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Behrouz IlKhanizadeh, Mohammad Taghizadieh, Mehrzad Mahzad-Sadaghiani, Farahnaz Noroozinia, Bahman Jahandideh,
Volume 3, Issue 1 (7-2005)
Abstract

Background: Leydig cell tumor is a rare form of testicular neoplasm which comprises 1-3% of all testicular tumors and only about 3% of these tumors are bilateral. A few Leydig all tumor have been described in patients with klinefelter�s syndrome so far. Case: The patient described in this case report was a 24 year-old man with chief complaint of infertility for one year. Physical examination, semen analysis, testes sonography and hormonal assay were done for him. Right side simple orchiectomy was performed for patient. Conclusion: This tumor is always benign in children and approximately 90% are benign in adults. Clinical presentation is testicular enlargement, gynecomastia, sexual activity disturbances such as decreased libido, infertility and azoospermia. We recommend complete exam and karyotype in patients with infertility and azoospermia.
Behrouz IlKhanizadeh, Mohammad Taghizadieh, Mehrzad Mahzad-Sadaghiani, Farahnaz Noroozinia, Bahman Jahandideh,
Volume 4, Issue 2 (7-2006)
Abstract

Background: Over recent decades a possible decrease in sperm quality and an increase in the incidence of testicular cancer have been reported in many populations. Some recent findings, as cohort studies, showed an increased risk of testicular cancer in men with abnormal semen analysis.
Case: A 30 years old man referred to our clinic with chief compliant of infertility for 3 years. Spermogram revealed azoospermia and right extratesticular intrascrotal mass was detected by ultrasound examination. Right inguinal surgical approach showed intact small sized atrophic right testis and an intrascrotal mass. In microscopic examination of the mass mixed germ cell tumor with teratoma, yolk sac and embryonal components were reported.
Conclusion: Extragonadal germ cell tumors, like their testicular counterparts are associated with primary germ cell defects. The higher incidence of antecedent infertility suggests that either congenital or acquired primary germ cell defect contributes to defective spermatogenesis and therefore, there is higher risk of cancer development in incompletely migrated germ cells. We recommend complete evaluation of cancer in patients with infertility and azoospermia.
Maryam –sadat Hosseini, Parviz GharehKhani, Maryam Sadeghi,
Volume 5, Issue 5 (7-2007)
Abstract

Background: Severe preeclampsia is a quite well-known entity with high incidence of both maternal and fetal morbidity and mortality. Although little is known about its etiology, inherited disorders of hemostasis and antiphospholipid syndrome have been postulated as common causes. The present study was conducted to evaluate the association of these two entities with preeclampsia in a group of Iranian patients.
Materials and Methods: A case-control study was performed on 26 parturients with severe preeclampsia and 26 healthy pregnant women who were matched according to the age, parity, gestational age and previous history of abortion. A 10cc blood sample was obtained and the following factors were measured: factor V Leiden, protein S, protein C, antithrombin III, anticardiolipin antibodies (IgM and IgG) and the presence of the lupus anticoagulant antibody.
Results: We have not found any significant difference in the values of factor V Leiden, antithrombin III, protein C, protein S, and anticardiolipin-IgG between preeclamptic (case) and non-preeclamptic (control) parturients. Meanwhile, lupus anticoagulant antibody was detected in one case and one control. However, anticardiolipin IgM was shown to be significantly higher in the preeclamptic patients. Severe preeclamptic parturients were 4.4 times more likely to develop elevated levels of IgM (OR=4.4, 95% CI=1.9-10, p<0.05).
Conclusion: Our results failed to reveal any significant association between preeclampsia and indices of inherited disorders of hemostasis, except for anticardiolipin IgM. Thus, routine screening of these indices are not recommended due to high expenses and shortness of reliability. 
Ferdous Mehrabian, Behnaz Khani Robati,
Volume 8, Issue 1 (7-2010)
Abstract

Background: Heterotopic abdominal pregnancy is a rare entity which poses unique management challenges.
Case: A 24-year-old Gravida 1 woman with history of two years infertility and treatment with clomiphene citrate presented with acute right lower quadrant abdominal pain. Heterotopic abdominal pregnancy was recognized at 16 weeks gestation by transvaginal ultrasound scan. We aimed to remove ectopic pregnancy with prevention of maternal complications and preservation of intrauterine pregnancy (IUP). Surgical removal of the ectopic fetus and placenta was done. Abdominal pregnancy removed successfully without intra- or post-procedural complications but the IUP was aborted spontaneously on the second postoperative day.
Conclusion: Gynecologists should consider the possibility of heterotopic pregnancy following ovulation induction with clomiphene citrate which is increasing in recent years. A high index of suspicion to heterotopic pregnancy may be followed by a nonsurgical approach safely and affectively if they are clinically stable and the abdominal pregnancy is recognized early in gestation.
Bijan RezaKhaniha, Soheila Sirosbakht,
Volume 8, Issue 2 (7-2010)
Abstract

Background: Premature ejaculation (PE) is the most common sexual dysfunction compliant in about 35-40% of men younger than 40 years; therefore a study for survey and diagnosis of this disorder is very important.
Objective: In this study the efficacy of 2 drugs (fluoxetine and citalopram) for treatment of patients suffering from PE is compared. We studied the effectiveness of both drugs in PE with different protocols to find out the most effective drug with least side effects.
Materials and Methods: In total 77 patients referred to the Urology Clinic of Emam Reza Hospital Tehran from 2006 to 2008 for the treatment of PE including 25 patients with anxiety disorder were randomly divided into 2 study groups. Patients belonging to first group (N= 43) received 40 mg (2 capsules of 20 mg) fluoxetine daily for 4 weeks and patients of the group II (N=34) received 40 mg citalopram daily for 4 weeks.
Results: The mean Intra Vaginal Ejaculation Latency Time (IVELT) before treatment in patients of group I was 58.26±41.83 seconds while after treatment it raised to 466.2±10.85 seconds. In group II the mean IVELT before treatment was 51.76±34.39 seconds while after treatment it elevated to 403.8±7.58 seconds.
Conclusion: Difference was significant in mean IVELT before and after treatment with fluoxetine and citalopram (each drug separately). In this study both drugs improved ejaculation duration while difference between 2 drugs was not significant (p>0.05)
Behnaz Khani, Nahid Bahrami, Ferdous Mehrabian, Hormoz Naderi Naeni,
Volume 9, Issue 3 (7-2011)
Abstract

Background: Adhesion is a common complication of gynecology surgery so different barrier agents and solutions have been used during these operations to separate and protect tissues from adhesion after surgery. Adept is one of these solutions that have been postulated to reduce the chance of adhesion following gynecolgy surgery.
Objective: To evaluate the effect of 4% icodextrin in reducing adhesion formation in comparing with sterile water and human amniotic fluid in rabbits. Materials and Methods: In this prospective experimental study 30 white Newzealand female rabbits were selected and randomized in to three treatment groups. The rabbits were anesthetized and an abdominal incison was made, uterine horns were abrated with gauze until bleeding occurred. Before closing the abdomen, the traumatized area was irrigated either by 30cc of sterile water, 30cc of 4% Adept or 30cc of human amniotic fluid. The solutions were labeled only as solutions A (steriel water), B (icodextrin), or C (human amniotic fluid). On the seventh day after surgery, second laparotomy was performed to determine and compare adhesion formation in rabbits.
Results: There was significant difference between mean score of adhesions in 4% icodextrin group (2.1±0.70) in comparison to sterile water group (10.4±0.60) and amniotic fluid group (8.7±0.84). But the difference between mean score of adhesions in amniotic fluid group in comparison to sterile water group was not significant (8.7±0.84) versus (10.4±0.60).
Conclusion: The use of 4% icodextrin solution was more effective than human amniotic fluid and sterile water in reducing adhesion formation in a gynecological surgery model in rabbits
Elham Aliabadi, Malek Soleimani Mehranjani , Zahra Borzoei, Tahereh Talaei-Khozani, Hossein MirKhani, Hamed Tabesh,
Volume 10, Issue 2 (7-2012)
Abstract

Background: Sperm cells extracted from testes (TESE) have poor chromatin quality and motility. Various substances are used in the laboratory to increase sperm motility and improve the ART outcomes; however, there are few research which considered improving both sperm motility and chromatin quality.
Objective: The aim of this investigation was to evaluate the improvement of the testicular sperm motility and chromatin quality exposed to L-carnitine (LC) and L-acetyl-carnitine (LAC), which are normally concentrated in testis and epididymis, compared with Pentoxifylline (PF), which used for sperm motility enhancement in IVF procedures.
Materials and Methods: TESE samples from 30 male mice divided into four parts. The sperm samples were added to Ham' F10 (control) or the media contained 1.76mM of LC, LAC or PF), then, the samples were kept in the room temperature for 30, 90 and 180 min. At each time step, sperm motility and chromatin quality were assessed. Chromatin quality was evaluated by chromomycin A3 and aniline blue. Statistical analysis was performed using one way analysis of variance (ANOVA). A p-value less than 0.05 were accepted as a statistically significant difference.
Results: The results showed LC, LAC and PF significantly increased the sperm motility. However, sperm chromatin quality only improved significantly by administration of LC and LAC.
Conclusion: Administration of LC and LAC to the testicular sperm samples can lead to improve both sperm motility and chromatin quality. It may be because they can mimic in vivo sperm condition during late spermatogenesis.
Maryam Eftekhar, Farnaz Mohammadian, Fariba Yousefnejad, Parisa Khani, Abbas Aflatoonian,
Volume 10, Issue 2 (7-2012)
Abstract

Background: Fertilization failure is one of the most problems in assisted reproduction technology (ART).
Objective: The aim of this study was the evaluation of oocytes activation by addition of calcium ionophore in unfertilized oocytes in ICSI cycles.
Materials and Methods: This study was done on 15 ICSI cycles (stimulated with standard long protocol). Mature retrieved oocytes with normal morphology that had no evidence of fertilization 24 hours after ICSI were included in the study. The oocytes with fertilization and unfertilized oocytes with degeneration were excluded from the study. The unfertilized oocytes were washed with GIVF medium and were transferred to GIVF medium that contained 5 µmol of calcium ionophore and were incubated for 10 minutes. Then again oocytes were washed with GIVF medium and consequently were transferred to GIVF medium and were incubated at 37°C in 6% CO2. After 18 hours, the oocytes were examined and activated oocytes were defined with observation of at least one pronucleus or cleaved oocytes.
Results: After ovarian stimulation and oocytes retrieval, 175 mature oocytes were obtained and injection of sperm was done for all of them. 114 of 175 oocytes (66%) showed evidence of fertilization after 24 hours. A total of 61 oocytes (34%) showed no evidence of fertilization and 10 oocytes were degenerated and were excluded from the study. Only 51 unfertilized oocytes with normal morphology were selected and were exposed to calcium ionophore. 37 (72.5%) of treated oocytes were fertilized (2PN) and 32 (62.7%) of them showed evidence of cleavage. 6 (11.8%) embryos had good quality.
Conclusion: According to our results, oocytes activation with calcium ionophore had an acceptable fertilization rate, however high quality embryos remained low. We propose future studies to evaluate embryo quality.
Farnaz Sohrabvand, Shahrzad Sheikhhassani, Maryam Bagheri, Fedyeh Haghollahi, Maryam ShabihKhani, Mamak Shariat, Manijeh Nasr Esfahani,
Volume 10, Issue 3 (7-2012)
Abstract

Background: Polycystic ovary syndrome (PCOS) is a common cause of ovulatory disorders and infertility with high LH to FSH ratio. In order to prevent further increase of LH and follicle atresia, different regimens for ovulation induction have been recommended using FSH alone.  
Objective: This study was performed in PCOS patients to compare ART outcomes in cycles induced by FSH alone, using either recombinant or urinary products.  
Materials and Methods: In a randomized trial, from 623 patients who underwent down regulation with GnRH analogue in a long protocol, 160 PCOS patients were randomly divided into two groups of 80. Group A received 150 IU/d recombinant FSH (Gonal-F) and group B 150 IU/d urinary FSH (Fostimon).
Results: 33 cases (41.2%) in group A and 36 (45%) in group B achieved clinical pregnancy, which was not significantly different (p=0.67). Total number of oocytes retrieved (13.03±5.56 vs. 14.17±4.89, p=0.17), quality and number of embryos (7.42±3.35 vs. 7.63±3.28, p=0.68) and OHSS rate were similar in group A compared to group B. Endometrial thickness which was 9.66±1.67 mm in group A and 10.36±1.35 mm in group B, showed a significant difference (p=0.004).
Conclusion: It seems that in PCOS patients, both pure FSH products used for controlled ovarian hyperstimulation have similar effects on ART outcome and can be used according to availability and patient acceptance without significant difference.
Mazdak Razi, Rajab Ali SadrKhanloo, Hassan Malekinejad, Farshid Sarrafzadeh-Rezaei,
Volume 10, Issue 3 (7-2012)
Abstract

Background: The exact pathophysiology of testicular degeneration, following varicocele has not been completely understood yet.  
Objective: The current study was designed to determine the effect of varicocele on germinal epithelium (GE) cytoplasmic biohistochmical alterations.   Materials and Methods: To follow-up this study, left varicocele was induced in test groups. Non-varicocelized rats were served as control-sham (n=6). Following 4, 6 and 8 months, right and left testes were dissected out and the blood serum sample was taken. The GE cytoplasmic carbohydrate, lipid accumulation, lipase and alkaline-phosphates (ALP) ratios were analyzed. Serum levels of LH, FSH and testosterone were measured.
Results: Observations demonstrated that in varicocele-induced rats, the spermatogenesis cell lineage exhibited lower number of cells with periodic acid shift positive cytoplasm, higher number of cells with lipid and ALP positive stained cytoplasm in comparison to control animals. Lipase enzyme decreased by the time in the test animals. In varicocelized groups the number of Leydig cells decreased in to 2.25±0.41 and 1.16±0.75 per one mm 2 in left and right testicles respectively after 8 months, and these cells demonstrated an ALP positive feature. In test groups, the serum levels of LH and FSH reduced into 1.12±0.01 and 2.03±0.05 ng/ml respectively after 8 months. Although testosterone level diminished by the time in the test animals, and this decreasing was significant (p=0.031) after 8 months (3.08±0.10 ng/ml).
Conclusion: Our results suggest that following varicocele induction major alterations occur in GE, which may lead to loss of GE cells physiological function and ultimately result in fertility problems.
Korosh Khanaki, Ali Motavalizadeh Ardekani, Alieh Ghassemzadeh, Vahideh Shahnazi, Mohammad Reza Sadeghi, Masoud Darabi, Amir Mehdizadeh, Abotaleb Saremi, Jafar Soleimani-Rad, Ali Reza Imani, Mohammad Nouri, Ali Rahimipour,
Volume 10, Issue 4 (8-2012)
Abstract

Background: Endometriosis is a common chronic inflammation which leads to infertility and chronic pelvic pain in affected women. Secretory phospholipase A2 type IIa (sPLA2IIa) is an acute phase reactant that is markedly increased in inflammatory disorders.
Objective: To assess the effects of ω-3 and ω-6 polyunsaturated fatty acids (PUFAs) administration in endometrial cells culture on sPLA2IIa level and cell survival comparing homolog ectopic versus eutopic endometrial cells from endometriosis patients.
Materials and Methods: In this experimental study, ectopic and eutopic endometrial tissue samples obtained from 15 endometriosis patients were immediately frozen. After thawing and tissue digestion, mixed stromal and endometrial gland cells were cultured for 8 days in three different culture media; balanced ω-3/ω-6, high ω-3 and high ω-6 PUFAs ratio. Cell survival was measured using 2, 3-bis (2-methoxy-4-nitro-5-sulfophenyl)-5-(phenylamino) carbonyl-2H- tetrazolium hydroxide (XTT) method and sPLA2IIa level assessed with ELISA technique.
Results: The sPLA2IIa level was significantly higher in the ectopic endometrial cell culture compared to the eutopic group for each of the three matched treatments (balanced, high ω-3 and high ω-6). Also the sPLA2IIa level in the ectopic endometrial cell group was remarkably increased by each of the three PUFAs treatments compared to control condition (p<0.05, p<0.01, p<0.05 respectively). Cell survival in the eutopic group was significantly decreased by high ω-6 culturing compared to control medium (p<0.05).
Conclusion: The increase in sPLA2IIa level in ectopic endometrial cells by fatty acid treatments (especially high ω-3), strengthens the hypothesis that PUFAs stimulate secretion of cytokines leading to increased sPLA2IIa level.
Roya Faraji DarKhaneh, Atefeh Ghanbari, Maryam Asgharnia, Mitra Kian,
Volume 11, Issue 1 (4-2013)
Abstract

Background: Asphyxia is a common cause of perinatal mortality in 5-10% of all births worldwide. The present parameters for determining perinatal asphyxia, e.g. preeclampsia, cannot be considered as markers per se, and require auxiliary markers, e.g. increased number of nucleated red blood (NRBC) cells, for early diagnosis of perinatal asphyxia.
Objective: In this study, we evaluated the mean NRBC count in preeclampsia and to determine the usefulness of the NRBC as independent prognostic factors of perinatal complications.
Materials and Methods: This was a cross-sectional study in order to compare the NRBC in the umbilical cord of term neonates born to 50 mothers with preeclampsia and 150 normal mothers. The exclusion criteria were mother’s affliction with complications of pregnancy and inexact last menstrual period. The variables under study were maternal and neonatal data. The count of NRBC was determined with standard laboratory procedures in the blood samples from umbilical cord of the neonates. The acquired data were fed into SPSS 16 software and analyzed using statistical tests.
Results: The mean value of NRBC count was significantly higher in preeclamptic women (p<0.0001). The average 1st and 5th minute Apgar scores were significantly higher in normal mothers (p<0.001).
Conclusion: Increase of NRBC in neonates born to mothers with preeclampsia may be due to chronic hypoxia; this group of neonates has increased risk and requires more precise and extensive care during delivery and after birth in order to have reduced mortality and complications during the neonatal period.
Elham Movahed, Vahid Nejati, Rajabali SadrKhanlou, Abbas Ahmadi,
Volume 11, Issue 2 (4-2013)
Abstract

Background: Acyclovir (ACV), a synthetic purine nucleoside analogue, is known to be toxic to gonads.
Objective: The current study evaluated cytotoxicity of ACV on histopathological changes in testis tissue and serum testosterone and lipid peroxidation concentrations of male rats.
Materials and Methods: Animals were divided into five groups. One group served as control and one group served as control sham. In the drug treated groups ACV administered for 15 days. 18 days after the last injection, animals were sacrificed. Histopathological and histomorphometrical analysis of the testis was carried out. Serum levels of testosterone and Lipid Peroxidation and potential fertility of animals was evaluated.
Results: Male rats exposed to ACV had significant reduction in serum testosterone concentrations at 16 and 48mg/kg dose-levels (p<0.01). ACV induced histopathological changes in the testis and also increase the mean number of mast cells in peritubular or interstitial tissue in the testis at at 16 and 48mg/kg dose-levels (p<0.01). In addition ACV caused increase of serum level of Lipid Peroxidation at 48mg/kg dose-level (p<0.05). As well ACV decreased potential fertility in male rats.
Conclusion: The present results highly support the idea that ACV has adverse effect on the reproductive system in male rat.
Seyedeh Hajar Sharami, Roya Faraji DarKhaneh, Ziba Zahiri, Forozan Milani, Maryam Asgharnia, Maryam Shakiba, Zirak Didar,
Volume 11, Issue 5 (7-2013)
Abstract

Background: Vaginal bleeding is a common complication during pregnancy, which is observed in about 1/4 of pregnancies and in half of cases can lead to abortion. If vaginal bleeding happens during pregnancy some adverse pregnancy outcomes, including perinatal mortality and morbidity, low birth weight and preterm delivery will be increased.
Objective:  The aim of this study was to determine the relationship between vaginal bleeding and its characteristics in the first and second trimester of pregnancy and preterm labor.
Materials and Methods:  This is a case-control study conducted on 440 pregnant women referred to Al-Zahra Hospital in Rasht, Iran. Data were collected by a form. The form included demographic characteristics and confounding factors, the occurrence of bleeding during pregnancy and its features. Data were analyzed by T test, chi square and logistic regression in SPSS 16.
Results:  Findings showed that vaginal bleeding was associated with 3 times increased risk of preterm delivery (OR: 3, 1.84-4.89). Also, findings showed that bleeding characteristics including bleeding time, frequency, severity and intensity was significantly associated with preterm labor.
Conclusion:  According to significant association between vaginal bleeding and preterm delivery, it seems that performing some interventions to prevent preterm labor could be appropriate.
Maryam Asgharnia, Roya Faraji, Nooshaz Mirhaghjoo, Zahra Atrkar Roshan, Babak AshrafKhani, Mina Moslehi,
Volume 11, Issue 8 (11-2013)
Abstract

Background: Measuring the 24-hour urine protein ≥300 mg is the standard threshold value for diagnosis of preeclampsia.
Objective: This study was intended to determine if a patient’s 4-hour urine protein correlate with the 24-hour value for diagnosis of preeclampsia.
Materials and Methods: This was a cross sectional study performed on 84 women with suspected preeclampsia due to positive urinary test strip with minimum protein content of 1+ and BP ≥140/90 at Al-zahra Educational Hospital in Rasht (Iran) from May 2007 to January 2008. Urine samples were collected within 24 hours in successive periods: The first 4-hour and the next 20-hours urine, in separate containers. The protein contents of 4-hour and 24-hour urine samples were calculated. Data were analyzed by intra-class correlation coefficient, and Receiver Operating Characteristic (ROC) curve.
Results: The ROC curve showed the cut-off point of 55.5 for 4-hour urine protein. The correlation between 4- and 24-hour urine protein excretions identified that most women (about 85.1%) with protein excretion rate of 300 mg/24h or more (with preeclampsia) had the same amount of protein of 55.5 or more in their 4-hour urine excretion (p<0.001). Also, most of them (about 83.7%) with a total urinary protein excretion of less than 300 mg/24h (no preeclampsia) had a protein excretion rate of less than 55.5 mg/4h.
Conclusion: This study showed 4-hour protein collection can be used as acceptable substitute for assessing the protein content of 24-hour urine samples as a more convenient, faster, and cheaper method for diagnosis of preeclampsia and the cut-off point for 4-hour urine protein is 55.5 mg.
Maryam Asgharnia, Roya Faraji, Fatemeh Salamat, Babak AshrafKhani, Seyedeh Fatemeh Dalil Heirati, Samira Naimian,
Volume 11, Issue 9 (12-2013)
Abstract

Background: Amniotic fluid is an indicator of placental function on the fetal development. The amniotic fluid index is the most commonly used method of measuring amniotic fluid.
Objective: The purpose of this study was to compare the pregnancy outcomes of a borderline versus normal AFI.
Materials and Methods: This cross-sectional study was carried out on a total of 235 pregnant women referred to Alzahra Medical Center between 2009-2011. Women with a singleton pregnancy in third trimester were enrolled into this study; of these subjects, 141 cases were in normal AFI group and 94 cases in borderline AFI group. Adequate information was obtained from the patients' medical record and the groups were compared on maternal and fetal complications. Data analysis was performed by using SPSS.
Results: The mean maternal age in borderline AFI group was 25.96±5.92 years and in normal AFI group was 27.88±6.5 years (p=0.023). Maternal outcomes such as preterm delivery and labor induction in women with borderline AFI were considerably higher than those in normal group (p=0.01 and p=0.001). There were no significant differences between the two groups in terms of high blood pressure, preeclampsia, diabetes and neonatal respiratory distress. The borderline AFI group had higher rate of neonatal complications such as Apgar score of less than 7 (p=0.004), IUGR (0.0001), LBW (0.001), and crucial need to NICU (0.003).
Conclusion: Findings indicated that there are statistical differences between adverse outcomes in borderline AFI group and normal group.
Ozra Nasrolahi, Fereshteh Khaneshi, Fatemeh Rahmani, Mazdak Razi,
Volume 11, Issue 12 (1-2013)
Abstract

Background: The global prevalence of diabetes mellitus is on rise. Diabetes-induced oxidative stress has been known to affect liver, pancreas, kidney and reproductive organs pathologically. Honey is a natural product of bee with antioxidant properties.
Objective: Current study aimed to analyze the protective effects of Metformin (MF) alone and MF+ natural honey co-administration on diabetes-induced histological derangements in testis of rats.
Materials and Methods: Thirty six, mature male Wistar rats were randomly divided into six groups including; control, honey-dosed non-diabetic, diabetes-induced (65 mg/kg, single dose), honey-administrated diabetic (1.0 g/kg/day), Metformin-received diabetic (100 mg/kg/day), Metformin and honey-co-treated diabetic which were followed 40 days. The animals were anesthetized by diethyl ether and the blood samples were collected. The serum levels of testosterone, Insulin, LH and FSH analyzed using antibody enzyme immunoassay method. The testicular tissues were dissected out and underwent to histological analyses.
Results: The biochemical analyses revealed that the diabetes resulted in significantly reduced testosterone (p<0.01), LH and FSH (P<0.01, 0.001) levels in serum. Light microscopic analyses showed remarkable (p<0.01) reduction in seminiferous tubules diameter (STD), spermiogenesis index (SPI) and thickness of the epithelium in the diabetic group versus control and co-treated groups. Simultaneous administration of the honey with MF could fairly up-regulate testosterone, LH and FSH levels. The animals in metformin and honey-treated group exhibited with improved tubules atrophy, elevated spermiogenesis index and germinal epithelium thickness.
Conclusion: Our data indicated that co-administration of Metformin and honey could inhibit the diabetes-induced damages in testicular tissue. Moreover, the simultaneous administration of metformin and honey up-regulated the diabetes-reduced insulin, LH, FSH and testosterone levels.
Maryam Asgharnia, Fariba Mirblouk, Fatemeh Salamat, Babak AshrafKhani, Zahra Dirbaz,
Volume 12, Issue 4 (5-2014)
Abstract

Background: Preterm premature rupture of membranes (PPROM) occurs in 3% of pregnancies and 30-40% of preterm labors are related to this problem. Early diagnosis of PPROM is very important due to its impact on pregnancy outcomes.
Objective: To determine the diagnostic value of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in vaginal fluid for the diagnosis of preterm premature rupture of membranes as a non-invasive and available test.
Materials and Methods:  A total of 148 pregnant women between the 26th-36th gestational weeks were enrolled in the study. 74 patients were in PROM group and 74 in control group. AST and ALT levels in vaginal fluid were measured in each group. Mann Whitney U-test was used to compare AST and ALT levels in each group.
Results:  The mean of AST level in vaginal fluid was 12.77±10.06 in PROM group vs. 6.91±10.92 in control group (p<0.001), while there were no significant difference between ALT levels in PROM group 1.51±3.17 and control group 0.89±1.15 (p=0.49). Optimal cut point of AST for the diagnosis of PROM was 4.5 IU/L in this study. The sensitivity, specificity, positive and negative predictive values were 82.4%, 63.5%, 69.32% and 78.33% respectively.
Conclusion:  According to the findings of this study, measurement of AST level in vaginal fluid can be used as a reliable test for diagnosis of PROM, but there is no good cut point for ALT level that can be practically used.
Rehana Rehman, Rakhshaan Khan, Mukhtiar Baig, Mehwish Hussain, Syeda Sadia Fatima,
Volume 12, Issue 9 (10-2014)
Abstract

Background: Intracytoplasmic sperm injection (ICSI) is an advanced technique employed in assisted reproductive clinics for treatment of infertile couples. The reproductive endocrinologists try their level best to identify factors that enhance success rate after ICSI.
Objective: To compare estradiol progesterone ratio on ovulation induction day amongst pregnancy outcome groups following ICSI.
Materials and Methods: A cross sectional study was conducted on 323 couples of Assisted Reproductive Clinic in Islamabad from June 2010 till August 2011. Down regulation of females aged 18-40 years with gonadotrophin releasing hormone agonist was followed by calculated stimulation with gonadotrophin injections (COS). Oocytes pickup was done 36 hours after ovulation induction by 16G adapter and double lumen oocyte aspiration needle under general anesthesia. Oocytes were fertilized in vitro, graded and only blastocysts were transferred seven days after ovulation induction. Serum estradiol and progesterone were measured by enzyme linked immuno sorbent assay on ovulation induction day, ratio was compared in three groups of females; no conception with βhCG 5-25 mIU/ml, preclinical abortion with βhCG >25 mIU/ml and no cardiac activity on transvaginal scan and clinical pregnancy with βhCG >25mIU/ml and cardiac activity on transvaginal scan.
Results: Females having high estradiol/ progesterone ratio were able to achieve clinical pregnancy shown by a positive βhCG and cardiac activity on transvaginal scan. These females also had significantly high number of oocytes, endometrial thickness and implantation rate.
Conclusion: A high estradiol/progesterone ratio on the day of ovulation induction predicts the success of intra cytoplasmic sperm injection.
Korosh Khanaki, Mohammad Reza Sadeghi, Mohammad Mehdi Akhondi, Masoud Darabi, Amir Mehdizadeh, Mahdi Shabani, Ali Rahimipour, Mohammad Nouri,
Volume 12, Issue 11 (12-2014)
Abstract

Background: Endometriosis, a common chronic inflammatory disorder, is defined by the atypical growth of endometrium- like tissue outside of the uterus. Secretory phospholipase A2 group IIa (sPLA2-IIa) and fatty acid binding protein4 (FABP4) play several important roles in the inflammatory diseases.
Objective: Due to reported potential anti-inflammatory effects of ω-3 and ω-6 fatty acids, the purpose of the present study was to investigate the effects of ω-3 and ω-6 polyunsaturated fatty acids (PUFAs) on fatty acid binding protein 4 and extracellular secretory phospholipase A2IIa in cultured endometrial cells.
Materials and Methods: Ectopic and eutopic endometrial tissues obtained from 15 women were snap frozen. After thawing and tissue digestion, primary mixed stromal and endometrial epithelial cell culture was performed for 8 days in culture mediums supplemented with normal and high ratios of ω-3 and ω-6 PUFA. sPLA2-IIa in the culture medium and FABP4 level was determined using enzyme immuno assay (EIA) technique.
Results: Within ectopic endometrial cells group, the level of cellular FABP4 and extracellular sPLA2-IIa were remarkably increased under high ω-3 PUFA exposure compared with control condition (p=0.014 and p=0.04 respectively).
Conclusion: ω-3 PUFAs may increase the level of cellular FABP4 and extracellular sPLA2-IIa in ectopic endometrial cells, since sPLAIIa and FABP4 may affect endometriosis via several mechanisms, more relevant studies are encouraged to know the potential effect of increased cellular FABP4 and extracellular sPLA2-IIa on endometriosis.

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