon Sawan Campus, Nakhon Sawan, ThailandAreepan SophonsritsukReproductive Endocrinology and Infertility Unit, Department of Obstetrics and Gynecology, Faculty of Medicine,
Ramathibodi Hospital, Mahidol University, Bangkok, Thailand0000-0002-4589-0030Journal Article19700101<strong>Background</strong><br /> Progestin has been used for symptomatic treatment of adenomyosis, although its effect on the immune system has not been studied. The aim of this study was to investigate the changes of macrophage and natural killer (NK) cell infiltration in tissues obtained from women with adenomyosis who did or did not receive oral progestin dienogest. <br /><strong>Materials and Methods</strong><br /> In this randomized controlled clinical trial study, 24 patients with adenomyosis who re- quired hysterectomy were enrolled. Twelve patients received dienogest 28-35 days before surgery, and the other 12 patients were not treated with any hormones. The endometrial and myometrial tissue samples were immediately collected after hysterectomy, and immunohistochemistry for a macrophage marker (CD68) and a NK cells marker (CD57) was performed. <br /><strong>Results</strong><br /> The number of CD57 cells was significantly increased in endometrial glands of the treated group compared to the untreated group (P=0.005) but not in stroma in the endometrium of the treated patients (P=0.416). The differ- ence in the number of CD68 cells was not statistically significant between treated and untreated groups in the endo- metrial glands (P=0.055) or stromal tissues (P=0.506). <br /><strong>Conclusion</strong><br /> Administration of oral progestin dienogest to patients with adenomyosis increased the number of uterine infiltrating NK cells in glandular structure of eutopic endometrium. The differential effects of progestin on NK cells depended on the site of immune cell infiltration. The effects of oral progestin on uterine NK cells in adenomyosis have the potentials to be beneficial to pregnancies occurring following discontinuation of treatment in terms of embryo im- plantation and fetal protection (Registration number: TCTR20150921001).Royan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X11420180101Accuracy of Two-Dimensional Transvaginal Sonography and Office Hysteroscopy for Detection of Uterine Abnormalities in Patients with Repeated Implantation Failures or Recurrent Pregnancy Loss2872924544810.22074/ijfs.2018.5034ENMarzieh ShivaDepartment of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for
Reproductive Biomedicine, ACECR, Tehran, IranFirouzeh AhmadiDepartment of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive
Biomedicine, ACECR, Tehran, Iran0000-0002-7840-6428Arezoo ArabipoorDepartment of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for
Reproductive Biomedicine, ACECR, Tehran, IranMansoureh OromiehchiDepartment of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for
Reproductive Biomedicine, ACECR, Tehran, IranMohammad ChehraziDepartment of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute
for Reproductive Biomedicine, ACECR, Tehran, IranJournal Article19700101<strong>Background</strong><br /> We sought to compare diagnostic values of two-dimensional transvaginal sonography (2D TVS) and office hysteroscopy (OH) for evaluation of endometrial pathologies in cases with repeated implantation failure (RIF) or recurrent pregnancy loss (RPL). <br /><strong>Materials and Methods</strong><br /> This prospective study was performed at Royan Institute from December 2013 to January 2015. TVS was performed before hysteroscopy as part of the routine diagnostic work-up in 789 patients with RIF or RPL. Uterine biopsy was performed in cases with abnormal diagnosis in TVS and/or hysteroscopy. We compared the diagnostic accuracy values of TVS in detection of uterine abnormalities with OH by receiver operating characteristic (ROC) curve analysis. <br /><strong>Results</strong><br /> TVS examination detected 545 (69%) normal cases and 244 (31%) pathologic cases, which included 84 (10.6%) endometrial polyps, 15 (1.6%) uterine fibroids, 10 (1.3%) Asherman’s syndrome, 9 (1.1%) endometrial hy- pertrophy, and 126 (15.9%) septate and arcuate uterus. TVS and OH concurred in 163 pathologic cases, although TVS did not detect some pathology cases (n=120). OH had 94% sensitivity, 95% specificity, 62% positive predictive value (PPV), and 99% negative predictive value (NPV) for detection of endometrial polyps. In the diagnosis of myoma, sen- sitivity, specificity, PPV, and NPV were 100%. TVS had a sensitivity of 50% and specificity of 98% for the diagnosis of myoma. For polyps, TVS had a sensitivity of 54% and specificity of 80%. Area under the ROC curve (AUROC) was 70.69% for the accuracy of TVS compared to OH. <br /><strong>Conclusion</strong><br /> TVS had high specificity and low sensitivity for detection of uterine pathologies in patients with RIF or RPL compared with OH. OH should be considered as a workup method prior to treatment in patients with normal TVS findings.Royan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X11420180101Quality of Life and Its Influencing Factors of Couples Referred to An Infertility Center in Shiraz, Iran2932974629710.22074/ijfs.2018.5123ENBahia Namavar JahromiInfertility Research Center, Shiraz University of Medical Sciences, Shiraz, IranDepartment of Obstetrics and Gynecology, Shiraz School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranMahsa MansouriStudent Research Center, Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, IranSedighe ForouhariShahid Sadoughi University of Medical Sciences, Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, IranTahere PoordastInfertility Research Center, Shiraz University of Medical Sciences, Shiraz, IranDepartment of Obstetrics and Gynecology, Shiraz School of Medicine, Shiraz University of Medical Sciences, Shiraz, IranAlireza SalehiResearch Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, IranJournal Article20161123Background: Infertility adversely affects quality of life (QoL). The present study aims to evaluate QoL and its associated<br />factors among infertile couples.<br />Materials and Methods: In this cross-sectional study, the Fertility QoL (FertiQoL) instrument was used to measure<br />QoL among 501 volunteer couples who attended the Infertility Clinic at the Mother and Child Hospital, Shiraz, Iran.<br />We used an additional questionnaire to assess participants’ demographic and clinical characteristics. The relationship<br />between the scores of QoL to the sociodemographic and treatment data was analysed.<br />Results: The subjects with lower income levels had lower relational, mind/body, emotional, and total core scores. Female<br />participants without academic education had lower scores in the emotional subscale, while the male participants<br />showed lower scores in emotional, mind/body, relational, social, and total QoL domains. Subjects who had undergone<br />any type of treatment, including pharmacological treatment, intrauterine insemination (IUI), intra-cytoplasmic sperm<br />injection (ICSI), and in vitro fertilization (IVF) showed significantly lower scores in the environmental domain. Participants<br />with lower infertility duration obtained significantly greater QoL scores. Finally, tolerability, emotional, and<br />environmental domains were significantly more desirable when the infertility problem was related to a male factor.<br />Conclusion: Infertile couples with shorter duration of infertility and male etiology have higher QoL. Lower academic<br />education, lower income levels, or prior unsuccessful treatments are associated with lower QoL.Royan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X11420180101The Effects of Exercise on Expression of CYP19 and StAR mRNA in Steroid-Induced Polycystic Ovaries of Female Rats2983054545010.22074/ijfs.2018.5035ENFatemeh AghaieDepartment of Physiology, Faculty of Life Science and Biotechnology, Shahid Beheshti University, Tehran, IranHomayoun KhazaliDepartment of Physiology, Faculty of Life Science and Biotechnology, Shahid Beheshti University, Tehran, IranMehdi HedayatiCellular and Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of
Medical Sciences, Tehran, IranAli AkbarnejadCollege of Physical Education and Sports Sciences, University of Tehran, Tehran, IranJournal Article19700101Background: Polycystic ovarian syndrome (PCOS) is the most frequent female endocrine disorder that affects 5-10% of women. PCOS is characterized by hyperandrogenism, oligo-/anovulation, and polycystic ovaries. The aim of the present research is to evaluate the expression of steroidogenic acute regulatory protein (StAR) and aromatase (CYP19) mRNA in the ovaries of an estradiol valerate (EV)-induced PCOS rat model, and the effect of treadmill and running wheel (voluntary) exercise on these parameters. Materials and Methods: In this experimental study, we divided adult female Wistar rats that weighed approximately 220 ± 20 g initially into control (n=10) and PCOS (n=30). Subsequently, PCOS group were divided to PCOS, PCOS with treadmill exercise (P-ExT), and PCOS with running wheel exercise (P-ExR) groups (n=10 per group). The expressions of StAR and CYP19 mRNA in the ovaries were determined by quantitative real-time reverse transcriptase polymerase chain reaction (qRT-PCR). Data were analyzed by one-way ANOVA using SPSS software, version 16. The data were assessed at α=0.05. Results: There was significantly lower mRNA expression of CYP19 in the EV-induced PCOS, running wheel and treadmill exercise rats compared to the control group (P < 0.001). Treadmill exercise (P=0.972) and running wheel exercise (P=0.839) had no significant effects on CYP19 mRNA expression compared to the PCOS group. mRNA expression of StAR in the ovaries of the PCOS group indicated an increasing trend compared to the control group, however this was not statistically significant (P=0.810). We observed that 8 weeks of running wheel and treadmill exercises could not statistically decrease StAR mRNA expression compared to the PCOS group (P=0.632). Conclusion: EV-induced PCOS in rats decreased CYP19 mRNA expression, but had no effect on StAR mRNA expression. We demonstrated that running wheel and moderate treadmill exercise could not modify CYP19 and StAR mRNA expressions.Royan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X11420180101Congenital Malformations in Singleton Infants Conceived by Assisted Reproductive Technologies and Singleton Infants by Natural Conception in Tehran, Iran3043084545110.22074/ijfs.2018.5415ENRamin Mozafari KermaniHealth Metrics Research Center, Iranian Institute for Health Sciences Research, ACECR, Tehran, IranMansoureh FarhangniyaHuman and Animal Cell Bank, Iranian Biological Resource Center (IBRC), ACECR, Tehran, Iran;Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine,
ACECR, Tehran, I0000-0002-7878-6942Seyed Abolhassan Shahzadeh FazeliHuman and Animal Cell Bank, Iranian Biological Resource Center (IBRC), ACECR, Tehran, Iran;Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine,
ACECR, Tehran, IPezhman Bagheri5Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, IranMahnaz Ashrafi6Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive
Biomedicine, ACECR, Tehran, IranAhmad Vosough Taqi Dizaj7Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran Abstract Background: Multiple pregnancies occur more frequently in assisted reproductJournal Article19700101Background: Multiple pregnancies occur more frequently in assisted reproductive technology (ART) compared to normal conception (NC). It is known that the risk of congenital malformations in a multiple pregnancy are higher than single pregnancy. The aim of this study is to compare congenital malformations in singleton infants conceived by ART to singleton infants conceived naturally. Materials and Methods: In this historical cohort study, we performed a historical cohort study of major congenital malformations (MCM) in 820 singleton births from January 2012 to December 2014. The data for this analysis were derived from Tehran’s ART linked data file. The risk of congenital malformations was compared in 164 ART infants and 656 NC infants. We performed multiple logistic regression analyses for the independent association of ART on each outcome. Results: We found 40 infants with MCM 29 (4.4%) NC infants and 14 (8.3%) ART infants. In comparison with NC infants, ART infants had a significant 2-fold increased risk of MCM (P=0.046). After adjusting individually for maternal age, infant gender, prior stillbirth, mother’s history of spontaneous abortion, and type of delivery, we did not find any difference in risk. In this study the majority (95.1%) of all infants were normal but 4.9% of infants had at least one MCM. We found a difference in risk of MCMs between in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). We excluded the possible role of genotype and other unknown factors in causing more malformations in ART infants. Conclusion: This study reported a higher risk of MCMs in ART singleton infants than in NC singleton infants. Congenital heart disease, developmental dysplasia of the hip (DDH), and urogenital malformations were the most reported major malformations in singleton ART infants according to organ and system classification.Royan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X11420180101Comparison of In Vitro Fertilization/Intracytoplasmic Sperm Injection Cycle Outcome in Patients with and without Polycystic Ovary Syndrome: A Modified Poisson Regression Model3093134545210.22074/ijfs.2018.5117ENAmir Almasi-HashianiDepartment of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute
for Reproductive Biomedicine, ACECR, Tehran, Iran;Department of Epidemiology and Biostatistics, School of PuMohammad Ali MansourniaDepartment of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, IranMahdi SepidarkishDepartment of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute
for Reproductive Biomedicine, ACECR, Tehran, IranSamira VesaliDepartment of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute
for Reproductive Biomedicine, ACECR, Tehran, IranAzadeh GhaheriDepartment of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute
for Reproductive Biomedicine, ACECR, Tehran, IranArezoo EsmailzadehDepartment of Obstetrics and Gynecology, Zahedan University of Medical Sciences, Zahedan, IranReza Omani-SamaniDepartment of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute
for Reproductive Biomedicine, ACECR, Tehran, IranJournal Article19700101<strong>Background</strong><br /> Polycystic ovary syndrome (PCOS) is a frequent condition in reproductive age women with a prevalence rate of 5-10%. This study intends to determine the relationship between PCOS and the outcome of assisted reproductive treatment (ART) in Tehran, Iran. <br /><strong>Materials and Methods</strong><br /> In this historical cohort study, we included 996 infertile women who referred to Royan Institute (Tehran, Iran) between January 2012 and December 2013. PCOS, as the main variable, and other potential confounder variables were gathered. Modified Poisson Regression was used for data analysis. Stata software, version 13 was used for all statistical analyses. <br /><strong>Results</strong><br /> Unadjusted analysis showed a significantly lower risk for failure in PCOS cases compared to cases without PCOS [risk ratio (RR): 0.79, 95% confidence intervals (CI): 0.66-0.95, P=0.014]. After adjusting for the confounder variables, there was no difference between risk of non-pregnancy in women with and without PCOS (RR: 0.87, 95% CI: 0.72-1.05, P=0.15). Significant predictors of the ART outcome included the treatment protocol type, numbers of embryos transferred (grades A and AB), numbers of injected ampules, and age. <br /><strong>Conclusion</strong><br /> The results obtained from this model showed no difference between patients with and without PCOS ac- cording to the risk for non-pregnancy. Therefore, other factors might affect conception in PCOS patients.Royan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X11420180101Estimation of Day-Specific Probabilities of Conception during Natural Cycle in Women from Babylon3143174545310.22074/ijfs.2018.5100ENHanan Al-taeeDepartment of Physiology, Collage of Medicine, University of Babylon, Babil, IraqBan J. EdanDepartment of Physiology, Collage of Medicine, University of Babylon, Babil, IraqJournal Article19700101Background: Identifying predictors of the probabilities of conception related to the timing and frequency of intercourse in the menstrual cycle is essential for couples attempting pregnancy, users of natural family planning methods, and clinicians diagnosing for possible causes of infertility. The aim of this study is to estimate the days in which the likelihood of conception happened by using first trimester ultrasound fetal biometry in natural cycles and spontaneous pregnancy, and to explore some factors that may affect them. Materials and Methods: This study is retrospective cohort study, with random sampling. It involved 60 pregnant ladies at first trimester; the date of conception was estimated using: i. Crown-rump length biometry (routine ultrasound examinations were performed at a median of 70 days following Last menstrual period or equivalently 10 weeks), ii. Date of last menstrual cycle. Only women with previous infertility and now conceiving naturally with a certain date of Last menstrual period were selected. Results: The distribution of conception showed a sharp rise from day 8 onwards, reaching its maximum at day 13 and decreasing to zero by day 30 of Last menstrual period. The older and obese women had conceive earlier than younger women but there was insignificants difference between the two groups (P > 0.05). According to the type of infertility, the women with secondary infertility had conceived earlier than those with primary infertility. There was a significant difference between the two groups (P < 0.05). Conclusion: Day specific of conception may be affected by factors such as age, BMI, and type of infertility. This may be confirmed by larger sample size in metacentric study.Royan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X11420180101Pregnancy in Non-Communicating Rudimentary Horn of A Unicornuate Uterus3183204545410.22074/ijfs.2018.5022ENMania KavehEndometriosis and Gynecological Disorder Research Center, Iran University of Medical Science, Tehran, Iran;Department of Obstetrics and Gynecology, Zabol University of Medical Science, Zabol, IranAbolfazl Mehdizadeh KashiEndometriosis and Gynecological Disorder Research Center, Iran University of Medical Science, Tehran, IranKambiz SadegiPain Research Center, Iran University of Medical Science, Tehran, Iran;4Department of Anesthesiology, Zabol University of Medical Science, Zabol, IranForough ForghaniDepartment of Obstetrics and Gynecology, Zabol University of Medical Science, Zabol, Iran0000-0001-7433-4204Journal Article19700101Diagnosis and management of pre-rupture stage of the pregnant horn are difficult and usually missed on a routine ul- trasound scan. Also most cases are detected after rupture of pregnant horn. We presented a 28-year-oldG2 L1 woman with diagnosis of rudimentary horn pregnancy (RHP) at 14 weeks of gestation. We diagnosed her with a normal intrauterine pregnancy, whereas a pregnancy in a right-sided non-communicating rudimentary horn with massive he- moperitoneum was later discovered on laparotomy. RHP has a high risk of death for mother, so there must be a strong clinical suspicion for the diagnosis of RHP. Although there is a major advancement in field of diagnostic ultrasound and other imaging modalities, prenatal diagnosis has remained elusive and a laparotomy surgery is considered as a definitive diagnosis.Royan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X11420180101The Many Guises of Endometriosis: Giant Abdominal Wall Endometriosis Masquerading as An Incisional Hernia3213254545510.22074/ijfs.2018.5126ENChiara PetroselliniDepartment of General Surgery, Queen Elizabeth Hospital, London, United KingdomSala AbdallaDepartment of General Surgery, Queen Elizabeth Hospital, London, United KingdomTayo OkeDepartment of General Surgery, Queen Elizabeth Hospital, London, United KingdomJournal Article19700101Endometriosis is defined by the presence of ectopic endometrial tissue outside the uterine cavity. Although it is a leading cause of chronic pelvic pain and infertility, its clinical presentation can vary, resulting in diagnostic and therapeutic challenges. Extrapelvic endometriosis is particularly difficult to diagnose owing to its ability to mimic other conditions. Endometrial tissue in a surgical scar is uncommon and often misdiagnosed as a granuloma, abscess, or malignancy. Cyclical hemorrhagic ascites due to peritoneal endometriosis is exceptionally rare. We report the case of a pre-menopausal, nulliparous 44-year-old woman who presented with ascites and a large abdominal mass that arose from the site of a lower midline laparotomy scar. Five years previously, she had undergone open myomectomy for uterine fibroids. Soon after her initial operation she developed abdominal ascites, which necessitated percutaneous drainage on multiple occasions. We performed a laparotomy with excision of the abdominal wall mass through an inverted T incision. The extra-abdominal mass consisted of mixed cystic and solid components, and weighed 1.52 kg. It communicated with the abdominopelvic cavity through a 2 cm defect in the linea alba. The abdomen contained a large amount of odourless, brown fluid which drained into the mass. There was a large capsule that covered the small and large bowel, liver, gallbladder, and stomach. Final histology reported a 28×19×5 cm mass of endometrial tissue with no evidence of malignant transformation. The patient recovered well post-operatively and has remained asymptomatic. Our case illustrates that, despite being a common disease, endometriosis can masquerade as several other conditions and be missed or diagnosed late. Delay in diagnosis will not only prolong symptoms but can also compromise reproductive lifespan. It is therefore paramount that endometriosis is to be considered early in the management of premenopausal women who present with an irregular pelvic mass or hemorrhagic ascites.Royan Institute, Iranian Academic Center for Education Culture and Research (ACECR)International Journal of Fertility and Sterility2008-076X11420180101Uterus Dysplasia Associated with Cervico-Vaginal Agenesis3263274545610.22074/ijfs.2018.5111ENAli MahdaviDepartment of Radiology, Tehran University of Medical Sciences, Tehran, IranHadi MirfazaelianDepartment of Emergency Medicine, Tehran University of Medical Sciences, Tehran, IranLadan Younesi AslDepartment of Radiology, Iran University of Medical Sciences, Tehran, Iran
AbstractZeynab HasaniDepartment of Radiology, Tehran University of Medical Sciences, Tehran, IranMaryam BahreiniDepartment of Emergency Medicine, Tehran University of Medical Sciences, Tehran, IranJournal Article19700101Müllerian ducts can form upper parts of normal female reproductive system and any failure in ductal fusion may result in to müllerian duct anomalies (MDA). We present a case of MDA and a uterus dysplasia with no evidence of cervical or upper vaginal tissue. This case showes the role of magnetic resonace imaging (MRI) on MDA diagnosis and urges the need for a unified reliable and practical classification more compatible with clinical practice.