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Mohammad Reza Moein, Mohammad Ali Khalili, Arash Davoudi,
Volume 3, Issue 1 (7-2005)

Background: Pentoxifylline (PX) is a methyxanthin derivative that influences the sperm motion characteristics. In general, PX has been reportedly effective in preserving sperm motility in vitro, also when administered orally to the asthenozoospermic patients. Objective: The main objective of this prospective clinical trial study was to rule out the effect of oral administration of PX on sperm progressive motility of asthenozoospermic ejaculates obtained from men with or without mild testicular varicoceles. In addition, the role of patient�s age on sperm motility following PX administration was investigated. Materials and Methods: A total of 68 infertile men with asthenozoospermia were allocated to this study. Following physical examination, 20 cases were found with mild varicocele of testis. A dosage of 400 mg PX/ twice daily for duration of 3 months was administered to each patient. Two semen samples (one before and one after the PX therapy) were evaluated under blind condition. Semen parameters of sperm concentration, total and fast progressive motility (%) and morphology (%) were analyzed for each sample. Also, the sperm motion characteristics of asthenozoospermic patients with testicular varicocele were compared with cases lacking varicocele. The subjects were divided into two age groups of <30 and ?30 years old. Results: PX was significantly effective on the fast progressive motility of sperm (p<0.01). Also, total progressive motility was enhanced from 26.82�16.8 to 29.60�22.2 with PX therapy. However, PX did not have any negative effect on other semen parameters. Oral therapy of PX was also effective in improving the fast progressive motility of sperm of samples from cases with or without mild testicular varicocele (p<0.01). Fast progressive motility was also significantly enhanced in ejaculates of men from both age groups. Conclusion: Our results demonstrate that low dose of oral therapy of PX is significantly useful in enhancing fast progressive motility of sperms from infertile men with asthenozoospermia. Also, testicular varicocele did not interfere with enhancing effect of PX on sperm motility.
Mohammad Reza Moein, Vali Ollah Dehghani, Nasim Tabibnejad, Serajadin Vahidi,
Volume 5, Issue 3 (7-2007)

Background: Reactive Oxygen Species (ROS) are a group of free radicals that in excessive amounts have negative influence on sperm quality and function.
Objective: We compared ROS levels in seminal plasma of infertile men with this level in healthy donors. We also determined the ROS level in semen of infertile men according to the etiology of infertility, and also the effect of smoking on its level.
Materials and Methods: In total, 63 infertile patients and 63 healthy donors as control were selected. Complete physical examination, semen analysis, scrotal sonography and hormone assay were done for all patients. Azoospermic patients were excluded from the study. ROS level in semen was measured by chemiluminescence assay in both groups. Patients also were divided in two groups according to the etiology of infertility.
Results: The mean age of normal subjects and infertile men were 30.78±3.73 years and 31.43±6.60 years respectively. The mean ROS level in normal men was 180.05 RLU (Relative light unit), while this was 1852.04 RLU in infertile patients, which is significantly higher in case group (p=0.000). Fifty patients had varicocele and in 13 patients no specific etiology was found. The mean ROS level in varicocele patients was 2215.42 RLU and in unknown group was 454.44 RLU (p=0.048).
Conclusion: Our study showed that the level of ROS in seminal fluid of infertile men is significantly higher than fertile donors and also in infertile patients with varicocele it is higher than patients with unknown cause.
Mohammad Reza Moein, Mehrdad Soleimani, Nasim Tabibnejad,
Volume 6, Issue 3 (7-2008)

Background: Reactive oxygen species (ROS) are a group of free radicals that in excessive amounts have negative influence on sperm quality and function.
Objective: To study the effect of varicocele and its severity on the level of ROS in infertile men with clinical varicocele.
Materials and Methods: In this controlled prospective study, 42 men with clinically diagnosed left varicocele and 30 fertile men were studied. Patients were asked about history of urogenital infection, using any antioxidant medication and smoking. Grade of varicocele was determined by physical examination. Levels of ROS in seminal plasma were measured in each group by a chemiluminiscence assay. The sperm parameters were also determined and compared in different groups.
Results: The ROS levels were significantly higher in patients with varicocele than normal men (mean: 1575.42 RLU (Radio Luminescence Unit) vs. 53.79 RLU, p=0.005). In total 20 patients had grade I, 20 patients grade II and 2 patients had grade III varicocele. The mean ROS levels were 669.12 RLU, 2406.87 RLU and 2324 RLU in patients with grade I, II and III varicocele respectively (p=0.144). In case group, 15 patients were smoker and 27 were non-smokers. The mean ROS levels in patients with the history of smoking was 1367.71 RLU while in non-smokers it was 897.672 RLU (p=0.729). Conclusion: Our study showed that increased levels of ROS production in the seminal fluid can be an important factor in the etiology of male infertility in patients with varicocele, and this effect is more prominent with higher grade of varicocele.
Ahmad Haerian-Ardakani, Zia Eslami, Fahimeh Rashidi-Meibodi, Alireza Haerian, Pantea Dallalnejad, Marjan Shekari, Amir Moein Taghavi, Solmaz Akbari,
Volume 11, Issue 8 (11-2013)

Background: Periodontal infections, which serve as a reservoir of inflammatory mediators, may pose a threat to the fetal-placental unit and cause adverse pregnancy outcomes.
Objective: The aim of this study was assessing the periodontal status of women during puerperium and determining the possible relationship between their periodontal disease and low birth weight delivery.
Materials and Methods: This was a case-control study. The sample included 88 ex-pregnant women were seen at maternity hospitals of Yazd, Iran. Half of the mothers had low birth babies (LBW) (birth weight below 2500g- case group) and the others had normal weight babies (>2500g- control group). The mothers’ data were obtained from medical files, interview and periodontal clinical examination carried out up to 3 days after delivery. Bleeding on probing, presence of supra-gingival calculus and CPITN (Community Periodontal Index for Treatment Needs) were used for periodontal assessment.
Results: Among the known risk factors of LBW babies, history of previous LBW infant among case mothers reached statistical significance (p=0.0081, Student t-test). Mothers of LBW infants had less healthy areas of gingiva (p=0.042), and more deep pockets (p=0.0006, Mann-Whitney test).
Conclusion: The maternal periodontal disease can be a potential independent risk factor for LBW.
Saghar Salehpour, Nasrin Saharkhiz, Aida Moeini, Anahita Enzevaei,
Volume 11, Issue 12 (1-2013)

One of the most common endocrine disorders in women of reproductive age is polycystic ovary syndrome (PCOS) which its prevalence is reported around 6.5-8% (1). Some clinical trials assessed association between PCOS and other autoimmune related endocrinopathies such as impaired glucose tolerance (IGT), type 2 diabetes mellitus and thyroid dysfunction with controversial results (2). Some investigators showed increase level of serum antiovarian antibodies in the half of affected women (3, 4). However, the exact mechanism of autoimmune processes in PCOS pathogenesis is remained to be fully elucidated. Autoimmune thyroid disorder including hashimoto’s thyroiditis also has been shown to have correlation with PCOS (5). According to Janssen’s et al study the prevalence of autoimmune thyroiditis (AIT) was three times higher in patients with PCOS compared with control group (6). The cause of this high incidence is open to speculation. Genetic defect was assumed to predispose persons to AIT as well as PCOS. Both disorders seem to have an oligo-genetic background (5, 7). To date, a common genetic background has not been found. Gleicher et al hypothesized that development of PCOS could be attributed to functional autoantibodies including thyroid autoantibodies [anti-thyroid peroxidase antibodies (anti-TPO), and thyroglobulin antibodies (TG-Ab)] (8). Ott et al reported a poor treatment response in infertile PCOS women with elevated anti-TPO levels (9). In a cross-sectional study at Infertility and Reproductive Health Center (IRHRC), we evaluated serum level of thyroid function tests (TFT) including autoantibodies and to assess their relation with other characteristic and hormonal parameters of PCOS. A total of seventy five women with average age of 26 years who fulfilled the 2003 Rotterdam Criteria underwent gynecologic evaluation and blood sampling between January 2009 and December 2011. The mean±SD of serum anti-TPO in Ott et al, Ganie et al, Kachuei et al, Janssen et al and our study were 52.2±98.5, 321.4±189.6, 216±428, 123±328, and 41.06±91.18 IU/ml respectively (5, 6, 9, 10). The wide range of reported values could be attributed to different type of laboratory assessment, value of cut point and heterogeneity of selected patients. About fifteen percent of our patients were anti-TPO positive; the reported range of positive anti-TPO percentage was 15 to 30 in different studies (5, 6, 9, 10 and present study). In fact, the observed ratio in our research is lower than Kachuei’s study which held in a same country (5). In that research, authors did not find difference in rate of positivity between PCOS and control group. Percentage of anti-TPO positivity in Ganie et al and Janssen et al in normal women were zero and eight percent respectively (6, 10). In our study, presence or absence of anti-TPO did not have a major influence on the characteristics and hormonal values of the PCOS patients; only hip circumference and estradiol level were significantly higher in anti-TPO positive cases. In another study this difference was observed for hypoechoic ultrasound pattern, patient’s age and LH to-FSH-ratio. Ott et al suggested that anti-TPO could be a good predictive marker for treatment response in infertile women with PCOS (9). They reported a higher anti-TPO level in patients who were resistant to clomiphene citrate treatment. TSH level in our PCOS patients was 3.16±3.55 mU/l; other investigators report its value between 2 and 3 mU/l. We did not find any difference in biochemical and hormonal serum values of patients between euthyroid and hypothyroid ones. TSH level in PCOS patients and control subjects did not differ significantly in Ganie et al, Kachuei et al researches which is in contrast to the results of Janssen and colleagues (5, 10). High prevalence of thyroid autoimmunity in PCOS women of reproductive age brings this question in our mind that is it necessary to screen these patients for hypothyroidism? Due to increased risk of morbidity in hypothyroid mother and her newborn, it seems logical to assess thyroid function test in suspicious patients. To have a proper answer for this question, however, several prospective researches should be conducted with more number of participants in a longer follow up period. Based on our data, it is more likely to see a disturbance in serum values of thyroid function test and autoantibodies in women with PCOS. We recommend evaluation of these parameters by longitudinal cohort studies with more number of cases and a longer follow up period.
Mohammad Reza Moein, Serajedin Vahidi, Jalal Ghasemzadeh, Nasim Tabibnejad,
Volume 12, Issue 5 (6-2014)

Background: Male are involved in near 50% of cases of infertility and reactive oxygen species (ROS) playing an important role in decreasing fertility potential. Accurate measurement of ROS seems to be important in evaluation of infertile male patients.
Objective: To compare ROS measurement in neat and washed semen samples of infertile men and define the best method for evaluation of ROS in these patients.
Materials and Methods: We measured the level of ROS in semen samples of thirty five non-azoospermic men with infertility. The semen samples were divided into two parts and the semen parameters and ROS levels in neat and washed samples were evaluated. We also evaluated the presence of pyospermia using peroxidase test.
Results: The differences regarding sperm count and quick motility were significant in neat and washed semen samples. The mean ROS level was significantly higher in neat samples compared with washed spermatozoa (7.50 RLU vs. 1.20 RLU respectively). Difference in ROS levels was more significant in patients with pyospermia compared to whom with no pyospermia (378.67 RLU vs. 9.48 RLU respectively).
Conclusion: Our study confirmed that neat or unprocessed samples are better index of normal oxidative status of semen samples. Because we do not artificially add or remove factors that may play an important role in oxidative equilibrium status.
Mohammad Reza Moein, Mahmoud Reza Moein, Jalal Ghasemzadeh, Parvin Sabeti, Soheila Pourmasoumi,
Volume 13, Issue 11 (12-2015)

Background: About 10% to 15% of infertile men have azoospermia, which could be obstructive or non-obstructive. Diagnostic biopsy from the testis and recently testicular sperm extraction (TESE) are the most precise investigations in these patients. Testicular biopsy can be done unilaterally or bilaterally. The worth of unilateral or bilateral testicular biopsy in men with azoospermia is controversial. Objective: To evaluate the necessity of bilateral diagnostic biopsy from the testis in new era of diagnosis and treatment of male infertility. Materials and Methods: In this retrospective study, we reviewed the results of testis biopsy in 419 azoospermic men, referred to Yazd Research and Clinical Center for Infertility from 2009-2013. Patients with known obstructive azoospermia were excluded from the study. Results: In totally, 254 infertile men (60.6%) were underwent unilateral TESE, which in 175 patients (88.4%) sperm were extracted from their testes successfully. Bilateral testis biopsy was done in 165 patients (39.4%) which in 37 patients (22.4%), sperm were found in their testes tissues. Conclusion: Due to the low probability of positive bilateral TESE results especially when we can’t found sperm in the first side, we recommend that physicians re-evaluate the risk and benefit of this procedure in era of newer and more precise technique of sperm retrieval like micro TESE.
Mahin Jamshidi Makiani, Sara Minaeian, Soheila Amini Moghaddam, Seyed Akbar Moosavi, Zahra Moeini, Vajihe Zamani, Mahnaz Karbalaei Sabbagh, Hosein Forghani,
Volume 15, Issue 5 (6-2017)

Background: Human papilloma virus (HPV) is one of the major public healthproblems and the main causes of cervical cancer. The prevalence HPV infection indeveloping countries with low financial resources is high.
Objective: This study aimed to determine the relative frequency of HPV genotypesand its sociodemographic characteristics in women referred to a general hospital inTehran, Iran from 2014-2015.
Materials and Methods: This cross-sectional study was performed in 400 womenwith Pap smear samples, referring to to a general hospital in Tehran, Iran from 2014-2015. The detection of 28 HPV genotypes was performed by using the MultiplexPCR technique. The sociodemographic survey was conducted for each HPV positivewoman.
Results: HPV-positive infection was detected in 155 (38.75%) women aged 17-85years. HPV 16 (19.1%) was the most prevalent type, followed by HPV 39 (12.5%)and HPV 18 (8.9%). The highest rate of HPV infection was observed at the age of36 years (7.7%). The level of education and economic situation of each woman wereshowed most of HPV-positive women had a high school diploma (34.6%) andaverage economic situation (67,9%). 60.9% of these women were a housewife, and67.3% lived in the capital .
Conclusion: Determination of HPV genotype and risk factor related to HPVinfection in each geographical region can lead to the production of effectivevaccines against the HPV virus. It can also be useful for disease management andhigh sensitivity diagnosis of cervical intraepithelial neoplasia.
Sepideh Sadeghi, Ali Reza Talebi, Abbas Shahedi, Mohammad Reza Moein, Abolghasem Abbasi-Sarcheshmeh,
Volume 17, Issue 4 (April 2019 2019)

Background: Tamoxifen (TX) is widely used for the treatment of male factor and idiopathic infertility. It has been shown that TX induces sperm production and so improves male fertility.
Objective: This study evaluated the effects of different doses of TX on the sperm parameters and chromatin quality in mice.
Materials and Methods: In this research, 24 male NMRI mice were divided into three groups including group A: control animal receiving vehicle; group B: the group receiving basal diet and TX 0.4 mg/kg/day; and group C: the group receiving basal diet and TX 0.6 mg/kg/day for 35 days. Thereafter, epididymal spermatozoa were analyzed for standard parameters and nuclear chromatin quality using Aniline Blue (AB) and Toluidine Blue (TB) staining.
Results: The results indicated that although the TX did not affect the sperm count, motility, and viability parameters, it could elevate the percentage of sperm cells with abnormal morphology and abnormal chromatin at both doses. In addition, in comparison with the control mice, a significant elevation was observed in spermatozoa with residual histones (assessed by AB staining) at high doses of TX.
Conclusion: Our experimental data in mice suggested that the use of TX for treating male infertility might increase the rates of spermatozoa with abnormal chromatin in a dose-dependent manner.

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