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Showing 27 results for Fallah

Motahhareh Golestan, Razieh Fallah, Sedighah Akhavan Karbasi,
Volume 6, Issue 5 (7-2008)

Background: Low birth weight (LBW) is one of the major determinants of neonatal survival as well as postnatal morbidity.
Objective: The main objective of the present study was to determine neonatal mortality rate (NMR) in LBW infants in Yazd, Iran.
Materials and Methods: In a prospective-cohort study, all births in the maternity hospitals of Yazd, Iran in 2004 were evaluated and mortality rate in LBW population over the course of the first month of extra uterine life was determined.
Results: In total, 8.4% (507 of 6016 births) of all newborns were LBW and 18.7% (95/507) of all LBW neonates died. Neonatal mortality rate in Yazd was 24/1000 live births .Two- third (95 /143) of all neonatal deaths occurred in LBW. Neonatal mortality rate (NMR) in LBW, Moderately low birth weight (MLBW), Very low birth weight (VLBW) and Extremely low birth weight (ELBW) were 23, 11.5 , 62.5 and 117 times more than that of normal weight newborns, respectively. Nearly 65% of all LBW neonatal deaths occurred in first 24 hours after birth. Overall NMR, Early Neonatal mortality rate (ENMR) and Late Neonatal mortality rate (LNMR) in LBW were 187, 118 and 9.8 in 1000 live births, respectively. The main causes of mortality among LBW in order of prevalence were respiratory distress syndrome (RDS) (59%), asphyxia (20%), septicemia (12%) and congenital malformation (9%).
Conclusion: Neonatal mortality rate in Yazd is high and LBW accounted for two-third of neonatal deaths. Therefore, effort should be intensified to implement effective strategies for the reduction of LBW births and improving the care of these vulnerable neonates.
Seyed Mohammad Seyedhassani, Massoud Houshmand, Seyed Mehdi Kalantar, Abbas Aflatoonian, Glayol Modabber, Fatemeh Hadipour, Mohammad Hossein Fallahzadeh,
Volume 8, Issue 1 (7-2010)

Background: Mitochondrial transfer RNAs (tRNA) genes are essential components of protein biosynthesis. These genes are hotspots for mutations. These mutations are associated with a wide spectrum of human disease. Many genetic factors are known in assessment of repeated pregnancy loss (RPL). Objective: The aim of this study was analysis of tRNA Thr and tRNA Pro in women with RPL.
Materials and Methods: The nucleotide variations of threonine and proline were investigated in 96 women with idiopathic repeated pregnancy loss. The related mitochondrial area was amplified using a polymerase chain reaction (PCR). The PCR products were demonstrated by 2% agarose gel electrophoresis and all the positive samples were purified and verified by an automated DNA sequencing method.
Results: The sequence analysis revealed 4 mutations in tRNA Thr. These mutations were A15907G in 2 cases (2.08%) A15924G in 3 cases (3.12%) G15928A in 10 cases (10.42%) as the most common mutations and G15930A in 3 cases (3.12%) as a novel mutation. Also the result of tRNApro sequencing showed the T15972C mutation in 1 woman (1.04%) as a novel mutation.
Conclusion: These tRNAs mutations can alter their steady state level and affect the structure of tRNAs. It results in protein synthesis defects and in turn mitochondrial dysfunction. The mutations of these genes may help in the assessment of RPL. Further study of an expanded series of these tRNA mutants is recommended to describe their etiologic role in idiopathic RPL.
Marzieh Agha Hosseini, Ashraf Aleyasin, Atossa Mahdavi, Sara Mokhtar, Leila Safdarian, Parvin Fallahi,
Volume 8, Issue 4 (7-2010)

Background: Anti-mullerian hormone (AMH) levels may represent the ovarian follicular pool and could be a useful marker of ovarian reserve. The clinical application of AMH measurement has been proposed in the prediction of quantitative and qualitative aspects in assisted reproductive technologies. Objective: This study aimed to assess the relationship between the serum levels of AMH and results of assisted reproductive technique (ART) outcome in polycystic ovary syndrome (PCOS) patients versus control group.
Materials and Methods: This cohort study was conducted on 61 (PCOS) patients and 28 patients without PCOS (controls) candidates for assisted reproductive technique. Serum levels of AMH were measured on the 3rd day of menstrual cycle and all the patients underwent controlled ovarian hyper stimulation and ART. The relationship between AMH serum level with retrieved oocytes, mature oocytes and pregnancy rate were assessed.
Results: There was significant correlation between the AMH level with number of total retrieved oocytes and mature oocytes in patients with PCOS and controls (p=0.001). In PCOS and control groups AMH level in pregnant patients was higher, but it was not statistically significant (p=0.65, p=0.46, respectively). The major outcome of the study (pregnancy) did not differ significantly between two groups.
Conclusion: This study revealed that AMH level was higher in pregnant patients undergoing ART; but AMH may not be an accurate predictor for pregnancy in PCOS patients.
Robab Davar, Mojgan Javedani, Mohammad Hossein Fallahzadeh,
Volume 9, Issue 1 (7-2011)

Background: Polycystic ovary syndrome (PCOS) is associated with approximately 75% of women who suffer from infertility due to anovulation. Additionally, around 20– 25% of anovulatory women with PCOS do not respond at all to clomiphene citrate and are considered to be “clomiphene– resistant”. Aromatase inhibitors have been suggested as an alternative treatment to clomiphene as the discrepancy between ovulation and pregnancy rates with clomiphene citrate has been attributed to its anti-estrogenic action and estrogen receptor depletion.
Objective: The aim of this study is to compare results of Metformin-letrozole with Metformin-clomiphene citrate in clomiphene resistance PCOS patients undergoing IUI.
Materials and Methods: In this single blind randomized trial, ovarian cycles were studied in 100 clomiphene- resistant patients with PCOS. The inclusion criteria were patients who received 150mg clomiphene citrate daily for 3 cycles and failed to become pregnant. The patients were matched for their age, body mass index (BMI), and infertility period. They were randomly allocated to a metformin-letrozole group (n=50) and a metformin-clomiphene citrate group (n=50). Chemical and clinical pregnancies were assessed after IUI. Abortion rates were determined in both groups.
Results: Regarding pregnancy rate, there was no significant difference between the two groups. One miscarriage (2%) occurred in the metformin-clomiphene citrate group, whereas none was seen in the metformin-letrozole group.
Conclusion: There is no significant difference in pregnancy rate between clomiphene citrate and letrozole groups although it has been 2% in the former and 5% in the latter. Article
Leili Safdarian, Shohre Movahedi, Ashraf Aleyasine, Marzie Aghahosaini, Parvin Fallah, Zahra Rezaiian,
Volume 9, Issue 4 (7-2011)

Background: Despite numerous developments in the field of assisted reproduction the implantation rate remains low .Recent studies suggested that local injury to endometrium in controlled ovarian hyper stimulation cycle improves implantation rate. Studies have attempted to intervene in the development of endometrium.
Objective: The aim of the present study was the exploration of the possibility that local injury of the endometrium increases implantation rate.
Materials and Methods: In this interventional study, 100 good responders to hormone stimulation patients were divided into control group (n=50) and experimental group (n=50) which undergo endometrial biopsy by biopsy catheter )piplle) on day 21 of their previous menstrual cycle with use of contraceptive pills before the IVF-ET treatment. In total, 26 patients were removed from the study because the number of stimulated follicles were below 3, or there was no embryo or there was the risk of OHSS. The remaining patients were 33 in experimental group and 41 in the control group.
Results: There were no significant differences between the two groups in terms of the age of the patients, duration of infertility and BMI, base line FSH level and responses to hormone stimulation. The rates of embryo implantation, chemical and clinical pregnancy in the experimental group were 4.9%, 18.2% and 12.1% with no significant differences with the control group (6.7%, 19.5%, 17.1%). Cancellation rate was 26%.
Conclusion: In our study, endometrial biopsy didn’t increase the chances to conceive at the following cycle of treatment.
Ahmad Fayaz, Susan Simani, Vida Fallahian, Ali Eslamifar, Mahboob Hazrati, Firoozeh Farahtaj, Nader Howaizi, Peivand Biglari,
Volume 10, Issue 2 (7-2012)

Background: Rabies is a fatal infectious disease and rabies post-exposure prophylaxis is the method of choice for prevention of human rabies.
Case series: We report rabies antibody levels in cord blood and also in serum of pregnant women who were bitten by suspected animals to rabies and were immunized by purified Vero cell rabies vaccine (PVRV) and Human Rabies immunoglobulin (HRIG) serum. During the years of 2007-2010, six pregnant women by the age range of 22-35 years were admitted in treatment and prevention of rabies center in Pasture institute of Iran, in Tehran. Among them two cases were at first trimester, one at second trimester and three at third trimester of conception. The interval between biting with delivery was 5-265 days (mean 121 days).
Conclusion: Results of immunoglobulin illustrate that levels of rabies antibody in maternal sera with the fetus are not equal and uniform but it is proved that baby will find efficient immunity as well with minimum protective level of 0.5 IU/ml in all cases except a newborn whom had been born just 5 days after the mother’s immunization and in a shorter time than the appropriate immunization of the mother who had received her second vaccination courses.
Leili Safdarian, Zahra Khayatzadeh, Ebrahim Djavadi, Atossa Mahdavi, Marzieh Aghahosseini, Ashraf Aleyasin, Parvin Fallahi, Sima Khayatzadeh, Arash Ahmadzadeh, Mohhamad Bagher Larijani,
Volume 10, Issue 3 (7-2012)

Background: Detection of best predictor of ovarian reserve in patients with temporarily or consistently elevated early follicular phase serum levels of FSH is one of the most important goals in assisted reproductive technique (ART).
Objective: To evaluate whether high level of anti-mullerian hormone level is related to success of ART in patients with temporarily or consistently elevated early follicular phase serum levels of FSH.  
Materials and Methods: Sixty three women underwent intracytoplasmic sperm injection (ICSI) with GnRH-agonist long protocol or intrauterine insemination (IUI) in a prospective cohort study. FSH, inhibin B and anti-Mullerian hormone (AMH) levels were measured in these women whom were divided to three groups (persistently elevated FSH, variably elevated FSH and, normal FSH level). Basal characteristics, stimulation parameters, and pregnancy occurrence were evaluated.
Results: AMH was significantly higher in women with persistently elevated early follicular phase FSH achieving pregnancy. Women with normal FSH did not have significant difference in AMH level between conceived and non conceived cycles. Women with only one elevated early follicular phase FSH achieving pregnancy did not have significant difference in AMH level with non pregnant women. Response to gonadotropin stimulation, recommendation to oocyte donation significantly differed between the groups.
Conclusion: This study has demonstrated that relatively young women with persistently or intermittently elevated day 3 FSH levels have diminished ovarian reserve and lower ART success. However, in women whose FSH levels were constantly elevated, AMH (not inhibin B) concentrations were significantly higher in ART cycles resulting in pregnancy. Therefore, AMH level is a good predictor of ART outcome in patients with elevated early follicular phase serum levels of FSH.

Mehri Makki, Elham Saboori, Mohammad Ali Sabbaghi, Raheleh Aram, Mohammad Hasan Fallahian, Fatemeh Peyghambari, Hessam Roustaei, Abbas Ahmadi,
Volume 10, Issue 4 (8-2012)

Background: In vitro maturation (IVM) of human oocytes is an emerging procedure quickly incorporated into the world of assisted reproductive technologies. As an effective method of in vitro maturation, several studies have reported the critical role of differentions on activating the complex process involved in both gamete maturation and fertilization.
Objective: In this study, we supplemented a chemically defined medium with different combinations of selenium, calcium and calcium ionophore concentrations to obtain the best rate of human oocytes maturation, survival, and fertilization.
Materials and Methods: As an experimental study, Three combinations of [selenium (5 μg/ml), calcium (5 μg/ml) and calcium ionophore (1 μg/ml)], [selenium (10 μg/ml), calcium (7 μg/ml) and calcium ionophore (2 μg/ml)] and [selenium (15 μg/ml), calcium (10 μg/ml) and calcium ionophore (5 μg/ml)] added to the chemically defined medium and the morphology of oocytes assessed after 22-24 hours in vitro maturation of the oocytes.
Results: The highest percentage of MII (meiosis II) oocytes (68%), developing beyond the morula (20.1%) and the blastocyst formation (11.1%) observed in oocytes treated with 15µg/ml selenium, 10µg/ml calcium and 5µg/ml calcium ionophore. Moreover, we showed the significant rate of survival in each three combinations after 36, 72 and 96 hours.
Conclusion: Maturation and activation of oocytes may be triggered by changes in intracellular ion concentrations as second messengers in signal transduction pathways. Here, we received the highest percentage of in vitro maturation and fertilization among three combinations of selenium, calcium and calcium ionophore treatments. Using this combination of ions beside other factors might be useful for the enrichment of the human oocytes IVM medium.

Hossein Fallahzadeh, Maryam Hossienzadeh, Fatemeh Yazdani, Atefeh Javadi,
Volume 10, Issue 4 (8-2012)

Background: Evidences shows that menopause affects womenchr('39')s health, but womenchr('39')s knowledge of proper care and maintenance is insufficient.
Objective: To determine knowledge of hormone therapy (HT), reproductive physiology, and menopause in a population of 40-60 year old women.
Materials and Methods: This cross-sectional study was conducted through a cluster sampling among 330 women in Yazd, Islamic Republic of Iran, in 2010. Data was collected using a questionnaire containing questions about reproductive physiology related to menopause and HT by interviewing. Inferential and descriptive statistics via SPSS.15 software were used for data analysis.
Results: Overall, 2.1% of women were current takers of HT, 13.4% had taken it in the past but had stopped and 84.5% had never taken hormone replacement therapy. Iranian women had low knowledge of HT, reproductive physiology, and menopause. Most of the women (85.5%) knew that hot flashes are common around menopause and only 77.2% knew decreasing estrogen production causes the menopause. They knew little about the effects of progestagens and the effects of HT on fertility. Logistic regression determined that age, educational level and BMI were the most important factors predicting use of HT after adjusting for other variables.
Conclusion: Iranian women have a low HT usage rate and the majority of them are lacking of the knowledge about HT and menopause. Women need improved knowledge of the risks and benefits of HT as well as education about the reproductive system around menopause.

Zia Islami, Razieh Fallah, Toktam Mosavian, Mohammad Reza Pahlavanzadeh,
Volume 10, Issue 5 (10-2012)

Background: Low birth weight (LBW or birth weight <2500 g) is one of the most serious health problems in todaychr('39')s world.
Objective: The purpose of this study was to evaluate growth parameters of neonatal intensive care unit (NICU) admitted LBW preterm neonates at corrected ages of 6 and 12 months.
Materials and Methods: In a prospective cohort (follow up) study, all LBW preterm neonates whom were admitted to Shahid Sadoughi Hospital NICU in 2008, followed up for one year and their weight, height and head circumference evaluated at ages of 6 and 12 months.
Results: Twenty four boys and 26 girls with mean gestational age of 31.3±2.7 weeks and mean birth weight of 1480.3±422.8gr were evaluated. The most frequency of underweight and short stature was seen at the age of six months. Exclusive breast feeding infants had the lowest frequency of underweight at the age of six. Frequency of underweight at the age of six months and NICU stay days were more in neonates with birth weight of less than 1000 gr.
Conclusion: It is necessary to emphasize on the importance of growth assessment of LBW children and proper education of their mothers about nutrition of their children for early and timely diagnosis and management of growth retardation and prevention of subsequent problems.
Nourossadat Kariman, Maryam Afrakhte, Mehdi Hedayati, Masoumeh Fallahian, Hamid Alavi Majd,
Volume 11, Issue 2 (4-2013)

Background: Rupture of fetal membranes can occur at any gestational age. Premature rupture of membranes (PROM) means rupture of fetal membranes before the onset of labor.
Objective: The purpose of this study was to evaluate and compare the reliability of the vaginal washing fluid urea and creatinine for the diagnosis of PROM and to determine cut-off values.
Materials and Methods: A total of 179 pregnant women were recruited. All patients underwent different examinations. These included nitrazine paper test, fern test, amniotic fluid pooling, vaginal washing fluid urea and creatinine sampling. The one group consisted of 126 pregnant women between 14 and 41 weeks of gestation with the complaint of vaginal fluid leakage. Patients who had positive pooling, nitrazine paper test and fern test were considered as confirmed PROM group (group 1). On the other side, patients with pooling (-) and/or nitrazine paper test (-) and/or fern test (-) were taken as suspected unconfirmed PROM cases (group 2). The control group consisted of 53 pregnant women between 14 and 41 weeks of gestation without any complaint or complication. Weconducted one-way ANOVA test on the urea and creatinine measures and post-hoc comparison test. Cut-off value was determined by receiver operating characteristic (ROC) curve.
Results: Vaginal fluid concentrations of urea and creatinine were significantly different between the three groups (p<0.001). The sensitivity, specificity, positive and negative predictive values and accuracy were all 100% in detecting premature rupture of membranes by evaluation of vaginal fluid creatinine concentration with a cut-off value of 0.45 mg/dl, respectively.
Conclusion: This study demonstrates that of two markers investigated creatinine has the higher diagnostic power.
Sayyed Mohsen Miresmaeili, Iman Halvaei, Farzaneh Fesahat, Asghar Fallah, Narges Nikonahad, Mohaddeseh Taherinejad,
Volume 11, Issue 5 (7-2013)

Background: Nanoparticles have wide range of application while there are some reports regarding their probable effects on male reproductive system and spermatozoa.
Objective:  The aim of this study was to evaluate the effect of different doses of silver nanoparticles (AgNPs) (70nm) on acrosome of rat spermatozoa and number of spermatogenic cells.
Materials and Methods:  In this experimental study, in experimental group, 32 male wistar rats (8 rats/group) received oral feeding AgNPs every 12 hr in one spermatogenesis period (48 days) by means of gavages in 25, 50 , 100 and 200 mg/kg concentration (experimental groups 1-4, respectively). The control group (8 rats) was treated on schedule with distilled water. Spermatozoa were stained by triple staining protocol for acrosome reaction. Histological evaluation on testis sections was performed using tissue processing and hematoxylin-eosin (H&E) staining.
Results:  There was significant difference between the control group and the experimental group 1 for acrosome reaction (11.00±0.00 and 24.25±3.68, respectively, p=0.01). There was only significant reduction in spermatogonia cells in experimental group 4. Experimental groups 2, 3 and 4 showed a significant reduction in the number of primary spermatocytes and spermatids as well as spermatozoa. But there were no significant differences between different groups for Sertoli cell number and seminiferous tubule diameter.
Conclusion:  It seems that Ag NPs have acute and significant effects on spermatogenesis and number of spermatogenic cells and also on acrosome reaction in sperm cells. More experimental investigations are necessary to elucidate better conclusion regarding the safety of nanoparticles on male reproduction system.
Hossein Fallahzadeh, Zohreh Farajpour, Zahra Emam,
Volume 11, Issue 5 (7-2013)

Background: Short birth intervals have been associated with adverse health outcomes, including infant, child and maternal mortality.
Objective:  We aimed to investigate the duration and determinants of inter birth intervals among women of reproductive age in Yazd, Iran.
Materials and Methods:  A cluster sampling technique was used to select 400 ever-married women aged 15-49 years in Yazd, Islamic Republic of Iran. Data were obtained by interview questionnaire and analyzed with life table, Kaplan-Meier survival and Cox regression analyses.
Results:  The mean duration of inter birth interval was 49.76 (standard error 1.82) months (95% CI: 46.19-53.34 months) with a median of 39. In 28.5% of women the birth interval was <2 years, in 28% it was 3-5 years and in 25.5% it was ≥6 years. Among explanatory variables of interest, age of marriage, and womanchr('39')s education were significant predicators of the birth interval. Women who stated an ideal preference of two children constituted 59.9% of the sample and 16% had 3 children as well as 10.7% had an ideal preference for 4 or 5.
Conclusion:  The study recommended an educational program to have optimal birth intervals and ideal number of children per family for the prevention of adverse prenatal outcomes.
Razieh Fallah, Sedighah Akhavan Karbasi, Mohammad Taghi Galalian, Razieh Dehghani-Firouzabadi,
Volume 11, Issue 5 (7-2013)

Background: Approximately one percent of current live births of the world are conceived via assisted reproductive technologies (ART).
Objective:  The purpose of this study was to compare the developmental status of children born through assisted and natural conceptions at the age of five years.
Materials and Methods:  In a retrospective cohort study, developmental status of 5 years old children was evaluated via Persian version of 60-month Ages and Stages Questionnaires. Case group consisted of 61 singletons, term babies whom were born through ART in the Research and Clinical Center for Infertility, Yazd, Iran in 2005. Control group consisted of 61 term, first child, singleton and spontaneously conceived born five years old children whom were referred to Shahid Akbari primary health care center in 2010.
Results:  58 girls (47.5%) and 64 boys (52.5%) were evaluated. Frequency of developmental delay in domains of fine motor (47.5% vs. 24.6%, p=0.008) and problem solving (60.6% vs. 34.4%, p=0.004) were more in ART born children. On logistic regression, fine motor development state was independently affected by maternal educational level (OR: 5.3, 95% CI: 1.67-16.30, p=0.004) and developmental status in problem solving domains was independently affected by maternal educational level (OR: 4.88, 95% CI: 1.25-19.07, p=0.02) and birth weight (OR: 7.1, 95% CI: 1.78-29.01, p=0.006).
Conclusion:  Maternal educational level and birth weight are important factors that influenced developmental outcome of ART born children.
Mohammad Hosein Baghianimoghadam, Amir Hossein Aminian, Behnam Baghianimoghadam, Nasrin Ghasemi, Ali Mohammad Abdoli, Najmeh Seighal Ardakani, Hosein Fallahzadeh,
Volume 11, Issue 6 (9-2013)

Background: Infertility is accompanied by numerous psychological and social problems. Infertile couples are more anxious and emotionally distressed than other fertile people. Previous studies suggested that infertility is more stressful for women than men.
Objective: The purpose of this study was to determine the status of general health of infertile couples.
Materials and Methods: This cross-sectional study evaluated general health of 150 infertile couples attending to Yazd Research and Clinical Center for Infertility that were selected consequently. The data were gathered by the researchers, based on face to face interview before and after three months of treatment by two questionnaires. The first questionnaire had questions on demographic information and the second one was the General Health Questionnaire-28 (GHQ-28). This questionnaire has four sub- scales areas. All data were transferred directly to SPSS 15 and analyzed.
Results: The mean age of women was 28.3 and men were 32.4 years. The scores for all sub- scales of GHQ in women were more than men. There was significant difference between age and general health at physical symptoms scales (p=0.002), anxiety and sleep disorders (p=0.003). The age group 25-29 years had higher scores (more than 7) than other age groups. There was significant difference between the scale of social dysfunction and results of treatment.
Conclusion: Our results, similar to the previous studies have revealed negetive social and mental effects of infertility on women is more than men, so there is need that they be educated specially.
Sedighah Akhavan Karbasi, Motahhareh Golestan, Razieh Fallah, Mohammad Golshan, Zinabossadat Dehghan,
Volume 11, Issue 7 (10-2013)

Background: Admission of low birth-weight (LBW) neonates in neonatal intensive care unit (NICU) causes their deprivation of tactile and sensory stimulation.
Objective: The purpose of this study was to evaluate efficacy of body massage on growth parameters (weight, height and head circumference) gain velocity of LBW in Yazd, Iran.
Materials and Methods: A randomized clinical trial study was conducted on LBW neonates whom were admitted to NICU of Shahid Sadoughi Hospital, Yazd, Iran from March to December 2011. Neonates were randomly assigned to two groups. In group one, 20 neonates were received massage three times in a day for consecutive 14 days by their mothers. In group two, intervention consisted of standard and routine care as control group. The primary endpoints were efficacy in increase of mean of weight, height and head circumference that were evaluated 14 days after intervention, at ages one and two months. Secondary outcome was clinical side effects.
Results: 17 girls and 23 boys with mean gestational age of 34.4±1.22 weeks were evaluated. In the body massage group, only weight at the age of two months was significantly higher than the control group (mean±SD: 3250±305 vs. 2948±121 gr, p=0.005). No adverse events were seen in the two groups.
Conclusion: Body massage might be used as an effective and safe non-medical intervention for increasing of weight gain velocity in LBW preterm neonates.
Soghra Rabiee, Roya Kaboodmehri, Mohammad Fallah, Mahnaz Yavangi, Marzieh Sanouei Farimani,
Volume 11, Issue 10 (12-2013)

Embryo transfer and its related factors received little clinical attention and had been, until recently, the most inefficient step in in-vitro fertilization (IVF). Factors which appear to influence implantation rates are: contamination of the catheter tip with cervical bacteria, stimulation of uterine contractions during the procedure, the type of catheter, ultrasound guidance during the transfer, the position of the embryos in the uterine cavity and perhaps cervical mucus (1-4). Easy and atraumatic transfer is essential for successful implantation and the embryos need to be placed in the middle of the cavity, away from the fundus (5). The goal of trans-cervical embryo transfer is to non-traumatic deliver the embryo to an optimal intra uterine location for implantation. Cervical canal mucus may cover the catheter tip and it can be a source of bacterial contamination of uterine cavity. Therefore, aim of this study was evaluation of effect of removal of cervical mucus on clinical pregnancy rate. This study was carried out as a randomized controlled trial. Randomization was done for stratification of age, method of treatment and cause of infertility. A total of 120 women (18-35 years) with male factor infertility, was undergoing IVF cycles with long protocol, divided to two groups: 60 infertile women as cases (group A) that cervical mucus was aspirated and 60 women as controls (group B), without aspiration. In both groups scrub was done by normal saline. Aspiration of cervical mucus was performed by Mucat catheter just before embryo transfer in case group. Embryo transfer was done after 36 hours of puncture. Bed rest for all women after embryo transfer was 1 hours. Primary outcome and pregnancy defined as: positive βhCG 12 days after embryo transfer. The mean age of group A was 29.93±5.04 years, and in the group B was 29.03±4.5 years (p>0.05). The mean duration of infertility in group A was 7.6±5.6 years and in group B the mean duration of infertility was 5.5±3.2 years (p>0.05). The frequencies of previous IVF in group A and B was 38.3%, and 28.13% respectively (p>0.05, OR=1.64 in group A, OR=2.64 in group B). There was no significant difference between two groups in terms of number of transferred embryos statistically (p=0.06). The quality of transferred embryo in group A was as following: grade a 67.7%, grade b 16.7%, grade c 6.7%, and in group B was: grade a 85% and grade b 15%, and two groups were also no significantly different (p>0.05). Contact bleeding was happened in 1.7% of group A and 3.3% of group B. The rate of pregnancy (positive βhCG) in the group A was 11.7% (n=7), however, in the group B was 16.7% (n=10) and two groups had not significant difference statistically (p>0.05, OR=0.66). This study indicates that, removal of cervical mucus during embryo transfer (ET) has no positive effect on the pregnancy rate. However, according to some reports, removal of cervical mucus during ET had been postulated to increase the pregnancy and implantation rates by not interfering with embryo implantation (6). Some researchers suggested that, this is a time- consuming procedure that may increase the incidence of difficult transfers by removing the naturally lubricant mucus. In addition, any cervical manipulation at the time of embryo transfer may cause unwarranted uterine contraction. Several studies have shown a correlation between cervical mucus aspiration and increase pregnancy rates (4, 7). According to the study of Yazd University of Medical Sciences, cervical mucus aspiration with insulin syringe before embryo transfer can increase the pregnancy rate (8). According to some reports the presence of bacterial contamination of catheter tip during embryo is evidently limited and does not significantly affect the cycle outcomes (2). Several studies have shown that cervical mucus aspiration can decrease infection rate with E. coli, Mycoplasma, Uroplasma, Streptococcus B, D, Staphilococcus and increase implantation rate (9). In addition to cleaning cervical mucus, other interventions, such as drug prescription (ritodrine for example) also has no significant effect on pregnancy rate (10). Present study showed no positive correlation between this intervention and result of pregnancy outcome; however, total pregnancy rate in both groups was not high. Because of this procedure may increase the incidence of difficult transfer by removing the naturally lubricant mucus and may cause uterine contraction. In conclusion, the data presented in this study suggest that cervical area and uterus environment manipulation before embryo transfer is not recommended.
Sedigheh Borna, Mamak Shariat, Mohaddese Fallahi, Leila Janani,
Volume 11, Issue 11 (12-2013)

Background: Our information regarding immunity to toxoplasmosis among reproductive age women is indeterminate and there is significant variation between reported results; it is necessary to perform a Meta-analysis study on subjects to obtain required findings and develop preventive measures accordingly.
Objective: Estimation level of immunity to toxoplasmosis in reproductive ages.
Materials and Methods: All published papers in main national and international databases were systematically searched for some specific keywords to find the related studies up to 2012. we selected only original articles that either reported percentage of positive anti Toxoplasma IgG or total anti toxoplasma antibody by using ELISA or IFAT method (provided that the titer ≥1.20 is considered positive for IFAT) in childbearing age women and the full text of papers were found too.
Results: Studies involved a total of 13480 participants. The maximum and minimum reported prevalence rates of anti-Toxoplasma IgG antibody using IFTA serological method were 21.8% and 54%; using ELISA serological method were 23% and 64%, respectively. The overall estimation for prevalence of anti-Toxoplasma IgG antibody using IFTA serological method was 34.5% (95% CI: 28.5-40.5); using ELISA method was 37.6% (95% CI: 30.4-44.9). The overall estimation for prevalence of anti-Toxoplasma total antibody was 39.9% (95% CI: 26.1-53.7).
Conclusion: In Iran, screening is not routinely performed yet. The incidence of toxoplasmosis is too high to justify routine screening. Prenatal screening can help to identify mothers susceptible to infection. Screening for the presence of antibodies allows primary prevention of toxoplasmosis infection where eating habits and hygiene practices have clearly been identified as risk factors.
Mohammad Ebrahim Baki, Sayyed Mohsen Miresmaili, Majid Pourentezari, Esmail Amraii, Vahid Yousefi, Hamid Reza Spenani, Ali Reza Talebi, Morteza Anvari, Mohammad Fazilati, Ali Asghar Fallah, Esmat Mangoli,
Volume 12, Issue 2 (2-2014)

Background: Nano-particles are extensively employed in most industries. Several studies have been started to explore the probable detrimental effects of nano-particles on human reproduction. However, there is insufficient and controversially evident of effects of silver nano-particles on sperm parameters and other reproductive indices.
Objective: Investigation of the effects of silver nano-particles on sperm parameters, sex hormones and Leydig cells in rat as an experimental model.
Materials and Methods: In this experimental study, 75 male prepubertal Wistar rats were categorized in five groups including control group and 4 experimental groups (n=15 in each group). The rats in the experimental groups were fed silver nano-particles (60 nm in dimension) with concentrations of 25, 50, 100, and 200 mg/kg/day. After 45 days (about one duration of spermatogenesis in rat), samples of blood were taken from the rats for testosterone, leuteinizing hormone (LH), and follicle stimulating hormone (FSH) assessments. Afterwards, the epididymis and the testis of each rat were dissected for analyzing sperm parameters and Leydig cells.
Results: The results demonstrated a statistically significant reduction in number of Leydig cells in experimental groups compared to control one. In addition, the data showed a reduction in testosterone and a rise in LH level which was more obvious in high doses (p<0.05); however, FSH level showed a reduction but it was not statistically significant. A significant decrease was also found in sperm motility and normal sperm morphology in the experimental groups compared to the control one.
Conclusion: Our results demonstrated that silver nano-particles, in addition to interruption in functions of sex hormones, can diminish the number of Leydig cells and sperm parameter indices. It should be noted that the effects of nano-particles on reproductive indices are dose-dependent.

Zahra Moazami Goudarzi, Hossein Fallahzadeh, Abbas Aflatoonian, Masoud Mirzaei,
Volume 12, Issue 8 (8-2014)

Background: Some trials have compared laparoscopic ovarian drilling (LOD) with gonadotropins but, because of variations in study design and small sample size, the results are inconsistent and definitive conclusions about the relative efficacy of LOD and gonadotropins cannot be extracted from the individual studies.
Objective: To evaluate the relative efficacy of LOD and gonadotropins for infertile women with clomiphene citrate- resistant poly cystic ovary syndrome (PCOS).
Materials and Methods: A complete electronic literature search in databases including EMBASE, MEDLINE, Cochrane Library and Google scholar for some specific keywords was accomplished. We contained randomized clinical trials comparing outcomes between LOD, without medical ovulation induction, and gonadotropins.
Results: Six trials, covering 499 women, reported on the primary outcome of pregnancy rate. There was no evidence of a difference in pregnancy rate when LOD compared with gonadotropins (OR: 0.534; 95% CI: 0.242-1.176, p=0.119, 6 trials, 499 women, I2=73.201%). There was evidence of significantly fewer live births following LOD compared with gonadotropin (OR: 0.446; 95% CI: 0.269-0.74, p=0.02, 3 trials, 318 women, I2=3.353%). The rate of multiple pregnancies was significantly lower in the LOD arm compared to the gonadotropins arm (OR: 0.127; 95% CI: 0.028-0.579, p=0.008, 3 trials, 307 women, I2=0%).
Conclusion: Our result revealed that there was no evidence of a significant difference in rates of clinical pregnancy and miscarriage in women with clomiphene citrate-resistant PCOS undergoing LOD compared to the gonadotropin arm. The decrease in multiple pregnancies rate in women undergoing LOD makes this option attractive. The increase in live birth rate in the gonadotropin group may be because of the higher rate of multiple pregnancies in these women. However, more focus on the long-term effects of LOD on ovarian function is suggested.

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