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Mohammad Ghafourzadeh, Mojgan Karimi, Mohammad Ali Karimazadeh, MahShid Bokai,
Volume 2, Issue 2 (7-2004)

Background: Infertility affects about 10-15% of reproductive-age couples. About half the causes of infertility are female related and approximately 40% of the cases are caused by anovulation, mostly in PCO women. Objective: This study was conducted to determine and compare the effects of two drug treatment regimens: higher dose of clomiphene and a combination of lower dose of clomiphene and tamoxifen in treating infertile women with PCO. Materials and Methods: The study was a randomized clinical trial conducted on 100 infertile patients who referred to Yazd-Iran Infertility Clinic between the years 2001-2003. The patients were selected who had received at least 3 periods of clomiphene, but no pregnancy had occurred. They were randomly divided into two groups. In the first group, clomiphene was increased to 100 mg and the second group 20 mg of tamoxifen was added to 50 mg of clomiphene from day 5-9 of menstruation cycle. Infertility duration, duration of medicine used, PCT score, endometrial thickness, ovulation, and pregnancy rate were studied in both groups. Results: Ovulation rate in clomiphene group was 54.9%; Tamoxifen + clomiphene group was 73.5% without significant differences in both groups. (PV = 0.053). Positive pregnancy rate in clomiphene group was 39.2%; clomiphene + tamoxifen group was 61.2% (P value < 0.05), which could be concluded that pregnancy rate was higher in clomiphene/tamoxifen group than in the clomiphene group. The presence of a dominant follicle in the two treatment groups in women between 18-24 was not significant, but in women between 25-39 years was significant (PV= 0.049) (Table III). Conclusion: The recommendation is to add Tamoxifen to Clomiphene in 35-39 women with 20? BMI ?26.99 before the use of gonadotropins treatment in PCOS with or without IUI, because these options have higher risk of multiple pregnancy and ovarian hyperstimulation syndrome. Article
Mahmoud Salami, Zahra Aghanouri, Ali Akbar RaShidi, Mansoor Keshavarz,
Volume 2, Issue 2 (7-2004)

Background: Fetal alcohol syndrome is associated with numerous problems in the development and function of the brain. Learning and memory deficits are among well known effects of prenatal exposure to alcohol. Objective: This study aimed to examine the spatial working memory of 60-day old rats who were exposed to alcohol during their fetal life and to find the relation between the possible alcohol-impaired spatial memory and gestational period of exposure to alcohol. Materials and Methods: Pregnant rats in different stages of gestation period were administered with ethanol. Using a radial arm maze, the offspring were subjected to spatial working memory training at 60 days of postnatal age. Results: The rats exposed to ethanol during the first 10 days of fetal life indicated lower performances compared to the controls. Those receiving alcohol during the second half of pregnancy period had no problem in maze navigation. Behavior of the animals exposed to alcohol during the first and the second quarter of the gestation period demonstrated that only the latter were weak in solving maze tasks. The groups related to the third and the forth quarter of gestation period had a similar behavior with the control group. Comparison of the animals' performances in all groups revealed that only the second quarter group was the most disadvantaged. Conclusion: Our data indicates that the second quarter of the gestation period is more sensitive to harmful effects of alcohol on the areas of brain involved in learning and memory. Since the hippocampus is central in cognitive functions and this part of brain is highly vulnerable to alcohol effects it can be concluded that the hippocampus is mostly affected in the second quarter of prenatal life. Article
Iraj RaShidi, Mansoureh Movahedin, Taki Tiraihi,
Volume 2, Issue 2 (7-2004)

Background: Pentoxifylline (PX) prevents cAMP breakdown by inhibiting the activity of the cAMP-phosphatase and presumably, stimulates sperm motion. Incubation with PX causes hyperactivation of sperm, an important step in achieving fertilization, and leads to changes in membranes associated with sperm capacitation. Objective: The purpose of this study was to examine the effects of pentoxifylline on sperm viability, motility and fertilization rate after mouse sperm preservation. Materials & Methods: Epididymal spermatozoa from adult NMRI mice were collected in T6 medium supplemented with 5% BSA and divided into four control and four experimental groups. The control groups included: (1) Fresh sperm sample (2) Preserved sperm sample at room temperature for 18 hours. (3) Preserved sperm sample at incubator 37°C for 18 hours. (4) Preserved sperm sample at 4°C for 18 hours. Experimental groups were the same groups after treatment with 3mmol/L PX. All the samples were assessed according to World Health Organization Criteria. Oocytes from superovulated NMRI female mice were inseminated in-vitro incubated sperm of all the control and experimental groups. After insemination and washing, the fertilization rate and cleavage rate were assessed by the presence of two pronucleus (2PN) and 2-cell stage embryos. To study the acrosomal reaction of control and treated spermatozoa transmission electron microscopy (TEM) technique was used. Results: The results showed that addition of 3mmol PX to preserved mouse spermatozoa at 4 ºC and 37 ºC could increase the motility rate significantly (P<0.05) and also it could enhance abnormal morphology rate. Significant increase of fertilization rate was seen after preservation of treated sperm at 4 ºC (P<0.05), but there was not seen significant difference regarding cleavage rate comparing treated and non-treated spermatozoa (P>0.05). Studies with electron microscopy showed that addition of PX to the preserved spermatozoa prevent early acrosomal reaction. Conclusion: The results of this study demonstrated that addition of pentoxifylline in mouse sperm samples after short time preservation can enhance the motility and fertilization rate, although it can enhance the abnormal morphology. It also can increase the number of intact sperm after preservation Article
Ashok Agarwal, SuShil Anandh Prabakaran,
Volume 3, Issue 1 (7-2005)

Infertility is one of the most stressful conditions amongst married couples. Male factor infertility is implicated in almost half of these cases. Recent advances in the field of reproductive medicine have focused the attention of many researchers to consider reactive oxygen species (ROS) as one of the mediators of infertility causing sperm dysfunction. Although, ROS is involved in many physiological functions of human spermatozoa, their excess production results in oxidative stress. Mitochondria and sperm plasma membranes are the two locations of ROS production that involves complex enzyme systems such as creatine kinase and diaphorase. ROS causes damage to the spermatozoa DNA, resulting in increased apoptosis of these cells. The production of ROS is greatly enhanced under the influence of various environmental and life style factors such as pollution and smoking. An effective scavenging system is essential to counteract the effects of ROS. Various endogenous antioxidants belonging to both enzymatic and non-enzymatic groups can remove the excess ROS and prevent oxidative stress. Since, ROS is essential for the normal sperm physiology, rationale use of antioxidants is advocated.
Seyed Saeid Mazloomy, Mahdieh Shirvani-Anarak, Abbas-Ali Dehghani, Nasim Tabibnejad, Mohammad Hasan Sheikhha,
Volume 4, Issue 1 (7-2006)

Background: Since AIDS is not only a vital medical problem, but also a socioeconomic complication, therefore increasing people's knowledge and replacing their unhealthy behavior by a healthy one is of important consideration. Women, specially in reproductive ages of their life, have a special situation regarding the probability of pregnancy and infection of their fetus.
Objective: The aim of this study was to explore pregnant women's knowledge about HIV/AIDS, their perception of risk, risk behavior and management, and their attitudes towards AIDS.
Materials and Methods: In a cross sectional study, a total of 120 pregnant women, who referred to family health clinics in Yazd, were selected by simple random sampling. Information was collected via a special designed questionnaire containing 22 questions for evaluating knowledge and 6 questions for evaluating attitude. Statistical analysis was performed using Chi-square test with SPSS software.
Results: The knowledge of pregnant women about AIDS was not significantly different in different age groups (p=0.151), while it had a significant relationship with their education (p=0.000). There was a correlation between general knowledge and attitude in pregnant women (p=0.033) (r=0.126). The attitude about AIDS in pregnant women was fairly good and there was a significant difference in this regard related to their education (p=0.000), while there was not significant difference regarding their age (p=0.410) (Mean =19.8).
Conclusion: There is an urgent need for HIV prevention efforts, such as health education and focusing on the pregnant women in developing world. Health educators should tailor education programs for women at risk, particularly those with lower education, to enhance their knowledge about HIV and to improve their attitude about AIDS.
Seyed Mahmood GhoraiShian, Seyed Mehdi Klantar, Seyed Mohammd Seyed Hasani, Mohammad Ghafourzadeh,
Volume 4, Issue 2 (7-2006)

Recurrent abortion is a critical problem in which many factors play a crucial role such as anticordiolipin antibody and antiphospholipid antibody. This study was conducted to evaluate the frequency of anticardiolipin antibody and antiphospholipid antibody in pregnancy failures in women with the history of recurrent pregnancy loss. In 154 women with the history of two or more recurrent pregnancy losses, serum anticardiolipin and serum antiphospholipid were measured using ELISA method. The positive IgG anticardiolipin and IgG antiphospholipid were detected in 12. 34% (19 patients) and 6.5% (10 patients) of patients respectively. Although 16 out of 19 patients with positive IgG anticardiolipin were negative for IgG antiphospholipid and 7 out of 10 patients with positive IgG antiphosphplipid were negative IgG anticardiolipin, but there was a significant correlation between IgG anticardiolipin and IgG antiphaspholipid ( r = 0.222 p=0.000). Our data concluded that anticardiolipin antibody is found to be more important than anti phospholipid antibody in recurrent abortion.
Ensieh Shahrokh Tehrani Nejad, Ashraf Moini, Elham Amirchaghmaghi, Batol Hossein RaShidi, Parvin Jaberi Pour, Elham Azimi Neko,
Volume 5, Issue 3 (7-2007)

Background: Although the uterine fibroids are common, their influence on fertility remains controversial. The association of submucosal fibroid with subfertility is well recognized, but debate persists as to whether intramural fibroids can cause infertility and the evidence for its effect on pregnancy in cycles of assisted conception remains unclear.
Objective: The purpose of present study was to determine the effect of intramural fibroids less than 6 cm not compressing uterine cavity on the outcome of ART cycles in patients undergoing IVF/ICSI cycles.
Materials and Methods: In this prospective cohort study, 94 women with uterine intramural fibroids and 184 controls referred to Royan Institute between 2001 and 2002 were enrolled. The intramural fibroids and their location were detected by transvaginal ultrasound performed just before the ART cycle. All patients underwent long standard GnRH agonist protocol. Student t-test and Chi-square test were used for the statistical analysis.
Results: The mean age of patients was 33.9 ±3.37 years in myoma group (n=94) and 33.28 ±3.59 years in control group (n=184). The total dose of gonadotropin used, estradiol level on day of hCG administration, the number of metaphase II oocytes retrieved, fertilization rate, number and quality of embryos developed and transferred, the clinical pregnancy and abortion rates were similar in two groups.
Conclusion: The presence of intramural fibroids less than 6 cm not compressing endometrial cavity does not adversely affect clinical pregnancy rate in patients undergoing IVF or ICSI.
Natsuko TokuShige, Moamar Al-Jefout, Hilmy Salih, Ian S Fraser,
Volume 5, Issue 4 (7-2007)

Endometriosis is a common gynaecological disease that can cause severe pelvic pain such as dysmenorrhoea and dyspareunia, however the mechanisms by which pain is generated are not well understood. Nerve fibres in endometriotic plaques have been reported by several authors. We have recently demonstrated the presence of unmyelinated sensory nerve fibres (using the pan-neuronal marker PGP9.5) in the functional layer of endometrium in women with endometriosis and a significantly increased nerve fibre density in endometrium and myometrium in women with endometriosis compared with women without endometriosis. Sensory C nerve fibres were only detected in the functional layer of endometrium of women with endometriosis and never in women without endometriosis. This finding is so consistent that it may become an effective means of making the diagnosis of endometriosis. Nerve fibres expressing a range of neuronal markers and an over-expression of nerve growth factor (NGF) and nerve growth factor receptor (NGFRp75) were also demonstrated in peritoneal endometrial plaques in women with endometriosis. Effects of currently available medications for endometriosis on nerve fibres in eutopic endometrium in hormonally treated women have been also studied. This review will describe nerve fibres in eutopic endometrium and ectopic endometriotic plaques in women with endometriosis.
Ensieh Shahrokh Tehrani Nejad, Behnaz Attar Shakeri, Batool Hoseini RaShidi, Fatemeh Ramezanzade, Mamak Shariat,
Volume 6, Issue 2 (7-2008)

Background: Recently different studies suggested that discontinuation of gonadotrophin releasing hormone analogue (GnRHa) at beginning of ovarian stimulation (improvement of ovarian response to gonadotrophins) may have some benefit to poor responder patients in invitro fertilization (IVF) cycles. Objective:The efficacy of GnRHa stop protocol in poor responder patients in IVF cycles was assessed.
Materials and Methods: This study was a prospective, randomized controlled trial that 40 poor responder patients (less than three mature follicles in a previous cycle) with normal basal follicle stimulating hormone (FSH) were randomly allocated into two protocols: 1) Non-stop protocol: long GnRHa suppression, and start gonadotrophins from day 3 of mense. 2) Stop-protocol: GnRHa is stopped with the onset of menses, and gonadotrophin doses remained similar to group 1.
Results: A significantly higher number of follicles, oocytes, embryos and fertilization rate also shorter stimulation days and lower human menopausal gonadotropins (HMG) ampoules were recorded in the stop protocol compared to the control group. Both protocols resulted in a similar cancellation rate, pregnancy rate, estradiol level and LH level.
Conclusion: Early follicular cessation of GnRHa permitted the retrieval of a significantly higher number of follicles, oocytes and embryos, and can reduce the number of HMG and stimulation days.
Arash Khaki, Mahnaz Heidari, Marefat Ghaffari Novin, Amir AfShin Khaki,
Volume 6, Issue 3 (7-2008)

Background: Ciprofloxacin is a commonly prescribed antibiotic in the treatment of genitourinary tract infection.
Objective: The aim of this study was to investigate the effects of ciprofloxacin on testis apoptosis and sperm parameters in rat.
Materials and Methods: Twenty male Wistar rats were selected and randomly divided into two groups; control (n=10) and experimental (n=10). The experimental group was orally received 12.5 mg/kg ciprofloxacin daily for 60 days and the control group just received water and food. Rats were then killed and sperm removed from cauda epididymis and analyzed for sperm motility, morphology, and viability. Testis tissues were also removed and prepared for TUNEL assay to detect apoptosis.
Results: Results showed that ciprofloxacin significantly decreased the sperm concentration, motility (p<0.05) and viability (p<0.001). In addition, ciprofloxacin treatment resulted in a significant decrease in the number of spermatogenic cells (spermatogonia, spermatocyte, spermatid and sperm) in the seminiferous tubules when compared with the control group. The apoptotic germ cells per seminiferous tubular cross section was significantly increased in the experimental group (15.11±3.523) as compared with the control group (7.3±0.762) (p<0.05).
Conclusion: It is concluded that ciprofloxacin has the toxicological effects on reproductive system in male rats.
Amir AfShin Khaki, Arash Khaki, Shahram Garachurlou, Fereshteh KhorShidi, Nazila Tajadini, Navid Madinei,
Volume 6, Issue 3 (7-2008)

Background: Men are unavoidably exposed to ambient electromagnetic fields (EMF) generated from various electrical gadgets and from power transmission lines. Prostate gland plays an important role in secretion of semen as largest accessory gland of male reproductive system. It seems that protection of this gland against EMF is important in spermatogenesis process.
Objective: The goal of this study was to investigate the effect of non ionizing radiation on ultra structure of prostate gland.
Materials and Methods: In total 50 male and 50 female rats, aged 15 weeks, were mated in animal house of Tabriz University of Medical Sciences. Then among born rats, 20 randomly were chosen as control and 30 were randomly chosen for exposure to EMF. They were exposed to 50 Hz EMF (8 M.T.) during in utero development (approximately 3 weeks) and postnatal life (5 weeks). Samples of prostate gland were processed and observed under light and transmission electron microscope.
Results: In the experimental group, the secretory epithelial cells were generally inactive and cuboidal and their nuclei were dense with more corpus amylace compared to the control. Smooth muscle fibers spread out in different directions with heterochromatic nuclei. Mitochondria seemed without cristae and electron opaque.
Conclusion: The results indicate that EMF had a deleterious effect on ultra structure of prostate gland in rat.
Seyed Gholam Ali Jorsaraei, Hiroaki Shibahara, Ayustawati , Yuki Hirano, Yasuko ShiraiShi, Ali Khalatbari, Yousofreza Yousofnia Pasha, Mitsuaki Suzuki,
Volume 6, Issue 4 (7-2008)

Backgrand: Cotinine (COT) is a major degradation product of nicotine (NIC). The participation of leptin in female reproduction is well-established, but any role in male reproductive function is at the best tenuous.
Objective: The aim of this study was to evaluate the in-vitro effects of nicotine, cotinine and leptin on sperm parameters in normal semen of non-smokers fertile men.
Materials and Methods: Ten healthy nonsmokers aged 25-40 years old were devided into 7 groups, Thier semens were divided into 7 aliquots. (A) was layered with basal solution 70 ng/ml NIC, (B) 35 µg/ml NIC, (C) 300 ng/ml COT, (D) 200 µg/ml COT, (E) 30 ng/ml leptin, (F) 300 ng/ml leptin respectively and (G) was layered with mHTF. After migration, the samples were examined at time 0, +1, +2, +4, +8, and + 24 h of incubation.
Results: These findings were obtained: sperm count: 75.66±66.25x10 6 /ml, forward motility: 75.55±14.80%, progress: 33.66±13.01, VSL: 51.58±6.99 µm/s, VCL: 103.33±14.52 µm/s, ALH: 4.33±0.77 µm, BCF: 25.60±2.97 HZ, STR: 79.33±8.04 %, LIN: 52.55±10.52 %, ELO: 74.22 ± 12.76 % and ARE: 3.04 ± 1.50 u/sq. The parameters were similar before 8 hr and were being decreased after that.
Conclusion: According to the results. nicotin and cotinin have negative effects on the sperm parameters but despite the positive effect of leptin, there is no correlation between leptin concentration in semen and its physical characteristics.
Arash Khaki, Fatemeh Fathiazad, Mohammad Nouri, Amir AfShin Khaki, Chelar C Ozanci, Marefat Ghafari-Novin, Mohammad Hamadeh,
Volume 7, Issue 2 (7-2009)

Background: Ginger rhizome (Zingiber officinale R., family: Zingiberaceae) is used medicinally and as a culinary spice.
Objective: Medicinal use of ginger dates back to ancient China and India. Ginger and its constituents are stated to have antiemetic, antithrombotic, antihepatotoxic, anti-inflammatory, stimulant, cholagogue and antioxidant. It has been used since ancient time as medicinal and food origins it contain antioxidative and androgenic activities and have well effect in diseases treatment in more countries world-wide. As an antioxidant’s ginger has a useful effect on spermatogenesis and sperm parameters.
Materials and Methods: Wistar male rat (n=30) were allocated into three groups, control (n=10) and test groups (n=20), that subdivided into groups of 2 that received ginger rhizome powder (50 and 100mg/kg/day) for 20 consequence day. Animals were kept in standard conditions. In twentieth day the testes tissue of Rats in whole groups were removed and sperm was collected from epididymis and prepared for analysis.
Results: Serum total testosterones significantly increased in experimental group that has received 100 mg/kg/day Ginger (p<0.05) in comparison to control group. Besides, the percentage of sperm viability and motility in both test groups significantly increased (p<0.05) in comparison to control group, Whereas, LH, FSH hormones, sperm concentration, morphology and testes weights in both experimental and control group were similar.
Conclusion: Results revealed that administration of 100 mg/kg/day of ginger significantly increased sperm percentage, viability, motility and serum total testosterones. This suggested that ginger may be promising in enhancing sperm healthy parameters.
Ensieh Shahrokh Tehrani Nejad, Batool Hosein RaShidi, Atefeh Larti, Zahra Ezabadi, Nadia Jahangiri, Elham Azimi Nekoo,
Volume 7, Issue 2 (7-2009)

Background: Endometriosis is one of the most challenging diseases that constitute 20% - 40% of women searching for their infertility diagnosis. Objective: This study was undertaken in order to compare the outcome of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in women with endometriosis, and tubal factor infertility as controls.
Materials and Methods: From 2005 to 2006 a retrospective study was carried out in patients with endometriosis (n=80) and tubal infertility (n=57) after treatment with IVF/ICSI. The main outcome measures were ovarian responsiveness, quality of oocytes, implantation, pregnancy and ongoing pregnancy rates. Appropriate statistical analysis was performed using χ2 and student t-tests.
Results: No differences were found in mean number of ampoules of hMG, duration of hMG injection, number of MΙΙ oocytes, number of embryo transferred, and rates of implantation, pregnancy, ongoing pregnancy and twin birth between women with endometriosis and tubal infertility and also between women with stages I/II or those with stages III/IV disease with women with tubal factor infertility.
Conclusion: Our results suggest that endometriosis does not seem to have adverse effect on outcome of IVF/ ICSI as compared with tubal infertility.
Lida Mohammad Gholizad, Samad Zare, Vahid Nejati, Ali EyShi Oskooii,
Volume 7, Issue 3 (7-2009)

Background: Fertility protection is important in young patients with Hodgkin's lymphoma.
Objective: The goal of this study was to determine the effects of ABVD and ChlVPP chemotherapeutic protocols for Hodgkin's disease on the spermatozoa fertility indices of male rat.
Materials and Methods: After determining tolerance dose of drugs in pilot study, 24 male rats were divided to four groups: ABVD (doxorubicin, bleomycine, vinblastin, dacarbazine) group,   ChlVPP (chlorambucil, vinblastin, procarbazine, prednisolone) group and two control groups one for each treatment group. One half of the lethal dose for fifty percent of population was used for treatment of animals in each protocol. Spermatozoa were used for computer- assisted sperm analysis (CASA) and morphology analyses. Heads of spermatozoa were counted.
Results: Body weight, testis and epididymis weights, spermatozoa number, and live ratio in treated rats were significantly less than their control groups (p<0.05) specifically these parameters in ABVD group was less than ChlVPP group (F= 19.6, p=0.000). Spermatozoa morphology in treated groups were more abnormal than control groups (p<0.05). Evaluation of reproductive system efficacy showed that there was no pregnancy in ABVD group and in ChlVPP group there was only one pregnant female (16.6%).
Conclusion: According to this study results, the ChlVPP had fewer side effects than ABVD in tolerance doses on male rats' reproductive system. More clinical trial studies are suggested on Hodgkin's patients. With equal treatment effectiveness, it will be better to use the most reliable and safe treatment especially in young patients.    
Ashraf Aleyasin, Marzieh Aghahosseini, MahShid Mohseni, Atossa Mahdavi,
Volume 7, Issue 5 (7-2009)

Background: Reviewing the literature reveals that pentoxifylline (PTX) plus tocopherol (vitamin E) are used mainly to promote sperm quality. However trials focusing on the effects of these drugs in female partner are limited. Combination of pentoxifylline and vitamin E appeared to improve the pregnancy rate in patients with a thin endometrium by increasing the endometrial thickness and improving ovarian function.
Objective: To determine whether combined PTX and tocopherol treatment can improve clinical pregnancy rate.
Materials and Methods: One hundred twelve infertile women undergoing standardized controlled ovarian hyperstimulation for ICSI- ZIFT entered this randomized clinical trial. Patients were randomized to equal groups of combined PTX and tocopherol therapy or none (not receiving PTX and tocopherol). These drugs were administered to the intervention group for two cycles before starting ICSI-ZIFT cycle. Main outcome measure was clinical pregnancy rate. SPSS.11 software (SPSS Inc. Chicago IL.) was used for data collection and analysis.
Results: The clinical pregnancy was higher in the intervention (combined PTX and tocopherol) group in comparison to the other group (57.14% vs 39.29% p=0.01). However there was no difference in the mean endometrial thickness number of retrieved oocytes the number of metaphase II oocytes and grade of them in both groups.
Conclusion: This study showed that PTX plus tocopherol could improve the ZIFT outcome in infertile couples. Local effects and anti oxidative characteristics of these drugs may be the cause of better results.
Sedigheh Soheilykhah, Mahdie Mogibian, Sodabeh Rahimi-Saghand, Maryam RaShidi, Saeideh Soheilykhah, Maryam Piroz,
Volume 8, Issue 2 (7-2010)

Background: Gestational Diabetes Mellitus (GDM) is the most common metabolic complications of pregnancy and causes fetal mortality and morbidity. Therefore early diagnosis of GDM is necessary to reduce maternal and fetal morbidity and to help prevent or delay the onset of type 2 diabetes
Objective: This prospective study was carried out to determine the incidence of GDM in Yazd and to assess the effect of various contributing factors. Materials and Methods: One thousand and seventy one pregnant women were screened for GDM at 24-28 weeks. Initial screening was done by a glucose challenge test with 50 g glucose. If the 1-hour blood glucose level exceeded 130 mg/dl then a 3-hour oral glucose tolerance test (OGTT) with 100g glucose was performed and diagnosis was established according to American Diabetes Association criteria.
Results: Three hundred and forty two (31.9%) women had an abnormal screening test and proceeded to oral glucose tolerance testing. The overall incidence of GDM was 10.2% (n=110). Seventy six of subjects (7.1%) have one abnormal OGTT. There was a significant association between incidence of GDM and age familial history of diabetes BMI before pregnancy parity history of GDM macrosomic baby still birth during previous pregnancies and systolic and diastolic blood pressure.
Conclusion: According to high incidence of GDM in our area we recommend screening for GDM in all pregnant women and modification of contributing factors in high risk women.
Seema Bibi, Mohammad Ali Pir, Roshan Ara Qazi, Misbah Bibi QureShi,
Volume 8, Issue 3 (7-2010)

Background: Hyperhomocysteinemia (hhcy) has been considered as a risk factor for several obstetrical complications such as early pregnancy loss pre-eclampsia and IUGR. Recently its association with infertility has been underscored in IVF failures; however limited information is available about the relationship of hhcy and subfertility.
Objective: To find out the association between unexplained subfertility and hhcy in Pakistani women.
Materials and methods: This observational study was conducted in Department of Obstetrics and Gynaecology Liaquat University Hospital Hyderabad from 1st April 2008 to 31st March 2009. Study group consisted of all those women who were subfertile for more then one year have body mass index less than 25 regular menstrual cycle normal pelvic examination findings and no past history of pelvic inflammatory disease. Exclusion criteria was male factor subfertility endocrine and ovulatory dysfunction and tubal blockage. Evaluation was done by semen analysis pelvic ultrasound scan hystero-salpingography and hormonal assays. Fasting serum levels of homocysteine were determined using a fluorescence polarization immunoassay.
Results: In total 61 subjects were enrolled in the study including 49 subfertile women and 12 healthy women. Among subfertile women 39 (80%) were suffering from primary subfertility while 10 (20%) were complaining of secondary subfertility. Majority of the subjects were young house wives and residents of Hyderabad city. Mean serum fasting homocysteine levels were significantly higher in women suffering from unexplained subfertility as compared to controls (12.8+5.1 versus 9.7+1.7 p-value= 0.04).
Conclusion: Hyperhomocysteinemia was observed in women suffering from unexplained subfertility. However large scale clinical studies are required to confirm the association.
Elham Pourmatroud, Batool Hosein RaShidi, Maryam Rahmani,
Volume 8, Issue 4 (7-2010)

Background: There is a fundamental correlation between follicles and endometrium in intracytoplasmic sperm injection (ICSI) cycles.
Objective: To assess the relation between perifollicular perfusion and sub endometrial parameters in Doppler ultrasonography and outcome of in ICSI cycles.
Materials and Methods: In this prospective deh1ive pilot study 10 patients were enrolled. Strict inclusion criteria were considered. Routine long protocol was used for ICSI. On the day of follicle retrieval colour Doppler indices were determined. Sub endometrial pulsatility index (PI) and resistance index (RI) and perifollicular perfusion were assessed. After oocyte retrieval the count of metaphase 2 (M2) oocytes emberyo with grade A quality and the result of cycle were evaluated also.
Results: RI and PI indices had a positive correlation. Follicles with ≥18 mm diameter and follicles with &gt;75% perfusion had a direct relation. Also subendometrial RI had a significant relation with follicular status (p-value= 0.04) But there was not a significant triple correlation (between endometrium follicles and outcome).
Conclusion: The mutual effects of vascularization status in two fundamental parts in ART is still unclear. The evaluation with Doppler ultrasonography should focus on two compartments together as one functional part at the same time. It means even in presence of good markers in each part the final decision must be taken by co-evaluation of follicles and endometrium.
Seyed Gholam Ali Jorsaraei, Hiroaki Shibahara, Ayustawati , Yuki Hirano, Tatsuya Suzuki, Eisa Tahmasbpour Marzony , Mahtab Zainalzadeh, Mitsuaki Suzuki,
Volume 8, Issue 4 (7-2010)

Background: Leptin is a polypeptide hormone secreted by white adipose tissue in proportion to body energy. Although the participation of leptin in female reproduction is well established any role in male reproductive function is at best tenuous.
Objective: The objective of this study was to compare the leptin concentration in human seminal plasma and then the relationships between seminal leptin and semen parameters were evaluated.
Materials and Methods: Semen samples were provided from 71 men; normozoospermic (n=22) asthenozoospermic (n=31) and oligoasthenozoospermic (n=18) referring to Jichi Medical University Hospital for in vitro fertilization-embryo transfer (IVF-ET) treatment. After liquefaction all sperm specimens were evaluated for sperm parameters and motility characteristics by computer-assisted semen analysis (CASA) system. After semen analysis concentrations of leptin in seminal plasma of all groups were measured by ELISA.
Results: The mean concentrations of leptin in seminal plasma of normozoospermic asthenozoospermic and oligoasthenozoospermic men were 0.75+/-0.09 ng/ml 0.8+/-0.14 ng/ml and 0.8+/-0.15 ng/ml respectively. A trend was observed for a lower leptin concentration in seminal plasma of normozoospermic men compared with asthenozoospermic and oligoasthenozoospermic men. There was a significant negative correlation between seminal plasma leptin concentration with sperm motility (p<0.05) and Curvilinear Velocity of the sperm kinetic parameter (p<0.01).
Conclusion: It was demonstrated that there was a significant correlation between seminal leptin with the sperm motility.

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