Iranian Journal of Reproductive Medicine (IRAN J REPROD MED )

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    ABSTRACT: Background: Polycystic ovarian syndrome (PCOS) is a complex, heterogeneous disorder of uncertain etiology with strong genetic background. Insulin resistance is present in the majority of PCOS cases with linkage and association between single nucleotide polymorphisms of insulin receptor (INSR) gene and PCOS. Objective: To examine whether the exon 17 of INSR gene contributes to genetic susceptibility to PCOS in Iraqi women and its effects on glucose tolerance test and lipid profile. Materials and Methods: Sixty-five healthy Iraqi women and eighty-four infertile women with PCOS, divided into two subgroups depending on the BMI were studied. Restriction fragment length polymorphism (RFLP-PCR) analysis was performed to determine the genotypes for the His 1058 C/T polymorphism at the tyrosine kinase domain in the INSR gene. Clinical, anthropometric and biochemical parameters were also estimated. Results: The C/T polymorphism at His 1058 in exon 17 of INSR was associated with PCOS (obese and non-obese). CC genotype frequency was higher in PCOS patients whereas TT genotype was higher in control women. Those with CC genotype had higher BMI, GTT and lipid profile than those with TT genotype. Conclusion: An association of C/T polymorphism at His1058 of INSR with PCOS in Iraqi women was observed. Its association with indices of insulin resistance and dyslipidemia were also noticed.
    Iranian Journal of Reproductive Medicine 07/2014; 12(7):499-506.
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    ABSTRACT: Background: The largest percentage of failed invitro fertilization (IVF (cycles, are due to lack of implantation. As hereditary thrombophilia can cause in placentation failure, it may have a role in recurrent IVF failure. Objective: Aim of this case-control study was to determine whether hereditary thrombophilia is more prevalent in women with recurrent IVF failures. Materials and Methods: Case group comprised 96 infertile women, with a history of recurrent IVF failure. Control group was comprised of 95 healthy women with proven fertility who had conceived spontaneously. All participants were assessed for the presence of inherited thrombophilias including: factor V Leiden, methilen tetrahydrofolate reductase (MTHFR) mutation, prothrombin mutation, homocystein level, protein S and C deficiency, antithrombin III (AT-III) deficiency and plasminogen activator inhibitor-1 (PAI-1) mutation. Presence of thrombophilia was compared between groups. Results: Having at least one thrombophilia known as a risk factor for recurrent IVF failure (95% CI=1.74-5.70, OR=3.15, p=0.00). Mutation of factor V Leiden (95% CI=1.26-10.27, OR=3.06, P=0.01) and homozygote form of MTHFR mutation (95% CI=1.55-97.86, OR=12.33, p=0.05) were also risk factors for recurrent IVF failure. However, we could not find significant difference in other inherited thrombophilia's. Conclusion: Inherited thrombophilia is more prevalent in women with recurrent IVF failure compared with healthy women. Having at least one thrombophilia, mutation of factor V Leiden and homozygote form of MTHFR mutation were risk factors for recurrent IVF failure.
    Iranian Journal of Reproductive Medicine 07/2014; 12(7):467-470.
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    ABSTRACT: Intrauterine Insemination (IUI) remains the first thought of infertility treatment.
    Iranian Journal of Reproductive Medicine 07/2014; 12(7):493-8.
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    ABSTRACT: Background: Surrogacy is one of the new techniques of assisted reproduction technology in which a woman carries and bears a child for another woman. In Iran, many Shia clerics and jurists considered it permissible so there is no religious prohibition for it. In addition to the risk of physical complications for complete surrogate mothers, the possibility of psychological complications resulted from emotional attachment to a living creature in the surrogate mother as another injury requires counseling and assessment prior to acceptance by infertile couples and complete surrogate mothers. Objective: The purpose of this study was to assess the emotional experiences of surrogate mothers. Materials and Methods: This was a qualitative, phenomenological study. We selected eight complete surrogate mothers in Isfahan. We used convenient sampling method and in-depth interview to collect the information. The data analysis was fulfilled via Colaizzi's seven-stage method. Reliability and validity study of the roots in the four-axis was done. Results: The findings of these interviews were classified into two main themes and four sub themes: acquired experiences in pregnancy (feelings toward pregnancy, relationship with family, relatives and commissioning couple) and consequences of surrogacy (complications of pregnancy, religious and financial problems of surrogacy). Conclusion: Surrogacy pregnancy should be considered as high-risk emotional experience because many of surrogate mothers may face negative experiences. Therefore, it is recommended that surrogates should receive professional counseling prior to, during and following pregnancy.
    Iranian Journal of Reproductive Medicine 07/2014; 12(7):471-480.
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    ABSTRACT: Oligomenorrhea, a prevalent disease with serious complications, has been declared in the Avicenna traditional medicine in detail. Avicenna in his famous book, Cannon of Medicine, presents a syndrome termed 'uterine strangulation', as a complication of menstrual bleeding cessation and lack of sexual satisfaction. We have explained this syndrome from both traditional and conventional medicine viewpoints to propose a new hypothesis for diagnosis and treatment of women with oligomenorrhea and systemic signs/symptoms admitting to clinics for further evaluation. This hypothesis definitely needs to be further assessed and confirmed by strong clinical trials.
    Iranian Journal of Reproductive Medicine 07/2014; 12(7):453-458.
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    ABSTRACT: Background: Polycystic ovary syndrome (PCOS) is the most common hyperandrogenic disorder among women and is often defined as hyperandrogenic syndrome. These patients are at risk for oligo/amenorrhea, chronic anovulation, infertility, obesity, spontaneous abortion, insulin resistance, hyperinsulinemia and metabolic syndrome. Thyroid disorders especially hypothyroidism is more common in these people. In PCOS patients, subclinical hypothyroidism may aggravate insulin resistance. Objective: The goal was to find any relationship between subclinical hypothyroidism and insulin resistance in PCOS patients. Materials and Methods: In this prospective cross sectional study we included all PCOS patients coming to infertility clinic of Taleghani Hospital in 2010-2012 who had the criteria of Rotterdam for PCOS. Then the clinical examination was done for them and height, weight, body mass index and lab data were measured including thyroid hormone and biochemical profile. The data were analyzed by SPSS software version 20. Results: Among 75 PCOS patients, 19 (25.5%) had subclinical hypothyroidism and 56 patients (74.4%) were euthyroid. The prevalence of insulin resistance was 22.7% and 77.3% of patients had no insulin resistance were normal. Conclusion: We could find no relationship between insulin resistance and subclinical hypothyroidism in PCOS patients.
    Iranian Journal of Reproductive Medicine 07/2014; 12(7):481-486.
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    ABSTRACT: Background: Frozen embryo transfer (FET) is one of the most important supplementary procedures in the treatment of infertile couples. While general information concerning the outcome of fresh embryo transfer has been documented, paucity of investigations has addressed the clinical factors influenced on pregnancy rates in FET. Objective: In this study, we performed a retrospective analysis of clinical factors that potentially influence the outcome of FET. Materials and Methods: We reviewed the data from 372 women who were subjected to FET registered from April 2009-2011 at the Research and clinical center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Baseline data and pregnancy rate were collected. The data were analyzed statistically using the Kolmogorov-Smirnov, and Mann-Whitney tests. Results: The clinical pregnancy rate was 57.7 and 29.2% in women <35 years old, and women >35 years old, respectively (p<0.0001). Clinical pregnancy rates in women with FSH <10 IU/ml, and FSH >10 IU/ml were 56.3% and 17.5 %, respectively (p<0.0001). Whereas the other clinical parameters consist of reason of fetus freezing, primary IVF protocol, IVF procedure, endometrial thickness, treatment duration to fetal transfer found to be unrelated to FET outcomes (p>0.05). Conclusion: Female age and basal FSH level are the most important factors influencing the clinical pregnancy rate following FET.
    Iranian Journal of Reproductive Medicine 07/2014; 12(7):513-518.
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    ABSTRACT: Background: Hyaline membrane disease (HMD) has remained a common neonatal problem and is a cause of morbidity in infants. The shake test can be used to assess whether surfactant is present in the infant's lungs at birth. Objective: The goal of this study was to determine the usefulness and accuracy of gastric aspirate shake test for the diagnosis of two HMD. Materials and Methods: This was a diagnostic accuracy study carried out on 49 preterm infant born at Shahid Sadoughi hospital in 2012 (25 newborns without pulmonary diseases and 24 newborns with HMD). Shortly after birth, the shake test was performed using gastric fluid. The results of the shake test were correlated with definitive diagnosis of HMD. Results: All infants who developed HMD had negative test results. In 23 of 25 infants with no respiratory distress, the test was positive. Our findings indicated that the gastric aspirate shake test has 100% sensitivity, 92% specificity, a 92.3% predictive value for surfactant deficiency, and 100% predictive value for surfactant sufficiency. Conclusion: According to this study gastric shake test (GST) is a reliable test and is a simple procedure to identify those neonates who will develop respiratory distress syndrome (RDS) and therefore to decide prophylactic exogenous surfactant replacement.
    Iranian Journal of Reproductive Medicine 07/2014; 12(7):487-491.
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    ABSTRACT: Advances in embryo culture technology and cryopreservation have led to a shift in in vitro fertilization (IVF) from early fresh or frozen-thawed cleavage embryo transfer to fresh or frozen-thawed blastocyst stage transfer.
    Iranian Journal of Reproductive Medicine 06/2014; 12(6):409-14.
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    ABSTRACT: Malignancies are not rare in girl and women during their reproductive years. Over the past three decades, the survival rate for cancer has been improving due to progress in cancer diagnosis and treatment. These patients frequently experience a variety of treatment, and disease-related side effects that diminish their quality of life during and after treatment; among these are loss of fertility and sexual dysfunction. There have been recent advances in the field of fertility preservation, which can allow many of these genital cancer survivors to have children in the future. This topic review discusses available options and specific strategies for fertility preservation in adolescent and young women with malignancies who wish to preserve their ability to become pregnant in the future.
    Iranian Journal of Reproductive Medicine 06/2014; 12(6):377-82.
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    ABSTRACT: In some cases infertile men showed small deletions of specific genes in the Y chromosome. It had been confirmed, these deleted genes are greatly associated with spermatogenic failure. However, the frequency and the patterns of such microdeletions among infertile men are not clearly clarified.
    Iranian Journal of Reproductive Medicine 06/2014; 12(6):383-8.
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    ABSTRACT: Embryo transfer to a developed endometrium is an important prognostic factor in frozen-thawed embryo transfer cycle outcome. Vaginal estrogen, such as Vagifem vaginal tablets and Premarin vaginal cream, is a regimen used for the patients with refractive endometria.
    Iranian Journal of Reproductive Medicine 06/2014; 12(6):415-20.
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    ABSTRACT: Nicotine consumption can decrease fertility drive in males by inducing oxidative stress and DNA damage. Urtica dioica L (U.dioica) is a multipurpose herb in traditional medicine for which some anti-oxidative and anti-inflammatory properties have been identified.
    Iranian Journal of Reproductive Medicine 06/2014; 12(6):401-8.
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    ABSTRACT: Increased serum progesterone on the day of human chorionic gonadotropin administration may affect in vitro fertilization (IVF) outcome.
    Iranian Journal of Reproductive Medicine 06/2014; 12(6):427-34.
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    ABSTRACT: One of the most important points concerning the patients who undergo assisted reproductive techniques (ART) for getting pregnant can be the possible neonatal chromosomal abnormalities as a result of these methods.
    Iranian Journal of Reproductive Medicine 06/2014; 12(6):435-8.
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    ABSTRACT: Primary and secondary infertility are the most common presenting symptom in patients with pelvic tuberculosis (PT). Endometriosis is commonly associated with an increased risk of infertility.
    Iranian Journal of Reproductive Medicine 06/2014; 12(6):439-41.
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    ABSTRACT: Introduction: Retarded ejaculation (RE) is probably the least common, and one of the most challenging male sexual disorders. It may contribute with the persistent or recurrent delay or absence of orgasm after a normal sexual excitement phase. Materials and Methods: We describe a successful treatment of an unconsummated couple for 18 months, which was associated with RE and secondary erectile dysfunction in male partner and primary vaginismus in woman, in Isfahan psychosexual clinic. Results: The young woman, who complained about sever pain during several penetration attempts, diagnosed as vaginismus. She reported that never have seen her husband to ejaculate during sexual contacts and complained about a recently developed erectile disorder for her partner. Young man claimed that he can ejaculate during his recurrent masturbation with an idiosyncratic method. He attributed his recurrent ejaculation failure to high level of anxiety during his first sexual intercourse (FSI); and fear of contamination and conception during unprotected sex. The RIGI scan test showed normal results. The couple reported full vaginal penetration with ejaculation after a period of gradual exposure exercises assisted by a female sexologist. Furthermore, the male partner taught to alter the style of masturbation through his partner stimulation to experience increasing levels of arousal. Conclusion: The family expectation about conducting FSI during the wedding night, conservative sexual upbringing and limited sexual knowledge in Iran may elicit negative emotionality towards sexual cues and, exert pressure on young people. Individual and dyadic sexual education programs may help newly married couples to overcome their sexual problems.
    Iranian Journal of Reproductive Medicine 06/2014; 12:37.

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