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Showing 33 results for سقط مکرر

Zarnegar Rasti, Mahboobeh Nasiri, Leila Kohan,
Volume 14, Issue 2 (2-2016)

Background: Recurrent pregnancy loss (RPL) is defined as two or more miscarriages before the 20 th week of gestation and its etiology is unknown in 50% of the cases. Interleukin 6 is an immune mediator, plays a regulatory role in embryo implantation and placental development.
Objective: The purpose was to assess the association between IL-6 -634C/G polymorphism and, susceptibility to idiopathic RPL for the first time in Iran.
Materials and Methods: In total 121 women with RPL and 121 healthy women as control group were enrolled in this case-control study. This study was performed from August 2013 to October 2014 in the Molecular Genetics Laboratory of Arsanjan University. Candidate polymorphism was evaluated by PCR-RFLP method on extracted genomic DNA. Data was analyzed using the statistical SPSS package.
Results: Our results showed an increased risk of RPL in patients with GG + GC genotype (OR=5.1, 95%CI: 1.04-25.3, p=0.04) in comparison to CC genotype. The frequency of mutant allele G in patients and controls was 0.75 and 0.66 respectively. The mutant allele G predisposes women to miscarriage 1.5 times greater than controls (OR=1.5, 95%CI: 1.03-2.27, p=0.036). The mean number of live births in RPL women (1.3±2.3) was significantly lower compared to control women (4.8±2.3).
Conclusion: This study indicated that the promoter polymorphism (-634C/G) of the IL-6 gene has likely influence on individual susceptibility to RPL.  
Ali Reza Talebi, Farzaneh Fesahat, Esmat Mangoli, Jalal Ghasemzadeh, Maryam Nayeri, Fatemeh Sadeghian-Nodoshan,
Volume 14, Issue 3 (3-2016)

Background: Etiology of more than half of Recurrent Spontaneous Abortion. The etiology of more than 50 percent of Recurrent Spontaneous Abortions (RSA) cases has been remained unexplained. It is supposed that RSA may have "paternal effect" due to supply 50% of embryonic genomic content by male gamete.
Objective: The aim of present study was to evaluate the role of sperm apoptosis and protamine deficiency at same time in RSA cases.
Materials and Methods: Forty fertile (control) and 40 unfertile men with RSA (case) were enrolled in this case-control study. Semen analysis was performed in accordance with WHO criteria and sperm apoptosis and protamine deficiency were evaluated by cell apoptosis detection kit and chromomycin A3, respectively.
Results: Results showed significant different between normal morphology and total motility in two groups. Case group had higher percentage of spermatozoa with protamine deficiency and apoptosis compared to controls significantly.
Conclusion: Our results showed that in cases of RSA, in addition to abnormal sperm parameters, we have a high percentage of spermatozoa with protamine deficiency and apoptosis and these two anomalies may consider as important causes of idiopathic recurrent abortions. It should be advised that sperm chromatin and DNA examinations are useful tools in the process of RSA treatments.
Nadia Arabkhazaeli, Kasra Ghanaat, Mohammad Bagher Hashemi-Soteh,
Volume 14, Issue 5 (5-2016)

Background: Recurrent pregnancy loss (RPL) is caused by different factors, including genetics and thrombophilia. Beside Factor V Leiden, another nucleotide change in a factor V (FV) gene (A4070G; His1299Arg) has been identified linking to hereditary thrombophilia. Also, two proposed MTHFR polymorphisms, C677T and A1298C (Glu429A) are linked with RPL.
Objective: In this study, the effect of two factors, A4070G in FV and A1298C in MTHFR are evaluated in RPL patients from Mazandaran province, Iran.
Materials and methods: Sample population of 100 women with RPL and 100 controls with Mazandarani ethnics from northern Iran were consist. The factor V (A4070G) and MTHFR (A1298C) polymorphisms were genotyped by PCR-RFLP.
Results: Molecular study showed 5 women from patients and 9 women from control group were heterozygous AG for A4070G. Frequency of "A" allele in patient and control groups was 97.5% (0.975) and 95.5% (0.955) respectively, and "G" allele frequency was 2.5% (0.025) and 4.5% (0.045) respectively. No significant association (p≤0.05) between FV A4070G genotype and RPL with an OR=1.88, CI 95%=0.6-5.82, was observed (p=0.4). Also, for A1298C, all patients and control individuals were AA genotype. "A" allele frequency in patients and control was 100% and "C" allele frequency was zero. There was no significant difference for A1298C between groups.
Conclusion: Our finding showed that A4070G and A1298C polymorphisms cannot be considered as a cause of PRL in women from Mazandaran province, northern Iran.
Shokoufeh Fazelnia, Touraj Farazmandfar, Seyed Mohammad Bagher Hashemi-Soteh,
Volume 14, Issue 5 (5-2016)

Background: Spontaneous abortion is considered as the most complex problem during pregnancy. Thrombophilia is resumed as a cause of recurrent pregnancy loss (RPL). Glycoprotein IIIa (GPIIIa) gene is involved in thrombosis and abortion. Angiotensin converting enzyme (ACE) converts angiotensin I to angiotensin II and is involved in thrombosis. The most common polymorphism in this gene is the insertion/deletion (I/D).
Objective: In this study, we analyzed the association between ACE I/D and GPIIIa c.98C >T polymorphisms in women with unexplained RPL from the north of Iran.
Materials and Methods: Sample population consisted of 100 women with unexplained RPL and 100 controls. The ACE I/D and GPIIIa c.98C>T polymorphisms were genotyped by TETRA-ARMS PCR. The association between genotypes frequency and RPL were analyzed using χ2 and exact fisher tests. Associated risk with double genotype combinations was also investigated by binary logistic regression.
Results: There was significant association between ACE DD genotype and RPL (OR=2.04; 95% CI=0.94-4.44; p=0.036). ACE D Allele was also significantly associated with the RPL (OR=1.59; 95% CI=1.05-2.41; p=0.013). No significant association was observed between GPIIIa c.98C>T polymorphism and RPL.
Conclusion: ACE I/D polymorphism may probably be a prognostic factor in female family members of women with the history of recurrent abortion.
Maryam Fotoohi, Nasrin Ghasemi, Seyed Ali Mirghanizadeh, Mahmood Vakili, Morteza Samadi,
Volume 14, Issue 7 (7-2016)

Background: Human leukocyte antigen-E (HLA-E)is a non-classical major histocompatibility complex (MHC) class I antigens which expressed on extra villous cytotrophoblast, which interacts with NKG2A, is an inhibitory receptor on natural killer (NK) cells and leading to down regulation of immune response in the maternal-fetal interface and provides maternal immune tolerance of the fetus. 
Objective: This study was designated to investigate the gene frequencies of E0101 and E0103 in HLA-E gene in Iranian women with recurrent spontaneous abortion (RSA). 
Materials and Methods: Amplification Refractory Mutation System (ARMS-PCR) technique was carried out to detect polymorphism in exon 3 of the HLA-E gene in women with RSA and controls (n=200). Differences between groups were analyzed by SPSS19 software using χ2 test. 
Results: There was no significant difference in the allele frequencies of the HLA-E polymorphism between RSA and fertile controls but HLA-E 0101/0103 heterozygous genotype was found to be significantly higher in RSA group (p=0.006, OR=1.73), so this genotype might confer susceptibility to RSA. 
Conclusion: Our results suggest that HLA-E 0101/0103 heterozygous genotype leads to increase of RSA risk. It seems that by genotyping of HLA-E polymorphism, we can predict the risk of RSA in infertile women.
Nazila Alizadeh, Elnaz Mosaferi, Laya Farzadi, Jafar Majidi, Amir Monfaredan, Bahman Yousefi, Behzad Baradaran,
Volume 14, Issue 7 (7-2016)

Background: Human leukocyte antigen-G (HLA-G) is a non-classical class I molecule highly expressed by extravillous cytotrophoblast cells. Due to a single base pair deletion, its function can be compensated by other isoforms. Investigating the frequency of null allele in Recurrent Miscarriage (RM) subjects could be useful in understanding the relationship between frequency of this allele and RM in a given population. 
Objective: This study aimed to determine the frequency of HLA-G*0105N null allele and its potential association with down-regulation of HLA-G in subjects with RM. 
Materials and Methods: Western blotting was used to assess the level of HLA-G protein expression. For investigating the frequency of HLA-G*0105N null allele in RM subjects, PCR-RFLP method was used. Exon 3 of HLA-G gene was amplified by polymerase chain reaction (PCR). Subsequently, PpuM-1 enzyme was employed to digest the PCR products and fragments were analyzed using gel electrophoresis. 
Results: Digestion using restriction enzyme showed the presence of heterozygous HLA-G*0105N null allele in 10% of the test population. Western blotting results confirmed the decrease in expression of HLA-G in the placental tissue of subjects with RM compared to subjects who could give normal birth. 
Conclusion: The frequency of heterozygous HLA-G*0105N null allele was high to some extent in subjects with RM. The mutation rate in subjects suggested that there is a significant association between RM and frequency of mutations in this allele.
Maryam Eftekhar, Sepideh Miraj, Maryam Farid Mojtahedi, Nosrat Neghab,
Volume 14, Issue 11 (11-2016)

Background: Although pregnancy rate in in vitro fertilization-embryo transfer (IVF-ET) cycles has been increased over the preceding years, but the majority of IVF-ET cycles still fail. Granulocyte colony stimulating factor (GCSF) is a glycoprotein that stimulates cytokine growth factor and induces immune system which may improve pregnancy rate in women with history of implantation failure.
Objective: The aim of this study was to evaluate GCSF ability to improve pregnancy rate in women with history of implantation failure
Materials and Methods: 0.5 ml (300 μg/ml) GCSF was infused intrauterine in intervention group. Pregnancy outcomes were assessed based on clinical pregnancy.
Results: The mean age of participants was 31.95±4.71 years old. There were no significant differences between demographic characteristics in two groups (p>0.05). The pregnancy outcome in GCSF group was improved significantly (p=0.043).
Conclusion: GCSF can improve pregnancy outcome in patients with history of implantation failure.
Nasrin Ghasemi, Razieh Dehghani Firouzabadi, Shahnaz Ahmadi,
Volume 15, Issue 2 (3-2017)

Background: Ovarian hyperstimulation syndrome (OHSS) is one of the most important complications of assisted reproduction treatment (ART). Many substances are involved in the regulation of the vascular permeability, which have been concerned to cause OHSS. Vascular endothelial growth factor (VEGF) has emerged as one of the main angiogenic factors, which could be responsible for increased vascular permeability.
Objective: This project evaluated potential association between OHSS and VEGF gene -460 C/T and +405 G/C polymorphism.
Materials and Methods: This case-control study was performed at Research and Clinical Center for Infertility, Yazd, Iran for one year. One hundred sixty women enrolled in this study, which were received conventional stimulation. Eighty five of 160 patients were normoresponder (control group) and seventy five were OHSS (case group). After DNA extraction from whole blood by salting-out method, VEGF gene polymorphisms were amplified by PCR-RFLP.
Results: There were no significant difference in the frequency of -460 C/T polymorphism between cases and controls (Chi-square test, p=0.85). The frequency of +405 G/C was significantly higher in the OHSS group (p=0.03, OR=2.44; 95% CI=1.23-4.82).
Conclusion: In women who developed OHSS, VEGF gene polymorphism +405 could be effective. Two of the polymorphisms -460 C/T and +405 G/C were reported to be associated with increased VEGF basal promoter activity. However, only +405 G/C gene polymorphisms was more frequent in cases than controls
Hamid Reza Ashrafzadeh, Tahere Nazari, Masoud Dehghan Tezerjani, Maryam Khademi Bami, Saeed Ghasemi-Esmailabad, Nasrin Ghasemi,
Volume 15, Issue 8 (9-2017)

Background: Tumor necrosis factor-alpha (TNF-α) is a multifunctional cytokine that regulates different cellular activities related to spermatogenesis. Tumor necrosis factor-alpha receptor 1 (TNFR1) mediates TNF-α activity and polymorphism in TNFR1 could lead to gene dysfunction and male infertility.
Objective: The aim of this study is to determine the association of TNFR1 36 A/G polymorphism with the idiopathic azoospermia in Iranian population.
Materials and Methods: This case-control study included 108 azoospermic and 119 fertile men. This research investigated the frequency of TNFR1 36 A/G polymorphism in cases who were idiopathic azoospermic men referred to Yazd Research and Clinical Center for Infertility, Iran in comparison with controls. polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP) method was used to investigate the polymorphism in both case and control groups. PCR fragments were digested by Mspa1I enzyme and products were appeared by gel electrophoresis. The abundance of A→G was calculated in the azoospermic and healthy men.
Results: According to the present study, GG and AG genotypes frequency in the azoospermic men group were higher than the control group (OR= 2.298 (1.248-4.229), p=0.007), (OR=1.47 (0.869-2.498, p=0.149). Our findings also showed that G allele frequency in azoospermic men had significant difference compared to the control group (OR=2.302 (1.580-3.355), p<0.001).
Conclusion: It seems that the GG genotype and G allele have an association with increased risk of non-obstructive azoospermia
Elaheh Mesdaghinia, Behnaz Mohammad-Ebrahimi, Fatemeh Foroozanfard, Hamid Reza Banafshe,
Volume 15, Issue 10 (12-2017)

Background: Recurrent spontaneous abortion has high incidence rate. The etiology is unknown in 30-40%. However high uterine artery resistance is accounted as one of the recurrent abortion reasons.
Objective: The objective of the current study was to determine the impacts of vitamin E and aspirin on the uterine artery blood flow in women having recurrent abortions due to impaired uterine blood flow.
Materials and Methods: This randomized clinical trial was conducted on 99 women having uterine pulsatility index (PI) more than 2.5 and the history of more than two times abortions. The candidates were categorized into three groups; receiving aspirin, only vitamin E, and aspirin+vitamin E. After 2 months, uterine PIs were compared with each other.
Results: All drug regimens caused an enhancement in uterine perfusion with a significant decline in uterine artery PI value. The women receiving vitamin E in accompanied with aspirin had the least mean PI of the uterine artery (p<0.001). The total average PI score of the right and left uterine arteries in groups receiving vitamin E in accompanied with aspirin was lower than the two counterparts significantly (p<0.001).
Conclusion: Vitamin E, aspirin and especially their combination are effective in improving uterine artery blood flow in women with recurrent abortion due to impaired uterine blood flow. More well-designed studies are needed to find out whether the enhancement of uterine perfusion may lead to a better pregnancy outcome.
Mahboobeh Nasiri, Kobra Jahangirizadeh,
Volume 16, Issue 1 (2-2018)

Background: Granulocyte colony-in stimulating factor (G-CSF) gene can be a potential candidate gene implicated recurrent pregnancy loss (RPL), a common complication of pregnancy with the prevalence of 1-5% among women of reproductive age.
Objective: To investigate the association between rs1042658 polymorphism in the 3' untranslated region (3'UTR) of G-CSF gene and the risk of unexplained RPL among Iranian women.
Materials and Methods: In total, 122 women with unexplained RPL and 140 healthy postmenopausal women as a control group were enrolled in this case-control study. Tetra-primer amplification refractory mutation system-polymerase chain reaction was performed to determine the rs1042658 genotypes in all subjects.
Results: Statistically significant differences were detected between the distribution frequencies of both heterozygote CT, and carriage of T allele (TT+CT) genotypes of the rs1042658 between case and control groups. Allelic association was not observed with RPL.
Conclusion: Regarding the results of the present study, G-CSF rs1042658 gene polymorphism could be considered as a probable risk factor for unexplained RPL among Iranian women.
Mahnaz Heidari, Niknam Lakpour, Mahsa Darbandi, Sara Darbandi, Saeideh Shani, Leila Goharbakhsh, Ghazaleh Cheshmi, Mohammad Mehdi Akhondi, Mohammad Reza Sadeghi,
Volume 16, Issue 7 (7-2018)

Background: Sperm processing methods separate motile sperms with good morphology from dead and abnormal forms of sperms, immature germ cells, and non-sperm cells.
Objective: The propose of this study was to compare the efficacy of upstream and swim-up processing techniques to separate sperms with the high quality especially in relation to sperm chromatin integrity.
Materials and Methods: This experimental study used semen samples from 60 normozoospermic men. Specimens were divided into equal aliquots for processing by swim up (group A), and upstream (group B) methods and compare with control by raw semen (group C). Sperm concentration, morphology, motility, DNA fragmentation and chromatin maturation were measured in these three groups.
Results: The results revealed that sperm concentration in the swim up samples was significantly greater than upstream samples (p≤0.04). as addition, motile sperm recovery including the percentage of progressive motility and a total number of motile sperm was better in the swim-up compared to an upstream method and raw semen (p≤0.001). The cell debris and seminal fluid were equally removed by both methods and the percentage of normal forms was also similar in both procedures (p≥0.4). In addition, sperm DNA fragmentation and chromatin maturation were not significantly different between the three groups (p≥0.1).
Conclusion: According to results, apparently the upstream method had no significant efficiency to separate good quality sperms compare to swim up. Therefore, swim up seems to be a simple, inexpensive, reliable and widely available method with an efficient yield to separate motile sperm with good morphology and better chromatin integrity for insemination in the infertility clinics.
Noorodin Karami, Seyed Hamidreza Mirabutalebi, Fatemeh Montazeri, Seyed Mehdi Kalantar, Mohammad Hasan Sheikhha, Maryam Eftekhar,
Volume 16, Issue 10 (10-2018)

Background: Recurrent miscarriage, as the occurrence of two or more of pregnancy loss before the 20th wk, can occur for multiple causes. One of the causes of miscarriage may be a defect in the process of angiogenesis because the delivery of nutrients to the fetus is decreased and it may lead to miscarriage. Also, micro ribonucleic acids play an important role in the development of diseases. The microRNAs 16 and 21 are the most well-known angiogenesis-related miRNAs, which their gene targets are vascular endothelial growth factor-A and phosphatase and tensin homolog, respectively. Objective: To evaluate the changes in expression of microRNAs 16 and 21 and their association with the gene targets in women with unexplained RM. Materials and Methods: In this case-control study, blood samples were taken from 25 women with unexplained RM and 25 controls. After extraction of RNA, the relative expression of microRNAs and their gene targets was measured using real-time quantitative reverse transcription-PCR method.
Results: Our findings showed that miR-21 expression was significantly decreased in both plasma and peripheral mononuclear cells (p=0.04 and p=0.02, respectively) and could be associated with the PTEN expression (p=0.03), however, there is no significant correlation between miR-16 and VEGF-A. Conclusion: One of the most remarkable results of this study is that miR-21 showed significant changes in both plasma and peripheral mononuclear cells, which can be related to the etiology and progression of RM.
Leila Keshavarz, Majid Yavarian,
Volume 17, Issue 7 (7-2019)

Background: Recurrent spontaneous abortion (RSA) often remains unclear and can be burden for the patient and time consuming for clinician. RSA may initiates from a genetic or non-genetic factors. It is well known that the quality of placental circulation is critical for implantation and embryo development. Because of angiogenic effects of VEGF–KDR pathway on placenta, the genes involved in this pathway (the KDR or VEGFR genes) are thought to be linked with RSA.
Objective: The aim of this study was to investigate the relationship between Gln472His (A/T) polymorphism of the KDR gene with RSAs in southern Iran.
Materials and Methods: In this case-control study, 50 aborted embryonic tissue obtained from fetuses and 50 umbilical cord blood of newborn babies were studied.
Fetal sample from mothers with history of at least two consecutive miscarriages and controls from mothers who had at least one full-term infants born were taken. Genomic DNA was extracted by using PureLink genomic DNA kit (Life Technologies, CA). The Rotor-Gene Q real-Time PCR machine and High-resolution melting curve analysis (HRM) technique were used for genotyping.
Results: Based on the AA genotype as reference, it is shown that the T allele (OR =2.447, 95% CI = 1.095–5.468, p = 0.029) as well as AT heterozygote genotype was significantly associated with an increased risk of miscarriage (OR = 2.824, 95% CI = 1.210-6.673, p = 0.016).
Conclusion: A positive correlation between Q472H polymorphism of the KDR gene and RSA may be the cause in southern Iran.
Bishista Bagchi, Siddhartha Chatterjee, Rajib Gon Chowdhury,
Volume 17, Issue 12 (12-2019)

Background: Latent Female Genital tuberculosis (FGTB) or tubercular infestation is prevalent in Southeast Asia and even the presence of tubercular bacilli in the genital tract is becoming an important factor for reproductive failure. An immature endometrium becomes non-receptive, preventing implantation or rejection of implanted embryo in early months, resulting in recurrent pregnancy loss (RPL) in association with other factors.
Objective: To detect the underlying causes of RPL in addition to the proven causes like uterine cavity defects, thrombophilia, chromosomal abnormalities, etc.
Materials and Methods: 317 women with RPL, enrolled over a period of 60 months (January 2014 to December 2018) conducted at Calcutta Fertility Mission in the present study. They were grouped in A, B, and C and undergone routine tests for the same along with the PCR test with an endometrial aspirate.
Results: Patients with only latent FGTB (Group A), patients with FGTB and associated factors (Group B), and patients with other causes of RPL (other than latent FGTB) (Group C) were34.4%, 42.3%, and 23.3% respectively. About 29.36%, 47.01%, and 21.62%of the patients had achieved pregnancy in Group A, B, and C, respectively. The rate of miscarriage was high in both Groups A and B, affected with latent FGTB, and live-birth was higher (75%) in Group C that did not have tubercular involvement of the genital tract.
Conclusion: The tubercular infestation or latent FGTB as per our study appears to be a very important cause of RPL in patients with recurrent “unexplained” miscarriage. It should be treated adequately at an early stage to prevent permanent damage to pelvic organs and restore reproductive health in women.

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